Survey Of Practices Research Articles

Assessment of visual problems after acquired brain injury: a survey of current practice in Danish hospitals.

To explore current hospital practice in relation to the assessment of vision problems in patients with acquired brain injury. A survey study. A total of 143 respondents from hospital settings, with background in occupational therapy and physical therapy, participated in the survey. The survey questionnaire, developed collaboratively by Danish and Norwegian research groups, encompassed 22 items categorically covering "Background information", "Clinical experience and current practice", "Vision assessment tools and protocols", and "Assessment barriers". It was sent out online, to 29 different hospital departments and 18 separate units for occupational therapists and physiotherapists treating patients with acquired brain injury. Most respondents worked in acute or subacute hospital settings. Few departments had an interdisciplinary vision team, and very few therapists had formal education in visual problems after acquired brain injury. Visual assessment practices varied, and there was limited use of standardized tests. Barriers to identifying visual problems included patient-related challenges, knowledge gaps, and resource limitations. The study emphasized the need for enhanced interdisciplinary collaboration, formal education, and standardized assessments to address visual problems after acquired brain injury. Overcoming these challenges may improve identification and management, ultimately contributing to better patient care and outcomes in the future.

Current axillary management of patients with early breast cancer and low-volume nodal disease undergoing primary surgery: results of a United Kingdom national practice survey.

UK NICE guidelines recommend axillary node clearance (ANC) should be performed in all patients with biopsy-proven node-positive breast cancer having primary surgery. There is, however, increasing evidence such extensive surgery may not always be necessary. Targeted axillary dissection (TAD) may be an effective alternative in patients with low-volume nodal disease who are clinically node negative (cN0) but have abnormal nodes detected radiologically. This survey aimed to explore current management of this group to inform feasibility of a future trial. An online survey was developed to explore current UK management of patients with low-volume axillary disease and attitudes to a future trial. The survey was distributed via breast surgery professional associations and social media from September to November 2022. One survey was completed per unit and simple descriptive statistics used to summarise the results. 51 UK breast units completed the survey of whom 78.5% (n = 40) reported performing ANC for all patients with biopsy-proven axillary nodal disease having primary surgery. Only 15.7% of units currently performed TAD either routinely (n = 6, 11.8%) or selectively (n = 2, 3.9%). There was significant uncertainty (83.7%, n = 36/43) about the optimal surgical management of these patients. Two-thirds (n = 27/42) of units felt an RCT comparing TAD and ANC would be feasible. ANC remains standard of care for patients with low-volume node-positive breast cancer having primary surgery in the UK, but considerable uncertainty exists regarding optimal management of this group. This survey suggests an RCT comparing the outcomes of TAD and ANC may be feasible.

Real-world outcomes in patients with chronic spontaneous urticaria receiving omalizumab: insights from a clinical practice survey

Objective: Chronic spontaneous urticaria (CSU) is a debilitating inflammatory skin condition, often impacting quality of life. International guidelines recommend omalizumab, an anti-immunoglobulin E antibody, for second-line treatment. Our objective was to understand patient characteristics associated with prescription of omalizumab, and assess real-world outcomes in patients with CSU treated with omalizumab. Methods: We analyzed data from the Adelphi Real World CSU Disease Specific Programme™, a cross-sectional survey with retrospective data collection (December 2020–October 2021) from physicians and patients with CSU in the United States. Results: Data from allergists (n = 45), dermatologists (n = 51), and primary care physicians (PCPs; n = 20) were included. At the time of data collection, one-third of patients were receiving omalizumab (n = 220) and 67% were eligible for but not receiving omalizumab (n = 455). Using logistic regression, the odds of receiving omalizumab were higher in patients whose entire bodies were affected by hives [OR = 2.551; 95% CI 1.502-4.333; p < 0.001] or with deteriorating/unstable prognoses at treatment initiation [OR = 2.219; 95% CI 1.031-4.777; p = 0.042], and lower in patients managed by PCPs [OR = 0.276; 95% CI 0.130-0.584; p < 0.001]. Estimates from an inverse probability weighted regression adjustment model indicated that patients receiving omalizumab had higher treatment satisfaction, improvements in itching, hives, angioedema, insomnia, and anxiety, and lower impact on work productivity, compared with patients not receiving omalizumab. Conclusion: Around two-thirds of patients with CSU considered eligible for omalizumab were not receiving the guideline-recommended therapy. Patients receiving omalizumab had better real-world outcomes compared with patients not receiving omalizumab. Ensuring patients receive the most appropriate treatment could benefit patients with CSU.

