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PubMed1992

[Pregnant women's knowledge about HIV and AIDS].

This investigation is based upon information from 820 pregnant women who replied to a questionnaire about AIDS during the period 17.4.1989-14.7.1989. The questions included sources of information, knowledge about routes of infection and risk groups and the extent of spread of infection and disease in the population. 95% agreed to participate. Knowledge had been obtained primarily via the electronic media, while the health services had limited significance. The employment of sources of information depended on age and occupation. Apart from knowledge about the risk involved in breast feeding, the women were, in general, well informed about routes of infection. Knowledge about risk groups and the current extent of spread of infection was, on the the other hand, deficient. Defective knowledge was concentrated in groups which may be characterized by age (less than 24 years) and occupation (trained and untrained workers and the group of "other occupations"). Information obtained from health staff was connected with better knowledge about the extent of spread of infection. The majority of women desired routine information about AIDS in connection with antenatal control. Prophylactic measures should be based, among other things, on knowledge about development in the knowledge in the population and its employment of sources of information, so that specific information may be directed to certain groups of the population by using the most frequently employed and most effective routes of information. The knowledge of population groups, the attitudes and behaviour should be followed continuously.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Pennsylvania dental hygienists' knowledge, attitudes, and infection control practices in relation to AIDS and AIDS patients.

PURPOSE: Limited documentation is found on dental hygienists' attitudes toward acquired immunodeficiency syndrome (AIDS) patients and their knowledge and practice of clinical infection control to prevent disease transmission to themselves and their patients. The purpose of this paper was to survey practicing Pennsylvania dental hygienists to document 1) their infection control practices; 2) their attitudes towards AIDS patients; and 3) their knowledge of clinical infection control practices. METHODS: A self-administered survey questionnaire, with fixed-alternative responses, was mailed in January 1991 to a random sample (N = 300) of licensed, practicing Pennsylvania dental hygienists. The questionnaire comprised eight multiple-choice questions for demographic purposes and 89 Likert-type questions eliciting information in five areas: AIDS-related knowledge, attitudes toward AIDS patients, knowledge of recommended Centers for Disease Control and Prevention (CDC) infection control measures, individual infection control measures, and individual laboratory infection control measures. Means and modes for individual questions and for specific categories were determined and analyzed utilizing Spearman rho correlation coefficients (p < .05). Mean scores were also tabulated for actual operator/laboratory infection control practices for both a routine patient and an AIDS patient. Those scores were analyzed utilizing the Wilcoxen signed-ranks test. RESULTS: Two hundred twenty questionnaires were returned for a 73.3% initial response rate. One hundred fifty-four of those returned were usable, for a 64% response rate. Results indicated that 94.2% of surveyed dental hygienists had comprehensive knowledge about AIDS and 92% had comprehensive knowledge of CDC-recommended infection control procedures. Eighty-five percent of respondents possessed a moderate or high feeling of worry concerning treatment of AIDS patients. The majority of surveyed dental hygienists routinely practiced the use of glasses, masks, and gloves; the use of disposable items; and surface disinfection of light handles, instrument bracket trays, and patient chair switches. Knowledge of recommended infection control procedures for dentistry was found to be associated (r = .22) with adherence to recommended infection control practices. Accurate knowledge about AIDS showed a weak (r = -.088) and nonsignificant relationship with dental hygienists' attitudes toward AIDS patients. Use of recommended infection control practices was found to be associated (r = -.20) with less fear concerning the treatment of AIDS patients. In addition, dental hygienists' infection control practices varied according to their perception of patient HIV status. CONCLUSIONS: Since Pennsylvania dental hygienists, within the limitations of this study, appear not to follow CDC guidelines on proper and responsible operatory/laboratory aseptic techniques stringently, and to differentiate infection control procedures based on perceived patient HIV status, recommendations are that 1) the Commonwealth of Pennsylvania should mandate that all Pennsylvania-licensed dental hygienists take at least one state-approved course on operatory/laboratory infection control every two years to qualify for relicensure; 2) all dental and dental hygiene education institutions and professional organizations should place more emphasis on strict adherence to the various agency recommended clinical guidelines for infection control; and 3) all dental hygienists should continually strive to update their own knowledge of current infection control practices.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Increasing disparity in knowledge of cardiovascular disease risk factors and risk-reduction strategies by socioeconomic status: implications for policymakers.

