Low Acceptance Research Articles

Public acceptance of coercive measures in Nigerian mental health care.

For the first time, Nigeria has enacted a new mental health law that regulates the use of coercive measures in mental health care. The study aimed to investigate the extent to which the Nigerian public accepts the use of coercive measures in the treatment of people with mental health conditions and to understand the impact of stigma and other sociodemographic characteristics. A cross-sectional survey was conducted among 615 adult respondents from Nigeria's six geopolitical zones. The study instrument included a case-specific vignette, a social distance scale, and a brief sociodemographic form. Descriptive and inferential statistics were conducted with SPSS v.25 software. More than half of the study respondents agreed that the vignette character should be forced to go to the hospital if he refuses to go (65%, n = 400), and he should be forced to take medications at the psychiatric hospital (55.1%, n = 339). The least accepted coercive measure was Isolation (28.8%, n = 177). There were significant associations between social distance and the acceptance of involuntary admissions, forced medication, mechanical restraints, and isolation (p < .05). Social distance score was highest among respondents who agreed that the vignette character should be isolated (24.023 ± 5.503; F = 24.672, p < .001). The study highlights variations in public attitudes toward coercive psychiatric measures, within the Nigerian context compared to other countries. The lower acceptance rates for isolation as a coercive measure underscore the cultural importance of social interaction in Nigeria. The relatively recent implementation of Nigeria's Mental Health Act also suggests a potential gap in public knowledge regarding the criteria for coercive measures. Future research should aim to include diverse populations and consider longitudinal approaches to assess changes in public attitudes as awareness of mental health legislation increases.

Patient awareness, knowledge, and acceptability of antenatal perineal massage: A single-center cross-sectional study from Saudi Arabia.

This study assessed the knowledge, awareness, and acceptability of antenatal perineal massage (APM) among pregnant women in Saudi Arabia. This cross-sectional study included 240 pregnant women who met the predefined inclusion criteria and attended the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia, from 1 October to 31 December 2023. Participants answered seven knowledge questions, classified as having good knowledge if they answered ≥4 correctly and poor knowledge if <4 were correct. Most women (46.25%) reported it was their first encounter with APM. Common sources of information included the internet (39.58%), physicians/midwives (7.92%), and friends/family (3.75%). Nearly half (47.5%) had heard of APM, but only 8.75% had practiced it, and 3.75% attended related classes. Only 17.5% knew that APM could be performed by the woman or her partner, while 25.83% knew it should start at 34 weeks, and 17.92% recognized the recommended duration of 5 to 10 minutes daily. Additionally, 22.5%, 15.83%, and 35.42% acknowledged APM's benefits for labor duration, anal sphincter dysfunction, and perineal injuries, respectively. The average knowledge score was 1.39±1.84, with 84.17% classified as having poor knowledge. No significant differences were found between knowledge levels (p>0.05). Low acceptability was noted, with only 58% of patients and 37% of their partners willing to engage in APM. No significant differences in acceptability were found between poor and good knowledge groups (p>0.05). The study revealed low awareness, poor knowledge, and weak acceptability of APM among pregnant patients. Targeted education for patients and healthcare providers could enhance knowledge and improve maternal-fetal health outcomes.

Advancements in p53-Based Anti-Tumor Gene Therapy Research

The p53 gene is one of the genes most closely associated with human tumors and has become a popular target for tumor drug design. Currently, p53-based gene therapy techniques have been developed, but these therapies face challenges such as immaturity, high safety hazards, limited efficacy, and low patient acceptance. However, researchers are no less enthusiastic about the treatment because of its theoretical potential to treat cancer. In this paper, the advances in p53-based gene therapy and related nucleic acid delivery technologies were reviewed and prospected in order to support further development in this field.

Scoping review of enablers and challenges of implementing pharmacogenomics testing in the primary care settings.

