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Ashraf AR, Mackey TK, Fittler A. Search Engines and Generative Artificial Intelligence Integration: Public Health Risks and Recommendations to Safeguard Consumers Online. JMIR Public Health Surveill 2024; 10:e53086. [PMID: 38512343 PMCID: PMC10995787 DOI: 10.2196/53086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/27/2023] [Accepted: 01/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious public health risks by dispensing substandard or falsified medicines. Search engine providers have started integrating generative artificial intelligence (AI) into search engine interfaces, which could revolutionize search by delivering more personalized results through a user-friendly experience. However, improper integration of these new technologies carries potential risks and could further exacerbate the risks posed by illicit online pharmacies by inadvertently directing users to illegal vendors. OBJECTIVE The role of generative AI integration in reshaping search engine results, particularly related to online pharmacies, has not yet been studied. Our objective was to identify, determine the prevalence of, and characterize illegal online pharmacy recommendations within the AI-generated search results and recommendations. METHODS We conducted a comparative assessment of AI-generated recommendations from Google's Search Generative Experience (SGE) and Microsoft Bing's Chat, focusing on popular and well-known medicines representing multiple therapeutic categories including controlled substances. Websites were individually examined to determine legitimacy, and known illegal vendors were identified by cross-referencing with the National Association of Boards of Pharmacy and LegitScript databases. RESULTS Of the 262 websites recommended in the AI-generated search results, 47.33% (124/262) belonged to active online pharmacies, with 31.29% (82/262) leading to legitimate ones. However, 19.04% (24/126) of Bing Chat's and 13.23% (18/136) of Google SGE's recommendations directed users to illegal vendors, including for controlled substances. The proportion of illegal pharmacies varied by drug and search engine. A significant difference was observed in the distribution of illegal websites between search engines. The prevalence of links leading to illegal online pharmacies selling prescription medications was significantly higher (P=.001) in Bing Chat (21/86, 24%) compared to Google SGE (6/92, 6%). Regarding the suggestions for controlled substances, suggestions generated by Google led to a significantly higher number of rogue sellers (12/44, 27%; P=.02) compared to Bing (3/40, 7%). CONCLUSIONS While the integration of generative AI into search engines offers promising potential, it also poses significant risks. This is the first study to shed light on the vulnerabilities within these platforms while highlighting the potential public health implications associated with their inadvertent promotion of illegal pharmacies. We found a concerning proportion of AI-generated recommendations that led to illegal online pharmacies, which could not only potentially increase their traffic but also further exacerbate existing public health risks. Rigorous oversight and proper safeguards are urgently needed in generative search to mitigate consumer risks, making sure to actively guide users to verified pharmacies and prioritize legitimate sources while excluding illegal vendors from recommendations.
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Affiliation(s)
- Amir Reza Ashraf
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Tim Ken Mackey
- Global Health Program, Department of Anthropology, University of California, La Jolla, CA, United States
- Global Health Policy and Data Institute, San Diego, CA, United States
- S-3 Research, San Diego, CA, United States
| | - András Fittler
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
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Huberty J, Beatty CC, Yourell J. Using science as a differentiator in a crowded digital mental health market. Front Digit Health 2024; 5:1306527. [PMID: 38259255 PMCID: PMC10800404 DOI: 10.3389/fdgth.2023.1306527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
The digital mental health industry has seen remarkable growth in recent years. However, within this crowded landscape, many companies overlook a critical factor for gaining a competitive edge: the integration of science. In this context, "science" refers to the strategic collection and analysis of information (i.e., data) at digital mental health companies, aimed at guiding business decisions and achieving business objectives. This paper demonstrates that science is integral, yet underutilized in the digital mental health industry, with common misconceptions about its role. When science is integrated within a company, it enables them to (1) innovate, (2) understand customers, (3) make informed decisions, and (4) drive revenue. Digital mental health companies recognizing the multifaceted value of science may be better equipped for sustainable growth and success amid the crowded digital health market.
