Main Challenges and Actions Needed to Improve Conservation and Sustainable Use of Our Crop Wild Relatives

Crop wild relatives (CWR, plural CWRs) are those wild species that are regarded as the ancestors of our cultivated crops. It was only at the end of the last century that they were accorded a high priority for their conservation and, thus, for many genebanks, they are a new and somewhat unknown set of plant genetic resources for food and agriculture. After defining and characterizing CWR and their general threat status, providing an assessment of biological peculiarities of CWR with respect to conservation management, illustrating the need for prioritization and addressing the importance of data and information, we made a detailed assessment of specific aspects of CWRs of direct relevance for their conservation and use. This assessment was complemented by an overview of the current status of CWRs conservation and use, including facts and figures on the in situ conservation, on the ex situ conservation in genebanks and botanic gardens, as well as of the advantages of a combination of in situ and ex situ conservation, the so-called complementary conservation approach. In addition, a brief assessment of the situation with respect to the use of CWRs was made. From these assessments we derived the needs for action in order to achieve a more effective and efficient conservation and use, specifically with respect to the documentation of CWRs, their in situ and ex situ, as well as their complementarity conservation, and how synergies between these components can be obtained. The review was concluded with suggestions on how use can be strengthened, as well as the conservation system at large at the local, national, and regional/international level. Finally, based on the foregoing assessments, a number of recommendations were elaborated on how CWRs can be better conserved and used in order to exploit their potential benefits more effectively.

Broad Spectrum project: factors determining the quality of antibiotic use in primary care: an observational study protocol from Italy

INTRODUCTION

The overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia.

METHODS AND ANALYSIS

Knowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician.

ETHICS AND DISSEMINATION

The project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community.

The Effect of the COVID-19 Pandemic on Physicians' Use and Perception of Telehealth: The Case of Lebanon

The COVID-19 pandemic forced physicians to quickly adapt and find ways to provide their usual offline services by using online tools. We aimed to understand how physicians adapted to the sudden need for telehealth and if their perception of telehealth changed due to their experience during the COVID-19 pandemic. We conducted an exploratory sequential mixed-methods study. We interviewed five Lebanese physicians and thematically analyzed the interviews. We developed a questionnaire based on the analysis results and administered it online to physicians in Lebanon. In total, 140 responses were collected. We found that, during the COVID-19 pandemic, physicians engaged in more telehealth activities in the realms of telemedicine, public awareness, continuing medical education, research, administration, and teaching. They also expanded their repertoire of information-technology tools. Our results also show that there was a significant shift in the physicians' perceptions, indicating greater openness and willingness to adopt telehealth services. However, a significant amount of skepticism and uncertainty regarding telemedicine remains, especially concerning its efficiency, safety, and the adequacy of existing regulations. Based on our findings, we offer recommendations for health IT policy makers, developers, and researchers, to sustain the continuity of telehealth activities beyond the COVID-19 pandemic.

Nurses' Viewpoints on Barriers and Facilitators to Use Hospital Information Systems

In this qualitative study, we explored the nurses' experience in using hospital information systems (HIS) to identify barriers and facilitators of using this system. We interviewed twenty one purposefully-selected nurses who have experience in using HIS and analyzed the data using conventional content analysis. We identified 17 facilitators and 12 barriers classified into main themes. Lack of support for nurses, their resistance, any force for using HIS, perceived difficulty of using HIS, inadequate system quality, data loss, discontinuity of information in different systems are the main barriers. However, considering nurses' perspectives, pilot implementation of HIS, training, planned implementation, appropriate financial and non-financial incentives, adding new and appropriate functionalities, increased ease of use and usability, easy access to information, improved data quality in HIS, and saving nurses' working time through using HIS result in increased adoption the system to use.

An observational study demonstrating the adherence and ease of use of the injector device, RebiSmart®

Background: Adherence to Multiple Sclerosis (MS) treatment is considered one of the crucial factors for ensuring optimal clinical outcomes. Research has shown that the use of self-injector devices improves patient compliance with treatment. Therefore, the main purpose of this study is to evaluate the ease of use of RebiSmart® 2.0 in clinically isolated syndrome/relapsing-remitting MS patients during 12 months treatment period.Methods: A total number of 290 subjects entered into data collection; 249 (86%) of them completed the whole 12 months study period. The primary endpoints and the secondary endpoints were assessed by the User Study Questionnaire. Adherence data were retrieved from RebiSmart® 2.0 (Menu - Dose History) on the respective patient's visit. Outcome measures also included Expanded Disability Status Score, Kurtzke Functional Systems, and Modified Social Support Survey, Modified Social Support Survey-5.Results: This study demonstrated a very high proportion (>95%) of patients with a positive rating of the overall ease of use and the overall convenience of RebiSmart®. The proportion of patients with a positive rating of the ease of use by individual domains and the functions of RebiSmart® were also high (>80%).Conclusion: The findings demonstrate a very good perception of the usability of the device by patients overall and in its individual functions.