Pharmacogenomic testing (PGx) plays a crucial role in improving patient medication safety, yet ethical concerns and limitations impede its clinical implementation in the primary care settings. To systematically review the current state of PGx in the primary care settings and determine the enablers and challenges of its implementation. A scoping review was carried out by adhering to Arksey and O'Malley's 6-stage methodological framework and the 2020 Joanna Briggs Institute and Levac et al. DATA SOURCES: Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed were searched up to 17 July 2023. All peer-reviewed studies in English, reporting the enablers and the challenges of implementing PGx in the primary care settings were included. Two independent reviewers extracted the data. Information was synthesised based on the reported enablers and the challenges of implementing PGx testing in the primary care settings. Information was then presented to stakeholders for their inputs. 78 studies discussing the implementation of PGx testing are included, of which 57% were published between 2019 and 2023. 68% of the studies discussed PGx testing in the primary care setting as a disease-specific themes. Healthcare professionals were the major stakeholders, with primary care physicians (55%) being the most represented. Enablers encompassed various advantages such as diagnostic and therapeutic benefits, cost reduction and the empowerment of healthcare professionals. Challenges included the absence of sufficient scientific evidence, insufficient training for healthcare professionals, ethical and legal aspects of PGx data, low patient awareness and acceptance and the high costs linked to PGx testing. PGx testing integration in primary care requires increased consumer awareness, comprehensive healthcare provider training on legal and ethical aspects and global feasibility studies to better understand its implementation challenges. Managing high costs entails streamlining processes, advocating for reimbursement policies and investing in research on innovation and affordability research to improve life expectancy.

FOOD SELECTION OF CHILDREN WITH AUTISM SPECTRUM DISORDER ENROLLED IN NATEA CAETÉS

Introduction: Autism Spectrum Disorder (ASD) is understood as a neurological disorder characterized by behavioral heterogeneity, affective blunting, and stereotypical behaviors. Objective: To understand the eating habits of children with Autism Spectrum Disorder and the main foods and restrictions regarding the child's diet. Methodology: This is an observational, cross-sectional study with a qualitative descriptive approach, since the objective is to observe and delve deeper into the food selectivity of autistic children. The target population will be mothers of children with autism spectrum disorder registered with NATEA in the city of Capanema. Results: The sample consisted of 42 participants, of which 85.71% were male, reflecting the male predominance frequently observed in ASD diagnoses. The most represented age group was 5 to 12 years (61.90%), and the majority of participants identified as brown (85.72%). Regarding diagnosis, 64.29% of children were diagnosed between 1 and 5 years of age, and support levels ranged from mild (33.33%), moderate (40.48%) to intense (26.19%). Regarding feeding, 80.49% of children presented food selectivity, with a greater preference for carbohydrates and sweets, and low acceptance of vegetables and fats. Mealtimes were challenging for caregivers, with 70.97% reporting greater difficulty at the beginning of meals, suggesting initial resistance to food engagement. In addition, 80% of participants reported difficulties with food consistency, highlighting the importance of adapted nutritional interventions. Conclusion: The results indicate the need for integrated strategies to improve food acceptance and provide emotional support to caregivers. It is concluded that the demographic profile, associated with food selectivity and socioeconomic difficulties, reinforces the importance of multidisciplinary support programs to promote a balanced diet and well-being for this population.

Acceptability of single-dose HPV vaccination schedule among health-care professionals in Kenya: a mixed-methods study.

The World Health Organization recommends a single-dose human papillomavirus (HPV) vaccination schedule for girls and boys to accelerate progress toward cervical cancer elimination. We applied the Theoretical Framework of Acceptability (TFA) within the context of HPV vaccination to assess the acceptability of a single-dose schedule among health-care professionals in Kenya. A REDCap survey was developed using relevant Theoretical Framework of Acceptability domains and validated with health-care professionals. Descriptive analyses and multivariate Poisson regression were conducted to assess factors associated with increased acceptability. Free-text responses were analyzed using a rapid qualitative approach, and findings were presented using a joint display. Among 385 responses, 74.2% of health-care professionals were female and 48.6% were nurses. On average, respondents had been in their position for 60 months, and one-third (33.2%) were based at level-4 facilities. The majority (75.84%) thought that giving a single-dose of the HPV vaccine to adolescent girls and young women was either acceptable or very acceptable. Qualitative findings highlighted that lack of information was the underlying reason for health-care professionals who were resistant, and most clinicians thought that a singled-dose schedule was less burdensome to clinicians and patients. Hospital directors had a non-statistically significantly lower acceptability likelihood than nurses (incident rate ratio = 0.93, 95% confidence interval = 0.45 to 1.71) and health-care professionals at urban facilities had a non-statistically significantly lower acceptability likelihood than clinicians in rural facilities (incident rate ratio = 0.97, 95% confidence interval = 0.83 to 1.13). Although not statistically significant, predictors of increased acceptability provide information to tailor strategies to increase HPV vaccination coverage and accelerate progress toward cervical cancer elimination.

