Development of a questionnaire for evaluating genetics education in general practice

To support developments in genetics education, we constructed the GPGeneQ questionnaire to assess skills required for the practice of genetics by general practitioners (GPs). We describe the process of developing and validating this questionnaire to provide a detailed guide in the construction for questionnaires in the application of evaluating genetics education. The GPGeneQ was developed through a multi-step process with the initial draft based on a theoretical framework and literature review. The subsequent draft instrument contained three scales pertaining to GPs' knowledge, self-reported behaviour and attitudes regarding genetics in medicine. Content and ecological validity were measured by an iterative Delphi process involving experts, GPs and consumers of health services. Piloting to assess construct and criterion validity was conducted with a sample of GPs attending an educational workshop that was presented on a number of separate occasions in Victoria, Australia. Results from evaluations of 145 GPs participating in ten workshops revealed evidence for validity and reliability of the GPGeneQ: knowledge change (p < 0.001; CI, -1.63 to -0.68), behaviour change (p < 0.001; CI, -4.15 to -2.21), attitudinal change (p = 0.002; CI, -2.68 to -0.62). This paper details the procedures involved in developing and validating an assessment questionnaire for genetics education. The GPGeneQ is the first validated questionnaire covering a broad range of topics that is designed to provide a reliable measure for the evaluation of genetics education specifically in general practice. The procedures used are transferable to the construction of any instrument for use in genetics or other medical education.

Russian health care workers' knowledge of tuberculosis and infection control

BACKGROUND

Lack of knowledge may contribute to a higher risk of nosocomial tuberculosis (TB) among Russian TB health care workers (HCWs).

DESIGN

Community-based participatory study. Russian TB HCWs at five TB facilities (n = 96) were surveyed to assess knowledge specific to TB and infection control.

RESULTS

Overall scores were low. Analysis of variance showed a significant difference in knowledge by job category. Physicians scored significantly higher than nurses, laboratory staff and support staff. Nurses and laboratory technicians scored significantly higher than support staff. The biggest area of knowledge deficit was in infection control.

CONCLUSION

Knowledge level of TB among HCWs could influence the prevalence of nosocomial TB infection.

Knowledge, attitude and practices related to diabetes among community members in four provinces in Kenya: a cross-sectional study

BACKGROUND

This cross-sectional study sought to establish the level of knowledge of diabetes among community members in rural and urban setups in Kenya and determine how this impacts on their attitude and practices towards diabetes.

METHODS

A face-to-face interview was done for selected respondents using a structured questionnaire for data collection.

CONCLUSION

1982 respondents, 1151 (58.1%) female and 831 (41.9%) males aged between 13 and 65 years were interviewed. 539 (27.2%) of all the respondents had good knowledge of diabetes; of these 52% had tertiary education; 25% had secondary education while 14% and 9% had primary and no education, respectively. Only 971(49%) of the respondents had a positive attitude towards diabetes while 813 (41%) demonstrated good practices towards diabetes.

CONCLUSION

This study indicates that the level of knowledge of diabetes in all regions in the country is very poor. It also indicates very poor attitudes and practices of the community towards diabetes. A comprehensive nationwide diabetes education programme is necessary to improve this situation.

Awareness on psychosomatic health among adolescent girls of three schools in north Kolkata

INTRODUCTION

Psychosomatic health of adolescent girls at crossroads of childhood and mature adulthood, may lead to various health problems in future.

OBJECTIVE

To determine the improvement in the knowledge and attitude on health among adolescent girl students of Kolkata after the health education intervention.

MATERIALS AND METHODS

This 'Health Education Intervention Study' was conducted in October and November 2006, in three senior secondary schools of North Kolkata. The Simple Random Sampling Technique was applied to select three schools from the spot map of North Kolkata for this study, and 282 girl students in the adolescent age group of 13 to 19 years were selected from the completed updated list of students from the enrollment registers in these schools.

RESULTS

The mean age of the participants was 15.7 years (±1.8 years). This health education intervention showed a significant improvement in their knowledge on adolescent health, in the aspects of sex differences in pubertal spurts, probable causes of health problems during adolescence, physical changes in adolescent boys and girls, and psychological problems of adolescence. A significant improvement in positive attitude was observed, with regard to their opinion on substance abuse in the adolescent period and importance of sex education for adolescents.

CONCLUSION

This study revealed some unknown parts of psychosomatic health among adolescent girls, in this part of India.

Temporomandibular Disorders: Knowledge, Attitude and Practice among Dentists in Tehran, Iran

Background and aims

Temporomandibular disorders (TMD) account for the most common orofacial pains rising from musculoskeletal origin. The aim of this study was to investigate the level of knowledge, attitudes and practice of dental practitioners regarding TMD in Tehran, Iran.

Materials and methods

A questionnaire, containing 29 questions on etiology, signs and symptoms, diagnosis and treatment of TMD, was given to 200 randomly selected general dental practitioners and specialists as well as 11 TMD ex-perts.

Results

An overall response rate of 97% was achieved among participants (mean age: 39 ± 8.2 years old; mean years in practice: 11.5 ± 7.4). The mean score of knowledge of TMD was found to be 10.85± 2.54 (of a total of 23). TMD specialists were significantly more knowledgeable than general dental practitioners (p<0.05). With respect to attitude, there was a significant difference among various age groups, and by increasing age and years in practice, the attitude towards TMD had weakened. However, no significant difference was recorded between general dental practitioners’ attitude and that of TMD experts towards TMD. There was a positive correlation between subjects’ knowledge and attitude (P= 0.007, r=0.138).

Conclusion

According to the results, the level of knowledge and attitude of general dental practitioners of Tehran regarding TMD is not desirable. The majority are not willing to admit and treat TMD patients.

Rural Latino farmworker fathers' understanding of children's oral health

PURPOSE

This study's purpose was to examine rural Latino fathers' understanding of their children's oral health.

METHODS

A convenience sample (n=20) of fathers from a small agricultural community in California was recruited door-to-door and interviewed in their homes. Individual qualitative interviews in Spanish were conducted. Interviews were audiotaped, translated, and transcribed. Codes were developed, and the text was analyzed for recurrent themes.

RESULTS

Fathers came from Mexico (n=15) and El Salvador (n=5). Fathers had very little understanding of the etiology and clinical signs of dental caries. Overall, 18 of 19 fathers reported that their wife was primarily responsible for taking care of the children's hygiene. Fathers agreed that children's teeth should be taken care of from a young age, considered to be after 2 years. The fathers described very minimal hygiene assistance given to children by either parent and often considered a verbal reminder to be sufficient assistance. Fathers generally thought a child did not need supervision after approximately age 4 (range=1-11 years).

CONCLUSIONS

While rural Latino fathers might not actively participate in their children's oral hygiene, they do place value on it. Men are supportive of dental treatments, albeit later than recommended. Educational messages aimed at these families will disseminate to the fathers, indirectly.

Providers' knowledge, attitude and dispensing practices of e-pills in government dispensaries of South district in delhi, India

Background:

South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills) were assessed among health care providers of government dispensaries in South Delhi.