Inequalities Between Migrants and Non-Migrants in Accessing and Using Health Services in Greece During an Era of Economic Hardship

A cross-sectional study was conducted from April 2013 until March 2014 to explore the existence of inequalities in access to and utilization of health services by migrants compared to non-migrants in Greece and to test the influence of various factors on these disparities. Also, we investigated the influence of several socioeconomic and demographic characteristics. Study population included 1,152 migrants and 702 non-migrants. Migrants, participants suffering from a chronic disease, those without health insurance, and patients who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in getting their medication. Uninsured participants, females, those unemployed or without a permanent occupational status, and those who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in access to health services during the last year. Regarding the use of health services, those with health coverage, non-migrants, and females were statistically more likely to go for a blood test as a hospital outpatient. Greece, despite administrative delays and barriers, provided full coverage to the uninsured, asylum seekers, and migrants, even many groups of undocumented migrants.

Hall Technique for Carious Primary Molars: A Review of the Literature

The high frequency of caries in primary teeth and its inadequate treatment are major public health problems during childhood. Nowadays, the Hall technique is one of the methods used for biological sealing in carious lesions in primary molars. Thus, the bacteria will be sealed from oral environment and the caries will be inactive. The objective of this article was to provide an updated search on the Hall technique description, indication, contraindication, advantages, concerns, success and failure, cost-effectiveness, acceptability, and preference in pediatric dentistry, and to compare the Hall technique with traditional crown preparation and conventional treatment options for carious primary molars. A discussion of the recently published articles on the Hall technique reveals that the Hall technique is considered a promising restorative option with high acceptability and longevity; with low failure rate for managing carious primary molars compared to conventional treatment modalities used in primary care settings. Furthermore, the survival rate of stainless steel crowns (SSCs) is considered high, whether provided using Hall technique or traditional preparation by a pediatric dentist. Thus, the Hall technique can be an effective addition to the clinician’s range of treatment options for carious primary molars. However, it should be chosen in restricted cases.

Addressing Inequity: Evaluation of an Intervention to Improve Accessibility and Quality of a Green Space

Green space areas offer several benefits that support our physical, psychological, and social health. However, the level of engagement with green space areas may not be the same across population groups. Using a mixed-method research design, we investigated the use of a green space area and whether and how the area was beneficial for health, social inclusion, and physical activity for all socioeconomic groups in a suburban area in Norway. The study showed significantly increased use of the area from 2015-2018 and that users belonged to different socioeconomic groups. The motivation for using the area was the opportunity to experience nature and to interact socially. While no significant changes in self-rated health, life satisfaction, or levels of physical activity were found, the study indicates that factors such as location, availability, and designated places for social interaction are important motivating factors for use. Users from the lower socioeconomic groups were among the frequent users but were also the least satisfied with the quality and availability of the path. Our findings call for closer consideration of the location and availability of green spaces and that including places for social interaction and relaxation can contribute to increased use of green spaces.

An Electronic Health Tool to Prepare for the First Orthopedic Consultation: Use and Usability Study

Background

The use of electronic health (eHealth) technology to prepare patients with hip or knee osteoarthritis (OA) for their first orthopedic consultation seems promising. Exploration of the use and usability of an educational eHealth tool may highlight potential modifications that could increase patient engagement and effectiveness.

Objective

This study aimed to (1) identify the use and usability of a stand-alone educational eHealth tool for patients with suspected hip or knee OA, (2) explore whether the recorded questions in the eHealth tool were in line with an existing widely used question prompt list, and (3) investigate whether user characteristics are related to use and usability.