Europeanization, Mordenization: How the Syntax of Chinese New poetry Changed Influenced by the Translated Western Poems

The New Culture Movement of the early twentieth century promoted vernacular literature to construct a literature close to the people. However, the vernacular language was not used as an official language for a long time, resulting in its lack of complex structure and ability to express itself in refined ways. With the translation of modern Western poetry, their preserved modern Western syntax gradually influenced the creation of new poems, and the language of new poems was gradually Europeanized, with the emergence of many Europeanized syntactic features. Although this also resulted in the disadvantages of a strange and lengthy language and lower acceptance by the public, it provided a rich syntactic framework for the creation of new literature and adapted to the needs of modernization.

KardioNet Digital - a structured care model involving digital tools for intersectoral communication and a patient-focused strategy for treatment of heart failure

Abstract Introduction Inefficiencies and discontinuities in care at the interfaces within Germany's healthcare system, especially between acute and outpatient care, present significant challenges in managing patients with heart failure (HF). The management complexity of HF has increased with the advent of new digital tools, though patient acceptance of these tools remains contentious. The prevention of loss of diagnostic and therapeutic information for this complex disease is crucial for cross-sectoral communication (hospital - office-based cardiologist - general practitioner) and quality of care. Purpose Our goal was to examine the impact of digital app-supported coordination of HF management across different healthcare providers from hospital discharge to the ambulatory sector and to assess patients' acceptance of a structured care program. A patient-focused digital strategy, supported by a Heart Failure Nurse (HFN), aimed to facilitate structured follow-up and patient empowerment, focusing on patient-reported outcomes and experiences (refer to Table 1). Results Out of 401 patients screened during their hospital stay for HF, only 57 (14.9% male, 12.6% female) participated in the KardioNet Digital (KND) program. NYHA classifications were I (3.5%), II (49.1%), III (40.4%), and IV (7.1%); Diagnoses included CMP (26, 45.6%), CAD (19, 33.3%), valvular HF (8, 14.0%), and others (4, 7.0%). The mean age was 55.03 years, with a notable difference in participation based on age (≥70 years: 9.5% male, 33.3% female; &amp;lt;70 years: 90.5% male, 66.7% female). Age was a significant determinant of program participation. Patients who regularly used the app benefited from several features: A total of 35 alerts (17 patients) were triggered for reasons such as bodyweight increase (2kg or more) and device-induced alerts (i.e. false shock delivery, 3x slow-VT, Syncope), leading the HFN to contact the patients. This early intervention prevented rehospitalization due to decompensation of heart failure in 11 patients (64.7%) and addressed device-related alarms for organizing an emergency hospital visit by HFN. Despite substantial incentives, such as support from an HFN and expedited appointments with specialists for follow-up therapy, refusal rates were high (refer to Table 2). Conclusion A structured, digitally supported cross-sectoral care model for heart failure patients can potentially improve care coordination and outcomes. However, the success of such programs critically depends on patient willingness and the seamless integration into existing healthcare structures. Despite valuable incentives, we observed low acceptance of the program. Even among motivated participants (14.1%), there is a significant need for substantial support and education on digital literacy for the widespread implementation of digital tools in real-world settings for the treatment of heart failure.Workflow of structured digital supportReasons for Declining Participation

The assessment of society’s acceptance of artificial intelligence use in healthcare