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Ersöz S, Nissen A, Schütte R. Risk, Trust, and Emotion in Online Pharmacy Medication Purchases: Multimethod Approach Incorporating Customer Self-Reports, Facial Expressions, and Neural Activation. JMIR Form Res 2023; 7:e48850. [PMID: 38145483 PMCID: PMC10775049 DOI: 10.2196/48850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Online pharmacies are used less than other e-commerce sites in Germany. Shopping behavior does not correspond to consumption behavior, as online purchases are predominantly made for over-the-counter (OTC) medications. OBJECTIVE The objective of this study was to understand the purchasing experiences of online pharmacy customers in terms of critical factors for online pharmacy adoption. METHODS This study examined the perceived risk, perceived trust, and emotions related to purchasing medications online and, consequently, the purchase intention toward online pharmacies. In a within-subjects design (N=37 participants), 2 German online pharmacies with different perceptions of risk and trust were investigated for their main business, namely OTC and prescription drugs. The results of a preliminary study led to 1 online pharmacy with high and 1 with significantly low self-reported risk by the prestudy sample. Emotions were measured with a multimethod approach during and after the purchase situation as follows: (1) neural evaluation processes using functional near-infrared spectroscopy, (2) the automated direct motor response during the use of the online pharmacy via facial expression analysis (FaceReader), and (3) subjective evaluations through self-reports. Following the shopping experiences at both pharmacies for both product types, risk, trust, and purchase intention toward the pharmacies were assessed using self-assessments. RESULTS The 2 online pharmacies were rated differently in terms of risk, trust, emotions, and purchase intention. The high-risk pharmacy was also perceived as having lower trust and vice versa. Significantly stronger negative emotional expressions on customers' faces and different neural activations in the ventromedial prefrontal cortex and dorsomedial prefrontal cortex were measured when purchasing prescription drugs from the high-risk pharmacy than from the low-risk pharmacy, combined with OTC medications. In line with this, customers' self-ratings indicated higher negative emotions for the high-risk pharmacy and lower negative emotions for the low-risk pharmacy. Moreover, the ratings showed lower purchase intention for the high-risk pharmacy. CONCLUSIONS Using multimethod measurements, we showed that the preceding neural activation and subsequent verbal evaluation of online pharmacies are reflected in the customers' immediate emotional facial expressions. High-risk online pharmacies and prescription drugs lead to stronger negative emotional facial expressions and trigger neural evaluation processes that imply perceived loss. Low-risk online pharmacies and OTC medications lead to weaker negative emotional facial expressions and trigger neural evaluation processes that signify certainty and perceived reward. The results may provide an explanation for why OTC medications are purchased online more frequently than prescription medications.
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Affiliation(s)
- Semra Ersöz
- Institute for Marketing and Retail, Faculty of Economic Sciences, University of Duisburg-Essen, Essen, Germany
| | - Anika Nissen
- Institute for Business Administration, Faculty of Economic Sciences, University of Hagen, Hagen, Germany
| | - Reinhard Schütte
- Institute for Computer Science and Business Information Systems, Faculty of Economic Sciences, University of Duisburg-Essen, Essen, Germany
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Mitangala PN, Irenge LM, Musubao ET, Kahindo JBM, Ayonga PN, Kyembwa Safari I, Kubuya JB, Ntabe EN, Kabangwa Senga RK, Mutombo GN, Ambroise J, Gala JL. Prevalence of anti-SARS-CoV-2 antibodies in people attending the two main Goma markets in the eastern Democratic Republic of the Congo. Epidemiol Infect 2023; 151:e167. [PMID: 37724000 PMCID: PMC10600894 DOI: 10.1017/s0950268823001498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/20/2023] Open
Abstract
The Democratic Republic of the Congo (DRC) officially reports low coronavirus disease 19 (COVID-19) prevalence. This cross-sectional study, conducted between September and November 2021, assessed the COVID-19 seroprevalence in people attending Goma's two largest markets, Kituku and Virunga. A similar study in a slum of Bukavu overlapped for 1 month using identical methods. COVID-19-unvaccinated participants (n = 796 including 454 vendors and 342 customers, 60% of whom were women) were surveyed. The median age of vendors and customers was 34.2 and 30.1 years, respectively. The crude and adjusted anti-SARS-CoV-2 antibody seroprevalence rates were 70.2% (95% CI 66.9-73.4%) and 98.8% (95% CI 94.1-100%), respectively, with no difference between vendors and customers. COVID-19 symptoms reported by survey participants in the previous 6 months were mild or absent in 58.9% and 41.1% of participants with anti-SARS-CoV-2 antibodies, respectively. No COVID-19-seropositive participants reported hospitalisation in the last 6 months. These findings are consistent with those reported in Bukavu. They confirm that SARS-CoV-2 spread without causing severe symptoms in densely populated settlements and markets and suggest that many COVID-19 cases went unreported. Based on these results, the relevance of an untargeted hypothetical vaccination programme in these communities should be questioned.