Study Design:

A descriptive epidemiological study.

Materials and Methods:

Both medical and paramedical (n = 428) providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule.

Results:

Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively (P < 0.05) correlated with their knowledge. Training resulted a significant (P < 0.05) improvement in knowledge, attitude and dispensing practice of the providers. Knowledge and training combined together contributed 35% to the dispensing practice (R² = 0.35).

Conclusion:

Besides knowledge, behavior change communication strategies should form a part of the training curricula of health care providers that would help to improve the dispensing practice of E-pills.

Knowledge, attitude and practice of emergency contraception among graduating female students of jimma university, southwest ethiopia

BACKGROUND

Emergency contraception refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods including emergency contraceptives. The objective of this study was to assess the knowledge, attitude and practice of emergency contraception among graduating female students of Jimma University main campus.

METHODS

A cross-sectional study was conducted in Jimma University main campus in 2009. The calculated sample size was allocated to each faculty proportions to size of female students. Then within the faculty the sample unit was selected by using simple random sampling technique. Data was collected using self administered questionnaire and analyzed using SPSS for widow version 16.0.

RESULTS

A total of 389 (96.5%) volunteered graduating female students participated in the study. One hundred sixty three (41.9%) were ever heard of Emergency Contraceptive, only 11(6.8%) used the method. The common sources of information were friends 60 (36.5%), radio 37 (22.8%) and television 20 (12.3%). One hundred sixteen (71.2%) agreed to use Emergency Contraceptive when they practice unintended sexual intercourse.

CONCLUSION

Awareness and use of emergency contraception among graduating female students of Jimma University was low. There is a need to educate adolescents about emergency contraceptives, with emphasis on available methods and correct timing of use.

Knowledge and practices of pesticide use among farm workers in the West Bank, Palestine: safety implications

OBJECTIVES

The objectives of this study were to assess the knowledge and practices associated with pesticide use in an agricultural community in Palestine, and to determine the prevalence of self-reported health symptoms related to pesticide exposure.

METHODS

In this cross-sectional questionnaire study, agricultural farm workers in Nablus district, Palestine, were interviewed on their knowledge and practices of pesticide use. Comparisons of knowledge and practices of pesticide use between various groups were performed using the Mann-Whitney U-test or the Kruskal-Wallis rank test of variance. The program of the Statistical Package for Social Sciences (SPSS) version 15 was used for data analysis.

RESULTS

The questionnaire was completed by 381 farm workers. The mean age ± SD of the participants was 38.8 ± 11.8 years. The majority (97.9%) of the participants were male. The mean participant scores for knowledge and safety procedures were 2.8 ± 3.2 out of 8 and 9.8 ± 2.4 out of 15, respectively. There was a significant positive correlation (r = 0.323; P < 0.001) between the knowledge and safety procedure scores. Unsafe behaviors were identified as the storage of pesticide products at home, the preparation of pesticides in the kitchen, inadequate disposal of empty pesticide containers, eating and drinking during pesticide application, and using inadequate protective clothing. The most frequent self-reported toxicity symptoms associated with pesticide use were skin rash (37.5%), headache (37%), excessive sweating (24.9%), and diarrhea (21.3%). There was a strong significant negative correlation (r = -0.83; P < 0.001) between self-reported toxicity symptoms and scores for protective measures.

CONCLUSION

The results of this study indicate that most farm workers in this district need more educational programs regarding the safety and use of pesticides. Legislation promoting the use of safer pesticides is also needed.

Reliability and validity of a Malay-version questionnaire assessing knowledge of breastfeeding

BACKGROUND

There is a need to identify the knowledge that mothers have about breastfeeding to help promote it. Therefore, it is important to develop a valid and reliable questionnaire to provide useful and comparable data about breastfeeding knowledge. The objectives of this study were to determine the reliability and validity of a Malay version of a questionnaire assessing breastfeeding knowledge and describe the breastfeeding knowledge level among respondents.

METHODS

A cross-sectional study was conducted from 1 January to 31 May 2008 among female staff working at the Universiti Sains Malaysia Health Campus. A self-administered questionnaire containing 53 items assessing breastfeeding knowledge was given to respondents. The questions were adapted and modified from a breastfeeding questionnaire developed by a team of Hospital Universiti Sains Malaysia paediatric nurses. Exploratory factor analysis, internal consistency reliability, and descriptive analysis of respondents' knowledge were conducted.

RESULTS

A total of 252 female staff participated in the study. Factor analysis constructed 10 domains of knowledge and excluded 6 items, leaving 47 items in the final questionnaire. Cronbach's alpha of the final questionnaire was 0.77. Respondents' lowest knowledge was on the practical aspects of breastfeeding.

CONCLUSION

The questionnaire is reliable and valid to assess the breastfeeding knowledge of Malaysian women.

A study on knowledge, attitude and practice of contraception among college students in Sikkim, India

OBJECTIVE

To assess the knowledge, attitude and practice of contraception among the college students.

MATERIALS AND METHODS

A cross sectional study was conducted in the Government College, Gangtok, Sikkim, during the month of April 2009 to evaluate the knowledge, attitude and practice of contraception among 156 students enrolled in the first year bachelor course. Descriptive statistics was used for data analysis.

RESULTS

98% (153/156) of the students had knowledge about family planning and 86% (134/156) of them had heard about contraceptives. Most of them knew about condoms (85%) and contraceptive pills (40%) but knowledge about permanent methods and Cu-T was poor (average 12%). Most students thought contraceptives were to be used to prevent unwanted pregnancy (35%) and for birth spacing (30%). 11% of students had used some form of contraceptive in the past and 7% were currently users. The most commonly used contraceptives were condoms, followed by combined use of OCP and condom.

CONCLUSION

The study highlights the need to motivate the youth for effective and appropriate use of contraceptives when required and arrest the trend towards unwanted pregnancy.

Have we done enough with diabetic education? A pilot study

BACKGROUND

Patients' education and empowerment are essential parts of a disease management. Patients have to be educated on the disease as well as lifestyle changes that they need to practise for a holistic and consistent improvement in their disease status. This study examined patients' knowledge on diabetes and nutrition as well as the role of dietician in the patient education.

METHODS

This was a cross-sectional study of patients aged more than 18 years, in a primary care centre in Kuala Lumpur. Patients responded to a pre-tested self-administered questionnaire which contains socio-demographic profiles of patients, knowledge on diabetes and nutrition. Patients were also asked on dietician consultation and the number of dietician visits. Patients were conveniently selected on the data collection days. Only consented patients and those who could understand Malay or English language were selected.

RESULTS

There were 110 patients who participated in the study. Overall the patients had good knowledge on diabetes and nutrition. The mean total knowledge score was 71.2% ± 9.34. Domains such as diabetes complications, exercise, meal practice, food sources and proportion need reinforcement. Only 60 (54.9%) patients had seen a dietician. Patients who had seen dietician showed significantly higher level of knowledge score (p=0.04). However frequent meeting with the dietician did not show any significant improvement in the knowledge (p=0.10). Factors such as patients' gender, ethnicity, level of education, employment status, glycaemic level, duration of illness and body mass index did not show any significant association with the overall diabetic and nutrition knowledge.

