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Knowledge and attitudes towards contraception among undergraduate students: a multicentre, cross-sectional study in Vietnam

Por: Doan · D. A. · Pham · S. T. · Nguyen · T. T. X. · Luu · T. N. N. · Nguyen · T. T. P. · Le · G. B. · Dinh · D. X.
Objective

To investigate Vietnamese undergraduate students’ knowledge and attitudes towards contraception and their associated factors.

Design

Cross-sectional study.

Setting

Six universities in Vietnam from April to May 2025.

Participants

1134 undergraduate students.

Primary outcome measures

Students’ knowledge and attitudes towards contraception were measured via an online survey, and a cut-off point of 50% was used to categorise their scores. Associations between students’ knowledge and attitude scores and their sociodemographic characteristics, academic background, sexual and relationship experiences, contraceptive education and information sources were evaluated using multivariable linear regression. Independent variables were selected through Bayesian Model Averaging.

Results

Students’ average knowledge and attitude scores were 10.93±2.86 (possible range: 0–22; actual range: 0–19) and 54.14±6.57 (possible range: 15–75; actual range: 35–74), respectively. 62.1% demonstrated good knowledge, and 91.4% showed positive attitudes towards contraception. Higher knowledge was observed among older students (per 1 year increase, β=0.33, 95% CI 0.23 to 0.43), those from public universities (β=1.32, 95% CI 0.64 to 2.00), using mass media as a contraceptive information source (β=0.58, 95% CI 0.25 to 0.91) and having sexual experience (β=1.16, 95% CI 0.73 to 1.58). By contrast, students who were single and had never been in a romantic relationship (β=–0.88, 95% CI –1.23 to –0.52) and those enrolled in non-healthcare disciplines (β=–1.06, 95% CI –1.55 to –0.56) had significantly lower knowledge scores. Positive attitudes were more prevalent among female students (males vs females: β=–2.07, 95% CI –2.80 to –1.34), those using the Internet as a source of contraceptive information (β=5.65, 95% CI 4.29 to 7.01) and those with higher knowledge scores (per one-unit increase, β=0.67, 95% CI 0.55 to 0.79). All associations were statistically significant (p

Conclusions

In general, undergraduate students’ knowledge of contraception was relatively low, while their attitudes were positive. Implementing education programmes focusing on correct usage and storage of condoms and the safety of emergency contraceptive pills may help improve their understanding and promote safer sexual practices, thereby contributing to reducing the risk of sexually transmitted infections and unintended pregnancies.

Effects of fermented versus unfermented red cabbage on symptoms, immune response, inflammatory markers and the gut microbiome in young adults with allergic rhinoconjunctivitis: a randomised controlled trial protocol

Por: Ngoumou · G. B. · Ngandeu Schepanski · S. · Blakeslee · S. B. · Diedering · A. · Twal · E. · Raue · S. L. · Schroeder · M. · Wicaksono · W. A. · Stritter · W. · Berg · G. · Seifert · G.
Introduction

Allergic rhinoconjunctivitis (ARC) is a highly prevalent immune-mediated condition associated with substantial symptom burden, impaired quality of life and increased healthcare use. Emerging evidence highlights the role of the gut microbiome in immune regulation and allergic disease. Fermented foods may contain live microbes (when unpasteurised or uncooked) and bioactive postbiotic metabolites that can modulate immune responses. Despite growing interest in dietary strategies targeting the microbiome, no randomised controlled trial has compared fermented versus unfermented red cabbage for ARC.

Methods and analyses

This single-centre, randomised, controlled trial with a sensory-matched, unfermented cabbage comparator investigates the effects of daily consumption of fermented red cabbage for 8 weeks compared with an unfermented red cabbage control in young adults (18–35 years) with ARC. A total of 158 participants will be randomly assigned (1:1). The primary outcome is change in Total Nose and Eye Symptom Score from baseline to week 8. Secondary outcomes include daily symptoms and medication use captured via mobile ecological momentary assessments, quality of life, psychological well-being, gastrointestinal symptoms, systemic inflammatory markers, total IgE, immune cell profile and metagenomic characterisation of stool samples. A nested qualitative component explores participants’ experiences and acceptability of the intervention. Analyses will include mixed-effects models, time-series analyses incorporating daily pollen counts and comprehensive microbiome statistics. Safety outcomes and adverse events will also be assessed.

Ethics and dissemination

This study was approved by the Ethics Committee of Charité—Universitätsmedizin Berlin (EA4/043/25) and is conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Results will be disseminated through peer-reviewed publications, conference presentations and a lay summary provided to participants. Anonymised datasets and analysis scripts will be made available in public repositories, and metagenomic sequencing data will be deposited in an international sequence archive to ensure transparency and reproducibility.

Trial registration number

DRKS00036475.