Postextubation dysphagia management in Danish intensive care units: A national survey.

Postextubation dysphagia (PED) is a common complication to endotracheal intubation in critically ill patients and may lead to pneumonia, prolonged ventilation, longer hospital stays, and increased mortality. Recognizing dysphagia is paramount to preventing adverse events. The aim of this study was to describe PED management by investigating practice in Danish intensive care units (ICUs) focusing on current practice in 2023 (screening, prevention, and treatment), perceived best practice (barriers and facilitators), and when possible, to compare practice in 2017 and 2023. Self-reported, cross-sectional survey of dysphagia practice in Danish ICUs administered from April to May 2023. In addition, data were compared with the 2017 Dysphagia in Intensive Care Evaluation study, when possible. Only half of Danish ICUs reported to have a PED protocol, and less than half routinely screen patients for dysphagia after extubation. Most common screening methods were the oral mechanism examination, water test, and Facio-oral tract therapy. Nurses and physicians often relied on an overall physical assessment of the patient. Best treatment methods were uniformly agreed to be patient positioning, modification of food and fluids, use of ergonomic utensils, and compensatory maneuvers. Key barriers to dysphagia management were lack of specialized staff, under-recognition of dysphagia as a health issue, and lack of standardized protocols. Awareness of PED is increasing and identification, prevention, and treatment is slowly improving, but systematic implementation of protocols for dysphagia screening and treatment could enhance dysphagia management in Danish ICUs.

A method to account for diversity of practices in Conservation Agriculture

Conservation Agriculture (CA) is actively promoted as an alternative farming system that combines environmental, economic, and social sustainability. Three pillars define CA: (i) minimum mechanical soil disturbance, (ii) permanent soil organic cover, and (iii) species diversification. The local context, constraints, and needs of the farmers influence the translation of the pillars into practices. Currently, there is no method for categorizing this diversity of CA practices, which hampers impact assessment, understanding of farmer choices and pathways, stakeholder communication, and policymaking. This paper presents a systematic method to identify and categorize the diversity of CA practices at the regional level, anchored in the three pillars and based on practices implemented by CA farmers. The classification method is grounded on the intersection of an archetypal analysis and a hierarchical clustering analysis. This method was used to study CA practices in Wallonia, Belgium, based on a survey of practices in a sample of 48 farmers. Combining the two clustering methods increases the proportion of classified farmers while allowing for the distinction between three CA-types with extreme and salient practices, and two intermediate CA-types comprising farmers whose practices fall between these references. The study reveals that three explanatory factors influence the implementation of CA practices in Wallonia: (i) the proportion of tillage-intensive crops and (ii) temporary grasslands in the crop sequence, and (iii) the organic certification. These factors lead to trade-offs that hinder the three pillars of CA from being fully implemented simultaneously. This new classification method can be replicated in other regions where CA is practiced, by adapting input variables according to context and local knowledge.

Weaning patients off long-term low dose prednisolone: an international survey of current endocrine practice

Weaning patients off long-term low dose prednisolone: an international survey of current endocrine practice

A survey of the radiation safety practices of veterinary practitioners during portable equine radiography in Ireland.