Methods

We used data from 144 participants in the intervention group of a randomized controlled trial, who were asked to use the educational eHealth tool to prepare for their upcoming first orthopedic consultation. We defined users and nonusers based on whether they had opened the tool at least once. Users were characterized as active or superficial depending on the extent of their use of the tool. The recorded questions for the consultation preparation were categorized into themes fitting 3 predefined questions or in a remaining category. Usability was measured using the System Usability Scale (SUS, 0-100). Data were collected including the patient demographic and clinical characteristics, knowledge of OA, and internet and smartphone usage in daily life. The characteristics associated with users and nonusers were analyzed using a multivariable logistic regression analysis.

Results

A total of 116/144 (80.6%) participants used the educational eHealth tool, of whom 87/116 (75.0%) were active users. Of the three components of the tool (information, my consultation, and medication), medication was the least used (34%). On the basis of recorded questions of the users, the fourth predefined question could be proposed. The mean (SD) SUS score was 64.8 (16.0). No difference was found between the SUS scores of superficial and active users (mean difference 0.04, 95% CI −7.69 to 7.77). Participants with a higher baseline knowledge of OA (odds ratio [OR] 1.2, 95% CI 1.0 to 1.4) and who used the internet less frequently in their daily life (OR 0.6, 95% CI 0.5 to 0.9) were more likely to use the educational eHealth tool. We found no differences between the demographics and clinical characteristics of the superficial and active users.

Conclusions

Based on the results of this study, it can be concluded that the use of an educational eHealth tool to prepare patients with hip and knee OA for the first orthopedic consultation is feasible. Our results suggest some improvements that should be made to the content of the tool to improve its usability. No clear practical implications were found to support the implementation of the educational eHealth tool in specific subgroups.

Trial Registration

Netherlands Trial Register NTR6262; https://www.trialregister.nl/trial/6262

Antibiotic Use: A Cross-Sectional Study Evaluating the Understanding, Usage and Perspectives of Medical Students and Pathfinders of a Public Defence University in Malaysia

Background: Antimicrobial prescribing behaviors are often influenced by the local culture and prescribing appropriateness of medical doctors and other health care professionals. Globally, antimicrobial utilization practices have a profound impact on antimicrobial resistance and are a tremendous public health concern. The aim of this survey was to explore the knowledge and attitudes of medical students from the National Defence University of Malaysia regarding antimicrobial usage and antimicrobial resistance. Research design and methods: This was a cross-sectional study. The study population consisted of undergraduate medical students in each year group from the National Defence University of Malaysia. Students receive limited formal training on the use of antibiotics in their curriculum, and most of this learning is opportunistic whilst on clinical placement. Universal sampling was used as the study population was small. Data were collected utilizing a previously validated instrument regarding antibiotic use. Simple descriptive statistics were used to generate frequencies and percentages with SPSS V21. This research was approved by the Centre for Research and Innovation Management, National Defence University of Malaysia. Results: 206 questionnaires were distributed with a response rate of 99.03%, 54% (110) male, and 46% (94) female. Out of the respondents, 65% (132) had used antibiotics in the last year. Respondents displayed a moderate level of knowledge about antibiotics. Conclusions: This study revealed that the older the student was, or when the year of study and total knowledge score was higher, the students were less likely to stop antimicrobials when they felt better or use leftover antibiotics without consulting a doctor. Therefore, the nearer the students were to graduation, the better their knowledge and skills were, and this translated into their own behaviors regarding use of antimicrobials. This finding has clear implications for curriculum design and the inclusion of formal teaching throughout the medical program on antimicrobial use and antimicrobial resistance (AMR). However, more research is needed on this topic, including the prescribing habits and antibiotic use of practicing doctors.

Parental Adverse Childhood Experiences and Pediatric Healthcare Use by 2 Years of Age

OBJECTIVE

To determine whether maternal and paternal exposure to adverse childhood experiences (ACEs) has an association with offspring healthcare use by 2 years of age.

STUDY DESIGN

A retrospective cohort study was performed on 454 patients at a large suburban pediatric primary care practice whose mother (n = 374) or father (n = 156) or both (n = 123) completed an ACE survey between October 2012 and June 2014. The association between self-reported parental ACEs and healthcare use by 2 years of age, including number of missed well-child visits, sick visits, and delayed or missed immunizations, was modeled using multivariable negative binomial regression. All analyses adjusted for child sex, payer source, and preterm birth.

RESULTS

Maternal, but not paternal, ACE exposure was significantly associated with missed well-child visits by 2 years of age. For each additional maternal ACE, there was a significant 12% increase in the incidence rate of missed well-child visits (relative risk, 1.12; 95% CI, 1.03-1.22; P = .010). Maternal and paternal ACE scores were not significantly associated with increased sick visits or delayed or missed immunizations.