Use of wearable technology in improving emergency care and health outcomes for patients with urgent health complaints: protocol for a scoping review

Por: Alotaibi · R. · Alghaith · A. · Noehrer · L. H. · Kitchen · G. B. · Body · R.
Introduction

Since the 1970s, telemedicine has transformed significantly, becoming a critical component of modern healthcare delivery. Over time, technological innovation has increasingly emphasised the integration of the human body with digital systems to develop non-invasive methods for monitoring physiological parameters. Among these technologies, wearable sensors demonstrate substantial potential for continuous patient monitoring. These devices can facilitate real-time data collection, enable more rapid clinical decision-making and promote active patient participation in health management. Such capabilities are particularly valuable in emergency contexts, including prehospital care provided by ambulance services and telephone triage systems. Despite the growing interest in wearable health technologies, their integration into emergency medical services (EMS) remains insufficiently explored and warrants further investigation. We aim to map current research, explore the use of wearables in EMS settings and identify gaps in knowledge regarding their use in EMS.

Methods and analysis

This scoping review will follow the Joanna Briggs Institute’s (JBI) methodology for scoping reviews. A systematic search of relevant databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, ProQuest and Web of Science) will be conducted, from inception to March 2026. All types of study designs, including quantitative and qualitative studies, will be considered in this scoping review. The inclusion is limited to studies published in English. Two independent reviewers (RA and AA) will conduct a thorough screening of titles and abstracts against the predefined inclusion criteria. Studies that meet the inclusion criteria will be reviewed in full text. Quality and risk of bias will be assessed using the JBI’s critical appraisal tools for the relevant study types. The findings will be presented using diagrams or tables, supplemented by narrative summaries following the JBI guidelines.

Ethics and dissemination

Ethical approval is not required. The findings of this study will be disseminated via publication in a peer-reviewed journal.

Registration

Open Science Framework (10.17605/OSF.IO/MUEFX).

Antibiotic self-medication and home storage among university students in Vietnam: a cross-sectional study

Por: Doan · D. A. · Nguyen · V. X. · Le · G. B. · Nguyen · T. T. X. · Dinh · D. X.
Objectives

Antibiotic self-medication and home storage are two common behaviours that can result in inappropriate drug use. This study elucidated their prevalence and associated factors among university students in Vietnam.

Design

Cross-sectional study.

Setting

Vietnam.

Participants

2230 university students.

Primary and secondary outcome measures

Antibiotic storage was evaluated at the time of the survey, while self-medication was assessed for 1 year preceding this time. Associated factors were determined via multivariable logistic regression models.

Results

Among 2230 participants, 418 (18.7%) reported self-medicating with antibiotics. The three main reasons for this behaviour included saving time (48.6%), mild diseases (45.0%) and the ease of purchasing antibiotics from community pharmacies (43.8%). Community pharmacies (88.3%) and home storage (36.4%) were the primary sources of antibiotics for self-treatment. Students mainly selected antibiotics based on community pharmacists’ consultation (59.8%) and their knowledge/experience (37.8%). They commonly read the patient information leaflet (64.6%) and asked for the community pharmacist’s advice to obtain information about antibiotic usage (52.9%). Besides, 296 students (13.3%) stored antibiotics at home. Over two-thirds had antibiotic leftovers from previous treatment and stored them for future use (69.3%), while 46.3% purchased antibiotics from community pharmacies without a prescription. Amoxicillin/clavulanic acid was the most commonly used antibiotic for self-medication (59.8%) and home storage (54.4%). Antibiotic self-medication was significantly associated with older age (adjusted odds ratio (aOR)=1.25; 95% CI 1.15 to 1.35), non-healthcare students (aOR=0.47; 95% CI 0.34 to 0.63), higher knowledge score (aOR=1.05; 95% CI 1.02 to 1.07) and storing antibiotics at home (aOR=7.12; 95% CI 5.34 to 9.51). Factors associated with home storage of antibiotics included non-healthcare students (aOR=2.77; 95% CI 2.01 to 3.83), region (north: aOR=6.50; 95% CI 3.49 to 13.54; south: aOR=5.92; 95% CI 3.06 to 12.65), having a family member working in the medical field (aOR=1.70; 95% CI 1.29 to 2.25), higher knowledge score (aOR=1.05; 95% CI 1.02 to 1.08) and antibiotic self-medication (aOR=7.58; 95% CI 5.69 to 10.14) (p values

Conclusions

The prevalence of antibiotic self-medication and home storage among students was relatively low but still raises public health concerns. Some interventions, such as integrating targeted health education programmes into university curricula, orientation sessions, extracurricular activities and campus campaigns, may help effectively promote rational antibiotic use.