Veterinary practitioners and other personnel involved in the examination are exposed to ionizing radiation while performing portable radiographs on horses. An online survey was distributed to all Veterinary Council of Ireland-registered practices where the self-reported practice profile is at least 20% equine work. The survey contained questions relating to radiation safety training, protocols, personal dosimetry and lead protection usage, repeat exposures, sedation, and personnel roles during the examination. The aim of the survey was to document the current radiation safety practices of equine veterinary practitioners during portable radiography. The results showed that although adherence to guidance set out by the Environmental Protection Agency (EPA) is reasonably good, compliance rates can be improved. Personal dosemeter usage and repeat rate reduction could particularly benefit from further improvement. This is of the utmost importance in ensuring that occupational radiation exposure to veterinary practitioners is kept to an absolute minimum during their daily practice.

Investigating public understanding and actions regarding Aedes mosquitoes and dengue prevention across altitudinal range in central Nepal.

Dengue fever, transmitted by Aedes mosquitoes, is a significant public health concern in Nepal. An extensive Knowledge, Attitude, and Practice (KAP) survey related to Aedes mosquitoes and the prevention of dengue was conducted along the route from Matihani (62 m asl) to Kalinchok (3840 m asl) in central Nepal. This research examined residents' awareness of Aedes mosquitoes and the diseases they transmit, aiming to support the World Health Organization's national and global fight against mosquito-borne diseases. The survey included 550 participants aged 18-75 years (249 males and 201 females). Door-to-door campaigns were conducted to gather data on knowledge scores, practices, and attitudes about Aedes mosquitoes using a standard structured questionnaire. Findings of this study revealed a moderate level of knowledge across the study area, with a mean knowledge score of 5.525±2.58 (correct answer rate of 46.05%). While 99.6% of respondents were aware of dengue transmission by mosquitoes, only 64.5% were able to report Aedes mosquitoes as the key transmitter. Less than one-third of the participants (27.8%) were familiar with black-and-white stripes in Aedes. Additionally, only 36.7% were knowledgeable about the day-biting behavior of Aedes mosquitoes. This KAP survey provides valuable insights into community understanding of Aedes mosquitoes and dengue prevention practices associated with various Nepalese communities residing in low to high altitudes of Central Nepal. The findings of this study can be adopted to address the increasing health burden faced by the countries with low- to-high altitude regions within the Hindu Kush Himalaya.

Rotator Cuff Rehabilitation: A Survey of Practice in India

Background- Rotator cuff related shoulder pain (RcRSp) and Rotator cuff (RC) tears constitute a significant amount of the caseload of shoulder disorders. Rehabilitation following surgical repair of the cuff is designed according to the stage of healing and has been widely studied with varying opinions on its progression.The present study aimed to describe the practice of rehabilitation following RC repair in India. Study Design - Cross-sectional descriptive survey study Methods- A content validated questionnaire to describe the rehabilitation practice following RC repair was developed and converted into an online survey. Results- We analysed 125 responses from physiotherapists. Majority of the participants commenced passive range of motion (ROM) and scapular exercises in the first week, active ROM in 4-6 weeks. Wide variability exists in commencing glenohumeral strengthening exercises. Conclusion-Rehabilitation practices show variability, with certain similarities to practice in other countries and non-uniform concordance to existing guidelines.

Survey of pharmaceutical industry's best practices around in vitro transporter assessment and Implications for Drug Development: Considerations from the IQ Transporter Working Group.

