IMPORTANCE Diseases of despair (ie, mortality or morbidity from suicidality, drug abuse, and alcoholism) were first characterized as increasing in rural White working-class populations in midlife with low educational attainment and associated with long-term economic decline. Excess mortality now appears to be associated with working-class citizens across demographic and geographic boundaries, but no known qualitative studies have engaged residents of rural and urban locales with high prevalence of diseases of despair to learn their perspectives. OBJECTIVETo explore perceptions about despair-related illness and potential intervention strategies among diverse community members residing in discrete rural and urban hotspots. DESIGN, SETTING, AND PARTICIPANTSIn this qualitative study, high-prevalence hotspots for diseases of despair were identified from health insurance claims data in Central Pennsylvania. Four focus groups were conducted with 60 community members in organizations and coalitions from 3 census block group hotspot clusters in the health system between September 2019 and January 2020. Focus groups explored awareness and beliefs about causation and potential intervention strategies. MAIN OUTCOMES AND MEASURESA descriptive phenomenological approach was applied to thematic analysis, and a preliminary conceptual model was constructed to describe how various factors may be associated with perpetuating despair and with public health. RESULTSIn total, 60 adult community members participated in 4 focus groups (44 women, 16 men; 40 White non-Hispanic, 17 Black, and 3 Hispanic/Latino members). Three focus groups with 43 members were held in rural areas with high prevalence of diseases of despair, and 1 focus group with 17 members in a high-prevalence urban area. Four themes emerged with respect to awareness and believed causation of despair-related illness, and participants identified common associated factors, including financial distress, lack of critical infrastructure and social services, deteriorating sense of community, and family fragmentation. Intervention strategies focused around 2 themes: (1) building resilience to despair through better community and organizational coordination and peer support at the local level and (2) encouraging broader state investments in social services and infrastructure to mitigate despair-related illness. CONCLUSIONS AND RELEVANCEIn this qualitative study, rural and urban community members identified common factors associated with diseases of despair, highlighting the association between long-term political and economic decline and public health and a need for both community-and state-level solutions to address despair. Health care systems participating in addressing community (continued) Key Points Question What do people living in communities with high prevalence of diseases of despair (suicidality, drug abuse, and alcoholism) believe is driving the crisis, and what are their potential solutions? Findings In this qualitative study, 60 participants from 3 communities identif...

Introduction: Poor dental hygiene has been associated with various perinatal complications in studiesdone worldwide but few studies in Nepal have explored the knowledge of pregnant ladies regardingdental hygiene. The aim of the study was to know the knowledge and practices of pregnant womenregarding oral health in a tertiary care center in Nepal. Methods: A qualitative study was carried out in Nobel Medical College and Teaching Hospital fromJanuary 15, 2018 to June 15, 2018 after approval from the Institutional Review Committee of NobelMedical College. Convenience sampling was done. Fifty pregnant women admitted in antenatalward were interviewed regarding their knowledge of dental care in pregnancy, the common dentalproblems they faced and the treatment taken. A predesigned proforma was used and results wereanalyzed using SPSS version 17. Results: Twenty two (44%) patients reported dental problems during pregnancy. Bleeding gumswas seen in 7 (14%) and toothache in 7 (14%) were commonly reported dental problems. Forty seven(94%) patients acknowledged that routine dental care was needed for health, only 6 (12%) wereaware that poor dental health could affect baby weight. Oral health not seen as priority in 24 (48%)was the main barrier to seeking dental care in pregnancy followed by costs of treatment in 18 (36%)and safety concerns in pregnancy in 8 (16%) cases. Conclusions: Though dental problems were a common occurrence in pregnancy, utilization ofservices was low for the same. The participants reported significant barriers to obtaining dental careincluding lack of knowledge about the importance of maternal oral health and the treatment costs.

Introduction: Effective nursing care by well-trained hands and affectionate heart constitute the backbone of medical intervention in HIV/AIDS. The apprehension often articulated by health professionals while dealing with people living with HIV/AIDS hampers in health care. The purpose of the present study was to assess the extent of knowledge and attitude towards HIV/AIDS amongst nursing students.Methodology: The present cross-sectional study was conducted among 113 selected proficiency certificate level nursing students of Parsa district of Nepal. Pre-tested anonymous questionnaire was administered to collect the responses necessary to infer the extent of knowledge on HIV/AIDS and nature of attitude towards PLWHA. The extent of knowledge was measured through an overall knowledge index constructed based on the responses to 10 objective questions. To ascertain the respondent’s overall attitude, responses to various opinions were scored and summed upto form an attitude index.Results: Almost half of the nursing students had good knowledge while almost a quintile numbers had incomplete knowledge about HIV/AIDS. Majority of them had negative attitude towards the care of PLWHA.Conclusions: In aggregate, nearly half of the respondents had good knowledge about the various aspects of HIV/AIDS; however, majority of them had negative attitude towards the care of PLWHA. The overall knowledge and attitude of senior class was better than their junior counterparts. The training programmes for nurses should aim at confidence and skill building to deal with HIV issues.SAARC J TUBER LUNG DIS HIV/AIDS, 2015; 12(1), Page: 8-13

Women who have been in jail are at increased risk of acquiring HIV when they are in the community. Nonoccupational postexposure prophylaxis (nPEP) reduces HIV transmission following high-risk behaviors and is an effective HIV prevention strategy. The authors designed a 15-minute interactive educational program to increase inmates' knowledge of nPEP. Before the program, participants self-reported high HIV risk yet low risk perception and lack of nPEP awareness. After the program, nPEP knowledge scores increased by 40% regardless of demographic or HIV-risk characteristics. This study demonstrates that a brief, easy-to-deliver educational intervention can be carried out in a jail, is effective at raising awareness of both HIV risk and nPEP, and may be useful for others seeking to increase use of this prevention strategy for high-risk women during incarceration.

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