CONCLUSION

There is still a need to improve the overall diabetic education particularly in areas that patients were lacking such as diabetes complications, exercise, meal practice, food sources and proportion. It is equally necessary to encourage all diabetics to see a dietician since it helps to improve their level of knowledge as shown in this study.

Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria

BACKGROUND

Traditional birth attendants (TBAs) assist most deliveries in Nigeria. Knowing and understanding all issues surrounding HIV/AIDS and Prevention of Mother-To-Child Transmission of HIV (PMTCT) can help them to protect themselves and others. This study aimed to assess the knowledge and practice of PMTCT amongst TBAs in Lagos, Nigeria.

METHODS

This was a cross-sectional survey. Multistage sampling method was used to select 108 registered TBAs in 2 local governments areas who were interviewed using a pre-tested questionnaire.

RESULTS

All the respondents were aware of HIV but their awareness of PMTCT specifically was not as high. Only 8.3% of the respondents had good level of knowledge about HIV and PMTCT and up to 13% of them claimed to be able to cure HIV using native remedies. The practices of HIV counseling of patients and referral of patients for HIV testing were low and higher levels of knowledge positively influenced these practices significantly (p < 0.05). They were also deficient in certain measures to prevent infection of patients and themselves.

CONCLUSION

Most of the TBAs did not have adequate knowledge and practice of PMTCT illustrating the need for periodic PMTCT training for TBAs.

Is pharmacy a knowledge-based profession?

An increasingly important question for the pharmacy educator is the relationship between pharmacy knowledge and professionalism. There is a substantial body of literature on the theory of knowledge and it is useful to apply this to the profession of pharmacy. This review examines the types of knowledge and skill used by the pharmacist, with particular reference to tacit knowledge which cannot be codified. This leads into a discussion of practice-based pharmacy knowledge and the link between pharmaceutical science and practice. The final section of the paper considers the challenge of making knowledge work in practice. This includes a discussion of the production of knowledge within the context of application. The theoretical question posed by this review, "Is pharmacy a knowledge-based profession?" highlights challenging areas of debate for the pharmacy educator.

Medication adherence, self-care behaviour and knowledge on heart failure in urban South Africa: the Heart of Soweto study

BACKGROUND

There is a paucity of data on treatment adherence in patients with chronic heart failure (CHF) in Africa.

METHODS

We examined the pattern of treatment adherence, self-care behaviour and treatment knowledge in 200 consecutive patients with CHF attending the Chris Hani Baragwanath Hospital, Soweto, South Africa via a combination of questionnaire (100%, n = 200) and pill count (41%, n = 82).

RESULTS

Mean age was 56 +/- 14 years, 157 were black African (79%) and 109 (55%) were male. CHF-specific treatment included loop diuretics (93%), beta-blockers (84%), ACE inhibitors (74%), spironolactone (64%) and cardiac glycosides (24%); mean number of medications was 6 +/- 2. Overall, 71% (58 of 82) adhered to their prescribed CHF regimen and individual medication adherence ranged from 64 to 79%. Behavioural adherence varied from 2.5 to 98%. Patient treatment knowledge was poor; 56% could not name medication effects or side effects. However, an average knowledge score of 69% was achieved on 10 questions concerning CHF management.

CONCLUSION

As in other regions of the world, non-adherence to complex CHF treatment is a substantial problem in Soweto. Our data confirm the need for a dedicated CHF management programme to optimise CHF-related outcomes in a low-resource environment.

What do Youth with Type 1 Diabetes Know about the HbA1c Test?

The purpose of this study was to examine youths' knowledge of the hemoglobin A1c (HbA1c) test and glycemic control. Seventy youths (11-16 year olds) with type 1 diabetes were interviewed concerning their knowledge of the HbA1c test, health risks associated with particular HbA1c values, and their own glycemic goals. Results revealed that only 13% of youths accurately described the HbA1c test. Fewer correctly identified the HbA1c ranges for good, fair, and poor glycemic control. The majority of youths did not know the blood glucose values corresponding to specific HbA1c results. Only a small number of youth correctly estimated the short-term and long-term risks associated with maintenance of HbA1c of 7% and 12%. In this sample of mostly lower-income, minority youths with type 1 diabetes, there was a significant lack of knowledge concerning the meaning and implications of the HbA1c test. Findings suggest that interventions for this patient population should use the HbA1c test results to help young patients to better understand and set goals for their glycemic control.

Mental health literacy towards depression among non-medical students at a Malaysian university

Background The aim of the present study was to evaluate the knowledge and perception of depression among students of University Sains Malaysia (USM), in Penang, Peninsular Malaysia.Method Face-to-face interviews were conducted using a pre-validated 21-item questionnaire among students at USM.Results A total of 500 respondents participated in the survey comprising 24.6% (n=123) males and 75.4% (n=377) females. Half (50.0%, n=250) were Malays, followed by Chinese (44.0%, n=220) and Indians (6.0%, n=30). Whilst exploring the respondents' knowledge of the symptoms of depression, it was found that Chinese females had a comparatively better knowledge (P=0.058) of the symptoms of depression in comparison with Malays and Indians. Overall, social issues were attributed as the possible cause of depression. A cursory knowledge level was observed regarding medication for depression. Female students were more inclined towards the use of alternative and traditional medicines. However, with regard to seeking professional help, consultation with a psychiatrist was preferred by the majority.Conclusion Overall, a moderate level of knowledge about the symptoms of depression and a cursory knowledge of its therapy were observed. Those with personal experience of depression had better knowledge of the symptoms and therapy. Alternative treatments and traditional medicines were also favoured. There is a risk that this may affect the ability of Malaysian youths to seek evidence-based mental health care.

What is biomedical informatics?

Biomedical informatics lacks a clear and theoretically-grounded definition. Many proposed definitions focus on data, information, and knowledge, but do not provide an adequate definition of these terms. Leveraging insights from the philosophy of information, we define informatics as the science of information, where information is data plus meaning. Biomedical informatics is the science of information as applied to or studied in the context of biomedicine. Defining the object of study of informatics as data plus meaning clearly distinguishes the field from related fields, such as computer science, statistics and biomedicine, which have different objects of study. The emphasis on data plus meaning also suggests that biomedical informatics problems tend to be difficult when they deal with concepts that are hard to capture using formal, computational definitions. In other words, problems where meaning must be considered are more difficult than problems where manipulating data without regard for meaning is sufficient. Furthermore, the definition implies that informatics research, teaching, and service should focus on biomedical information as data plus meaning rather than only computer applications in biomedicine.