Abstract Background We observe the surge of interest and application of artificial intelligence (AI) in various areas. AI use in healthcare and medicine is followed by society with interest; however, acceptance varies depending on the area of its application. This study aimed to understand the differences in acceptance depending on the type of solution and explain the factors influencing the attitude toward the use of AI in healthcare. Methods The data from the online survey was collected from a representative sample of 1109 adult Internet users in Poland. The respondents were asked about their acceptance of AI use for several purposes in healthcare. Based on the responses to these items, an ad-hoc score of AI acceptance in healthcare (AIAHC) was developed. The determinants of AIAHC were assessed with uni- (ULRM) and multivariable linear regression (MLRM) models. Results The highest acceptance of AI use was found for monitoring medication intake at home: mean (standard deviation, SD)-3.81 (1.39), the lowest for AI making decisions about the mode of therapy -2.78 (1.35). ULRMs showed that significant predictors of AIAHC were age, gender, chronic disease, vocational status, income, the use of the Internet (IU), and e-health literacy (eHL). In MLRM, only gender, vocational status, income, and eHL maintained a significant relationship with AIAHC. Males showed significantly higher AIAHC than females (B, 95%CI: 2.56, 1.42 - 3.71), and students had higher AIAHC than employees (B, 95%CI: 3.01, 0.14 - 5.89). Persons who refused to reveal their income demonstrated lower acceptance of AI use than those who revealed their income (B, 95%CI: -4.64, -6.54 - -2.74). Finally, greater eHL favored higher AIAHC (B, 95%CI: 0.46, 0.34 - 0.57). Conclusions Evidently, there is a hierarchy of potential areas of application in terms of society’s acceptance. Improving eHL should exert a positive effect on the acceptance of innovative technologies, including AI, in healthcare. Key messages • Citizens show moderate enthusiasm toward the broader use of AI in healthcare. • E-health literacy exerts a positive effect on the introduction of AI-based solutions in healthcare.

Application and Challenges of Battery Swapping Technology in the Development of New Energy Vehicle

Abstract: With the rapid growth of the new energy vehicle market, the construction of battery swapping stations has become an effective solution to the problem of insufficient charging facilities. Battery swapping technology can improve energy replenishment efficiency, alleviate pressure on the power grid, reduce charging costs through overnight charging, and increase battery utilization and profitability. However, battery swapping technology faces issues such as standardization, high costs, technical and safety challenges, and low market acceptance. It is suggested to promote standardization, government policy support, technological innovation and safety enhancement, the construction of a widespread battery swapping network, as well as innovation in business models and market promotion to promote the development of battery swapping technology.

The Development Prospect of Prefabricated Dish Industry

Abstract: In recent years, prefabricated dishes is a rapidly developing emerging industry in China. With a long industrial chain, wide connections and high technical requirements, it has become an important productive force for the upgrading of agricultural industry and has great development potential. However, the development of China's prefabricated dish still faces problems such as non-standard industry standards, unstable quality, low consumer acceptance, and insufficient innovation ability. The purpose of studying prefabricated dish is to explore more market potential, promote the upgrading of prefabricated dish industry, and meet more consumer needs. This paper introduces the present situation of China's prefabricated dishes, analyzes the different characteristics of overseas mature prefabricated dishes, and provides a development path for reference. It is suggested that the future prefabricated dishes industry should pay attention to food safety, expand sales channels, innovate dishes, and establish brand and marketing system. It also provides new ideas and suggestions for the future development of predicted dishes.

Relationship between coping strategies and change in symptom severity in contamination-focused OCD patients during the COVID-19: a one-year follow-up

Objective To examine the relationship between coping strategies and the change in symptom severity in contamination-focused OCD patients during the COVID-19 pandemic over a one-year follow-up. Methods In March 2020, a one-year follow-up study was initiated with 56 contamination-focused OCD patients in Turkey. Coping strategies were evaluated using the COPE scale. OCD symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at the beginning and end of the year. The Fear of COVID-19 Scale was administered mid-year. Results One year post the onset of COVID-19, 68% of patients showed increased OCD symptom severity, while 32% displayed a decrease. Higher scores on the fear of COVID-19 scale and lower acceptance scores from COPE subscales were correlated with increased OCD symptom severity. Conclusions The COVID-19 pandemic has intensified OCD symptoms in a substantial proportion of patients, particularly those with heightened fears related to the pandemic, and reduced acceptance-based coping strategies. Tailored interventions emphasising adaptive coping mechanisms may benefit OCD patients in managing their symptoms during external stressors like pandemics.

Factors affecting human papillomavirus vaccine acceptance among parents of Primary 4 to 6 boys and girls in Hong Kong.

