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Mexican-origin youth, as a large and growing population among U.S. youth, have been disproportionately affected by COVID-19. Understanding what, when, and how sociocultural factors may influence their COVID-19 vaccine uptake could inform current and future pandemic-response interventions promoting vaccination behaviors among Mexican-origin youth. The current study takes a developmental approach to reveal the long-term and short-term sociocultural antecedents of 198 Mexican-origin adolescents' COVID-19 vaccination uptake behaviors and explores the underlying mechanism of these associations based on the Knowledge-Attitude-Behavior model. The current study adopted Wave 1 (2012-2015) and Wave 4 (2021-2022) self-reported data from a larger study. Analyses were conducted to examine four mediation models for four sociocultural antecedents-daily discrimination, ethnic discrimination, foreigner stress, and family economic stress-separately. Consistent indirect effects of higher levels of concurrent sociocultural risk factors on a lower probability of COVID-19 vaccine uptake were observed to occur through less knowledge about the COVID-19 vaccines and less positive attitudes toward the COVID-19 vaccines at Wave 4. Significant direct effects, but in opposite directions, were found for the associations between Wave 1 ethnic discrimination/Wave 4 daily discrimination and the probability of COVID-19 vaccine uptake. The findings highlight the importance of considering prior and concurrent sociocultural antecedents and the Knowledge-Attitude-Behavior pathway leading to COVID-19 vaccination uptake among Mexican-origin youth and suggest that the impact of discrimination on COVID-19 vaccination uptake may depend on the type (e.g., daily or ethnic) and the context (e.g., during the COVID-19 pandemic or not) of discrimination experienced.

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Introduction: Misconceptions about dietary protein may exist due to unscientific information from commonly used sources such as social media. Understanding knowledge and attitudes towards protein is important for developing effective interventions to improve the dietary behaviors of U.S. college students. The objective of this study was to develop a questionnaire to evaluate college students' knowledge and attitudes towards dietary protein. Methods: The questionnaire had 64 questions, including 8 demographic, 24 knowledge, 14 attitude, and 18 behavior questions. Construct validity of the knowledge questions was assessed by performing known-group comparisons using an independent t-test. Exploratory factor analysis (EFA) with principal axis factoring and a promax rotation was used to evaluate the factor structure of the attitude questions. Results: Four hundred seventy participants (87.3% female) provided responses for the attitude questions. Fifty-five nutrition and Fifty-one non-nutrition students provided responses for the knowledge questions. Three factors were retained: animal protein sources' relationship with human and environmental health (Factor 1); organic protein sources (Factor 2); and adequacy of the protein recommended dietary allowance (RDA) for weight loss and vegetarian diets (Factor 3). Mean knowledge responses were 66.4 ± 11.5% and 47.6 ± 16.4% for nutrition and non-nutrition students, respectively (t-test p-value for difference <0.001). Conclusion: Protein attitudes appear multidimensional and correlated. Further testing is needed to confirm the three-factor model and to assess temporal reliability.

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Introduction: Inappropriate antimicrobial use (AMU) in livestock production is an important aspect of the global burden of antimicrobial resistance (AMR). In Ethiopia, a low-income country with a large and increasing livestock population, AMU in food animals is not properly regulated. Hence, farmers are fully free to use antimicrobials to their (perceived) benefit. Therefore, understanding farmers' mindsets is important to improve antimicrobial stewardship in the livestock sector. Methods: This cross-sectional study was conducted to assess livestock disease management practices and knowledge, attitude, and behavior (KAB) among livestock producers regarding AMU, residues, and resistance, as well as factors potentially explaining differences in KAB. We determined the KAB of livestock owners of three selected districts of central and western Ethiopia (n = 457), using a pretested questionnaire administered through face-to-face interviews. Logistic regression was used to evaluate the association between potential explanatory variables and the KAB scores of the respondents. Results: The results showed that 44% of the farmers used antimicrobials in the past few years, where antibiotics (21%) and trypanocides (11%) were most widely used to manage livestock diseases. Furthermore, most farmers showed poor knowledge about AMU, residues, and AMR (94%) and unfavorable attitudes (<50% correct answers) toward contributing factors for AMR (97%). On the contrary, 80% of the respondents had overall good behavior scores (≥50% correct answers) related to AMU. Multivariate analysis results showed that having good knowledge, keeping ≥2 animal species, and the occurrence of ≥4 livestock diseases on the farm in a year were strong predictors of bad behavior scores (p < 0.05). The findings of the current investigation also revealed that the incidence of livestock diseases on the farm and a higher level of formal education significantly contributed to better knowledge and desirable attitudes but bad AMU behavior. Conclusion: A low level of awareness about and undesirable attitudes toward AMU and AMR could potentially affect farmers' behavior toward judicious AMU, thus requiring awareness creation efforts on livestock disease management practices.