Making short-term climate forecasts useful: Linking science and action

This paper discusses the evolution of scientific and social understanding that has led to the development of knowledge systems supporting the application of El Niño-Southern Oscillation (ENSO) forecasts, including the development of successful efforts to connect climate predictions with sectoral applications and actions "on the ground". The evolution of "boundary-spanning" activities to connect science and decisionmaking is then discussed, setting the stage for a report of outcomes from an international workshop comprised of producers, translators, and users of climate predictions. The workshop, which focused on identifying critical boundary-spanning features of successful boundary organizations, included participants from Australia, Hawaii, and the Pacific Islands, the US Pacific Northwest, and the state of Ceará in northwestern Brazil. Workshop participants agreed that boundary organizations have multiple roles including those of information broker, convenor of forums for engagement, translator of scientific information, arbiter of access to knowledge, and exemplar of adaptive behavior. Through these roles, boundary organizations will ensure the stability of the knowledge system in a changing political, economic, and climatic context. The international examples reviewed in this workshop demonstrated an interesting case of convergent evolution, where organizations that were very different in origin evolved toward similar structures and individuals engaged in them had similar experiences to share. These examples provide evidence that boundary organizations and boundary-spanners fill some social/institutional roles that are independent of culture.

Male behavior toward reproductive responsibilities in sikkim

BACKGROUND

Failure to assess the impact of men's perceptions on reproductive health decisions has weakened reproductive health care programmes.

OBJECTIVES

We evaluated husbands' knowledge and practices with regard to the use of conventional contraceptives as manifested through reproductive health and sexual decisions.

MATERIALS AND METHODS

A population-based cross-sectional study was conducted in a rural setting of Sang PHC and Pakyong PHC area in Sikkim, India. Five hundred and ninety-six currently married men whose names were included in the eligible couple registers were selected by multistage random sampling. Information regarding knowledge and practice of contraceptive use was obtained from the participants by interview.

RESULTS

Out of the 596 male participants, the majority (55.87%) opined that they were in favor of using a contraceptive method after one child. Most participants (55.54%) said that their main source of information on contraceptive methods were the government health staff, while 24.84% acknowledged that most of their information came from the mass media. Eighty-two percent reported currently using some kind of the contraceptive method. Condom was used as a temporary method by only 16.27% of the responders, with the permanent method of vasectomy being opted for by only 4.87%. The method most widely used by their partners was the oral contraceptive pill (43.41%), followed by tubectomy (15.77%) and IUD (4.19%).

CONCLUSIONS

This research found that awareness and prevalence of contraceptive use among married men in a rural community in the East District of Sikkim were quite high. Nevertheless, female contraceptive methods continue to be the dominant method used in the community. Researchers and health care providers often ignore the sociodemographic significance of men and their role in the acceptance of contraceptive practices in the community.

Knowledge, attitudes and perceptions of nurses and nursing students towards HIV/AIDS

OBJECTIVE

To describe attitudes, knowledge and perceptions of nurses and nursing students towards the people who live with HIV/AIDS (PLWHA).

METHODOLOGY

Bibliographic study in which six electronic databases were searched using the key words: "attitude", "knowledge", "nursing", perceptions", "HIV/AIDS". Publications between 1998 and 2007 were considered.

RESULTS

560 articles limited by scientific researches or ministerial reports membership were retrieved. Finally a total of 38 publications were selected, the analysis showed that the level of knowledge of nurses and nursing students about PLWHA is good and the attitudes towards HIV/AIDS have improved over time. Nurses and nursing students have been able to identify both positive and negative aspects in the PLWHA care personally and professionally because there is a more favourable perception.

CONCLUSION

There are few studies in Latin America and Chile that study the attitudes and knowledge of the studied population towards PLWHA. According to publications found the knowledge and attitudes have improved because the perception is more favourable.

Beliefs about the causes of breast and colorectal cancer among women in the general population

OBJECTIVE

To describe and compare the causal beliefs and attributions about breast and colorectal cancer among unaffected women in the general population.

METHODS

A total of 439 unaffected women in the general population were recruited to complete a web-based survey assessing causal beliefs for either breast (n = 211) or colorectal cancer (n = 228).

RESULTS

Heredity was ranked as the most important causal factor, followed by diet or eating habits for both cancer sites. Women endorsed the following causes of breast or colorectal cancer, respectively: heredity (84.4, 78.5%), diet or eating habits (46.4, 69.7%), pollution in the environment (57.6, 40.3%), aging (48.8, 57.5%), alcohol (29.9, 40.8%), smoking (58.3, 50.8%), stress (27.5, 29.4%), and lack of exercise (35.7, 44.3%). Other factors such as prior surgery on the breast (23.7%) and colon (32.9%) or changes in one's immune system (60.6%-breast; 59.2%-colon) were also endorsed by some women. Significant differences in the degree of endorsement for various causes of breast and colorectal cancer were identified.

CONCLUSIONS

Both genetic and environmental causes for breast and colorectal cancer are endorsed by unaffected women. Misconceptions about the causes of these cancers are important targets for public education and risk communication efforts.

Ambiguity in knowledge transfer: The role of theory-practice gap

BACKGROUND

In spite of much literature written about the theory-practice gap in the international nursing journals, there is evidence that indicates this subject has not been probed comprehensively since nursing education was transferred to universities in Iran. In the recent years, the public and the government have criticized Iranian nurses because of poor quality of patient care. Although this subject has been lamented by some researchers, there is no comprehensive work on how this gap resulted. In the process of a larger study on "nursing knowledge translation to practice", of one PhD thesis, this process was explored.

METHODS

Using grounded theory analysis, indepth interviews were undertaken with a purposive sample of 29 nurses, with different levels of experience, from the school of nursing in Tehran University of Medical Sciences in 2006 from January to August. Data were analyzed using the constant comparative method.

RESULTS

Three main themes emerging from this study included clinical behavior structure, paradoxical knowledge and practice, and divergent nursing organization.

CONCLUSIONS

It seems that nursing education with some praxis and paradoxes in the realm of nursing knowledge and practice, along with divergent organizational structure have decreased nurses' ability in applying their professional knowledge and skills in order to bridge the gap between theory and practice. Moreover, in spite of increased academic input into nursing education, clinical behaviors of both education and practice settings was perceived as "traditional routine-based".

Are there gaps between medical students and professors in the perception of students' professionalism level?--Secondary publication

PURPOSE

The implementation of medical professionalism in education and evaluation is a recent trend in medical education. Although many studies on the subject have been carried out, they have generally been not focused specifically on the level of medical student professionalism, and the perception gaps between medical students and professors on this topic remain unresolved. This study attempts to determine whether such gaps exist.

MATERIALS AND METHODS

Two hundred fifty fourth-year medical students and 53 professors who were randomly selected from 41 medical schools were asked to complete a survey on the level of the professionalism of medical students. Using 31 core professionalism elements that are required for Korean medical students, students self-assessed their level of professionalism, and professors evaluated the professionalism level of medical students who were about to graduate.

RESULTS

Of the 31 core elements, significant perception gaps were found in 28 elements. The three domains into which the 31 core elements were divided - professional knowledge, professional skills, and professional attitude - all contained perception gaps, and professors' ratings generally were higher than those of the students, a noteworthy observation.

CONCLUSIONS

Medical professors need to encourage their students to elevate their professionalism. Furthermore, what the faculty think that they have taught regarding professionalism may not be fully assimilated by students. Therefore, further research is essential to determine the cause of such perceptional differences.

