Healthcare Attitudes Research Articles

Measuring cannabis-related knowledge, attitudes, perceptions, motivations, and influences among women of reproductive age: a scoping review

BackgroundCannabis use among women of reproductive age has increased substantially in recent decades. Understanding reasons for cannabis use in this population is critical for cannabis use prevention efforts. Thus, this scoping review aimed to identify and synthesize current measures on reasons for cannabis use in women of reproductive age.MethodsWe searched PubMed, PyschINFO, CINAHL, and Google Scholar for relevant studies published in English between January 2010 and April 2021. Peer-reviewed, quantitative studies reporting on measures of cannabis-related knowledge, attitudes, perceptions, motivations, and influences among women of reproductive age were eligible for inclusion. We excluded studies not focused on women of reproductive age and studies reporting cannabis use prevalence data only.ResultsWe included 11 studies (10 primary studies and 1 review) with varying subpopulation samples of women, including non-pregnant women (n = 2), women experiencing infertility (n = 1), pregnant women (n = 4), postpartum women (n = 3), and women in the perinatal period (n = 1). Measurement topic areas included information received from health care professionals, attitudes, perceptions and experiences about cannabis use, knowledge of potential harms, and motivations for cannabis use. Most studies including measures of risk perceptions were conducted among pregnant or postpartum women (n = 4). A single study measured influences of cannabis use; no studies measured social or peer influences of use. Most studies (n = 7) created their own measures, with 2 studies using secondary data via measures from population-based surveillance systems in the United States, and one using a previously validated instrument. Recommendations for future research were centered around addressing knowledge gaps of health effects of cannabis use across different time periods, and etiology of cannabis use.ConclusionsWe found vast measurement gaps in current measures of antecedents of cannabis use among women of reproductive age, providing clear direction for future research in this area. Findings necessitate psychometric evaluation of existing measures to ascertain validity and reliability, as well as development of additional measures of women’s cannabis-related attitudes, perceptions, motivations, and influences. This work is critical to guide not only epidemiologic studies, but cannabis-related prevention work as well.

Healthcare Professionals' Understandings of the Definition and Determination of Death: A Scoping Review.

Background.During the 1950s, advances in critical care, and organ transplantation altered the relationship between organ failure and death. There has since been a shift away from traditional cardiocirculatory based to brain-based criteria of death, with resulting academic controversy, despite the practice being largely accepted worldwide. Our objective is to develop a comprehensive description of the current understandings of healthcare professionals regarding the meaning, definition, and determination of death.Methods.Online databases were used to identify papers published from 2003 to 2020. Additional sources were searched for conference proceedings and theses. Two reviewers screened papers using predefined inclusion and exclusion criteria. Complementary searches and review of reference lists complemented the final study selection. A data extraction instrument was developed to iteratively chart the results of the review. A qualitative approach was conducted to thematically analyze the data.Results.Seven thousand four hundred twenty-eight references were identified. In total, 75 papers met the inclusion criteria. Fourteen additional papers were added from complementary searches. Most were narratives (35%), quantitative investigations (21%), and reviews (18%). Identified themes included: (1) the historical evolution of brain death (BD), (2) persistent controversies about BD and death determination, (3) wide variability in healthcare professionals’ knowledge and attitudes, (4) critical need for BD determination revision.Conclusions.We concluded that although BD is widely accepted, there exists variation in healthcare providers’ understanding of its conceptual basis. Death determination remains a divisive issue among scholars. This review identified a need for increased opportunities for formal training on BD among healthcare providers.

Managing the allergy and asthma epidemic in 2020s-Lessons from the Finnish experience.