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The public health environment in South Korea is advancing toward the late stages of the COVID-19 pandemic. However, there is limited knowledge about the extent of individuals' compliance with preventive measures during this transitional period and the potential predictors that determine such compliance behaviors. In this study, we employed the expanded health empowerment model to investigate factors associated with COVID-19 preventive behaviors among Korean adults in late 2022. Our theoretical framework integrates the knowledge-attitude-behavior model with the health belief model to conceptualize health empowerment underlying the formation of preventive behaviors. We collected data from 1100 Korean adults aged 40-69 years through an online survey conducted in October 2022. Participants responded to questions about their knowledge of COVID-19, attitudes towards the disease, adherence to preventive measures, infection history, and sociodemographic characteristics. Structural equation modeling was employed to assess the relationships between knowledge, attitudes, and preventive behaviors related to COVID-19. Results showed that attitudes toward the disease predict adherence to preventive behaviors. We also found that COVID-19 knowledge partially determined the attitudes toward the disease. However, COVID-19 knowledge was not directly associated with adherence to preventive behaviors. Additionally, the associations between knowledge, attitudes, and preventive behaviors did not differ between infected and never-infected individuals. Overall, this study finds empirical support for the expanded health empowerment model, which connects knowledge to preventive behaviors through positive attitudes toward the disease, while underscoring the limited role of infection history in this association. These findings can help policymakers understand individual responses to public health guidelines in the late pandemic era and develop policies to mitigate further transmission of COVID-19.

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Purpose: The outbreak of coronavirus disease has become an evolving global health crisis with wide-ranging implications. Clinical researches from several countries have reported greater morbidity and mortality from COVID-19 patients with diabetes. SARS-CoV-2/COVID-19 vaccines are currently the relatively effective means of prevention. The research was aimed to explore the attitudes of diabetic patients towards COVID-19 vaccine and the knowledge of COVID-19 related epidemiology and epidemic prevention. Methods: This case-control study was carried out in China via online and offline surveys. Knowledge questionnaire of COVID-19 and drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S) were used to compare the difference of COVID-19 vaccination attitude, preventive measures, and knowledge of SARS-COV-2 between diabetic patients and healthy citizens. Results: The diabetic patients showed lower vaccination willingness and insufficient knowledge of the transmission route and common symptoms of COVID-19. Only 60.99% diabetic patients were willing to be vaccinated. Less than half of diabetics knew the COVID-19 spread by surface touch (34.04%) or aerosol (20.57%). The common symptoms like shortness of breath/ anorexia/ fatigue/ nausea/vomiting/diarrhea (34.04%) and panic and chest tightness (19.15%) were not well comprehend too. Diabetes patients shown lower report intentions when they contact a person infected with the virus (81.56%) or have any of the disease symptoms (74.47%). Values, knowledge, and autonomy assessed by the DrVac-COVID19S scale also showed negative attitude of vaccination in patients with diabetes. Also, patient with diabetes pay less attention to national (56.03%) and international (51.77%) COVID-19 updates. The willingness to attend COVID-19 lectures (27.66%) or read information leaflets (70.92%) was low. Conclusion: Vaccination is the effective available method for preventing the virus. Social and medical workers can increase the vaccination of diabetic patients through knowledge's popularization and patient's education based on the above differences.