Extending the frontiers of knowledge: the report of a Royal College of Physicians-sponsored study visit

This is a report of a Royal College of Physicians-sponsored study visit to the U.K. The 'Taking knowledge overseas' scheme enables promising, talented and motivated physicians to have access to high-quality postgraduate educational experience early in their career which will stimulate learning and encourage them to share good practice and knowledge on their return home. By the end of 2008, 26 doctors from low-income countries had benefited from the programme.

Do doctors understand alcohol units?

A survey of 445 doctors in Yorkshire was conducted to ascertain their knowledge and awareness of alcohol units. Only 58% had some knowledge, and general practitioners scored better (69%) than hospital doctors (45%). However, 14% of doctors had no knowledge at all about alcohol units. Those who did not drink alcohol knew less than those who did and trainee doctors had significantly less knowledge than more senior physicians. Junior doctors who often deal with alcohol-related problems in their day-to-day hospital work had a poor knowledge. There needs to be a greater emphasis on alcohol and alcohol-related problems (including how to calculate alcohol units) in undergraduate and postgraduate curricula to improve doctors' knowledge and awareness of this important subject.

Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman

Objective This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.Methods A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.Results The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.Conclusion This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.

Knowledge and attitudes towards cardiopulmonary resuscitation and defibrillation amongst Asian primary health care physicians

Objective

To assess the knowledge and attitudes of local primary health care physicians in relation to cardiopulmonary resuscitation (CPR) and defibrillation.

Methods

We conducted a survey on general practitioners in Singapore by using a self-administered questionnaire that comprised 29 questions.

Results

The response rate was 80%, with 60 of 75 physicians completing the questionnaire. The average age of the respondents was 52 years. Sixty percent of them reported that they knew how to operate an automated external defibrillator (AED), and 38% had attended AED training. Only 36% were willing to perform mouth-to-mouth ventilation during CPR, and 53% preferred chest compression-only resuscitation (CCR) to standard CPR. We found those aged <50 years were more likely to be trained in basic cardiac life support (BCLS) (P < 0.001) and advanced cardiac life support (P = 0.005) or to have ever attended to a patient with cardiac arrest (P = 0.007). Female physicians tended to agree that all clinics should have AEDs (P = 0.005) and support legislation to make AEDs compulsory in clinics (P < 0.001). We also found that a large proportion of physicians who were trained in BCLS (P = 0.006) were willing to perform mouth-to-mouth ventilation.

Conclusion

Most local primary care physicians realize the importance of defibrillation, and the majority prefer CCR to standard CPR.

The HPV vaccine and the media: how has the topic been covered and what are the effects on knowledge about the virus and cervical cancer?

OBJECTIVE

In June 2006, the first vaccine for HPV was approved by the FDA and media coverage about the topic increased significantly. This study sought to explore the nature of the coverage and whether knowledge about HPV was affected by it.

METHODS

A content analysis, including 321 news stories from major newspapers, the AP wire and television news networks was conducted. A monthly RDD-recruited Internet survey with a national sample (n=3323) was used to assess changes in population knowledge.

RESULTS

Twenty-three percent of stories did not mention the sexually transmitted nature of the disease and 80% left out information about the need for continued cervical cancer screening after vaccination. Exposure to health-related media content was significantly associated with knowledge about HPV, even controlling for baseline knowledge (OR=1.62, 95% CI=1.12-2.35).

CONCLUSIONS

Changes in the volume of coverage over time were associated with knowledge about HPV, but the content analysis reveals that many of the stories were missing important information.

PRACTICE IMPLICATIONS

Clinicians must consider the potential media source patients are using for HPV-related information in order to correct inaccurate or incomplete information that could affect health behavior.

Development, psychometric testing, and revision of the Atlanta Heart Failure Knowledge Test

BACKGROUND AND RESEARCH OBJECTIVE

Several heart failure (HF) knowledge tools have been developed and tested over the past decade; however, they vary in content, format, psychometric properties, and availability. This article details the development, psychometric testing, and revision of the Atlanta Heart Failure Knowledge Test (A-HFKT) as a standardized instrument for both the research and clinical settings.

PARTICIPANTS AND METHODS

Development and psychometric testing of the A-HFKT were undertaken with 116 New York Heart Association (NYHA) class II and III community-dwelling HF patients and their family members (FMs) participating in a family intervention study. Internal consistency, reliability, and content validity were examined. Construct validity was assessed by correlating education level, literacy, dietary sodium ingestion, medication adherence, and healthcare utilization with knowledge.

RESULTS

Content validity ratings on relevance and clarity ranged from 0.55 to 1.0, with 81% of the items rated from 0.88 to 1.0. Cronbach alpha values were .84 for patients, .75 for FMs, and .73 for combined results. Construct validity testing revealed a small but significant correlation between higher patient and FM knowledge on sodium restriction questions and lower ingested sodium, r = -0.17, P = .05 and r = -0.19, P = .04, respectively, and between patient knowledge and number of days that medications were taken correctly (diuretics: r = 0.173, P < .05, and angiotensin-converting enzyme: r = 0.223, P = .01). Finally, patients seeking emergency care or requiring hospitalization in the 4 months before study entry were found to have significantly lower FM knowledge using both t test and logistic regression modeling.

CONCLUSIONS

The A-HFKT was revised using the content and construct validity data and is available for use with HF patients and FMs. The construct validity testing indicates that patient knowledge has a significant relationship to aspects of self-care. Furthermore, family knowledge may influence patient adherence with sodium restriction and healthcare utilization behavior.

Beliefs, benefits, barriers, attitude, intake and knowledge about peanuts and tree nuts among WIC participants in eastern North Carolina

The objective of this study was to assess beliefs (e.g. advantages, disadvantages, benefits, barriers) and knowledge about eating peanuts and tree nuts. Personal interviews based on the Theory of Planned Behavior were conducted to elicit beliefs about eating nuts. Then, a cross-sectional survey was administered to WIC participants from one county in North Carolina. One-hundred-twenty-four WIC participants (mean (SD) age=28.39 (8.09) completed the study. Most were Caucasian (51.6%) females (96%). About one third believed that eating nuts may help to lower cholesterol level. However, only about one forth believed that nuts can lower a risk of a heart attack or diabetes. More than one third believed that eating nuts will cause weight gain. The knowledge of respondents' about nutrient content of nuts was low with correct answers to most questions about 20% or below. The mean (SD) positive attitude, negative attitude, benefits and barriers scores, based on a range from 1 to 5, were 2.53 (0.91), 3.25 (0.89), 2.97 (0.85) and 2.90 (0.76), respectively. WIC participants' beliefs regarding the health effects of nuts are inconsistent with the most recent research findings. They are in a need to education about benefits of eating nuts.

The anterior temporal lobes and the functional architecture of semantic memory

Recently, three accounts have emerged on the role of the anterior temporal lobes (ATLs) in semantic memory. One account claims that the ATLs are domain-general semantic hubs, another claims that they underlie knowledge of unique entities specifically, and yet another account claims that they support social conceptual knowledge generally. Here, we review neuropsychological and neuroimaging studies that bear on these three accounts and offer suggestions for future research to elucidate the roles of the ATLs in semantic memory.