In Finland, a systematic public health programme was implemented from 2008 to 2018 to mitigate the burden of allergic disorders by revisiting the prevention strategy. Allergy health and contacts with natural environment were emphasized to promote immunological and psychological resilience instead of poorly justified avoidance. Allergy management practices were improved and low‐valued recommendations for care, for example for food allergy, were revised. Patients and families were empowered to use guided self‐management to proactively stop symptom exacerbations. A professional non‐governmental organization implemented the nationwide education for healthcare and patient NGOs for patients, families and lay public. In healthcare, the work supporting allergic patients and families was organized towards common goals and integrated into everyday work without extra costs. Reaching the predefined goals was followed by employing the national healthcare registers and questionnaire surveys. Governmental bodies contributed with kick‐off funding, which was supplemented by private funding. International collaboration, for example with the European patient organization (EFA), increased awareness of the Finnish action and predisposed it for peer review. The 10‐year results are favourable, patients are less disabled, practices and attitudes in healthcare have changed, and major cost savings have been obtained. Views of the lay public and patients are slow to move, however. Local multidisciplinary allergy teams were set up to continue the activities also after the Programme. Changes in environment and lifestyle in the last 50 years are the main reasons for the allergy rise. The Finnish experience may help to manage allergic diseases, improve nature relatedness in the fast‐urbanizing world, combat nature loss and reduce the disease burden.

Effect of Breastfeeding Training Using Educational Toolkit on Primary Health Care Nurses' Knowledge, Attitudes and Problem-Solving Skills

Effect of Breastfeeding Training Using Educational Toolkit on Primary Health Care Nurses' Knowledge, Attitudes and Problem-Solving Skills

Self-harm and suicidal behaviours among pregnant adolescent girls and young women could be doubly compounded in sub-Saharan Africa: A call for further research.

The recent systematic review by Mutahi and colleagues published in eClinicalMedicine1 sought to synthesise available evidence on the mental health problems and service gaps experienced by pregnant adolescent girls and young women (aged 12–24 years) in sub-Saharan Africa. Among other findings, depression was the most frequently reported mental health problem, while mental health care for pregnant adolescent girls and young women (PAGYW) were characterised by poor health-care worker attitudes, lack of confidentiality, and lack of tailored services.

Burden of whooping cough in China (PertussisChina): study protocol of a prospective, population-based case–control study

IntroductionPertussis is one of the top 10 diseases of children under 10 years of age, and the few vaccine-preventable diseases who is on a rise in China in recent years;...

Cross-border reproductive healthcare attitudes and behaviours among women living in Florence, Italy

BackgroundThe number of women living in Italy and seeking cross-border reproductive care (CBRC), especially for medically assisted reproduction (MAR), has increased. The purpose of this study was to explore CBRC attitudes and behaviours among a cohort of reproductive-aged women who have never engaged in CBRC to gauge social and cultural perceptions and gain a deeper understanding of family planning discourse.MethodsIn-depth interviews were conducted during May – June 2018 with 30 women aged 18–50 living in or around Florence, Italy and enrolled in the Italian healthcare system. Interviews offered in-depth insight into CBRC attitudes, behaviours, and experiences among a cohort of women living in Italy who had never engaged in CBRC. Researchers used an expanded grounded theory through open and axial coding. Emergent themes were identified via a constant comparison approach.ResultsThree themes and two subthemes emerged from the data. Participants discussed how limitations in Italy’s access to MAR can lead women to seek reproductive healthcare in other countries. Women had mixed feelings about the effect of religion on legislation and reproductive healthcare access, with many views tied to religious and spiritual norms impacting MAR treatment-seeking in-country and across borders. Participants perceived infertility and CBRC-seeking as socially isolating, as the motherhood identity was highly revered. The financial cost of traveling for CBRC limited access and exacerbated emotional impacts.ConclusionsFindings offered insight into CBRC perceptions and intentions, presenting a deeper understanding of the existing family planning discourse among reproductive-aged women. This may allow policymakers and practitioners to address social and cultural perceptions, increase access to safe and effective local care, and empower women in their family planning decisions.