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@#Introduction: Workplace accidents have been a persistent problem in Malaysia’s manufacturing industry, particularly for small and medium-sized enterprises (SMEs). Employee behavior has been identified as a significant contributing factor to these accidents, and research has suggested that improving safety knowledge and attitudes can enhance safety behavior. Despite this, there have been no empirical intervention studies in Malaysia to investigate the effectiveness of safety intervention programs aimed at improving SME worker safety behavior. Therefore, this study aimed to assess the efficacy of the Occupational Hazard Self-Evaluation Module (OHSEM) intervention in enhancing safety knowledge, attitudes, and behavior (KAB) among SME workers in the manufacturing sector. Methods: A quasi-experimental design with control group was utilized to evaluate the effectiveness of the OHSEM intervention. The intervention was implemented over a 12-week period on production workers in the experimental group, while the control group received no intervention. A self-administered questionnaire was distributed to 88 production workers in both groups before and after the intervention to measure the improvement of safety KAB. Descriptive analysis and an independent t-test were used to analyse the data. Results: The post-test results showed that safety KAB for the control group was moderate (mean = 2.11), while the mean score in the experimental group was high (m=4.17). Furthermore, the t-test result revealed a significant difference in safety KAB mean scores between the experimental and control groups. Conclusion: This study provides empirical evidence on the effectiveness of the OHSEM intervention in enhancing safety KAB in SMEs in the Malaysian SME (manufacturing) sector.

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Background: Antimicrobial resistance (AMR) can be induced by overuse or misuse of antimicrobials. Few researches were involved in consumers' knowledge and attitude toward antimicrobial use (AMU) in food production. This study was designed to investigate the knowledge and awareness, perception, and attitude of Chinese consumers toward AMU in food production. Their behavior, purchase intention of antimicrobial-free food products, and confidence in information sources were also investigated. Methods: As a descriptive cross-sectional study, an online electronic survey questionnaire was conducted between February 25 and March 8, 2022, involving 1,065 consumers in China. Factor analysis was conducted to identify underlying patterns of the attitudes and information sources. Spearman correlations were employed to determine the relationship between knowledge, attitudes and the intention to pay extra. The differences in knowledge and attitudes were performed by independent t-test and one-way analysis of variance (ANOVA) test, and the difference in intention was performed by Chi-square test, when compared with demographic factors. Results: The findings showed that even though 75.0% of them heard of AMR, and 48.2% knew the definition of AMR, the level of consumers' knowledge of AMU in farming production and food regulations in China was not high (48.9% of participants replied correctly). About half viewed AMU and AMR as a potential risk to their health. Of these participants, 61.3% claimed that they were more likely looking for specific information about AMU on food packaging, and 58.3% changed their eating or cooking habits due to the concern. In addition, 79.8% were willing to pay extra for antimicrobial-free food products. Information sources from professionals and authorities were considered more accurate than those from media, the internet, word of mouth, and others. Conclusions: Chinese consumers had insufficient knowledge and neutral attitudes about AMU in farming production and food regulations in China. A large proportion of the participants were willing to purchase antimicrobial-free food products. Most of them obtained related information from the media. This study highlighted the importance of updated education and effective communication with consumers in China. It helps to develop the reliable foodborne AMR surveillance system along food chain and improve government communication and consumer awareness.

