Parental Knowledge Research Articles

Knowledge, Attitudes, and Practices of Parents Regarding Antibiotic Use for Acute Upper Respiratory Tract Infections in Children in Basrah, Iraq.

Upper respiratory tract infections (URTIs) are mainly caused by viral infections, but parental attitudes often lead to inappropriate antibiotic prescriptions, thereby increasing antibiotic resistance. This study aimed to evaluate parents' knowledge, attitudes, and practices (KAP) regarding antibiotic use for children with URTIs in Basrah, Iraq. A cross-sectional study was conducted at 14 primary healthcare centers in Basrah from November 2023 to April 2024. A questionnaire was designed and administered to determine parents' KAP regarding antibiotic use for children suffering from URTIs. Four hundred parents completed the questionnaire. The majority (81%) of parents were aware that antibiotic misuse leads to bacterial resistance. Sixty percent of respondents disagreed that viral infection is a leading cause of URTI and that it can be self-limited without antibiotics. A total of 67.6% of the parents were aware of the possibility of having side effects from antibiotic consumption. Moreover, more than half of parents (58.8%) never asked their pediatricians for an antibiotic prescription for their children. Educational interventions are necessary to raise parents' awareness of antibiotics to reduce inappropriate use and its consequences.

Association between micronutrient intake and cognitive performance of school-aged children attending selected private schools in Lagos State

Background: It has been reported that the academic performance of school-aged children has been on the decline in recent years. Feeding pattern determines micronutrient consumption and plays an important role in cognitive performance. Objectives: This research assessed the micronutrient consumption, feeding pattern, and cognitive performance of school-aged children in selected private schools in Lagos State. Methods: The socio-demographic characteristics of the parents and children, knowledge of parents on micronutrients, feeding pattern of the children, and identifying micronutrient-rich food among consumed foods were obtained using a semi-structured questionnaire. The micronutrient intake was assessed using twenty-four-hour dietary recall and the cognitive performance of the respondents was evaluated with structured questions from Slosson’s intelligence test revised third edition after which the micronutrient consumption was correlated against overall cognitive performance using Pearson’s multiple correlation range test. Results: The results indicated that the feeding pattern of the children showed that 51.3% were fed three times a day, 47.3% took snacks at least once a day and more than half (52.0%) took fruits and vegetables once a day. The micronutrient-rich foods among consumed foods were identified and they include efo and egusi, ewedu, okro, apple, orange, and milk, among others. There was a negative correlation (p<0.05) between micronutrient consumption and cognitive performance among the students studied. Conclusion: This study concludes that an increase in micronutrient consumption alone does not increase cognitive performance.

Knowledge and perception of asthma among parents of children with asthma.

Parents' knowledge is an integral part of healthcare quality, impacting treatment adherence, patient loyalty and healthcare utilisation in pediatric asthma. Parental knowledge is particularly crucial as parents influence decision-making for their child's healthcare. To assess parents' knowledge and perceptions of their children's asthma and to identify areas for weakness in therapeutic education. This is transversal survey study based on validated and translated self-administered questionnaire (Arabic asthma knowledge questionnaire AAKQ). The study was conducted in 2 departments: pediatric primary care department at Elomrane and pediatric pneumology outpatient clinics at Bechir Hamza children's hospital of Tunis during 6 months (March2022- October2022). One hundred forty-four parents were involved in the study. Most of the participants were mothers. The mean age was 38 years. Only 27,0% had higher education and smoking in parents was observed in 58% of cases. Our results showed moderate knowledge in 67,9% of participants. The mean of the total knowledge score was 57,7/85. Forty-six per cent of parents had poor knowledge for the first category of the questionnaire. The second category was the most successful part where only 14% had poor knowledge. The mean score of the third category was 13,5/20 with 35,4% of parents having poor knowledge. The mean of total knowledge was found to be higher among participants with higher education (P=0,000), when the gender of the child is masculine (P=0,038), when the parents were asked in Hospital of children of Tunis (P=0,003) and when there is a history of asthma in the siblings (P=0,05). No difference in caregiver's knowledge was based on their age or gender or history of asthma, on the age of the child, his hospitalization for asthma, his asthma control level or his compliance with medication. Knowledge of parents and their children suffering from asthma is acceptable but insufficient. An approach focusing on improving patient education skills is needed to help families understand and accept the disease and achieve optimal control.