Tanning behavior among young frequent tanners is related to attitudes and not lack of knowledge about the dangers

OBJECTIVE: To examine the importance of tanning among students in relation to attitudes and knowledge regarding skin cancer prevention. DESIGN: A cross-sectional survey. SETTING: College students at a major Midwestern university METHODS: Students were recruited to complete a self-administered questionnaire that included information on sun-sensitivity, knowledge and tanning attitudes and behaviors. Survey sampling statistical techniques that account for clustering among the 163 students recruited were used. RESULTS: We found a high level of skin cancer prevention knowledge; however knowledge was not related to a reduction in the importance of tanning. In many cases, higher levels of knowledge corresponded to a greater emphasis on the importance of tanning. Sunscreen use was low among this population. Those who placed an importance on tanning more often checked that they believed that "sunless tanning creams are safer than the sun". CONCLUSIONS: This population's belief that they look healthier and feel better with a tan strongly influences the desire to tan. Therefore, future cancer information campaigns or other prevention efforts should directly address the desire to tan by encouraging the use of sunless tanning products as an alternative method of tanning.

Mass media and HIV/AIDS in China

Exposure to mass media related to HIV/AIDS has been linked to attitudinal and behavioral changes. This study aims to identify the source(s) of HIV information for the general Chinese population and examine their association with HIV transmission knowledge and stigmatizing attitude toward people living with HIV/AIDS (PLWHA). A total of 3,716 market workers in Fuzhou, China, participated in a face-to-face survey. Multiple regression models were used to describe correlations among respondents' HIV/STD information sources, HIV transmission knowledge, and stigmatizing attitude toward PLWHA. Mass media sources, such as television programs, newspapers, and magazines, were more frequently identified as the channels for HIV information than interpersonal sources, such as friends and service providers. Exposure to multiple sources of HIV information (where at least one source is mass media) was significantly related to HIV knowledge and less stigmatizing attitude toward PLWHA. Mass media in China has been a major source of HIV information to the public. Enhancing the content and penetration of HIV/AIDS campaigns within various channels of the media can be an important strategy in disseminating HIV knowledge and reducing HIV-related discrimination.

Evaluation of knowledge of healthcare workers in hospitals of Zabol city on proper methods of blood and components transfusion

BACKGROUND AND AIMS

Blood and components are more frequently used in surgery and non-surgical procedures. In medical procedures blood transfusion is important and needs adequate expertise and practice, thus adequate knowledge in healthcare workers of this procedure is essential.

MATERIALS AND METHODS

This descriptive study is designed to assess the knowledge of healthcare workers about proper methods of blood transfusion, and how to promote their knowledge for proper performance if their knowledge is inadequate. Data were collected with aimed questionnaire and analyzed by statistics software.

RESULT

The study population mainly comprised 122 healthcare workers (HCWs). The main findings from this study showed that 26.2% of healthcare workers (HCWs) had low-level knowledge, 22.1% moderate and 51.6% acceptable knowledge. We did not find any significant correlation between knowledge of HCWs and years in profession, participation in training, number of blood transfusions per day, age, gender, etc. (P < 0.05).

DISCUSSION AND CONCLUSION

Results strongly emphasized the need for a curriculum to promote knowledge of HCWs about blood transfusion because we found low and moderate level of knowledge in approximately half our samples and on the importance of blood transfusion procedure, suggesting that more attempts should be made to build up knowledge about blood transfusion.

Knowledge of human papillomavirus: differences by self-reported treatment for genital warts and sociodemographic characteristics

The aim of this study was to evaluate knowledge about human papillomavirus (HPV) in individuals with genital warts compared with women from the general population without genital warts. Human papillomavirus (HPV) knowledge among women reporting treatment for genital warts compared with HPV knowledge in women reporting no treatment was assessed using data from the population-based 2005 Health Information National Trends Survey (HINTS). Three percent (N = 97) of women answered "yes" and 97% (N = 3,450) "no" to "Have you ever been treated for venereal warts or condyloma?" Women who reported treatment for genital warts, were more likely to have heard of HPV (odds ratio (OR): 2.4, 95% confidence interval (CI): 1.4-4.2 vs. no or don't know), to have been told they had HPV (OR: 24.5, 95% CI: 11.4-52.8), and to have accurate information about HPV, such as HPV causes cancer (OR: 2.7, 95% CI: 1.8-4.3). A large proportion (41%) of women who reported treatment for genital warts, however, had not heard of HPV. These women tended to be older, poorer, less educated, non-Hispanic Black, less likely to have had a recent Pap test, and divorced, widowed, or separated. Women with genital warts are learning about HPV, but socioeconomically disadvantaged groups may need to be targeted.

Language, literacy, and characterization of stroke among patients taking warfarin for stroke prevention: Implications for health communication

OBJECTIVE

Warfarin is a medication commonly prescribed to prevent strokes associated with certain medical conditions such as atrial fibrillation; however, little is known about how people taking warfarin perceive the goal of therapy and how they describe strokes. We assessed the stroke-related health literacy of anticoagulated patients to inform ways in which to improve health communication among people taking warfarin.

METHODS

We conducted a mixed-methods study of an ethnically and linguistically diverse sample of people taking warfarin to prevent stroke (N=183) and measured literacy using the short-form Test of Functional Health Literacy in Adults. We asked participants to (1) describe their indication for warfarin, and (2) describe a stroke. Transcribed answers were coded as concordant or discordant with established indications for warfarin and definitions of stroke.

RESULTS

Forty-three percent of participants provided a discordant response when describing their indication for warfarin. Only 9.3% reported that the purpose of taking warfarin was to prevent stroke. Not speaking English [OR=2.4 (1.1-5.6)] and less than a college education [OR=3.3 (1.4-7.3)] were independently associated with discordant answers about warfarin. Nearly 40% of subjects had inaccurate perceptions of stroke, and only one-third of subjects described a symptom or sign of stroke. Among English and Spanish-speaking participants, inadequate literacy was strongly associated with discordant responses about stroke [OR=5.8 (2.1-15.6)].

CONCLUSION

Among high-risk people taking warfarin to prevent stroke, significant gaps in stroke-related health literacy exist. These gaps likely represent mismatches in the ways clinicians teach and patients learn.

PRACTICE IMPLICATIONS

Since stroke risk awareness and early recognition of the signs and symptoms of stroke are critical aspects of stroke prevention and treatment, clinicians should more strongly link warfarin therapy to stroke prevention and ensure that patients know the presenting symptoms and signs of stroke. Public health communication strategies regarding stroke prevention need to target individuals with limited literacy and limited English proficiency.

Condom-use skills checklist: a proxy for assessing condom-use knowledge and skills when direct observation is not possible

Because of the continued importance of correct condom-use in controlling the HIV epidemic and the limited availability of tools for assessing correct condom-use, methods for assessing condom-application skills, especially when direct observation is not feasible, are needed. Accordingly, in the context of a high-risk population (The Bahamas) for HIV, a 17-item scale--the Condom-use Skills Checklist (CUSC)--was developed for use among young adolescents and adults. The rationale and approach to developing the scale and some measures of internal consistency, construct validity, and criterion-related validity have been described. It is concluded that the scale offers a reasonable alternative to direct observation among older subjects and that further development may make it more useful among pre-adolescents.