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OBJECTIVE: To evaluate the effectiveness of health education on knowledge, attitude and practice (KAP) relating to malaria control among overseas enterprise employees. METHODS: In September 2019, on-site malaria control health education was conducted among all Chinese employees of a China-funded mining enterprise in the Democratic Republic of Congo. The KAP questionnaire for malaria control was generated on the Questionstar website, and the participants were subjected to two questionnaire surveys prior to and 14 months after health education. After the questionnaires were recovered, all valid questionnaires were divided into 4 groups, including the baseline group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys before health education), the loss-to-follow-up group (the questionnaires filled out by respondents who received health education but only participated in the questionnaire survey after health education), the retest group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys after health education) and the new group (questionnaires filled out by respondents who did not receive health education and only participated in the questionnaire survey after health education) according to subjects' receiving health education and participation in two questionnaire surveys. The correct rate of malaria control knowledge, the proportion to good attitudes towards malaria control and the proportion of good practices towards malaria control were compared between the baseline group and the loss-to-follow-up group, between the baseline group and the retest group, and between the retest group and the new group. RESULTS: A total of 110 and 142 valid questionnaires were recovered during the two surveys, and the recovery rates were 90.9% and 70.3%, respectively. There were 77, 77, 33, and 65 valid questionnaires recovered from the baseline group, the loss-to-follow-up group, the retest group, and the new group, respectively. There were no significant differences in respondents' gender, age and educational levels between the baseline group and the loss-to-follow-up group (all P values > 0.05), and there were no significant differences between the two groups in terms of the mean score of malaria control knowledge (Z = 2.011, P > 0.05), the mean score of attitudes towards malaria control (t = -0.787, P > 0.05) and the mean score of practices towards malaria control (t = -0.787, P > 0.05). There were significant differences between the retest group and the baseline group in terms of the mean score of malaria control knowledge (10.83 vs. 9.79; Z = -4.017, P < 0.05), the mean score of attitudes towards malaria control (29.48 vs. 28.61; Z = -1.981, P < 0.05) and the mean score of practices towards malaria control (6.43 vs. 5.91; Z = -2.499, P < 0.05). There were no significant differences between the retest group and the new group in terms of gender, age or education levels (all P values > 0.05), and a higher mean score of malaria control knowledge was found in the retest group than in the new group (10.83 vs. 9.81; Z = -2.962, P < 0.05), while no significant differences were seen in the mean score of attitudes towards malaria control (29.48 vs. 30.17; Z = -1.158, P > 0.05) and the mean score of practices towards malaria control (6.43 vs. 6.37; Z = -0.048, P > 0.05) between the two groups. CONCLUSIONS: Malaria control health education may significantly improve the understanding of malaria control knowledge, positive attitudes towards malaria control and the compliance of practices towards malaria control among overseas enterprise employees.

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Objective:To investigate the knowledge, attitude and practice of adult oxygen inhalation therapy among nurses and analyze its influencing factors.Methods:A self-designed questionnaire was used to investigate the status of knowledge, attitude and practice of adult oxygen inhalation therapy among 1 410 nurses from many tertiary, secondary and lower hospitals in Chongqing, Jiangsu, Sichuan, Shanxi and other provinces and cities from December 2020 to January 2021 by convenient sampling method.Results:The score of nurses′ knowledge of adult oxygen inhalation therapy was 1-39 (23.10 ±4.82) points, the standard score was (44.42 ±9.27) points, the score of excellent was 0, the score of moderate was 1.8%(25/1 410), the score of poor was 98.2%(1 385/1 410). The score of nurses′ attitude of adult oxygen inhalation therapy was 6-30 (25.06 ±4.37) points, the standard score was (83.53 ±14.58) points, positive attitude accounted for 42.9%(605/1 410), neutral attitude accounted for 54.6%(770/1 410), negative attitude accounted for 2.5%(35/1 410). The score of nurses′ practice of adult oxygen inhalation therapy was 9-54 (33.82 ±6.32) points, and the standard score was (75.12 ±13.99). Positive practice accounted for 21.2%(299/1 410), neutral practice accounted for 70.4%(993/1410) points, negative practice accounted for 8.4%(118/1 410). The knowledge and attitude of nurses to adult oxygen inhalation therapy were positively correlated with practice( r=0.193, 0.554, both P<0.01). Multiple linear regression analysis showed that nurses′ knowledge, attitude and training frequency were the influencing factors of adult oxygen inhalation therapy practice( t=3.17, 23.33, 8.64, all P<0.01). Conclusions:Nurses should strengthen the study and training of adult oxygen inhalation therapy, correct attitude and improve practice, reduce or avoid the occurrence of excessive oxygen therapy and oxygen therapy complications, standardize clinical oxygen therapy to ensure the safety and effectiveness of oxygen therapy.