Knowledge & Attitude among Parents of Children with Bronchial Asthma whom Attending Iraq Pediatric Hospital

Background: Asthma is a prevalent chronic condition in pediatric populations. The rising incidence, morbidity, and mortality rates associated with asthma have heightened public health concerns. Pediatric asthma imposes a substantial burden on affected children, their families, and the broader community. Effective asthma management encompasses regular monitoring, symptom control, and the prevention of exacerbations. Objectives: The study aimed to document the knowledge, attitudes of parents of children with asthma and to identify the factors associated with parent knowledge and attitude. Method: A study was conducted involving 205 parents of children under five years old with asthma, who attended the Karbala Pediatric Hospital between February 15 and May 15, 2023. A specially designed questionnaire was utilized, comprising three sections: the first section addressed socio demographic information of both children and parents, the second section evaluated the parents' knowledge, and the third section assessed the parents' attitudes. Responses were scored with one point for correct answers and zero points for incorrect or "I don't know" answers. Statistical analyses, including the Student's T-test, ANOVA, and linear regression, were employed to identify factors associated with parental knowledge. Results: The results indicated that the majority of participants were mothers, with a mean age of 29 years, and the majority of asthmatic children were male (69.3%), with a mean age of 34.4 months. It was found that 48.8% of participants had a poor knowledge score, while 61% had a poor attitude score. Key factors influencing knowledge scores included the family’s place of residence, the child’s birth order, the duration of the disease, the age at disease onset, the participant’s age, and the mother's educational level. Conclusion: Overall, the parents demonstrated limited knowledge and unfavorable attitudes regarding childhood asthma. Enhancing their understanding and attitudes could potentially lead to improved management practices among parents of children with asthma.

EDUKASI PENINGKATAN GIZI ANAK DALAM UPAYA CEGAH STUNTING DI GUNUNG GEULIS

The community service program on child nutrition education aimed at preventing stunting in Desa Gunung Geulis sought to address the high prevalence of stunting due to nutritional issues. Initial situation analysis revealed that 40% of children in the village experienced stunting, with 70% of parents having limited knowledge about balanced nutrition. Based on these findings, comprehensive and easily understandable educational materials and training modules were developed, covering essential information on balanced nutrition, types of nutritious foods, and methods for preparing and presenting healthy meals using local ingredients. The outreach and training were conducted at three strategic locations and attended by 150 parents and caregivers, employing interactive and practical methods. Follow-up support and monitoring over three months showed that 80% of the families improved their children’s nutritional intake. The final evaluation indicated a significant increase in parental knowledge about nutrition from 30% to 85% and a reduction in stunting prevalence from 10% to 8% within six months. These results demonstrate that a structured, community-based educational approach effectively enhances nutritional knowledge and reduces stunting, significantly impacting child well-being in Desa Gunung Geulis.

From recognition to cause: analyzing parental knowledge of children’s short stature, preliminary study

Short stature (SS) is a condition where children's growth rates are below the 2.5th percentile for their age and gender. Early intervention is vital due to its association with reduced quality of life and mortality. This study examines the understanding of Qassimi parents regarding their child’s SS. We surveyed 384 Qassimi parents, including those with growing children and those without children willing to participate. Knowledge scores ranged from 0 to 8, with scores over 4 indicating good knowledge. Most of the study participants were Saudis, females, or holding a university degree. The mean score was 4.44 and almost 47% of respondents demonstrated good knowledge. All the study participants were aware of at least one cause of short stature. Of more than 20 causes of short stature, only 24.3% of the study participants could correctly identify 4 or more causes. Multivariable regression revealed that higher knowledge scores were significantly noted among participants younger than 40 years (p-value: < 0.001), students (p-value: < 0.001), unmarried (p-value: 0.001), and/or having no children (p-values: 0.001). Among respondents with children, individuals with children younger than 12 years had significantly better knowledge (p-value: 0.003). In contrast, knowledge was seemingly independent of gender, level of education, nationality, or family history (p-values: > 0.05). Although the knowledge status is overall moderate, it’s recommended to further start public health initiatives and educational programs, while paying special attention to population groups associated with lower knowledge level.