CONCLUSIONS

The ACE exposure of mothers is negatively associated with adherence to preventive healthcare visits among their children early in life. Future research is needed to elucidate the mechanisms of this association and to develop and implement family-based intervention strategies.

Do UK sheep farmers use orf vaccine correctly and could their vaccination strategy affect vaccine efficacy?

Orf, a parapoxvirus, is a zoonosis causing a contagious pustular dermatitis, and has a high morbidity in sheep worldwide. Despite a vaccine being available, orf prevalence in England is estimated to be 2 per cent in ewes and 20 per cent in lambs​​. There is concern that farmers are not complying with the vaccination guidelines and therefore the objective of this study was to investigate if orf vaccine is used correctly on sheep farms in the UK and to identify barriers and motivators of sheep farmers to use the vaccine. The survey was completed by 570 respondents. The results show several areas of concern; only 27 per cent of respondents used the correct site (axilla), 37 per cent of respondents would use orf vaccine up to a week after opening a vial (shelf life is eight hours), 33 per cent of respondents would vaccinate their ewes too close to lambing and 73 per cent of respondents did not separate vaccinated and non-vaccinated animals (both leading to infection risk for non-vaccinated animals). When vaccinating, only 53 per cent of respondents were wearing gloves and 31 per cent washed their hands just before and immediately after vaccination. Results demonstrate that orf vaccination is not carried out correctly on all UK sheep farms, which is likely to affect vaccine efficacy. A concern around vaccine efficacy, the 'hassle' of the scratch administration, the 'risk of making it worse' and the zoonotic risk when vaccinating were the most common barriers for using orf vaccine, highlighting the importance of veterinary advice when prescribing orf vaccine.

Interoperable Electronic Health Records and Health Information Exchanges: Systematic Review

Background

As the availability of interoperable electronic health records (iEHRs) or health information exchanges (HIEs) continues to increase, there is greater need and opportunity to assess the current evidence base on what works and what does not regarding the adoption, use, and impact of iEHRs.

Objective

The purpose of this project is to assess the international evidence base on the adoption, use, and impact of iEHRs.

Methods

We conducted a systematic review, searching multiple databases—MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)—with supplemental searches conducted in Google Scholar and grey literature sources (ie, Google, Grey Literature Report, and OpenGrey). All searches were conducted in January and February 2017. Articles were eligible for inclusion if they were published in English, were published from 2006 to 2017, and were either an original research study or a literature review. In order to be included, articles needed to focus on iEHRs and HIEs across multiple health care settings, as well as on the impact and effectiveness of iEHR adoption and use.

Results

We included 130 articles in the synthesis (113 primary studies, 86.9%; 17 reviews, 13.1%), with the majority focused on the United States (88/130, 67.7%). The primary studies focused on a wide range of health care settings; the three most prevalent settings studied included acute care (59/113, 52.2%), primary care (44/113, 38.9%), and emergency departments (34/113, 30.1%). We identified 29 distinct measurement items in the 113 primary studies that were linked to 522 specific measurement outcomes. Productivity and quality were the two evaluation dimensions that received the most attention, accounting for 14 of 29 (48%) measurement items and 306 of 522 (58.6%) measurement outcomes identified. Overall, the majority of the 522 measurement outcomes were positive (298/522, 57.1%). We also identified 17 reviews on iEHR use and impact, 6 (35%) that focused on barriers and facilitators to adoption and implementation and 11 (65%) that focused on benefits and impacts, with the more recent reviews finding little generalizable evidence of benefit and impact.

Conclusions

This review captures the status of an evolving and active field focused on the use and impact of iEHRs. While the overall findings suggest many positive impacts, the quality of the primary studies were not evaluated systematically. When broken down by specific measurement item, the results directed attention both to measurement outcomes that were consistently positive and others that were mostly negative or equivocal.