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Objective To evaluate the effectiveness of health education on knowledge, attitude and practice (KAP) relating to malaria control among overseas enterprise employees. Methods In September 2019, on-site malaria control health education was conducted among all Chinese employees of a China-funded mining enterprise in the Democratic Republic of Congo. The KAP questionnaire for malaria control was generated on the Questionstar website, and the participants were subjected to two questionnaire surveys prior to and 14 months after health education. After the questionnaires were recovered, all valid questionnaires were divided into 4 groups, including the baseline group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys before health education), the loss-to-follow-up group (the questionnaires filled out by respondents who received health education but only participated in the questionnaire survey after health education), the retest group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys after health education) and the new group (questionnaires filled out by respondents who did not receive health education and only participated in the questionnaire survey after health education) according to subjects’ receiving health education and participation in two questionnaire surveys. The correct rate of malaria control knowledge, the proportion to good attitudes towards malaria control and the proportion of good practices towards malaria control were compared between the baseline group and the loss-to-follow-up group, between the baseline group and the retest group, and between the retest group and the new group. Results A total of 110 and 142 valid questionnaires were recovered during the two surveys, and the recovery rates were 90.9% and 70.3%, respectively. There were 77, 77, 33, and 65 valid questionnaires recovered from the baseline group, the loss-to-follow-up group, the retest group, and the new group, respectively. There were no significant differences in respondents’ gender, age and educational levels between the baseline group and the loss-to-follow-up group (all P values > 0.05), and there were no significant differences between the two groups in terms of the mean score of malaria control knowledge (Z = 2.011, P > 0.05), the mean score of attitudes towards malaria control (t = −0.787, P > 0.05) and the mean score of practices towards malaria control (t = −0.787, P > 0.05). There were significant differences between the retest group and the baseline group in terms of the mean score of malaria control knowledge (10.83 vs. 9.79; Z = −4.017, P < 0.05), the mean score of attitudes towards malaria control (29.48 vs. 28.61; Z = −1.981, P < 0.05) and the mean score of practices towards malaria control (6.43 vs. 5.91; Z = −2.499, P < 0.05). There were no significant differences between the retest group and the new group in terms of gender, age or education levels (all P values > 0.05), and a higher mean score of malaria control knowledge was found in the retest group than in the new group (10.83 vs. 9.81; Z = −2.962, P < 0.05), while no significant differences were seen in the mean score of attitudes towards malaria control (29.48 vs. 30.17; Z = −1.158, P > 0.05) and the mean score of practices towards malaria control (6.43 vs. 6.37; Z = −0.048, P > 0.05) between the two groups. Conclusion Malaria control health education may significantly improve the understanding of malaria control knowledge, positive attitudes towards malaria control and the compliance of practices towards malaria control among overseas enterprise employees.

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Objective:To learn about the knowledge, attitude and behavior of brucellosis and brucellosis infection in Tongyu County, Jilin Province, and to provide a reference for the formulation of prevention and control measures in relocated poverty alleviation and relocation areas.Methods:Using a multi-stage sampling method, three townships, Xianghai Township, Wulanhua Town and Xinhua Town were selected in Tongyu County, where the incidence of brucellosis is high in Jilin Province; then Miren, Huimin, Longjing, Xinfeng and Dayou villages from the three townships were surveyed. A face-to-face questionnaire survey was conducted among the villagers to collect the knowledge, attitude and behavior of brucellosis; and blood samples were collected from the villagers according to the principle of informed consent for brucellosis serological tests, and according to the "Diagnostic criteria for Brucellosis (WS 269-2007)" for diagnosis.Results:A total of 274 questionnaires were distributed and 244 valid questionnaires were collected with a recovery rate of 89.05%. Among them, 233 people had heard of brucellosis, accounting for 95.49%. The total awareness rate of knowledge related to brucellosis prevention and control was 39.29% (2 205/5 612), of which the total awareness rate of "knowledge related to brucellosis prevention" was 71.99% (527/732), and the total awareness rate of "knowledge related to human infection with brucellosis" was 38.08% (1 115/2 928), and the total awareness rate of "knowledge about brucellosis in animals" was 28.84% (563/1 952). A total of 90.13% (21/233) people supported the brucellosis prevention and control plan (such as free screening for brucellosis, publicity and education, immunization, culling, etc.), and 61.54% (48/78) of the people would take the initiative to buy protective equipment. The contact rates of livestock through assisted feeding and slaughtering were 27.46% (67/244) and 11.48% (28/244), respectively, and the total protection rates of sheep pens cleaning and slaughtering were 30.91% (102/330) and 21.43% (30/140), respectively. In terms of brucellosis infection, a total of 1 confirmed case, 1 latent infection and 37 suspected cases were found.Conclusions:The awareness rate of "knowledge related to brucellosis prevention" in Tongyu County is generally good, but the awareness rate of "knowledge about brucellosis in animals" is low, and the protection rate of some brucellosis prevention and control behaviors is poor. Health and epidemic prevention departments should carry out targeted health education, improve and optimize propaganda methods in order to improve the protection level of the general population and reduce the risk of brucellosis infection.