Parental norms and attitudes in Relation to Children’s sugar consumption − A mediation analysis of the “Are You Too Sweet?” intervention study

Parental influence on children’s dietary behaviour makes parents an obvious target for prevention strategies with nutritional foci. Mediation analysis is considered a valuable tool for understanding the underlying mechanisms of influence in intervention studies aimed at implementing behaviour change strategies.The present study used data from the multi-component cluster-randomised intervention “Are You Too Sweet?” with 153 Danish children (5–7 years) to explore mediating effects and role of parental determinants on added sugar intake in children.A pre-and post-intervention questionnaire evaluated parental knowledge, practices, self-efficacy, norms, and attitudes. Children’s dietary intake was estimated from a seven-day dietary record. Associations between children’s added sugar intake and parental responses and changes in responses following the intervention were evaluated using linear mixed models. Exploring potential behaviour change pathways of the intervention was done using mediation analyses.Children’s reduction in added sugar consumption was partly mediated by changes in parental norms and attitudes regarding limiting sugar-rich foods and drinks to special occasions. Parental knowledge of guidelines on the intake of sugar-rich discretionary foods and drinks increased as an intervention effect but did not demonstrate a mediating effect. No significant changes or mediating effects were found in parental self-efficacy or practices.The findings highlight parental norms and attitudes regarding restricting sugar-rich foods and drinks to special occasions as modifiable and a mediator for reducing added sugar intake in the “Are You Too Sweet?” intervention study.Trial registration: Retrospectively registered at ISRCTN: ISRCTN10409779.

Links between parental monitoring and parent-adolescent conflict: A multimodal test of bidirectional relations.

During adolescence, youth increase in both independence and conflict with parents. Parents vary in how much they know about their adolescents' whereabouts and activities and how they acquire this information (i.e., the sources of what parents know). We probed how parental knowledge of adolescents' whereabouts and activities-and their information sources-relates to (a) domains of parent-adolescent conflict (fighting about, or having different beliefs about, daily life topics) and (b) parent and adolescent attachment-related behavior during a conflict discussion task. Using the Actor-Partner Interdependence Model, we tested links between parental knowledge and its sources and conflict processes. Eighty-seven adolescents (Mage = 15.18; 55% female) and parents completed surveys about parental knowledge and its sources (i.e., parental solicitation of adolescents' activities, adolescent disclosure to parents about their activities) and separate interviews on conflict domains. A subset of parent-adolescent dyads (n = 65) interacted for 5 min about an adolescent-identified conflict topic. Different beliefs about daily life topics related to parental knowledge: parents' reports of greater different beliefs about daily life topics predicted less knowledge of adolescents' activities/whereabouts, solicitation, and disclosure, for both parent and adolescent reports of these domains. For adolescents, greater different beliefs related to less solicitation and disclosure. Only adolescent reports of parental knowledge, solicitation, and disclosure predicted attachment-related behaviors both dyad members displayed during the conflict discussion task. Findings reveal links between parental knowledge of adolescents' activities and conflict processes and demonstrate dyadic interdependence between parental knowledge of adolescents' activities and conflict processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parental awareness and knowledge toward their children#39;s halitosis due to intra-oral causes attending major children#39;s hospital

Parental awareness and knowledge toward their children#39;s halitosis due to intra-oral causes attending major children#39;s hospital