Human papillomavirus (HPV) poses a substantial but underestimated healthcare burden in Hong Kong. This study investigated factors affecting parental acceptance of HPV vaccination after the introduction of an immunisation programme for primary school girls. We assessed parental perceptions and related factors concerning HPV vaccination for both boys and girls. We conducted a cross-sectional survey between December 2021 and February 2022 among parents of Primary 4 to 6 students in Hong Kong. Our self-administered online survey collected data regarding socio-demographic characteristics, awareness and knowledge of HPV vaccination, attitudes towards HPV vaccination, and acceptance of HPV vaccination. Characteristics were compared between boys' parents and girls' parents. Factors associated with vaccine acceptance were analysed by multivariate logistic regression. We observed high awareness of HPV vaccination among boys' parents and girls' parents; however, they demonstrated relatively poor knowledge of HPV and the HPV vaccine. An alarming low HPV vaccination uptake rate was also observed. Attitudes towards the HPV vaccine were similar between parent groups. A majority of parents believed that the HPV vaccine was safe and effective in preventing infection. Parents of boys showed lower HPV vaccine acceptance. Factors associated with acceptance differed between parent groups. High awareness of HPV and HPV vaccine is predictive of vaccine acceptance. Boys' parents are less likely to accept HPV vaccination and emphasis should be placed on addressing potential HPV vaccine hesitancy in this group. Public education should also aim to raise awareness of government vaccination programme, and implementation of catch-up vaccination programme to school children beyond primary school should be considered.

Moving on from clinical animal-derived surfactants to peptide-based synthetic pulmonary surfactant.

Research on lung surfactant has exerted a great impact on newborn respiratory care and significantly improved survival and outcome of preterm infants with respiratory distress syndrome (RDS) due to surfactant deficiency because of lung immaturity. Current clinical, animal-derived, surfactants are among the most widely tested compounds in neonatology However, limited availability, high production costs, and ethical concerns about using animal-derived products constitute important limitations in their universal application. Synthetic lung surfactant offers a promising alternative to animal-derived surfactant by providing improved consistency, quality and purity, availability and scalability, ease of production and lower costs, acceptance, and safety for the treatment of neonatal RDS and other lung conditions. Third-generation synthetic surfactants built around surfactant protein B (SP-B) and C (SP-C) peptide mimics stand at the forefront of innovation in neonatal pulmonary medicine, while nasal continuous positive airway pressure (nCPAP) has become the standard non-invasive respiratory support for preterm infants. nCPAP can prevent the risk of chronic lung disease (bronchopulmonary dysplasia) and reduce lung injury by avoiding intubation and mechanical ventilation, is a relatively simple technique and can be initiated safely and effectively in the delivery room. Combining nCPAP with noninvasive, preferably aerosol, delivery of synthetic lung surfactant promises to improve respiratory outcomes for preterm infants, especially in low-and-middle income countries.

Determinants of net value added to produced and processed paddy rice in South East, Nigeria

The study principally examined the determinants of net value added to produced and processed paddy rice in South east Nigeria It specifically, identified the socio-economic characteristics of the respondents, analyzed the determinants of net value added to produced and processed paddy rice as well as ascertained the constraints to processed and produced paddy rice. Multi-stage sampling technique involving purposive and random sampling methods was used to select 240 respondents. Primary data were collected on rain-fed production season using structured questionnaires administered to the respondents by personal interview. Descriptive statistics,, multiple regression and principal component analysis were used to analyze the data. Results obtained showed that gender distribution of the respondents was 63%males and 38% females. More respondents are between the ages of 41-50 and31-40 respectively and house hold size of 4-6 .Farming experience showed that 136 respondents representing 57% had engaged in the business between 11-20yrs.The results also showed that 67% of the respondents accessed farm credit while 25% did not.66% of the respondents belonged to farmers association while 75% were not visited by extension agents. Variables (age, gender, years in school, household size, years of experience, training/extension visits, costs incurred, value addition technique and market price) significantly influenced the net value added while marital status, membership of cooperative, and access to credit did not. Constraints to paddy producers and processors were accessibility to farm machine, poor infrastructure and scarcity/high cost of labor, low access to credit/grant; low proactive measures to flood and drought control; insufficient knowledge of agro-chemicals, and late provision of essential training and services; and processors: use of outdated rice milling machines, high cost of modern rice processing machines, low access to modern rice processing machineries and low acceptability of local rice. Recommendations include; establishment of farm machinery hiring centers for producers and supply of modern rice milling machines to rice processing clusters, development of dams and irrigable lands, training and re-training on access to fund, utilization of biodegradable wastes from paddy rice, proactive measures of flood and drainage control, adequate use of agro-chemicals, use of modem techniques, and involvement of National Agency for Food and Drug Administration and Control in quality control. Keywords: Agriculture, Paddy Rice, Value Addition, Nigeria.