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Objectives: The objective of this study was to determine the identification rate of substandard and falsified medications and its association with knowledge among public. Methods: This descriptive cross-sectional study was conducted in different geographic areas among a convenient sample of people aged 18 or older. A validated web-based electronic questionnaire was used for data collection tool. The questionnaire contained three sections assessing the following: (1) Sociodemographic data; (2) Knowledge regarding counterfeit medicines; and (3) Ability to identify counterfeit medicines, according to 12 questions rated on a five-point Likert scale. Univariate and multivariate logistic regression analyses were used to assess the association between sociodemographic factors and counterfeit medication identification rate. Results: A total of 320 people participated in the study. Only 98 participants (30.6%, 95% CI 25.6-35.7%) identified the counterfeit medications. Ability to correctly identify counterfeit medications was significantly higher in participants who were older (p = 0.016), single (p = 0.001), Asian (p = 0.001), or American (p = 0.019), as well as those who indicated that they would check the certification of the medications (p = 0.015) and report counterfeit medications to the authorities (p < 0.0001). Conclusions: These results underscore the need for greater public awareness of the hazards associated with counterfeit medicines.

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Objective: To describe changes in knowledge, attitudes and preventive practices (KAP), risk perception, and psychological variables of Spanish population toward the COVID-19 pandemic from July to November 2020. Methods: Three samples, each of one composed by 1,000+ persons aged 18 years or older, were interviewed online in three rounds, every 2 months, from July to November 2020. Results: The level of knowledge on COVID-19 was high in the three rounds, with percentages above 95% of correct answers related to ways of contagion and correct use of face masks. The most accepted measure was the mandatory use of face masks (80-86% of agreement in the three rounds, p = 0.001), followed by the night curfew (63% of agreement). Most participants (>80%) consistently reported using face masks, ventilating spaces, and washing or disinfecting hands. However, risk perception and self-efficacy were low. Worry about losing a loved one, the health system overload and people who do not wear face masks was high (>85% of the samples). The percentage of respondents who felt depressed due to COVID-19 increased from round 1 to round 3 (p = 0.044). Conclusions: Spanish population has a high degree of KAP, but a relatively low risk perception and self-efficacy. These findings can help health authorities to guide containment measures and campaigns addressed to improve preventive practices.

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Despite evidence that breast cancer screening effectively diagnoses and treats cancer through early detection, mammography use remains low in Taiwan. We applied the health belief model (HBM) and the knowledge-attitude-behavior (KAB) model as theoretical frameworks to examine factors associated with mammography uptake among women aged 45-69 years in Taiwan. A cross-sectional survey January-July 2018 was conducted of women aged 45-69 years in five southern Taiwan health institutions. Survey questionnaires included demographics, HBM constructs, and health knowledge regarding breast cancer and screening. Multivariable logistic regression models explored the mediation effects of HBM constructs between health knowledge and mammography use. The final analytical sample included 621 women; 67 did not receive mammography and 554 received mammography. When the regression model was adjusted only for demographic factors, women with adequate health knowledge were more likely to undergo mammography (AOR = 2.321, 95%CI = 1.141-3.809); in regression models including health knowledge and HBM constructs, the likelihood effect of health knowledge declined and became insignificant (AOR = 1.711, 95%CI = 0.985-2.972), indicating potential mediation effects between health knowledge and up-to-date mammography use. Overall, based on the HBM and the KAB theoretical framework, our data support that health belief played a substantial mediating role in the association between health knowledge and mammography uptake, in particular perceived barriers and cues to action in the HBM, which were modifying factors of health beliefs. Therefore, to improve mammography uptake, it may be helpful to design educational model-based interventions through tackling those modifiable perceived barriers and enhancing the intensity of external cues to action.