The IQ Transporter Working Group had a rare opportunity to analyse a cross-pharma collation of in vitro data and assay methods for the evaluation of drug transporter substrate and inhibitor potential. Experiments were generally performed in accordance with regulatory guidelines. Discrepancies, such as not considering the impact of pre-incubation for inhibition and free or measured in vitro drug concentrations, may be due to the retrospective nature of the dataset and analysis. Lipophilicity was a frequent indicator of cross-transport inhibition (P-gp, BCRP, OATP1B and OCT1) with high molecular weight ({greater than or equal to}500 Da) also common for OATP1B and BCRP inhibitors. A high level of overlap in in vitro inhibition across transporters was identified for BCRP, OATP1B1 and MATE1 suggesting that prediction of DDIs for these transporters will be common. In contrast inhibition of OAT1 did not coincide with inhibition of any other transporter. Neutrals, bases, and compounds with intermediate-high lipophilicity tended to be P-gp and/or BCRP substrates whilst compounds with MW <500 Da tended to be OAT3 substrates. Interestingly the majority of in vitro inhibitors were not reported to be followed up with a clinical study by the submitting company, whilst those compounds identified as substrates generally were. Approaches to metabolite testing were generally found to be similar to parent testing with metabolites generally being equally or less potent than parent compounds. However, examples where metabolites inhibited transporters in vitro were identified supporting the regulatory requirement for in vitro testing of metabolites to enable integrated clinical DDI risk assessment. Significance Statement A diverse dataset showed transporter inhibition often correlated with lipophilicity and molecular weight (>500 Da). Overlapping transporter inhibition was identified, particularly that inhibition of BCRP, OATP1B1 and MATE1 was frequent if the compound inhibited other transporters. In contrast inhibition of OAT1 did not correlate with the other drug transporters tested.

HOW MUCH DO HIP ARTHROPLASTIES COST? THE BURDEN AND BUDGET IMPACT OF IMPLANTS AND HIP ARTHROPLASTY ON THE NATIONAL HEALTH SYSTEM FOR ENGLAND AND WALES

Total hip replacement (THR) is one of the most common and cost-effective elective surgical procedures. In the National Health Service (NHS) of England and Wales a myriad of implants for THR are offered at a variety of locally negotiated prices. This study aims to estimate the total burden of elective THR to the NHS, expenditure on implants, and different scenarios of cost changes if implant selection changed for different patient groups.Using National Joint Registry (NJR) data and NHS reference costs, we estimated the number and expenditure of NHS funded primary and revision THR in the 10-year period 2008–2017 and forecasted the number and expenditure on THR over the next decade. Using NJR average NHS Trust prices for the different implant combinations we estimated the average cost of implants used in THRs and estimated the budget impact on NHS providers from switching to alternative implants.The NHS spent over £4.76 billion performing 702,381 THRs between 2008–2017. The average cost of implants was £1,260 per surgery, almost a fifth of the cost of primary THR. Providing cemented implant combinations in primary elective THRs may potentially save up to £281 million over the next 10 years, whilst keeping 10-year revision risks low.The NHS is likely to spend over £5.6 billion providing primary elective THR over the next decade. There are efficiency savings to realise in the NHS by switching to more cost-effective implant combinations available for patients undergoing primary elective THR surgery, but these will need to be balanced against the risks inherent to a change in selection of implants and surgical practice. The HIPPY programme will be conducting practice surveys, discrete choice experiments and a large randomised controlled trial of cemented, uncemented and hybrid fixation in THR for patients under 70 to answer uncertainties.

6301970 Rapid Sequence Induction in Obstetrics: a Survey of Practice across the North East and Cumbria

6301970 Rapid Sequence Induction in Obstetrics: a Survey of Practice across the North East and Cumbria

HOW IS CARDIOPULMONARY EXERCISE TESTING CONDUCTED IN NSW AND ACT?