Development and evaluation of a web-based training program for oral health care providers on secondary prevention of eating disorders

Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p<.001); knowledge of oral manifestations from restrictive behaviors (p<.001) and purging behaviors (p<.001); knowledge of oral treatment options (p<.001); and attitudes towards the secondary prevention of ED (p<.001). Most participants strongly agreed or agreed that the program provided more information (89 percent) and resources (89 percent) about the secondary prevention of ED than were currently available; 91 percent strongly agreed or agreed that they would access this program for information regarding the secondary prevention of ED. This pilot project provides unique training in the clinical evaluation, patient approach, referral, and oral treatment that takes a multidisciplinary approach to address ED.

Diffusion of breast cancer risk assessment in primary care

BACKGROUND

Physicians who provide primary care to women have the opportunity to identify patients at high risk for breast cancer who are candidates for risk reduction strategies. Our objective was to determine the prevalence and determinants of the adoption of breast cancer risk assessment by primary care physicians.

METHODS

A cross-sectional survey of a nationally representative random sample of 351 internists, family practitioners, and obstetricians-gynecologists. We used a questionnaire that assessed knowledge, attitudes, discussion of breast cancer risk, use of software to calculate breast cancer risk, and ordering of BRCA1/2 testing.

RESULTS

Eighty-eight percent of physicians reported discussing breast cancer risk at least once during the previous 12 months; 48% had ordered or referred a patient for BRCA1/2 testing; and 18% had used a software program to calculate breast cancer risk. Physicians who had used BRCA1/2 testing or discussed breast cancer risk factors were more likely to be obstetrician-gynecologists and not in a solo practice; the use of risk software was also more common among obstetrician-gynecologists but was also associated with having a family member with breast cancer and a greater knowledge about breast cancer risk. Having patients ask for risk information was associated with the discussion of risk factors but not with the other risk assessment strategies.

CONCLUSIONS

Diffusion of breast cancer risk assessment is occurring in primary care practices, with a greater adoption of BRCA1/2 testing than of the use of risk assessment software. Adoption of these strategies seems to be related to the salience of breast cancer personally (for the physician) and within the practice, as well as the size of the practice, rather than attitudes about the risk assessment methods.

Impacts of a peer-group intervention on HIV-related knowledge, attitudes, and personal behaviors for urban hospital workers in Malawi

This report describes the effects of a peer-group intervention on Malawian urban hospital workers' HIV-related personal knowledge, attitudes, and behaviors. More than 850 clinical and nonclinical hospital workers received the intervention. Evaluation used independent surveys of a sample of workers at baseline (N = 366) and postintervention (N = 561). Compared with the baseline survey, after the intervention, workers had higher knowledge of HIV transmission and prevention; more positive attitudes including more hope, less stigmatization of persons with HIV, more positive attitudes toward HIV testing and condom use, and higher self-efficacy for practicing safer sex and for community prevention; more reported recent personal HIV tests, more discussion of safer sex with partners, and more reported community HIV prevention activities. However, health workers' risky sexual behaviors did not differ at baseline and postintervention. The intervention should be strengthened to support more sexual risk reduction and be made available to all health workers in Malawi.

Knowledge of Oral Hygiene among Hemophilic Patients Referred to Iranian Hemophilia Society

BACKGROUND AND AIMS

Hemophilic patients are faced with poor oral hygiene due to concerns about their dental care. The present study assessed the knowledge of hemophilic patients about oral hygiene and the effect of oral hygiene instruction in patients referred to Iranian Hemophilia Society.

MATERIALS AND METHODS

This cross-sectional study was carried out on 30 hemophilic patients randomly selected from volunteer patients referred to Iran Hemophilia Center. The study was performed by means of a questionnaire submitted to subjects before and after the instructional brochure submission. The questionnaire included demographic data and items regarding hemophilia and oral hygiene. Data was analyzed with McNemar test and paired t-test.

RESULTS

The mean age of the patients was 21 years; 27 (90%) were males and 3 ones (10%) were females. They were mostly A hemophilia infected. Most patients enjoyed fair knowledge of oral hygiene. Changes in knowledge after reading the bro-chure were significant regarding the appropriate time to replace the toothbrush (P < 0.01), necessary visits for tooth examina-tions (P < 0.04), adjunctive methods of caries prevention (P < 0.001) and factors related to bleeding (P < 0.01); other factors improved slightly without significant changes.

CONCLUSION

The knowledge of hemophilic patients was fair regarding oral hygiene while some relevant factors improved after instructions. However, more instruction is needed in order to attain more improvement in some behaviors.

Racial differences in knowledge and beliefs about Alzheimer disease

Alzheimer disease (AD) is a growing public health problem that disproportionately affects racial and ethnic minorities, including African Americans. Given that the perceptions of illness can influence response to treatment options and coping with disease burden, we examined differences between African Americans and whites with regard to their attitudes, beliefs, and knowledge about AD. A total of 301 participants (mean age = 57 y; 80% female; 47% African American) were surveyed by telephone, with overrepresentation of caregivers and first-degree relatives of people with AD (62% of sample). After controlling for potentially confounding covariates, the 2 groups differed in terms of the following: (1) their knowledge about the disease (eg, recognizing that AD is not a part of normal aging); (2) concern about AD (eg, worry about developing the disease); (3) beliefs about putative causes of AD (eg, stress); and 4) beliefs about the effectiveness of various options for reducing risk of and treating AD (eg, physical activity). Findings suggest that AD outreach and education efforts may do well to take into account divergent illness perceptions across racial and ethnic groups. Further research is needed to confirm these findings in more representative samples and to identify factors that explain these racial differences.

Benefits, barriers, self-efficacy and knowledge regarding healthy foods; perception of African Americans living in eastern North Carolina

African Americans in the United States suffer from many health disparities such as obesity, diabetes or hypertension. Lifestyle factors including diet and physical activity play an important role in prevention of these health conditions. The purpose of this research project was to assess beliefs, barriers and self-efficacy of eating a healthy diet and self efficacy of shopping for foods such as whole grains or foods designated as low fat or low sodium. Additionally, the objective was to assess beliefs about healthfulness, appropriate consumption, and protective aspect of specific foods including fruits, vegetables, and whole grains. The assessment was done using a survey instrument developed for this study. Data collection took place at two church locations. Data were obtained from 57 African Americans, mean age 50 years old (SD 12.70) completed the survey. The majority of respondents (58.1%) were females and most (75%) had at least some college education. Generally, benefits of eating healthy foods received considerably higher scores compared to barriers of eating healthy. A belief that healthy foods would help to take care of one's body received the highest mean score while a belief that healthy foods are too expensive had the highest score from all barriers. The results showed high self-efficacy of eating and purchasing healthy foods, high awareness of knowledge regarding foods associated with disease prevention but low awareness of recommendations for fruits and vegetables. The high scores for benefits, self-efficacy and knowledge regarding eating healthy foods did not translate into the perception of intake of such foods. Most participants believed that they do not eat enough of healthy foods. Interventions design to help African Americans make dietary changes should be culturally relevant and should involved working on a community level utilizing messages that are familiar and relevant to African Americans.