VACINAÇÃO CONTRA O HPV EM ADOLESCENTES: BENEFÍCIOS, DESAFIOS E PERSPECTIVAS - UMA REVISÃO SISTEMÁTICA

Introduction: Vaccination against the Human Papillomavirus (HPV) is a fundamental intervention for the prevention of cancers related to the virus, especially cervical cancer. Although recommended by the World Health Organization (WHO) and included in several national immunization programs, adolescent vaccination adherence still faces barriers. This systematic review aims to evaluate the benefits, challenges and prospects of HPV vaccination in adolescents, focusing on studies that address both clinical efficacy and factors influencing vaccine acceptance and coverage. Methodology: A search was conducted in the databases Latin American and Caribbean Literature in Health Sciences (LILACS) and Virtual Library in Health (VHL) to identify studies published between 2018 and 2024. Scientific studies were included that evaluated the effectiveness of vaccination, the perception of parents and adolescents, and public policies to encourage vaccination. Results and discussion: HPV vaccination shows up to 90% effectiveness in preventing infections by oncogenic strains of the virus. However, factors such as misinformation, fear of side effects and cultural resistance were identified as the main challenges for vaccine adherence. The implementation of educational campaigns and the strengthening of public policies aimed at immunization were highlighted as effective strategies to increase vaccination coverage. Conclusion: HPV vaccination in adolescents offers clear benefits in the prevention of virus-related diseases, such as cervical cancer. However, challenges such as low acceptance and misinformation about vaccine safety need to be overcome in order to maximize its effectiveness at the population scale. Coordinated actions between governments, health professionals and communities are needed to increase uptake and ensure broad and effective vaccination coverage.

Experience of a peer prereview service including a junior reviewer program in a professional association.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Scientific journals have reportedly low acceptance rates. Peer review support services offering manuscript review before journal submission are uncommon but may increase success with the publication process. The purpose of this report is to describe the development and experience with a peer prereview (PPR) service offered by the Clinical Pharmacy and Pharmacology (CPP) section of the Society of Critical Care Medicine. The CPP PPR service provides comprehensive review on research manuscripts before submission to a scientific journal. A junior reviewer program provides an opportunity for mentorship and professional development of reviewers. After the review is complete, authors and reviewers complete a survey regarding their experience with the service. Authors are also contacted biannually to determine their manuscript's status. From the program's start in 2011 through June 2022, 64% of the 58 manuscripts reviewed were accepted or published in journals with impact factors ranging from 0.915 to 9.296. Of the 31 (82%) authors responding to the survey, 94% said that the service met or exceeded their expectations and 84% would recommend the service to a colleague. Of the 29 (76%) reviewers responding to the survey, 100% said that the service met or exceeded their expectations and 92% would be willing to review again. The majority of manuscripts that went through the CPP PPR service were accepted for publication, and both authors and reviewers were highly satisfied with their experience. The CPP PPR service can be used as a framework for other institutions to implement.

Financial toxicity in early-phase cancer clinical trial participants.

Little is known about financial toxicity in early-phase clinical trial (EP-CT) participants. This study sought to describe financial toxicity in EP-CT participants and assess associations with patient characteristics and patient-reported outcomes (PROs). Prospectively enrolled EP-CT participants from were followed from April 2021 through January 2023. Participants completed the Comprehensive Score for Financial Toxicity (<26=financial toxicity) at time of treatment. Quality of life (QOL), symptoms, coping, and resource concerns were surveyed. Associations of financial toxicity with patient characteristics, PROs, and clinical outcomes were explored. Of 261 eligible patients, 197 completed baseline assessments (75.5%, median age=63.4 years [31.8-88.6], 57.4% female). Most common cancers were gastrointestinal (33.0%) and breast (20.8%). More than one third (34.0%) of patients reported financial toxicity. Patients with financial toxicity were more likely to be<65 years (70.2% vs 48.5%, p=.004), unemployed (45.5% vs 16.9%, p<.001), not have attended college (53.1% vs 26.4%, p=.002), and have income <$60,000 (59.7% vs 25.4%, p<.001). In adjusted models, patients with financial toxicity reported lower QOL (B=-6.66, p=.004) and acceptance (B=-0.78, p=.002), and increased self-blame (B=0.87, p<.001). They were more likely to have concerns regarding housing (10.6% vs 2.3%, p=.025), bills (31.8% vs 3.8%, p<.001), food (9.1% vs 0.8%, p=.006), and employment (21.2% vs 1.5%, p<.001). There was no difference in time on trial (hazard ratio, 1.03; p=.860) or survival (hazard ratio, 1.16; p=.496). More than one third of EP-CT participants reported financial toxicity. Factors associated with financial toxicity and demonstrated novel associations among financial toxicity with QOL, coping, and resource concerns were identified, highlighting the need to address financial toxicity among this population.