INTRODUCTION/AIM Cardiopulmonary exercise testing (CPET) is considered the gold standard of assessing functional capacity under stress. Given the growing utility of CPET, understanding the current standards of practice is crucial. However, little is known about CPET accessibility, protocols used, or barriers to testing in NSW and ACT. This study aimed to understand clinical CPET practices and identify possible areas of protocol variability. METHOD 40 hospitals were contacted: 28 in metropolitan Sydney, 9 in regional/remote NSW, and 3 in metropolitan Canberra. Hospitals confirming that they had a CPET service were asked to complete a 28-question survey of CPET practices via Qualtrics. The survey explored testing personnel, medical supervision, protocol design, data reporting, and barriers to CPET. RESULTS Most hospitals (n = 28) did not have a CPET service. Of the 11 sites that performed CPET, respondents were split evenly between adult (n = 6) and paediatric (n = 5) testing capacity. Cycle ergometry (n = 10) was the dominant exercise modality. Most sites reported using ramp (n = 8) rather than stepwise (n = 3) protocols. 73% of sites adapted the test work-rate to facilitate a test duration of 8-12 minutes. 27% used a standard work-rate, regardless of patient presentation or test indication. All sites reported anaerobic threshold-related variables, ECG-related measurements, and Borg scores. CPET endpoints were typically in line with American College of Sports Medicine guidelines (73%). Barriers to CPET included lack of suitable staffing (n = 10), lack of medical availability (n = 4), and space (n = 3). CONCLUSION Despite its value, CPET appears to be underused in NSW/ACT. While consistency in CPET reporting and endpoints was identified, there was variability in protocols across testing sites. This variation has potential to impact consistency and comparability of test results, affecting clinical decision-making.

Knowledge, attitude and practice survey of bacterial contamination of blood for transfusion in the Democratic Republic of the Congo.

We assessed healthcare worker's knowledge-attitude-practice regarding bacterial contamination of blood products in the Democratic Republic of the Congo. In three hospitals and the National Blood Transfusion Center (NBTC), two multiple-choice surveys were completed on a tablet computer: one each, for blood bank (31 questions) and for clinical ward staff (20 questions). A score was calculated for 11 overlapping knowledge questions. Among 247 participants (blood bank No.=62, ward No.=185), median (range) knowledge score was 10 (2-19) on a maximum of 20, with blood bank staff (12/20) scoring higher than clinical ward staff (9/20) (p<0.0001). Half (50.2%) of 247 participants recalled previous training in transfusion medicine. Participants had limited understanding of and compliance with NBTC-recommended preventive measures: incorrect assumption that wearing gloves prevents bacterial contamination (83.8%) and that blood banks test donor blood for bacteria (59.9%). Half (50.0%) of blood bank staff did not acknowledge the NBTC-recommended antisepsis procedure, 62.1% did not apply the appropriate number of antisepsis steps, and 32.3% saw no harm in touching the venipuncture site after antisepsis. Presence of bacteria on healthy skin (62.3%) and blood bank fomites (examination gloves: 30.8%, soap: 62.8%) was underestimated. Although 92.4% of clinical ward staff said to easily recognize transfusion reactions, only 15.7% recognized septic reactions and post-transfusion antibiotic treatment practices were not consistent. Challenges reported by blood bank staff and particular for low-resource settings were: frequent power cuts (98.4%), transport of blood products by patient attendants (41.1%), without cooling elements (64.4%), and reuse of finished antiseptic/disinfectant containers (75.4%). The present study points to gaps in knowledge, attitudes, practices along sampling, cold chain and transfusion which can feed customized training and monitoring.

A survey of current practices in post-polypectomy surveillance in Korea.

We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists. In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed. In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1-2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3-10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1-4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5-10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%-55.1%) discontinued the surveillance at the patient age of 80-84 years. A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

An international survey of contemporary practices towards fertility assessment and preservation in patients undergoing radical inguinal orchidectomy for testicular cancer