Evidence-based decision-making within the context of globalization: A "Why-What-How" for leaders and managers of health care organizations

In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the "evidence-based" issue remains for many health care professionals a day-to-day debate leading to unresolved questions. On one hand, many clinicians still resist to the implementation of evidence-based clinical practice, asking themselves why their current practice should be changed or expanded. On the other hand, many leaders and managers of health care organizations are searching how to keep pace with the demand of actionable knowledge. For example, they are wondering: (a) if managerial and policy innovations are subjected to the same evidentiary standards as clinical innovations, and (b) how they can adapt the scope of evidence-based medicine to the culture, context, and content of health policy and management. This paper focuses on evidence-based health care management within the context of contemporary globalization. In this paper, our heuristic hypothesis is that decision-making process related changes within clinical/managerial/policy environments must be given a socio-historical backdrop. We argue that the relationship between research on the transfer of knowledge and its uptake by clinical, managerial and policy target audiences has undergone a shift, resulting in increasing pressures in health care for intense researcher-practitioner collaboration and the development of "integrative KT platforms" at the crossroads of different fields (the field of knowledge management and the field of knowledge translation). The objectives of this paper are: (a) to provide an answer to the questions that health professionals ask most frequently about "Why" and "How" to bridge the know-do gap, (b) to illustrate by a Canadian example how the PRO-ACTIVE program helps in closing the evidence-based practice gap.

Knowledge, attitudes and practice about malaria in rural Tigray, Ethiopia

OBJECTIVE

To assess the knowledge, attitude and practice (KAP) regarding malaria and their determinants in a rural population of northern Ethiopia.

METHODS

The study was conducted in the district of Samre Saharti, Tigray, northern Ethiopia. A structured questionnaire collecting socio-demographic and malaria-related KAP information was administered to the mothers from a representative sample of households.

RESULTS

A total of 1652 questionnaires were available for analysis. Most of the respondents (92.7%) were able to mention at least one symptom of malaria. Mosquito as a cause of malaria was recognized by nearly half of the respondents (48.8%). Most of the households had a bed net (85.9%). To have a literate person at home, to belong to the lowland stratum, to have received some type of health education and to own a radio were associated with the knowledge of malaria. A strong association remained between living in the lowland stratum, to own a radio and to live close to the health post and the use of ITN. Being a housewife, lack of health education and to live further than 60 minutes walking distance to the health post were related to a delay on treatment finding.

CONCLUSION

This study has identified some aspects which the MCP might need to improve. The knowledge about malaria transmission should be strengthened. Promotion of literacy and participation in health education are vital components in terms of malaria knowledge and practice. Issues related to geographical location and accessibility to health post should be also carefully examined.

Why is the center of evidence-based dermatology relevant to Indian dermatology?

Evidence-based dermatology is the application of high-quality evidence to the care of individual patients with skin diseases. The Centre of Evidence-Based Dermatology in the UK promotes activities in this field through its three interlinking cogs, composed of the international Cochrane Skin Group, the UK Dermatology Clinical Trials Network (UKDCTN), and the UK national electronic library for skin disorders. The Cochrane Skin Group summarises what is already known about health care interventions by supporting systematic reviews of relevant randomized controlled trials (RCTs). The UKDCTN then addresses the key research gaps identified in systematic reviews by coordinating and carrying out well-designed RCTs. The Skin Disorders specialist library then plays a key role in disseminating new knowledge from systematic reviews and RCTs to a community of clinical users. The electronic resources at the Centre of Evidence-Based Dermatology are all freely available to Indian Dermatologists who can use the resources in a way that could benefit their patients. Such new knowledge only has value if it is shared and used.

Preschool children's views on emotion regulation: Functional associations and implications for social-emotional adjustment

Previous studies show that preschool children view negative emotions as susceptible to intentional control. However, the extent of this understanding and links with child social-emotional adjustment are poorly understood. To examine this, 62 3- and 4-year-olds were presented with puppet scenarios in which characters experienced anger, sadness, and fear. Forty-seven adults were presented with a parallel questionnaire. Participants rated the degree to which six emotion-regulation strategies were effective in decreasing negative emotions. Results showed that even the youngest preschoolers viewed cognitive and behavioral distraction and repairing the situation as relatively effective; compared to adults, however, preschoolers favored relatively "ineffective" strategies such as venting and rumination. Children also showed a functional view of emotion regulation; that effective strategies depend on the emotion being regulated. All participants favored repairing a negative situation to reduce anger and behavioral distraction to reduce sadness and fear. Finally, the more children indicated that venting would reduce negative emotions, the lower their maternal report of social skills. Findings are discussed in terms of functional emotion theory and implications of emotion-regulation understanding for child adjustment.

Knowledge, attitudes and risk perceptions about tuberculosis: US National Health Interview Survey

BACKGROUND

Tuberculosis (TB) disproportionately affects the human immunodeficiency virus (HIV) infected, foreign-born, Black, Hispanic, American Indian/Alaska Native, Asian, homeless, incarcerated, alcoholic, diabetic or cancer patients, male, those aged >44 years, smokers and poor persons.

METHODS

We present TB knowledge, attitudes and risk perceptions overall and for those experiencing TB disparities from the 2000-2005 US National Health Interview Survey (NHIS).

RESULTS

A total of 32% of respondents said TB is curable; 44% correctly recognized that TB is transmitted by air. Persons with less knowledge about TB transmission were aged 18-24 years, alcohol abusers, educated <12 years, Hispanics or males. Persons less likely to say TB is curable were aged 18-44 years, smokers, HIV-tested, uninsured, alcohol abusers or homeless/incarcerated. Only 28% of foreign-born persons from Mexico/Central America/the Caribbean said TB was curable.

CONCLUSIONS

Knowledge about TB transmission and curability was low among a representative US population. Renewed TB educational efforts are needed for all populations, but should be targeted to populations disproportionately affected, especially those who are HIV-infected, homeless/incarcerated, Black, alcohol abusers, uninsured or born in Mexico/Central America/the Caribbean.

Knowledge, attitude and practice of sawmill workers towards noise-induced hearing loss in kota bharu, kelantan

The purpose of this study was to determine the sawmill workers' knowledge, attitude and practice (KAP) in relation to noise-induced hearing loss (NIHL). A cross-sectional study was conducted involving 83 workers from 3 factories in Kota Bharu, Kelantan. Questionnaires were distributed to obtain the socio-demography, knowledge, attitude and practice level in relation to noise-induced hearing loss (NIHL). The weak areas identified in the knowledge section were treatment aspects (15.5%), signs and symptoms of NIHL (20.2%) and risk factors (31%). As for attitude; the prevention aspects were the lowest (25.3%), followed by risk taking attitude (26.2%), and causes of hearing loss (42.1%). Overall, the practice was not encouraging at all. It is important to have an education program to raise workers' awareness and to improve their attitude and practices towards noise-induced hearing loss.