Occurrence of Fipronil in residential house dust in the presence and absence of pets: a hint for a comprehensive toxicological assessment

The presence of the insecticide Fipronil and its main products of toxicological relevance, namely Sulfone and Desulfinyl, was assessed in 161 residential house dust samples in the absence (N = 101) and presence (N = 60) of cats and dogs in Italy. High-resolution mass spectrometry analysis revealed a significant difference (p < 0.001) in the dust contamination in the presence of pets (median: 467 vs. 24 ng/g dry weight), even if the highest value was found in the absence of pets (82,069 vs. 67,799 ng/g dry weight). Fipronil intake estimates from dust in toddlers, computed according to US-EPA and EU-ECHA guidelines, ranged from 333 to 556 and from 20 to 34 ng/kg per day for acute and chronic scenario, respectively. Dust seemed not able itself to lead to Fipronil overexposure with respect to acute and chronic toxicity health-based guidance values. Kittens were potentially overexposed to Fipronil under both acute (26,076 ng/kg per day) and chronic (1,633 ng/kg per day) scenarios. The mild symptomatology associated with acute intoxication could possibly determine case underreporting within pharmacosurveillance schemes. Its administration was estimated in 7.3-9.7 tons per year. Such a range suggests its prudent use under strict veterinary control to prevent pest resistance and ecotoxicological outcomes.

The dawn of phage therapy

Bacteriophages or phages, being the most abundant entities on earth, represent a potential solution to a diverse range of problems. Phages are successful antibacterial agents whose use in therapeutics was hindered by the discovery of antibiotics. Eventually, because of the development and spread of antibiotic resistance among most bacterial species, interest in phage as therapeutic entities has returned, because their noninfectious nature to humans should make them safe for human nanomedicine. This review highlights the most recent advances and progress in phage therapy and bacterial hosts against which phage research is currently being conducted with respect to food, human, and marine pathogens. Bacterial immunity against phages and tactics of phage revenge to defeat bacterial defense systems are also summarized. We have also discussed approved phage-based products (whole phage-based products and phage proteins) and shed light on their influence on the eukaryotic host with respect to host safety and induction of immune response against phage preparations. Moreover, creation of phages with desirable qualities and their uses in cancer treatment, vaccine production, and other therapies are also reviewed to bring together evidence from the scientific literature about the potentials and possible utility of phage and phage encoded proteins in the field of therapeutics and industrial biotechnology.

Design and development of the BD Odon DeviceTM : a human factors evaluation process

OBJECTIVE

To (1) determine how intended users interact with and use the BD Odon Device in simulation, (2) use these findings to alter progressively the design of the BD Odon Device and (3) validate that these changes have improved the ability of practitioners to use the BD Odon Device.

DESIGN

Human factors evaluation study.

SETTING

Simulation suite designed to mimic delivery room.

POPULATION OR SAMPLE

Three hundred and ninety simulated operative births, performed by 100 practising clinicians.

METHODS

Simulated operative vaginal births performed using the BD Odon Device and the device Instructions for use were subjected to three formative human factors evaluations and one human factors validation test. Following each evaluation, findings were reviewed and the design of the BD Odon Device and Instructions for use were modified.

MAIN OUTCOME MEASURES

Successful performance of an operative vaginal birth using the BD Odon Device in accordance with provided training and Instructions for use.

RESULTS

Using version two of the BD Odon Device, and following exposure to face-to-face training and written instructions, 25% of accouchers were able successfully to perform a simulated operative vaginal birth. In the final evaluation, following device design and training material alterations, all accouchers were able successfully to perform a simulated operative vaginal birth using version four of the BD Odon Device.

CONCLUSIONS

Human factors evaluations have enabled a multi-professional device and training materials design team to alter the design of the BD Odon Device and the Instructions for use in an evidence-based fashion. This process has resulted in a device which has a predictable and likely safe pattern of use.

TWEETABLE ABSTRACT

Human Factors evaluations help make the BD Odon Device safe and usable for clinical practice.

Effect of Lactamase Inhibitors on the Biosensor Penp during the Measurement of Lactam Antibiotics Concentration

PenP is a fluorescent biosensor of lactam antibiotics (LA). It is structurally derived from the mutant lactamase TEM-1 comprising the substitution E166C, where fluorescein is covalently linked to cysteine. The presence of LA in the medium produces a change in the intrinsic fluorescence level of the biosensor, and the integral of the fluorescence level over time correlates directly with the LA concentration. Previously, we have successfully used PenP to determine the concentration of lactam antibiotics in clinical samples. The use of lactamase inhibitors (LI) is a common strategy to enhance the effect of LA due to the inhibition of an important resistance mechanism of pathogenic microorganisms. Structurally, LI and LA share the common element of recognition of lactamases (the lactam ring), but they differ in the reversibility of the mechanism of interaction with said enzyme. Because the biological recognition domain of PenP is derived from a lactamase, LI is expected to interfere with the PenP detection capabilities. Surprisingly, this work provides evidence that the effect of LI is marginal in the determination of LA concentration mediated by PenP.