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Affiliation(s)
- Prudence Ndeba Mitangala
- Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Université Officielle de Ruwenzori, Butembo, Democratic Republic of Congo
| | - Leonid M. Irenge
- Center for Applied Molecular Technologies, Institute of Clinical and Experimental Research, Université catholique de Louvain (UCLouvain), Woluwe-Saint-Lambert, Belgium
| | | | | | - Patrick Ndeba Ayonga
- Département des maladies infectieuses et tropicales, Université de Bordeaux, Bordeaux, France
| | | | | | | | | | - Guy Ndongala Mutombo
- Division Provinciale de la Santé du Nord Kivu, Goma, Democratic Republic of Congo
| | - Jérôme Ambroise
- Center for Applied Molecular Technologies, Institute of Clinical and Experimental Research, Université catholique de Louvain (UCLouvain), Woluwe-Saint-Lambert, Belgium
| | - Jean-Luc Gala
- Center for Applied Molecular Technologies, Institute of Clinical and Experimental Research, Université catholique de Louvain (UCLouvain), Woluwe-Saint-Lambert, Belgium
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Shouman S, Emara T, Saber HG, Allam MF. Awareness and attitude of primary healthcare patients towards telehealth in Cairo, Egypt. Curr Med Res Opin 2022; 38:993-998. [PMID: 35404179 DOI: 10.1080/03007995.2022.2065141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Telehealth is delivering health care services remotely from healthcare facilities using telecommunications and virtual technology. Egypt is aiming to reach Universal Health Coverage; this increases the demand for telehealth in routine health services. Telehealth helps in increasing access to areas with no available medical services as patients can be monitored remotely. OBJECTIVE To measure the awareness of telehealth among attendees of primary health care units and their acceptance of applying telehealth. METHODOLOGY This was a cross-sectional study among attendees of primary health units. Ethical issues were considered. RESULTS A sample size was calculated to be 162 and 170 valid Arabic interview questionnaires were filled by attendees. The awareness percentage of telehealth among attendees was 64.7% while the willingness to implement telehealth was 78%. Both awareness and willingness were significantly associated with age groups, residence, socioeconomic status, and presence of computer with internet access. Age, residence, and possession of a PC were the only adjusted predictive factors for knowledge about telehealth among patients in the multivariable analysis. CONCLUSION Large percentages of attendees to primary health care centers are aware of telehealth and are willing to implement it. The major cause of refusal to implement telehealth was ignorance of using telecommunication devices and the desire to be in close contact with the physicians.
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Affiliation(s)
- Sara Shouman
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Emara
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Gamal Saber
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Farouk Allam
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Khan FU, Mallhi TH, Khan FU, Hayat K, Rehman A, Shah S, Khan Z, Khan YH, Ahmad T, Gudi SK, Karataş Y, Fang Y. Evaluation of Consumers Perspective on the Consumption of Antibiotics, Antibiotic Resistance, and Recommendations to Improve the Rational use of Antibiotics: An Exploratory Qualitative Study From Post-Conflicted Region of Pakistan. Front Pharmacol 2022; 13:881243. [PMID: 35662689 PMCID: PMC9159815 DOI: 10.3389/fphar.2022.881243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/25/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Antibiotics misuse is a global challenge, and the situation is likely to deteriorate in conflict zones with insufficient health services. The misuse of antibiotics is not only associated with antimicrobial resistance but may also lead to serious consequences. This study was aimed to investigate the knowledge, attitude, and practices on antibiotic consumption, antibiotic resistance (ABR), and related suggestions among residents of conflicted zones in Pakistan. Methods: Semi-structured interviews were conducted at community pharmacies between June 2020 and January 2021. The primary findings were ascertained through thematic content analysis. Themes, sub-themes, and categories were drawn from the final analysis. Data analysis was carried out in six steps from getting to know the data to final report development. Results: A total of 20 consumers were interviewed with a mean interview duration of 25.4 min. The average age of participants was 35.1 years, and most of them were males. ABR was unfamiliar to the participants. Most of the participants understood the term "antibiotics," but they did not know how to use them properly. The participants were unable to distinguish between bacterial and viral illnesses. Thirteen participants believed that antibiotics have a faster effect than any other drug. Most of the participants perceived that every antibiotic could cause diarrhea, and pharmacy staff sometimes prefer other medicines such as multivitamins. Consumer practices regarding antibiotic usage and ABR were found to be poor. Most participants recommended that health officials must ensure qualified staff at pharmacies with strict regulations. Five participants said that a leaflet with antibiotic instructions in Urdu (national language) is usually beneficial, especially when making solutions from powder. Conclusions: This study underscored poor knowledge, attitude, and practices among residents of conflicted zones towards antibiotics and ABR. Low literacy rate, unavailability of healthcare facilities, absence of pharmacists at community pharmacies, and uncontrolled sales of antibiotics are some factors attributed to serious hazards, ABR, and irrational use of drugs.