Breastfeeding practices among Syrian refugees in Turkey

BackgroundWe evaluated (a) opinion of Syrian and Turkish healthcare workers (HCWs), and perceptions and attitudes of Syrian refugee mothers, pregnant women, fathers and grandmothers on age-appropriate breastfeeding, (b) the effect of cultural characteristics, migration and pandemics on Syrian’s infant nutrition, and (c) the suggestions of HCWs and Syrian family members to improve breastfeeding practices in the Syrian refugee society in a qualitative study.MethodsThe qualitative study consisting of structured focus group discussions (FGDs) was held in four provinces in Turkey where Syrian refugees live intensely in September and October 2020. Seven different types of online FGDs were held with Turkish HCWs working in maternity hospitals, Syrian HCWs working in Refugee Health Centers (RHCs), Syrian pregnant women, mothers, fathers, and grandmothers. In total, we carried out 46 FGDs with 335 individuals. Thematic analysis of the transcripts in a deductive-inductive fashion was carried out with MAXQDA 11.ResultsMost Syrian HCWs did not get any training on breastfeeding counseling. The short duration of breastfeeding in Syrian refugees was seen to be related to the cultural characteristics, and migration. Some cultural characteristics can be summarized as “believing that breastfeeding harms mother’s health”, “adolescent marriages”, “wanting to have as many children as possible”, “giving anise to infants and not breastfeeding at night”, “prelacteal feeding”, “believing that milk is not enough”, “over controlling mother–child interaction by grandmothers, which limits the interaction”, “short pregnancy intervals”, and “not using modern family planning techniques”. We found out that migration increased the tendency for adolescent pregnancies, deepened the poverty, and decreased family social support. We did not observe any change in breastfeeding practices during pandemics.ConclusionsBreastfeeding counseling programs should be designed in consideration of cultural characteristics of Syrian HCWs and family members. Continuing health education programs for family members with socially appropriate interventions to prevent adolescent marriages are important.

Preparedness of tertiary care hospitals to implement the national TB infection prevention and control guidelines in Bangladesh: A qualitative exploration.

In high tuberculosis (TB) burden countries, health settings, including non-designated TB hospitals, host many patients with pulmonary TB. Bangladesh's National TB Control Program aims to strengthen TB infection prevention and control (IPC) in health settings. However, there has been no published literature to date that assessed the preparedness of hospitals to comply with the recommendations. To address this gap, our study examined healthcare workers knowledge and attitudes towards TB IPC guidelines and their perceptions regarding the hospitals' preparedness in Bangladesh. Between January to December 2019, we conducted 16 key-informant interviews and four focus group discussions with healthcare workers from two public tertiary care hospitals. In addition, we undertook a review of 13 documents [i.e., hospital policy, annual report, staff list, published manuscript]. Our findings showed that healthcare workers acknowledged the TB risk and were willing to implement the TB IPC measures but identified key barriers impacting implementation. Gaps were identified in: policy (no TB policy or guidelines in the hospital), health systems (healthcare workers were unaware of the guidelines, lack of TB IPC program, training and education, absence of healthcare-associated TB infection surveillance, low priority of TB IPC, no TB IPC monitoring and feedback, high patient load and bed occupancy, and limited supply of IPC resources) and behavioural factors (risk perception, compliance, and self and social stigma). The additional service-level gap was the lack of electronic medical record systems. These findings highlighted that while there is a demand amongst healthcare workers to implement TB IPC measures, the public tertiary care hospitals have got key issues to address. Therefore, the National TB Control Program may consider these gaps, provide TB IPC guidelines to these hospitals, assist them in developing hospital-level IPC manual, provide training, and coordinate with the ministry of health to allocate separate budget, staffing, and IPC resources to implement the control measures successfully.

Measuring pharmacovigilance knowledge and attitudes among healthcare sciences students: development and validation of a universal questionnaire.

Pharmacovigilance education and reporting of adverse drug reactions (ADRs) are important competencies that healthcare sciences students should develop before completing their studies and entering clinical practice. Since students frequently lack adequate knowledge in this area and fail to recognize the importance of ADRs monitoring and reporting, the aim of this study was to develop and validate a unique and reliable instrument for assessing health sciences students' knowledge and attitudes toward pharmacovigilance and ADRs reporting. A cross-sectional observational study was conducted from February to July 2021 to examine students' knowledge and attitudes toward pharmacovigilance activities. Students of medicine, dentistry, pharmacy, and nursing science of three faculties in the Autonomous Province of Vojvodina, Serbia were examined. A total of 211 of them completed the specially designed, three-section questionnaire (Demographic data section, Pharmacovigilance Knowledge test, PVKT, and Pharmacovigilance Attitude Questionnaire, PVAQ). The questionnaire was posted on the Google Forms platform, and the link was distributed to respondents via the official websites and social networks of all three faculties. Findings demonstrated good psychometric properties and reliability of the questionnaire. Six questions were removed from the PVKT after item analyses. After excluding these items, the calculated ordinal alpha of the final version of the PVKT, which included 14 items, was good (αord = 0.83), as were other statistical indicators. PVAQ reliability testing also revealed great performance of this questionnaire-calculated ordinal alpha for two PVAQ subscales was excellent (αord = 0.91, for both scales). This questionnaire has favorable validity and reliability in assessing healthcare sciences students' knowledge and attitudes toward pharmacovigilance and ADRs reporting.