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Objective To determine the status of HIV/AIDS-related knowledge, attitude and behavior in college students, and to provide the theoretical basis for strategy of control and prevention. Methods By using random cluster sampling method, we conducted an anonymous online questionnaire survey on a total of 917 young students in Songjiang District of Shanghai. Results The awareness rate of HIV/AIDS-related knowledge was 71.8% among 903 responders. 11.1% of the students had sexual experience, and the rate was higher in male students than in female students(χ2 = 10.549, P < 0.01). The average age of first sexual intercourse was 18.4±1.3 years old, and 60.0% of the students used condom when having sex for the first time. In this survey, only 28.2% were willing to take anonymous HIV antibody urine test, and 1.8% of the students had been tested for HIV. Conclusion The overall awareness rate of knowledge of prevention and control of HIV/AIDS, the rate of condom use, and the willingness to take anonymous HIV antibody urine test are low among young college students in Songjiang District of Shanghai. We suggest to carry out targeted health education activities and to expand coverage of HIV testing by promoting the anonymous HIV antibody urine test for control the spread of HIV/AIDS among young students.

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With both cost and safety taken into account in the context of the life-threatening COVID-19 pandemic globally, rural tourism is expected to be the top choice for Chinese residents for relaxation and enhancing parent-child relationships. In this paper, a structural equation (SEM) model was proposed to compare risk knowledge, risk perception, risk aversion attitudes and behavioral intentions towards rural tourism. According to the empirical results, there was a large proportion of tourists showing preference for rural tourism recently. Potential participants in rural tourism paid most attention to the performance realization and time cost of scenic spots, while the psycho-social risk posed by COVID-19 had little impact. The inherent risk nature of risk aversion attitudes made knowledge of the pneumonia risk less effective in reducing tourists' intentions, while knowledge of the pneumonia risk was more effective in alleviating the risk perception that potential tourists have towards rural tourism. With regard to travel intention and recommendation intention of rural tourism, the negative impacts of risk aversion attitude were more considerable compared to risk perception. Meanwhile, the parallel mediating effect of risk perception and risk aversion attitude in rural tourism needed to be taken into consideration together.

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This study aimed to investigate the hypertension-related knowledge, attitudes, behaviors (KAB), and socio-demographic determinants among community-dwellers who were at risk for hypertension in Shanghai, China. A cross-sectional survey was conducted in a district of Shanghai in 2017 using multi-stage cluster sampling, including 611 participants who were at risk for hypertension. Questionnaires were used to investigate KAB regarding hypertension prevention. Multivariable logistic regression was performed to examine the relationship between socio-demographic factors and hypertension-related KAB. The results indicated that more than 75% of the study population had accurate knowledge, but only 48.4% knew the Recommended Daily Intake of salt for adults; over 80% formed health beliefs, while less than 50% were keeping a healthy diet, maintaining regular physical activity and/or bodyweight control. Better knowledge was found in the below 60 age group (p < 0.01) and the 60-69 age group (p = 0.03) than in the ≥70 age group. The behaviors in females (p < 0.01) were better than in males and were better in those covered by the Urban Employee Basic Medical Insurance (p = 0.01) than in those with the New Rural Cooperative Medical Insurance. In conclusion, although the rates of accurate knowledge and belief of hypertension prevention were high in the study population, the rates of maintaining healthy behaviors were relatively low. Socio-demographic factors had important influences on hypertension-related KAB. Further health education and intervention of hypertension prevention was needed to improve their level of KAB and reduce their risk for hypertension among the target groups.

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Objective@#To learn the knowledge, attitude and behaviors of AIDS of men who have sex wth men ( MSM ) in a gay bathhouse, so as to provide evidence for AIDS prevention and control among MSM.@*Methods@#From April to June of 2017, the MSM in a gay bathhouse in Wuhan were investigated. Demographic information, awareness of AIDS related knowledge, attitude towards HIV infection, dating ways and purposes, and high-risk sexual behaviors were collected and analyzed.@*Results@#Among 278 MSM responded, 235 ( 84.53% ) were aware of the basic knowledge of AIDS. The awareness rates of " transfusion with HIV blood will be infected ", " sharing syringes with HIV infected people will be infected ", "proper use of condoms can reduce the spread of AIDS ", " only having sex with one partner ( or few partners ) can reduce the spread of AIDS " were more than 90%, while the awareness rate of " high risk of HIV infection in gay bathhouses " was only 56.12%. Most respondents cared about the HIV infection situation of MSM, accounting for 74.46% ( 207 cases ) ; most denied or did not know the condition of friends infected with HIV, accounting for 82.37% ( 229 cases ) . The main purpose of coming to gay bathhouses was to find sexual partners, accounting for 87.41% ( 243 cases ) . About 52.16% had sexual behaviors with both heterosexual and homosexual partners, and 66.21% of them did not often or never use condoms when having sex with heterosexual partners. @*Conclusions@#The MSM in a gay bathouse have lower awareness of HIV infection situation and their partners, both heterosexual and homosexual behaviors, and lower proportion of insisting on condom use.