Understanding Canadian experiences of suicidality during the COVID-19 pandemic: protocol of a pan-Canadian qualitative study

Por: Baharikhoob · P. · Hollenberg · E. · Cuperfain · A. B. · Rudoler · D. · Nicoll · G. · Blumberger · D. · Bolton · J. · Chartier · G. B. · Crawford · A. · Furqan · Z. · Gajaria · A. · Gratzer · D. · Hatcher · S. · Husain · M. I. · Kurdyak · P. · Lam · J. S. H. · Lavergne · M. R. · Marshall
Introduction

The COVID-19 pandemic led to major disruptions in society across many spheres, including healthcare, the economy and social behaviours. While early predictions warned of an increased risk of suicide during and after the COVID-19 pandemic, rates of suicide deaths remained stable or decreased over that period for most countries. In contrast, the prevalence of suicidal ideation doubled and suicide attempts slightly increased during the COVID-19 pandemic in the adult general population worldwide, accompanied by a higher prevalence of major depressive disorder and anxiety disorders. While these data can tell us what happened, they cannot tell us why. Qualitative suicide research seeks to understand experiences of individuals with suicide-related thoughts and behaviours, provides an in-depth exploration of their lives and interactions with others and centres their views and unique context. There is little qualitative research focusing on suicidality during the pandemic. This study will use a qualitative approach to explore the extent and impact of the COVID-19 pandemic on Canadians who experienced suicidality and review their experiences of accessing mental healthcare to identify key components in supporting safety and recovery.

Methods and analysis

This study will involve approximately 100 semistructured interviews with participants across four Canadian provinces and will explore experiences with suicide-related thoughts and behaviours during the COVID-19 pandemic. Transcripts will be analysed through qualitative analysis informed by constructivist grounded theory.

Ethics and dissemination

The study was approved by the Research Ethics Board of the Centre for Addiction and Mental Health, Toronto Academic Health Sciences Network (for JZ: CAMH REB No 104-2022). In addition to traditional peer-reviewed presentations and publications, a report will make study findings accessible to policy makers, media and the public.

I CAN DO Surgical ACP (Improving Completion, Accuracy and Dissemination of Surgical Advanced Care Planning): a protocol for a multisite, single-blinded, pragmatic randomised controlled trial to improve ACP completion in older adults in the presurgical set

Por: Welton · L. · Colley · A. · Sudore · R. L. · Melton · G. B. · Botsford · C. · Oreper · S. · O'Brien · S. E. · Koopmeiners · J. S. · Gibbs · L. · Carmichael · J. C. · Wick · E. C.
Introduction

Approximately, 20 million older adults undergo major elective surgery annually, yet less than 10% engage in advance care planning (ACP). This is a critical missed opportunity to optimally engage in patient-aligned medical decisions and communications in the perioperative setting. The PREPARE ACP programme (easy-to-read advance directives (ADs) and a patient-directed, online ACP programme) has been shown to increase ACP documentation and patient and clinician empowerment to discuss ACP. Yet, a gap remains in extending PREPARE’s use to surgical populations. We hypothesise that by delivering PREPARE in a patient-facing electronic health record (EHR) centric presurgery workflow for older adults, supported by automated patient reminders and outreach from a healthcare navigator (HCN), we can enable patients and/or surgical teams to engage in ACP discussions.

Methods and analysis

This is a three-site, single-blinded, pragmatic randomised trial comparing increasing intensity of ACP-focused, patient-facing EHR messaging and HCN support. The outreach occurs prior to a new presurgical clinic visit. We will enrol 6000 patients (2000 each site) aged 65 and older and randomise them equally to the following study arms: (Arm 1) ACP-related cover letter and PREPARE URL information sent via patient portal and postal mail (includes cover letter, AD and PREPARE pamphlet); (Arm 2) Arm 1 plus reminder message via text or MyChart message and (Arm 3) Arm 2 plus HCN outreach and support. The primary outcome is clinically meaningful ACP documentation in the EHR (ie, surrogate designation, documented discussions and ADs) within 6 months of the new surgical visit. The rate of ACP documentation will be compared between treatment groups using generalised estimating equations. Secondary outcomes include a validated four-item ACP engagement survey, administered 2 weeks after the presurgical visit and 6 months later. All analyses will follow the intention-to-treat principle and recent Consolidated Standards of Reporting Trials guidelines.

Ethics and dissemination

The study will be conducted according to the Declaration of Helsinki, Protection of Human Volunteers (21 Code of Federal Regulations (CFR) 50), Institutional Review Boards (21 CFR 56) and Obligations of Clinical Investigators (21 CFR 312). The protocol and consent form were reviewed and approved by Advarra, an National Insitutes of Health (NIH)-approved, commercial, centralised Institutional Review Board (IRB). The IRB/Independent Ethics Committee of each participating centre reviewed and approved the protocol and consent and obtained reliance agreements with Advarra prior to study initiation. The study is guided by input from patient and clinical advisory boards and a data safety monitoring board. The results of the study will be disseminated to both academic and community stakeholders, complying with all applicable privacy laws.

Trial registration number

ClinicalTrials.gov ID: NCT06090552.

Protocol number

Advarra Pro 00070994.

University of California, San Francisco IRB iRIS number

23-38948.

Protocol Date: 24 October 2024. Protocol Version: 4.

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