Sensor-Based Technology: Bringing Value to People with Diabetes and the Healthcare System in an Evolving World.

PurposeEvidence demonstrates that glucose-sensing technologies have enabled effective glycemic control for adults and children with type 1 diabetes (T1DM) or adults with type 2 diabetes (T2DM) on insulin therapy or non-insulin therapy. Here, we report on the wider value of glucose-sensing technology from the perspectives of person living with diabetes (PWD), healthcare providers (HCPs), and healthcare policy stakeholders.MethodologyLiterature searches were conducted to identify published records and analysis, including across various healthcare organizations and agencies, of the impact of the FreeStyle Libre® flash glucose monitoring system in diabetes. These findings were combined with the outcomes of three healthcare attitudes surveys among PWD and diabetes healthcare professionals in Canada, including two commissioned for this purpose.ResultsClinical trials data and real-world evidence have proven the benefits of the FreeStyle Libre system on limiting hypoglycemia, lowering HbA1c, optimizing metrics of glucose control and reducing hospital admissions. These benefits are accompanied by improvements in patients’ quality of life, work productivity, and savings to the health system. The FreeStyle Libre system has created an opportunity to change the organization and delivery of care, including during COVID-19 restrictions on access to standard care, thus generating system-wide benefits in addition to those accrued by patients and HCPs.ConclusionEvidence-based improvements in glucose control for PWD using flash glucose monitoring are accompanied by increased treatment satisfaction and quality of life. Telemedicine with such remote monitoring systems increases the opportunities for simultaneous review of glucose data with HCPs and shared decision-making, thus encouraging adherence with treatment.

Peer-led theoretically Desinged HIV/AIDS prevention intervention among students: a case of health belief model

Background & aimHIV/AIDS is one of the most dangerous viruses known in the world. In addition, considering its fatality rate and high cost of care, it is a serious threat to the health and economy of social communities. Adolescents are one of the high-risk groups. One of the most effective ways to prevent this disease is to promote healthcare, raise awareness, and change health-related beliefs and attitudes. This study aims at determining the effect of peer education, based on the health belief model, on the preventative measures against AIDS adopted by girls.Methods & materialsIn this empirical-interventionist study two schools were randomly selected, one of which was considered as the intervention group and the other as the control group. The classes were also randomly selected and 80 students from each school took part in the project following the entry criterion. A questionnaire with acceptable validity and reliability was used to collect data. In this study a few bright students were chosen as peer educators after being trained. The intervention group (N = 80) received 4 sessions of 60-min education through training, lectures, question and answer, and group discussion, But the control group received no instruction. The posttest was administered two months after the treatment. The data was fed into the SPSS 16. Finally, T-test, Chi-Square, and ANCOVA were employed to analyze the data.ResultsThe average scores obtained from the intervention group and the control group were not significantly different in terms of awareness level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, behavioral intention, and behavior in baseline (P>0.05). Two months after the intervention there was a significant increase in the average scores of all the variables in the experimental group (P > 0.05). However, there was no significant change in the scores of the control group (P > 0.05).ConclusionFollowing a health belief model focusing on peer eduaction among high school girls, the intervention eduaction can affect awareness level, susceptibility, severity, benefits, perceived barriers, perceived self-efficacy, behavioral intention, and finally avoidance of high-risk behavior.