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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with risk-taking behaviors, poor self-control, and interpersonal difficulties. Affected individuals have an increased probability of involvement with the criminal justice system, contributing to a higher rate of arrest, and imprisonment compared with the general population; they are also inadequately treated once sentenced. Because prison staff play a central role in the identification of inmates with mental disorders, they could well be key to improving provision of care. There is however little knowledge of the conceptions, perceptions, and attitudes of prison staff toward ADHD. Such information could help to identify starting points for awareness training and further implementation of specific ADHD treatment. To bridge this gap, we undertook a study based on a qualitatively-driven mixed methods design, combining qualitative data collection in the form of narrative interviews with 19 prison staff from a Swiss correctional facility with quantitative data collection in the form of a survey that included the Attitudes toward Prisoners scale. The interviews were analyzed with QSR NVIVO 11 and a qualitative content analysis approach was used to evaluate findings. Prison staff were generally aware of ADHD and its symptomology, believing it to a be "real," but "fashionable" disorder and favoring hereditary-genetic or biological explanatory models for its development. They viewed inmates with ADHD rather negatively, as complicating correctional efforts, and perceived them as sticking out, as tying up more resources and as frequently being involved in confrontations. Our findings suggest that difficulties in pragmatic aspects of communication and language comprehension may be perceived "as not listening or following instructions," creating additional tensions. Consequently, inmates with ADHD are more often exposed to disciplinary sanctions, such as solitary confinement-an intervention deemed "necessary" by staff. Therefore, staff training on ADHD might need to cover evidence on adverse effects. Non-pharmacological interventions for treatment were preferred and considered to be highly efficacious. Skepticism toward pharmacological treatment prevailed, even when benefits from stimulant medication were described. Interestingly, this skepticism was not the result of negative experiences with the misuse and diversion of stimulants. Acceptance of multimodal treatment among prison staff may require customized strategies.

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Objective This study aimed to analyze the knowledge, attitude, behavior, and practice of pneumococcal vaccination in type 2 diabetes mellitus patients. Methods From January to March 2018, 3000 patients with type 2 diabetes mellitus were randomly selected from patients with type 2 diabetes registered and managed in community health service centers to participate in a questionnaire survey, using multi-stage cluster random sampling. The questionnaire included basic information, pneumococcal vaccine awareness, and pneumococcal vaccination status and inoculation intention, 2896 valid questionnaires were collected. The chi-squared test and multivariate logistic regression analysis were used to analyze the knowledge, attitude, behavior, and practice and influencing factors of pneumococcal vaccination. Results Of all the patients, 1267 (43.75％) patients with type 2 diabetes were willing to receive pneumococcal vaccination, and 23 (0.79％) patients with type 2 diabetes were vaccinated against pneumococcal, 1295(44.72％) patients with type 2 diabetes believed that patients with chronic diseases were susceptible to pneumococcal. Eight hundred seventy-seven (30.38％) patients believed that pneumococcal vaccination for chronic disease patients could reduce the risk of outpatient, hospitalization and death. Seven hundred ninety-nine (27.59％) patients believed that diabetic patients were the primary recipients of the pneumococcal vaccine. Multivariate logistic regression analysis showed that retired patients; those who thought that patients with chronic diseases were susceptible to pneumonia; those who thought that pneumococcal vaccination could reduce the risk of needing outpatient care, hospitalization, and death;and those who thought that diabetes was the priority of pneumococcal vaccination were more willing to receive pneumococcal vaccination (OR=1.442, 0.764, 1.494, 1.713, P all<0.05). Conclusion Patients with type 2 diabetes in Shenzhen have lower pneumococcal vaccine awareness, inoculation intention, and vaccination rates. Health education on the prevention of diabetes complications and pneumococcal vaccination should be promoted.