Predictors of sleeping under cost-free mosquito bed nets among children under-five years in Mbarara, Uganda: a household survey

BACKGROUND

In 2010, Uganda Malaria Control Programme distributed cost-free mosquito bed nets to households with children under-five years and pregnant women in selected sub-counties. We assessed the factors associated with sleeping under costfree mosquito nets among children under-five years in Nyakayojo sub-county, Mbarara District, Uganda.

METHODS

381 households with at least a child under-five years and benefited from cost-free bed nets in Nyakayojo were randomly selected. Caregivers of children were interviewed using a questionnaire.

RESULTS

74% children slept under bed nets a night before the study. Children from households with ≥2 nets [aOR=1.75; 95% CI: 1.09-2.81, p=0.02], female caregiver [aOR=2.11; 95% CI: 1.16-3.79, p=0.01] and children from households that did not face problems (skin irritation, torn nets, suffocation, night sweating, nasal congestion and candle fire) when sleeping under bed nets [aOR=1.81; 95% CI: 1.10-2.98, p=0.02] were more likely to use nets. Main reason for not sleeping under a net was damage to the net (47.1%).

CONCLUSION

The proportion of children sleeping under nets was comparable to MDG target. Improvements in use of mosquito nets by children can be achieved through increasing number of nets in a household.

Knowledge and attitude about emergency contraception among Saudi women of childbearing age

Context

Emergency contraception (EC) use is rare in Saudi Arabia.

Aims

The aim of this study is to determine the knowledge, attitude, and practice of EC among Saudi women of childbearing age.

Settings and Design

This study is a cross-sectional descriptive study using a survey questionnaire tool.

Materials and Methods

We conducted a survey of married women of childbearing age (18-45 years) attending the Obstetrics and Gynecology Clinic at Riyadh, Saudi Arabia between January and April 2018.

Statistical Analysis Used

Pearson's Chi-square test is used for this study.

Results

This study included 370 of 525 (70.5%) women, with a mean age of 32.3 ± 6.3 years. Of these, 117 (31.6%) knew how to prevent pregnancy after unprotected sex, and 62 knew about EC. Forty-two women (67.7%) thought EC should be widely advertised, and 30 (48.4%) thought it should be made available even without prescription. Forty-seven women (75.8%) said that they were not shy to ask for EC, and 37 (59.7%) claimed that both partners should decide about the use of EC. The most common reason for not using EC was medical concerns (n = 30, 48.4%). Thirty three (53.2%) of the 62 women with knowledge about EC would use it immediately after sex. Knowledge, awareness, and use of EC were significantly correlated with higher monthly income, educated women, having three or more children, and working women.

Conclusions

Among Saudi women, knowledge, awareness, and use of EC remain low, although a positive attitude for future use of EC exists. Health information campaigns are necessary to reach women, particularly those of low socioeconomic status, less educated women, and housewives to explain EC, its availability, and its proper use.

Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study

BACKGROUND

Excessive use of various electronic entertainment and communication devices, particularly among children, has been associated with increased behavioral problems. Despite children's escalating use of these devices, parents' awareness about the impact thereof is still lacking.

OBJECTIVE

The objective of this study was to assess the use of electronic entertainment and communication devices among children attending a health care facility in Jeddah, Saudi Arabia, as well as the parental impression regarding the impact of electronic devices use on the behavior of their child.

METHODS

A focused 15-item questionnaire was designed for this cross-sectional study involving mothers of children attending the Well Baby Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from July 1, 2016 to November 30, 2016.

RESULTS

This study included 190 mothers. The mean ages of the children, mothers, and fathers were 7.3 (SD 3.5), 35 (SD 6.5), and 43 (SD 8.3) years, respectively. Most children were of Saudi Arabian nationality (106/190, 55.8%). The most used device in this study was television (154/190, 81.0%), followed by mobile phones (134/190, 70.5%), and tablets (116/190, 61.0%). Computers were the least used device in this study (59/190, 31.0%). In total, 24.7% (47/190) of children in this study used electronic entertainment and communication devices for more than 4 hours per day. Most mothers (129/190, 67.9%) felt that their child spends too much time on electronic devices. Hyperactivity or behavioral problems were reported by 20.0% (38/190) of mothers in this study. Children spending longer hours on electronic devices were much more likely to be perceived to suffer from hyperactivity or behavioral problems (P=.01).