Women's satisfaction with maternity care and its associated factors in Ikot Omin, Nigeria

Background/AimsWomen's satisfaction with care during the maternity period is a critical determinant of sustained use of maternity services and positive birth outcomes. This study examined factors associated with women's satisfaction with care during the maternity period in Ikot Omin, Calabar, Cross River State, Nigeria.MethodsThis was a cross-sectional descriptive study of 404 women of reproductive age who had received maternity care services from health facilities or were currently receiving either antenatal, delivery or postnatal services from health facilities in Ikot Omin. Data were collected using a 31-item validated questionnaire that asked questions on sociodemographic data, healthcare workers' attitudes and satisfaction with maternity care. The data were analysed using descriptive and inferential statistics, with the chi squared test and logistic regression being used to calculate association between variables.ResultsLess than half (47.3%) of the respondents were satisfied with their maternity care. The participants' overall satisfaction was statistically significantly associated with healthcare workers' attitudes (P<0.000), maternal age (P<0.000), parity (P<0.000), educational level (P<0.000) and marital status (P=0.035).ConclusionsRespondents' satisfaction with maternity care was varied and associated with healthcare workers' attitudes, as well as sociodemographic characteristics. Policies should be developed by stakeholders to encourage healthcare workers to adopt a positive attitude that is favourable to women during this sensitive and crucial period of women's lives. Mothers' educational level should be enhanced. Healthcare workers should be exposed to group reflection on the ethical codes relating specifically to their profession and value clarification sessions to improve their attitudes.

Oral health knowledge, attitudes and practices of primary healthcare workers of Lucknow district: A cross-sectional study.

Introduction:Oral diseases are considered a public health problem due to their high prevalence. It is the primary concern of oral health educators to impart positive oral health knowledge and behavior in the society. Health workers’ knowledge, attitude, and practices (KAP) toward oral health to a great extent influence the community as they can extend health education at the first contact in the community. Thus, the aim of the study was to assess the knowledge, attitude, and practices of health care workers.Material and Methods:A descriptive cross-sectional survey was designed to assess the knowledge, attitude, and practices towards oral health among health care workers. The study was conducted among health care workers aged between 20 and 60 years working in Primary Healthcare Centres and Community Healthcare Centres of Lucknow district. Informed consent was obtained from health care workers before the start of the study. The data were collected via a predesigned and pretested questionnaire. The data were analyzed using IBM SPSS Statistics-version 21.Results:The results of the study showed that 70.2% of the respondents ever visited the dentist due to somereason of which 19.2% visited once in a year. In addition, 38.9% of the respondents were daily smokers of which the majority belonged to the age group 20–40 years. A total of 63.9% of the respondents were daily chewable tobacco users, and 12.4% were routine users of alcohol.Conclusion:The present study gives a brief insight into the oral health knowledge, attitude, and practices of health care workers which were of fair degree.

Abstract PO-045: Experiences of oncologists treating cancer patients living with HIV: Opportunities to improve care and reduce disparities

Abstract Introduction: Prior database studies have demonstrated that cancer patients with comorbid human immunodeficiency virus (HIV) have higher cancer-specific mortality and are less likely to receive cancer treatment. People living with HIV (PLWH) who achieve viral suppression have near normal life expectancy, highlighting the critical importance of reducing cancer treatment disparities. The purpose of this study is to understand how oncologists make treatment decisions for cancer patients living with HIV and to elicit recommendations for improving care in this population. Methods: We conducted in-depth interviews with 25 attending medical, radiation, and surgical oncologists from Duke University, University of Utah, and community practices in Florida, Georgia, Louisiana, Pennsylvania, and Virginia who had recently engaged in a consultation with PLWH and cancer. In semi-structured interviews, we explored three domains: (1) care coordination with other healthcare professionals, (2) knowledge and attitudes regarding patients with comorbid HIV and cancer, and (3) recommendations for improvements in care delivery. Two analysts coded the data using ATLAS.ti. We utilized applied thematic analysis to identify inductive themes across the three domains. Results: Many participants (n=11) reported always communicating with a patient's Infectious Disease (ID) doctor, and others (n=5) said they only communicate with ID if the patient's HIV is not well-controlled. Ten medical oncologists noted they found it helpful to speak to an HIV pharmacist, particularly about drug-drug interactions. Participants also discussed efforts to connect patients with supportive services, such as transportation, payment assistance, and mental health counseling. Many participants described concerns in discussing the patient care plan in the presence of caregivers, given the possibility that patients have not disclosed their HIV status. None of the participants had formal training in management of comorbid cancer and HIV, and most noted that they learned through their own clinical practice. Participants made suggestions for improving treatment decision-making for PLWH, including: more evidence of the risk-benefit ratio of treatment (e.g. treatment goals, life expectancy calculators), greater access to social work and mental health resources, streamlined access to communication with HIV providers, and multidisciplinary HIV cancer rounds. Conclusions: This is the first physician-focused qualitative study interviewing oncologists caring for PLWH. Communication among multiple healthcare providers, particularly oncologist and ID doctor, are noted to be common but not universal in the care of comorbid HIV and cancer. Formal training in cancers in PLWH is lacking in medical training. Future steps to reduce disparities in cancer treatment and outcomes for PLWH may include the establishment of multidisciplinary HIV cancer rounds, facilitating connection and communication between healthcare providers, and enhancing supportive care resources for patients. Citation Format: Ashley Khouri, Jeanette Young, Patrick Galyean, Brandon Knettel, Emily M. Cherenack, Anthony Ariotti, Noelani Ho, Susan Zickmund, Melissa Watt, Kathryn Pollak, Peter Ubel, Angela Fagerlin, Gita Suneja. Experiences of oncologists treating cancer patients living with HIV: Opportunities to improve care and reduce disparities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-045.