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Affiliation(s)
- Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
- Institute of Pharmaceutical Sciences, the University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Asim.Ur Rehman
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Zakir Khan
- Institute of Health Sciences, Department of Pharmacology, Faculty of Medicine, Cukurova University, Adana, Turkey
- Pharmacovigilance Specialist, Balcali Hospital, Faculty of Medicines, Cukurova University, Adana, Turkey
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Tawseef Ahmad
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan
| | - Sai Krishna Gudi
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Yusuf Karataş
- Institute of Health Sciences, Department of Pharmacology, Faculty of Medicine, Cukurova University, Adana, Turkey
- Pharmacovigilance Specialist, Balcali Hospital, Faculty of Medicines, Cukurova University, Adana, Turkey
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
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Mohammadi-Nasrabadi F, Salmani Y, Broumandnia N, Esfarjani F. A Mixed-Method Study on COVID-19 Prevention in Iranian Restaurants. Front Public Health 2021; 8:585290. [PMID: 33569368 PMCID: PMC7868435 DOI: 10.3389/fpubh.2020.585290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/29/2020] [Indexed: 12/23/2022] Open
Abstract
Background: In the face of the COVID-19, as a public health emergency, the restaurant industry is struggling to organize itself. The aim of this study is to determine the knowledge, attitude, and practice and also the perceptions of restaurants' customers and managers toward COVID-19 prevention. Methods: This cross-sectional study was conducted using the mixed-method approach. Two online questionnaires were undertaken through WhatsApp Messenger among the 210 customers and 50 managers of restaurants. Multivariate linear regression analysis was conducted to identify the predictors of knowledge, attitude, and practice toward COVID-19 prevention. Then semi-structured, in-depth phone interviews were conducted with 45 subjects to identify their perceptions about the restaurant industry during the COVID-19 pandemic. Results: The majority of customers had moderate knowledge (72.4%), positive attitude (90.5%), and desirable practice (38.6%); whereas the majority of managers had sufficient knowledge (50%), negative attitude (82%), and acceptable practice (58%) toward the prevention of COVID-19 in restaurants. Multiple linear regression analysis showed with increasing each 10 years in the age of the customers, the practice score significantly decreased (Beta = -0.155, p < 0.05). Moreover, qualitative results revealed three categories (1. restaurant industry, 2. social media, and 3. government) in 9 themes with 32 sub-themes which were explored based on the perception of the participants toward COVID-19 prevention in restaurants. Conclusion: The majority of restaurant customers and managers have sufficient knowledge and acceptable practice, but a positive attitude among customers and a negative attitude among managers about the prevention of COVID-19 were shown. There is an urgent need to understand public awareness about preventing COVID-19 in restaurants at these critical moments. The results seek to provide strategies for the policymakers and restaurant industry to plan the specific educational intervention about how to manage future crises and public health improvement.
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Affiliation(s)
- Fatemeh Mohammadi-Nasrabadi
- Food and Nutrition Policy and Planning Research Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yeganeh Salmani
- Food and Nutrition Policy and Planning Research Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Broumandnia
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esfarjani
- Food and Nutrition Policy and Planning Research Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wakefield C, Brents BG. The Influence of Legal Brothels on Illegal Sexual Service Purchasing Habits: The U.S. Context. Int J Offender Ther Comp Criminol 2020; 64:249-264. [PMID: 31387419 DOI: 10.1177/0306624x19866306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this study, we use a survey of sex workers' clients to examine the relationship between having paid for services in legal brothels in Nevada and paying for criminalized sexual services among male clients. Using ordinary least squares (OLS) and generalized ordered logistic regression models, the use of legal brothels is found to be negatively related to reported purchasing of criminalized sexual services, regardless of criminal history, income, and most other demographic factors. When tested by criminalized purchase context, purchases made using the Internet, from public, outdoor contacts (such as the street) and indoor, public contacts (like bars), were less likely to occur with brothel experience. This study addresses a critical gap in scholarship on sex workers' clients purchasing choices with consideration to both market choice and frequency of purchase when having been exposed to a legal replacement for an illegal transaction. Implications and areas of further study are discussed.