AbstractObjectiveThe study aims to assess current international clinician attitudes, practices and barriers towards fertility assessment and preservation in patients undergoing radical inguinal orchidectomy (RIO) for testicular cancer.Materials and methodsAn international online survey of urologists and urologists in training who perform RIO for testicular cancer was developed by the British Association of Urological Surgeons (BAUS) Sections of Andrology and Oncology and the British Urology Researchers in Surgical Training (BURST). The recruitment process used social media and the emailing lists of national urological societies. Responses were collected between 10/02/2021 and 31/05/2021 and stored using password‐protected Research Electronic Data Capture (REDCap) database software. The primary outcome was the proportion of urologists who routinely offer semen cryopreservation prior to RIO. The study was reported according to the Checklist for Reporting Results of Internet E‐Surveys platform.ResultsA total of 393 respondents took part in the online survey; of these, the majority were from the United Kingdom (65.9%), with the remaining international respondents (34.1%) from six different continents, which included 45 different countries. Of the respondents, 57.1% reported that they would routinely offer semen cryopreservation to all patients undergoing RIO for testicular cancer. In addition, 36.0% of urologists routinely performed pre‐operative semen analysis, and 22.1% routinely performed pre‐operative testicular serum hormone profile. Of the respondents, 14.4% performed expedited RIO within 48 h; 31.2% of respondents reported that they considered no delay to RIO to allow for semen cryopreservation to be acceptable.ConclusionsA significant proportion of international urologists do not offer pre‐operative fertility assessment and preservation in men undergoing RIO for testicular cancer. Surgery is performed in an expedited fashion within 1 week in the majority of patients. Urologists perceive there to be a lack of access and availability to fertility services, and that delay to RIO to allow for fertility preservation is often not acceptable.

Behavior Selection Models of Fire Evacuations with the Consideration of Adaptive Evacuation Psychologies

With the acceleration of urbanization, the increasing frequency of building fires has caused a large number of deaths and economic losses. In order to delve into the evacuation route selection behaviors seen in library fires and analyze the impacts of individual evacuation psychologies on route decisions during escaping, based on practical survey data from the library on the Boda campus of Xinjiang University, this study built a mixed Logit (ML) model irrespective of latent psychological variables and a hybrid choice model (HCM) considering the latent variables of adaptive evacuation psychologies to investigate the internal formation mechanism of evacuees’ route decisions. The results indicate that evacuees’ non-adaptive conformity psychology, adaptive altruism psychology, and environmental familiarity have significant impacts on their route decisions. The stronger the evacuees’ non-adaptive inertia psychology, the more they lean towards the shortest route. Meanwhile, altruistic adaptive evacuation psychology has a significant negative impact on the probability of choosing the longest route. The stronger the evacuees’ environmental familiarity, the more they tend to choose the evacuation route with good emergency lighting. Personal socio-economic attributes have varying impacts on peoples’ evacuation route decisions. The findings of our study provide theoretical support for sustainable planning, preparedness, and the design of fire evacuations. This contribution aids in advancing sustainable practices for emergency responses.

Current practices and opinions on auditory training in adult cochlear implant recipients

ObjectiveTo examine current practices and opinions of cochlear implant (CI) providers with respect to post-implantation auditory training. MethodsA survey was submitted to the American Cochlear Implant Alliance membership that reviewed current practice and opinions with respect to post-implantation auditory training for adult CI recipients. Main outcome measuresReview of respondent practice, center volume, role on CI team, and current usage and opinions surrounding auditory training, including resources used and schedule of use. ResultsMost (79 %) of the 79 CI providers surveyed reported working at academic centers, 34 % at high-volume centers (>150 CIs/year), and 38 % were surgeons. Nearly all (99 %) respondents recommend auditory training for new adult CI recipients. Just over half (52 %) provide auditory training resources to the patient in the form of a broad list of patient-directed exercises from which a patient could select. A specific training resource, generally a computer-based auditory training program (e.g., AngelSound™), is recommended to patients by 30 % of the respondents.Regarding timing of rehabilitation, median preferred start time was 0 months (interquartile range [IQR] 0–1) post-activation. Sessions were preferably performed for a median of 3 h per week (IQR 2–4) and continued for a median of 12 months (IQR 6–12).Recommendations for auditory training were fairly consistent between surgeon and non-surgeon providers and by center volume. Non-surgeons more often had specific recommendations on training resources, benefits of music, and training condition (e.g., contralateral ear plugged). ConclusionsDespite a lack of clinical guidelines for adult post-implantation auditory training, a cross-sectional survey of providers' current practices and opinions demonstrates that these services are widely recommended and regarded as valuable. Training is almost universally patient-directed and believed to be most beneficial if started soon after activation. Interestingly, specific recommendations for which training approaches to use are not common, suggesting a gap in provider knowledge of which resources are most efficacious.