Knowledge and Attitudes of Mental Health Professionals towards Oral Care of Patients in Zimbabwe

Objective: This study aimed to assess the oral healthcare knowledge, attitudes, and practices among mental health professionals in Zimbabwe. There are numerous dental conditions associated with mental health conditions. It is, therefore, necessary to assess if mental health professionals are prepared to adequately manage and refer such cases where indicated. Methods: This was a descriptive cross-sectional study using convenience sampling to collect data using an online questionnaire administered to mental health professionals from the ten provinces of Zimbabwe. The target sample size was 82. Responses to each of the items in the knowledge and attitudes section were graded on a scale of 0 to 3. Descriptive statistics were performed. Composite scores were computed for knowledge and attitudes with the highest possible score for knowledge being 27 and the highest possible score for attitudes being 12. Open-ended responses in the knowledge section were manually analyzed and used to supplement findings from the closed-ended sections. Results: There were 71 respondents. 60.6% were females, the average (mean) age was 38.78, and the highest reported (mode) working experience was one year. The overall composite score for knowledge was 14.37 out of 27 (53.2%) and the overall composite score for attitudes was 7.66 out of 12 (63.3%). The open-ended section addressing practices revealed that only 1.4% of the respondents had received formal oral healthcare-related training. The rest of the respondents indicated they had no training or did not answer this question. Most respondents are not confident in handling oral health complications and several do not know the appropriate referral pathway. There were suggestions for further training and an increased interdisciplinary approach where oral health professionals work alongside mental health professionals. Conclusion: While the knowledge and attitudes regarding oral care are average amongst Zimbabwean mental health professionals, the practices remain below ideal. There is a need for increased training and a multidisciplinary approach. The formulation of a manual for oral care of mental health patients in the Zimbabwean context is also recommended.

Elder financial abuse and the COVID-19 pandemic: A call to action through training programmes?