CONCLUSIONS

Parental awareness is necessary to counteract the harmful effects of using electronic devices for a prolonged period. Parents require help to cope with this problem effectively.

Opinion and use of contraceptives among medical students of the University of Nigeria, Enugu campus

Background

Non-use or poor usage of any form of contraception increases the chances of unwanted pregnancies, abortion and sexually transmitted infections (STIs), including HIV/AIDS occurring with attendant problems. The knowledge of, and the appropriate use of contraceptives will reduce the prevalence of unwanted pregnancies and unsafe induced abortion as well as limit incidence of STIs and associated complications.

Objectives

Determination of the opinion and use of contraceptives; to examine the socio-demographics, knowledge and attitude towards contraception and contraceptive use among medical undergraduates in the University of Nigeria, Enugu campus.

Methodology

A cross-sectional study. Stratified probability sampling technique was employed using the different medical classes as strata. Individuals were subsequently chosen at random until a statistically determined sample size was achieved. Statistical Package for Social Sciences (SPSS version 20) software was utilized for data analysis.

Results

Our study found a statistically significant relationship between sex and contraceptive use. It was also statistically deduced that knowledge of possible contraceptives failure negatively impacts on opinion with regards to contraceptive use.

Conclusion

Positive opinion towards contraceptives will go a long way to encourage proper and effective contraceptives use. This can be achieved by utilizing counseling by health workers.

The impact of motives for Facebook use on Facebook addiction among ordinary users in Jordan

BACKGROUND

Facebook has become the most popular social networking site with more than 2.07 billion monthly active users. However, this popularity has its pains too reflected by some addictive behavior among its users. Although researchers have recently started to examine the factors that influence Facebook addiction, little research examined the links between motives for Facebook use and Facebook addiction. These studies mainly concentrate on students too. Also, little research has explored this issue among general public in general and among people in Jordan in particular.

AIMS

This study therefore examined the impact of motives for Facebook use on Facebook addiction among ordinary users in Jordan.

METHOD

A sample of 397 ordinary users is employed to achieve the study objective.

RESULTS

Results showed that 38.5% of the participants were addicted to Facebook. Facebook addiction was significantly associated with six motives, namely exhibitionism and companionship, entertainment, escapism and passing time, social curiosity, relationships formation and relationships maintenance.

CONCLUSION

Among these six motives, escapism and passing time, exhibitionism and companionship, and relationships maintenance were the strong predictors of Facebook addiction.

Risk Factors for Opioid Use Disorders in Adult Postsurgical Patients

The use of opioids in the treatment of chronic pain is one of the most controversial topics in medicine today. Many studies have proposed that the postoperative period is a vulnerable time for patients at risk for developing an opioid use disorder. Many patients are prescribed opioids for management of their postsurgical pain and continue using them for prolonged amounts of time following their surgeries. Some populations are more likely to develop an opioid use disorder following exposure to opioid medications than others. In this review, the authors discuss the patient-level risk factors for the abuse of these drugs in postsurgical patients.

Cancer and Complementary Therapies: Current Trends in Survivors' Interest and Use

Background. Cancer survivors use complementary therapies (CTs) for a variety of reasons; however, with interest and use reportedly on the rise and a widening range of products and practices available, there is a need to establish trends in and drivers of interest. We aimed to determine (1) frequencies of use, level of interest, and barriers for 30 specific CTs and (2) whether physical symptoms, perceived stress (PS), or spiritual well-being were related to interest levels. Method. A total of 212 cancer outpatients were surveyed at the Tom Baker Cancer Centre in Calgary, Canada. Results. Overall, up to 75% of survivors already used some form of CTs since their diagnosis. The most highly used were the following: vitamins B12 and D, multivitamins, calcium, and breathing and relaxation exercises. Those who had not used CTs indicated highest interest in massage, vitamin B12, breathing and relaxation, mindfulness-based stress reduction, and antioxidants. The most frequently reported barriers for all CTs were not knowing enough about what a therapy was and not having enough evidence on whether it worked. High PS predicted higher interest for all CTs, but spirituality was not significantly related to any. Physical symptoms, anxiety, and depression were significant predictors of interest for some CTs. Conclusion. These findings provide a blueprint for future clinical efficacy trials and highlight the need for clinical practice guidelines.