Influence of parents knowledge and attitudes on health

Influence of parents knowledge and attitudes on health

ANALYSIS BETWEEN KNOWLEDGE AND ATTITUDES OF PARENTS REGARDING PROVIDING DOUBLE IMMUNIZATION AT THE MINASA UPA COMMUNITY HEALTH CENTER

Immunization is the act of providing immunity against a disease by introducing specific substances into the body. The completeness of immunization can be influenced by several factors such as knowledge, attitudes, number of children, health worker attitudes, family support, distance from home, education, socio-cultural factors, and community trust. This study aims to determine the relationship between parental knowledge and attitudes toward administering double immunization in infants conducted at the Minasa Upa Community Health Center. The research method used was quantitative research with an observational analytic design with a cross-sectional approach and a non-probability sampling method with a purposive sampling technique, resulting in 85 samples. The study results found that most respondents had good levels of knowledge, with 46 respondents or 54.1%, and exhibited positive attitudes, with 43 respondents or 50.6%. The highest number of respondents who administered double immunization to infants were found to have good knowledge, accounting for 67.4%, with a P-value of 0.003. Meanwhile, the number of respondents who administered double immunization and had positive attitudes was 69.8%, with a P-value of 0.001. Based on this research, it can be concluded that there is a significant relationship between parental knowledge and attitudes towards the administration of double immunization in infants.

Parental knowledge and attitudes toward food allergies: a cross-sectional study on determinants and educational needs

BackgroundFood allergy (FA) may often lead to fatal consequences if it is treated promptly. Parents of children with FA should have adequate knowledge to improve health outcomes and reduce the associated burden. This study aimed to examine the knowledge and attitudes regarding FA among parents of children with FA.MethodsThis was a cross-sectional study conducted among parents attending a primary healthcare center using convenience sampling. The minimum sample size of 280 was calculated using an equation based on the local prevalence of FA among children, and was increased to account for missing data. The data were collected using a four-section questionnaire that collected data about the parents and their children and included questions about knowledge and attitudes regarding FA. The knowledge score was calculated by summing the number of correct answers, with a maximum of 15 points. The Mann–Whitney and Kruskal–Wallis tests were used to examine the associations between the knowledge score and other variables. Spearman’s correlation was employed to test the correlations between the knowledge score and other variables.ResultsA total of 381 parents completed the questionnaires, of whom 71.9% were mothers and 28.1% were fathers. The prevalence of food allergies was 14.22%. Almost one-third had children who had one or more types of FA (32.8%). Most of those patients had received a professional diagnosis of FA (75.3%). The median knowledge score was 7.0 (IQR = 6–8), with variable proportions of correct answers across and within topics. A higher knowledge score was significantly associated with parenting a child with FA (p = 0.006), comorbid asthma or eczema (p = 0.012), the preference to acquire information from professional health agencies (p < 0.001), and higher educational (p = 0.002) and income (p = 0.001) levels. Moreover, the number of discussions held with a healthcare professional regarding FA was significantly correlated with the knowledge score (r = 0.210, p = 0.019). Online resources were the most commonly reported source of information (65.4%). Parents believed that having a child with FA can cause stress in the family (76.1%) and impact siblings’ daily lives (66.7%), while only a minority viewed FA as stigmatizing. Additionally, the majority encouraged governmental spending on FA research (92.9%).ConclusionsParenting a child with FA, comorbid asthma or eczema, number of discussions held with healthcare professionals, and education and income levels were significantly associated with a higher knowledge score. Educational interventions targeting parents should blend emotional regulation, medical information, and management skills to increase knowledge about FA and alleviate associated stress.

Parental Asthma-Related Knowledge and Asthma Control in their Children in Accra, Ghana

Parental Asthma-Related Knowledge and Asthma Control in their Children in Accra, Ghana

Factors affecting the level of parental knowledge about their children's congenital heart diseases and their care.