Research Progress on Methods for the Deacidification of Small Berry Juice: An Overview

As some of the richest sources of natural antioxidants, small berry fruits have attractive colors and special tastes, with recognized benefits for human health. However, sour tastes in small berry juices result in a poor flavor and low acceptance among consumers, greatly limiting their marketability. Among the most commonly used deacidification methods, chemical deacidification methods can neutralize fruit juice via the addition of a deacidification agent, while physical deacidification methods include freezing deacidification, ion-exchange resin deacidification, electrodialysis deacidification, and chitosan deacidification. All of these methods can markedly improve the pH of fruit juice, but they introduce new substances into the juice that may have an influence on its color, taste, and stability. Biological deacidification can effectively remove malic acid from fruit juice, reducing the content from 15 g/L to 3 g/L; additionally, it maintains the taste and stability of the juice. Therefore, it is widely applied for fruit juice deacidification. On this basis, some compound deacidification technologies have also emerged, but they also present problems such as high costs and complicated working procedures. This review of deacidification methods for small berry juice provides a foundation for the industrial development of such juices.

How Time, Living Situation, and Stress Related to Technology Influence User Acceptance and Usability of a Socialization Service for Older Adults and Their Formal and Informal Caregivers: Six-Month Pilot Study.

Considering the growing population of older adults, addressing the influence of loneliness among this demographic group has become imperative, especially due to the link between social isolation and deterioration of mental and physical well-being. Technology has the potential to be used to create innovative solutions to increase socialization and potentially promote healthy aging. This 6-month study examined the usability and acceptability of a technology-based socialization service and explored how stress and living situation affect older adults' and their ecosystem's perceptions of technology, investigating cross-sectional and longitudinal differences among and across user groups. Participants were recruited in Tuscany and Apulia (Italy) through a network of social cooperatives and a research hospital, respectively. A total of 20 older adults were provided with the same technology installed on a tablet and on a smart television. The technology has three functionalities: video calling, playing games, and sharing news. Additionally, 20 informal caregivers (IC) and 13 formal caregivers (FC) connected to the older adults were included in the study. After both initial training in the use of the system (T0) and 6 months of using the system (T6), questionnaires on usability, acceptability, and technostress were filled in by older adults, IC, and FC. Nonparametric or parametric tests were conducted to investigate group differences at both time points and changes over time. Additional analyses on older adults were done to assess whether differences in usability and acceptability were related to living situation (ie, alone or with someone). Furthermore, correlation analyses were performed between usability, acceptability, and stress toward technology at T0 and T6. At both T0 and T6, older adults had lower usability scores than IC and FC and higher anxiety than IC. Over time, there was a significant decrease in older adults' attitudes toward technology score, depicting a negative attitude over time (T0 median 4.2, IQR 0.5; T6 median 3.7, IQR 0.8; Cohen d=0.7), while there was no change for IC and FC. At T0, those living alone had lower acceptability than those living with someone but this difference disappeared at T6. People or participants living with someone had a decline in anxiety, attitudes toward technology, enjoyment, and perceived usefulness. Stress toward technology affected usability and acceptability in the older adult group entering the study (ρ=-.85) but this was not observed after 6 months. In the IC group, stress affected trust at T0 (ρ=-.23) but not at T6. At the start of the study, older adults judged the system to be less usable and more stressful than did the caregivers. Indeed, at first, technostress was correlated with usability and acceptability; however, with repeated use, technostress did not influence the perception of technology. Overall, getting accustomed to technology decreased anxiety and stress toward technology.