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Nguyen ATL, Tran BX, Le HT, Le XTT, Do KN, Do HT, Vu GT, Nguyen LH, Latkin CA, Ho CSH, Ho RCM. Customers' Knowledge, Attitude, and Practices towards Food Hygiene and Safety Standards of Handlers in Food Facilities in Hanoi, Vietnam. Int J Environ Res Public Health 2018; 15:ijerph15102101. [PMID: 30257446 PMCID: PMC6211044 DOI: 10.3390/ijerph15102101] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 01/11/2023]
Abstract
Efforts to prevent foodborne illnesses in food facilities require sufficient knowledge on hygiene and safety standards from both food processors and customers. However, studies about knowledge, attitude, and practices of customers towards these issues are constrained. This study explored the knowledge, attitude, and practices (KAP) of customers regarding the practices of food facilities as well as potential associated factors. A cross-sectional survey was conducted in Hanoi from September to October 2015. Questions about knowledge, attitude, and practice towards food hygiene and safety were asked, alongside sociodemographic characteristics. Multivariate Tobit regression was used to identify the associated factors with the KAP. Among 1740 customers, the highest mean score of 98.4 (SD = 10.1) was found in knowledge about practices with raw and cooked food, following by knowledge about environmental practices when processing food (mean = 93.1, SD = 17.3), and knowledge about environmental requirements when processing food (mean = 33.3, SD = 33.3). Most of customers considered the processing and selling of hygienic meals without leaving any food overnight as the most important feature for food facilities (73.8%). About 63.2% of participants chose not to report food safety violation by facilities to authorities. The higher score of knowledge was found in groups of people who were not single, had college/university or higher education, and had specific criteria when choosing their places to eat. These findings imply the need for enhancing customers’ protection systems, the capability of inspecting and supervising the food processing progress by local authorities, and the awareness of customers about the environmental requirements of food facilities.
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Affiliation(s)
- Anh Tuan Le Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Xuan Thanh Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Hoa Thi Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Giang Thu Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
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Chowdhury F, Sturm-Ramirez K, Mamun AA, Iuliano AD, Bhuiyan MU, Chisti MJ, Ahmed M, Haider S, Rahman M, Azziz-Baumgartner E. Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh. Patient Prefer Adherence 2017; 11:479-486. [PMID: 28293104 PMCID: PMC5345980 DOI: 10.2147/ppa.s121800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. METHODS A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. RESULTS We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. CONCLUSION People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.
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Affiliation(s)
- Fahmida Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Correspondence: Fahmida Chowdhury, Respiratory Viruses Working Group, Programme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh, Tel +88 018 1705 4481, Email
| | - Katharine Sturm-Ramirez
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Abdullah Al Mamun
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A Danielle Iuliano
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mejbah Uddin Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Makhdum Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sabbir Haider
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
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Monto MA, Milrod C. Ordinary or peculiar men? Comparing the customers of prostitutes with a nationally representative sample of men. Int J Offender Ther Comp Criminol 2014; 58:802-820. [PMID: 23525181 DOI: 10.1177/0306624x13480487] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Recent media attention implies that prostitution seeking is widespread, an "ordinary" aspect of masculine sexual behavior. Other accounts suggest that customers are "peculiar," characterized by distinct qualities, perversions, or psychological impairments. Using the nationally representative General Social Survey (GSS), this study demonstrates that prostitution seeking is relatively uncommon. Only about 14% of men in the United States report having ever paid for sex, and only 1% report having done so during the previous year. Furthermore, this study dissects whether customers are ordinary or peculiar by comparing a new sample of active customers who solicit sex on the Internet with an older sample of arrested customers, a sample of customers from the GSS, and a nationally representative sample of noncustomers. The customers of Internet sexual service providers differed greatly from men in general and also from other customers. The remaining samples of customers differed slightly from noncustomers in general. We argue for a balanced perspective that recognizes the significant variety among customers. There is no evidence of a peculiar quality that differentiates customers in general from men who have not paid for sex.
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