To assess parental knowledge about their children's congenital heart disease using a newly-designed scale. The cross-sectional study was conducted from June 2020 to May 2021, at Alkhansaa maternity and child hospital, Mosul Iraq; after approval from the ethics review committee of Ninevah Medical College, Ninevah University, Iraq, and comprised parents with children having congenital heart disease. Data, including age, gender, type of congenital heart disease as well as parents' educational and socioeconomic levels, residence, internet use and knowledge of the disease with respect to type, burden, bacterial endocarditis, outcome, etc. was noted. Parental knowledge levels were measured using a self-designed scoring scale, having a total score of 18 and 4 categories; <6 = some knowledge, 7-12 = good knowledge, 13-17 = very good knowledge, and 18 = full knowledge. Data was analysed using SPSS 26. There were 364 children with mean age 83.72±47.4 months and a male-female ratio of 0.98. The mean age at diagnosis was 12.1±8.32 months. The overall mean parental knowledge level was 8.41± 3.88, with 126(34.6%) parents having some knowledge, 178(48.9%) having good, 58(16%) having very good, and 2(0.5%) having full knowledge about their children's health condition (p<0.001) There was a significant association of parental knowledge with educational level, socioeconomic status and the type of doctor caring for the child (p<0.05). The duration of the illness showed a significant correlation with knowledge level (p=0.021). Heart Defects, Congenital, Endocarditis, Bacterial, Social Class.

Parental perceptions and knowledge toward Asthma Action Plans

Introduction Personalized Asthma Action Plans (AAPs) are a cornerstone of pediatric asthma management. We aimed to assess parental knowledge and perceptions of the use of AAPs in managing their child’s asthma. Methods In 2023 we conducted a cross-sectional survey to assess knowledge and perceptions of AAPs in parents/caregivers of children aged 0–17 years with asthma who had an AAP and attended respiratory clinics at Sydney Children’s Hospital, Randwick. The questionnaire included parental perceptions on the utility of AAPs, parental asthma management self-efficacy (PAMSE), and an adapted version of the Asthma Action Plan Knowledge Interview tool (AAPKI). Descriptive statistics and regression analyses were used to assess associations between AAPKI, PAMSE and other outcomes. Results Seventy-one parents completed the survey. Mean PAMSE score was 4.2/5 (SD 0.5). Median AAPKI score was 70.2% out of 100% (IQR 20.4%). Most parents (80.0%, n = 56) were satisfied/very satisfied with using AAPs to manage their child’s asthma. Most agreed/strongly agreed that AAPs were helpful in knowing when to seek medical attention for their child’s asthma (81.7%, n = 58), helped their understanding of asthma severity (81.7%, n = 58), and increased their confidence in asthma management (76.0%, n = 54). Over half of parents (55.7%, n = 39) would prefer AAPs digitally and majority (78.6%, n = 55) would like color-coded AAPs. Conclusion High levels of AAP knowledge and self-efficacy scores were demonstrated. Most parents expressed understanding of the benefits of AAPs. Our findings suggest parents of children with asthma prefer AAPs in color and in digital version which may help guide standardization of AAPs across Australia.

Studi Fenomenologi: Pengalaman Ibu dengan Anak Tunagrahita di Sekolah Luar Biasa Negeri Tompokersan, Lumajang

Intellectual disability (tunagrahita) is a condition that poses significant challenges when experienced by children, characterized by intellectual impairment with an Intelligence Quotient (IQ) below the average. Children with intellectual disabilities face difficulties in self-care, communication, and adapting to their environment. This study aims to explore the experiences of mothers raising children with intellectual disabilities at SLBN Tompokersan, Lumajang. The study used a qualitative method with a phenomenological approach to gain an in-depth understanding of lived experiences from the perspective of the participants, involving five respondents. The findings revealed five main themes: parenting methods for children with intellectual disabilities, the emotional experiences of mothers, changes in parental (mother's) mindset after having a child with intellectual disabilities, lack of parental knowledge in caregiving, and the level of children's dependence on their mothers or others. A key takeaway from this study is that the different experiences of mothers in raising children with intellectual disabilities significantly influence their parenting styles.

Parents' Willingness to Vaccinate Their Children Aged From 6 Months to Under 5 Years With COVID-19 Vaccines.