Within the last decade, there has been a growing debate regarding financial capacity and abuse as one of the most important challenges that older adults are facing in their everyday lives.1 Currently older adults are highly impacted by pre-and post-COVID-19 measures and there is a massive increase in financial exploitation reports involving older adults worldwide,2 an increase that can be attributed to a number of reasons, such as the higher rates of depression among socially isolated seniors (a diagnosis itself linked to abuse, as it can worsen elders' cognitive and physical condition by making them dependent and vulnerable), but also due to of mass redundancies, financial pressure and stress faced by younger family members (childrenandgrandchildren).3 Althoughpriorresearchemphasizedmainlyindividualcognitive aspects (e.g. financial knowledge/self-beliefs/behaviors in the financial decision-making process), the interaction with emotional and socio-cultural factors are not thoroughly examined. Unfortunately, there are scarce organized large-scale research attempts at national and none at international level to focus on financial abuse of elders suffering from different types of neurocognitive disorders as well as healthy elders, not only before the COVID-19 era, but especially during and after COVID-19 health and social crisis.4 In addition to the lack of research neglecting the cross-cultural perspective, there is also a dire need to refocus previous research attempts that mainly examine perceptions of financial abuse with experimental manipulations, not in real world situations and only from the viewpoint of the patient/family, while disregarding the attitudes and education /educational needs of healthcare experts.5 Future research questions that deserve to be examined, but still remain unanswered, are: What are the cognitive-emotional characteristics of elders prone to abuse and of the persons in their social environment? How do medical-psychiatric conditions influence elders financial abuse? What and how do individuals and groups from different social and cultural settings define-perceive financial abuse and the characteristics of the 'offender' and 'victim'? Under what real-life conditions we-as-'guardians' detect and are willing to report elder financial abuse and how can we 'protect' elders? What do we expect from the state, legal systems and the important others to do? What do elders themselves think and feel about financial abuse and how do they react? What is the 'correct reaction/directives'? What are healthcare professionals' attitudes and knowledge on this topic? Could all the above-mentioned points be taught in programmes? All the above will not only give an alternative viewpoint on this hot, complex multifaceted ethical, legal and practical issue (that many of us are concerned with, but at the same time are unwilling to systematically explore), but may assist us in understanding, planning and acting 'appropriately'. For that to happen, different questions should be addressed and a combination of methods is needed (mixed quantitative and qualitative designs in cross-cultural settings). A final point that may help to elucidate this confusing problem is the introduction of new statistical approaches such as multilevel analyses, which allow simultaneous examination of group-level (society) and individual-level (elder) factors and thus reveal to us the broader context. Financial education programmes for the prevention of financial exploitation use a wide and appropriate range of delivery methods and dissemination channels focusing on the deficits, strengths as well as needs of the target groups (older adults, family members/caregivers, healthcare professionals). Due to the complex social situation, it is imperative to educate older adults as well as their caregivers to make sound financial decisions with the resources available. Such programmes have already success, because they provide not only access to financial advisors available for advice and questions on financial issues, they provide resources which are user-friendly (based on the reading level of the older individuals and caregivers), but include enough detail to be useful in planning.6 In the cases of individuals without computer access or without computer literacy, alternative options are offered, such as services accessible over the phone or in person, brochures, handouts, or other written materials, or individual sessions and classes.6 The aim of promotion of financial education on a regular basis, (both via interactive online and with the use of offline resources), includes information fostering knowledge of money management and scam prevention, not only on an individual, but at the community level.7 Revisiting existing research and asking for an update on emerging issues and unexplored realms is a researchers' obligation. So, are existing educational programmes adequate? A contemporary empirical re-assessment will tell us and old and new questions will make us ponder where to go next.

45 and Up COVID Insights: a dynamic and collaborative approach to evidence-making during the COVID-19 pandemic.

In response to the coronavirus 2019 (COVID-19) pandemic, a research project was developed with a cohort of 45 and Up Study participants to generate timely, relevant evidence to guide policy, practice and planning. This paper describes the research model, the cohort establishment and characteristics, and some findings. A subgroup of 45 and Up Study participants was invited to enrol in 45 and Up COVID Insights -a series of five online surveys conducted during 2020-22. The model involved a close collaborative partnership with the New South Wales Ministry of Health and a panel of scientific advisers, an agile data collection methodology and rapid dissemination of findings. Frequent, iterative engagement with stakeholders provided a framework for identifying survey themes and questions and ensured wide dissemination of findings. Themes included healthcare use, attitudes toward and uptake of COVID-19 prevention measures, and the impact of the pandemic on mental health, loneliness, and lifestyle behaviours. 45 and Up COVID Insights achieved strong stakeholder engagement through extensive consultation and rapid reporting of results. The project recruited a diverse cohort of 32 115 participants: median age 68 years (range: 56-100+); 8% from outer regional/remote areas; 12% from the most socioeconomically disadvantaged communities; and 9% from culturally and linguistically diverse backgrounds. The first four surveys found that the impact of the pandemic varied across populations and stages of the pandemic. Between February-April (survey 2) 2021, 10% reported missed healthcare in the past month because of the pandemic, rising to 26% by September-November 2021 (survey 4). Quality of life remained high (>90% good-excellent across the surveys). As the pandemic progressed, the proportion reporting worsened mental health as a result increased from 29% (July-December 2020, survey 1) to 46% (survey 4). In survey 2 (February-April 2021), 89% intended to get the COVID-19 vaccine, with 8% unsure. By late 2021, vaccination uptake was high, with 98% of respondents having received at least one vaccination. There is great value in harnessing a large longitudinal, well-described, and diverse cohort study to generate evidence in a changing context with evolving information needs. The collaborative model enhanced the value and relevance of the data to inform decisions.