Understanding the factors associated with COVID-19 vaccine hesitancy in Venezuela

BackgroundDespite nearly a quarter of Venezuelans remaining unvaccinated against coronavirus disease 2019 (COVID-19), the factors contributing to vaccine hesitancy in the country have not been thoroughly investigated.MethodsA cross-sectional study was conducted from October 15th to 30th, 2022, using a knowledge, attitudes, and practices (KAP) survey to identify factors associated with COVID-19 vaccine hesitancy.ResultsThe study analyzed data from 1,930 participants from all 24 states of Venezuela. The majority (93.4%) were vaccinated. The mean age was 40 years, predominantly female (67.3%), and held a university degree (70.6%). The mean KAP score was significantly higher among vaccinated individuals compared to unvaccinated ones (7.79 vs. 3.94 points for knowledge, 40 vs. 24 points for attitudes, and 16 vs. 10 points for practices, all p < 0.001). Increases in the scores for KAP were associated with increased odds of being vaccinated (84.6%, 25.6%, and 33% respectively for each one-point increase, all p < 0.001). Certain demographic factors such as marital status, occupation, religious beliefs, monthly income, and location influence COVID-19 vaccine knowledge. Higher income and certain occupations decrease the odds of low knowledge, while residing in specific states increases it. Attitudes towards the COVID-19 vaccine are influenced by age, health status, vaccination status, and location. Higher income and absence of certain health conditions decrease the odds of negative attitudes. Lastly, age, occupation, monthly income, and location affect vaccine practices. Advanced age and higher income decrease the odds of inappropriate practices, while residing in La Guaira state increases them.ConclusionFactors such as age, education level, occupation, monthly income, and location were found to be associated with knowledge and attitudes towards COVID-19 vaccine among the surveyed Venezuelans.

Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island

BackgroundRéunion Island is a French overseas territory located in the southern Indian Ocean, with a challenging socioeconomic and multicultural context. Compared to mainland France, Réunion has an overincidence and overmortality of cervical cancer. In order to investigate these two issues, it is important to evaluate the barriers and potential levers to Pap smear screening among female inhabitants of the island. We aimed to identify the specific socio-demographic factors, cultural factors, and living conditions associated with Pap smear screening in Réunion, with a view to increasing uptake.MethodsWe conducted a Knowledge Attitude Behavior and Practices (KABP) survey on cervical cancer screening practices among women aged between 25 and 65 years old living in Réunion Island, selected using random digit dialing sampling. Data were collected using Computer Assistant Telephone Interviews. Weighted chi-squared tests and Student’s t-tests were used to compare women who had up-to-date Pap smear screening with women who did not. Weighted logistic models were used to identify the factors associated with not having up-to-date screening.ResultsA total of 1000 women were included in the study. Of these, 88.1% had a Pap smear test during the previous three years. Factors independently associated with not being up to date were as follows: aged over 55 (AOR 2.3 [1.2–4.3]), no children (AOR 2.5 [1.4–4.3]), having free universal health coverage (AOR 1.7 [1.1–2.7]), an income per unit consumption lower than 1500€ per month (AOR 2.0 [1.1–3.7]), low health literacy (AOR 2.7 [1.7–4.1]), not consulting a general practitioner in the prior 12 months (AOR 3.6 [2.0-6.5]), and a BMI > 30 (AOR 2.6 [1.5–4.4]).ConclusionsThis is the first large-scale survey focusing on recommended Pap smear screening uptake in Réunion Island. Although self-reported screening incidence was higher than in mainland France, national screening policies must take into account the island’s diverse social and cultural characteristics (e.g., an ageing population, low health literacy), while implementing actions to fight against poverty and increase general access to healthcare.