Despite strides in vaccinating priority groups against COVID-19, children under 5 years in Vietnam are still under-immunized, emphasizing a significant gap in prioritization. This study aimed to assess parental willingness to vaccinate children aged 6 months to under 5 years against COVID-19 in Vietnam and identify influential factors affecting this willingness. Data were collected via a survey of 5960 parents/guardians between May and June 2022. Multinomial logistic regression was employed to analyze the impact of various factors on parents' willingness to vaccinate their children, alongside investigating reasons for reluctance or refusal and preferences for vaccine origins. Approximately 50.5%, 30.2%, and 19.3% of parents were willing, hesitant, and unwilling to vaccinate their children, respectively. Primary reasons for reluctance included concerns about vaccine safety, efficacy, and the severity of the pandemic. The most preferred vaccines originated in the United States. Factors significantly influencing willingness included parents' age, knowledge of COVID-19 and vaccines, residency, education, perception of information sufficiency, children's comorbidities, and family members' vaccination status. Promoting child vaccination habits can boost COVID-19 immunization rates. Targeting hesitancy among parents of children with comorbidities is crucial. Enhancing parental knowledge and leveraging fully vaccinated family members are effective strategies.

Analysis of Factors Associated with the Incidence of Injury in Children Under Five Years in Cakung East Jakarta

Children of toddler age (pre-school) very often experience injuries, both minor and major. Therefore, the role of parents is important in monitoring, protecting, and providing knowledge to children about what to do and what not to do. The study aims to determine the relationship between attitude, level of knowledge, and behavior with the incidence of injury in children under five years of age in Cakung, East Jakarta. This research plan uses an analytical descriptive design with a Cross-Sectional approach. The sample in this study was 134 people, and the sampling method was non-probability sampling. In collecting data, a questionnaire sheet for parents regarding attitudes, knowledge levels, and behavior was used. The results showed that the injury cases of children under five years of age were choking (47.0%), which was dominated by boys (52.2%). Then, parents with parental attitudes were dominated by moderate attitudes (48.5%), the level of parental knowledge was less (38.1%), and parental knowledge was less (41.8%). Analysis showed a significant relationship between parental attitude (p=0.028), knowledge level (p=0.004), and behavior (p=0.017) in Cakung, East Jakarta. Therefore, it is necessary to increase parents' knowledge and awareness of the need for parental supervision in order to prevent injuries to children.

Perceptions of emergency drills: a consensual qualitative research study with mothers of children with Down syndrome

This study aimed to explore the experiences of mothers of children with Down syndrome with emergency drills in the school setting. Consensual Qualitative Research (CQR), an inductive method, was utilized to explore interviewees’ descriptions of experiences. The method was chosen as it works well with rich and robust interview data often obtained through open-ended questions with a small number of participants about their innermost feelings. It is the first study following this methodology with parents of children with Down syndrome. Through following the CQR protocol, three major domains (Parent Perceptions, Child Experiences, School) were identified, as well as eight subthemes of parental awareness, parental concerns, parental knowledge, child overwhelmed, child unaware, child sensory, school communication, and school preparation. The themes identified within this study are directly related with critical constructs of social learning, as children must have preparation, awareness, and communication to promote optimal emergency preparation within social contexts. This innovative study identified that there is a need for greater communication between schools and parents to protect children with Down syndrome in case of an emergency.

“We are an active family”: a randomized trial protocol to evaluate a family-system social identity intervention to promote child physical activity

BackgroundRegular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child’s MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: (1) A standard education + planning intervention providing information about benefits, action planning, and coping planning; and (2) An augmented physical activity education + planning intervention that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family.MethodsA two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6–12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,<60 min/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial’s 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents’ experiences with the intervention.ResultsSo far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families.DiscussionThis study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children’s physical activity behaviors.Trial RegistrationThe clinical trial registration ID is NCT05794789. This trial was registered with clinicaltrials.gov on March 2nd, 2023, with the last updated release on September 28th, 2023.