Graveyard Walk in the First Third of the 19th Century: Healthcare, Memorial Politics, Aesthetics, Literature

The undertaken thorough historical and literary analysis of A. S. Pushkin’s poem “When lost in thought I wander beyond the town…” (“Kogda za gorodom zadumchiv ia brozhu…”, 1836) reveals its pretexts and likely sources among which the most important ones are G. G. Byron’s epigram “On Lord Elgin”, the 5th, 8th and 11th letters of A. Pichot’s “Voyage historique et littéraire en Angleterre et en Ecosse” and the 1st part of W. Wordsworth’s «Essay upon Epitaphs». Meanwhile, the article outlines a broader representative spectrum of sociocultural, psychological and aesthetical ideas which determine how the authors of the end of the 18th—the first third of the 19th century deal with funerary and memorial topics. The article shows how medical and healthcare attitudes of the epoch, as well as some ideological shifts, which paved the way for European cemetery reform, filter the choices and the ways of textual representations of traditional literary rhetorics (Horatian topos of beatus ille in particular). On the other hand, the study demonstrates how narrative models conventional for the first third of 19th century function as the universal language suitable for describing utterly different graveyard spaces. The important research subject is the authors’ critical attitude to the official state commemorative politics, which involved a major change in aesthetic trends of the epoch. Development of associanist perception and sentience theory constitutes new demands for funerary and commemorative material culture and, in the case of Pushkin’s poem, stimulates the rethinking and transformation of well-established elegiac figurative and narrative patterns.

Psychological factors of anti-vaccination behavior of Belarusians in the context of the COVID-19 pandemic

The article presents the results of a theoretical and empirical study of the psychological factors of refusal from preventive vaccinations against COVID-19 during an active campaign for mass vaccination of the population of Belarus. Among these factors, the individual characteristics of the subjective perception of the likelihood of infection, the severity of the course and consequences of coronavirus infection, as well as the effectiveness and safety of anticovid vaccination were considered; general attitudes in the field of vaccination and health care; and value attitudes towards health and life. The prevalence of the main categories of vaccination behavior — pro- and antivaccinational — was determined in the Belarusian population sample; the peculiarities of the cognitive assessment of COVID-19 and anticovid vaccination inherent in Belarusians, as well as their meaning-related determinants, were revealed; psychological differences between people with different directions of vaccination behavior are revealed; identified psychological predictors of antivaccination behavior. The empirical study was conducted on a representative population sample of residents of the Republic of Belarus (N=582, aged from 18 to 49 years, 178 men and 404 women), using questionnaire methods, as well as standardized personality questionnaires: “Scale of Basic Value”, “Scale of Healthcare Attitudes”, “Scale of Antivaccination Attitudes”. The results of the study indicate that generalized and nonspecific factors prevail in the regulation of the antivaccination behavior of Belarusians in the context of the coronavirus pandemic, which are associated with personal comprehension and cognitive assessment not so much of a new type of coronavirus infection and anti-vaccines offered to the population, but of the national healthcare system in general and vaccination as such. In this case, the leading factors and predictors of anti-vaccination behavior of Belarusians are general negative attitudes — anti-vaccination, anti-drug and anti-bureaucratic attitudes. In the course of the study, psychometrically developed and validated the original Russian-language “Scale of Antivaccination Attitudes”, designed to change the generalized negative-evaluative (skeptical-distrustful) attitude of the subject to vaccines and vaccination in general. The results obtained indicate the compliance of its measuring properties with conventional psychometric standards.