During the 1980s extensive local and national cardiovascular health promotion campaigns were implemented to improve knowledge of risk reduction. This study analyzed changes from 1980 to 1990 in knowledge of acquired cardiovascular risk factors (i.e., actual, objective knowledge of adverse lifestyle factors affecting cardiovascular health); perceived knowledge of risk-reduction strategies (i.e., subjective knowledge about how to reduce the likelihood of cardiovascular disease); and interest in risk modification (i.e., interest in changing risk-factor habits) by socioeconomic status using level of education. The study population included 2,455 women and men 25-74 years of age from three population-based cross-sectional surveys in two northern California cities. We found significant differentials in baseline knowledge that widened over the 10-year study period, resulting in larger disparities across educational groups at the final survey in 1990 (P < .05). From 1980 to 1990, individuals with < 12 years of education experienced only slight improvement in their knowledge of cardiovascular risk factors (mean summary score of 4.4 increasing to 5.5, based on a 17-item questionnaire of risk factors); those with > or = 16 years of education experienced twice as much improvement (mean of 8.4 increasing to 11.1) (P < .05). There were similar time-effect disparities in knowledge of risk-reduction strategies (P < .05). In contrast, interest in risk modification was high for all educational groups and remained uniform across time. The continuing and widening disparity in knowledge between socioeconomic groups suggests the need for policymakers to reform existing cardiovascular risk-reduction education campaigns.

Adult↗
PubMed1997

Knowledge and attitudes about depression among non-generalists and generalists.

BACKGROUND: The purpose of this study was to learn more about barriers to managing depression by comparing knowledge and attitudes about depression among physicians, internists, obstetrician-gynecologists, and a reference group of psychiatrists. Among the non-psychiatrists, we hypothesized that generalist physicians would have more favorable attitudes and greater knowledge about depression than non-generalists. METHODS: Survey questionnaires were sent to resident and faculty physicians (N = 375) of two university-affiliated medical centers. The physicians were classified as non-generalists (medicine subspecialists, transitional year interns, and obstetrician-gynecologists), generalists (general internists and family physicians), and psychiatrists. A 33-item written questionnaire assessed knowledge and three attitudinal dimensions: attitudes attributed by physicians to patients; physicians' confidence in managing depression; and physicians' psychosocial orientation. A knowledge scale and an attitudes scale were scored by adding the number of knowledge items answered correctly and the more favorable attitudinal responses. Multivariable regression was used to identify physician characteristics among non-generalists and generalists associated with higher knowledge and attitudinal scores. RESULTS: Response rate was 82%. Sixty percent of the respondents were male, 63% were resident physicians, and 14% had advanced psychosocial training. Non-generalists and generalists had similar demographic characteristics, but psychiatrists were significantly more experienced. Psychiatrists had the most favorable attitudes, followed by generalists and non-generalists. Compared with non-generalists, generalists were more confident in prescribing antidepressants (62% vs 25%), more likely to report that treating depression is rewarding (71% vs 39%), and less likely to refer to a psychiatrist (58% vs 79%). Generalist classification, increased experience, and higher levels of psychosocial training were associated with more favorable attitudes. Knowledge scores were significantly higher for psychiatrists than for non-generalists and generalists. Among non-psychiatrists, correct responses for knowledge items were: treatment efficacy (61%), treatment duration (59%), > or = 5 DSM-III-R criteria (52%), and prevalence of depression (30%). Among those with incorrect responses, both non-generalists and generalists overestimated the prevalence (52%) and underestimated the efficacy of drug therapy (30%). CONCLUSIONS: Generalists and non-generalists have similar and relatively good basic knowledge about depression. Misperceptions about treatment efficacy, and attitudinal barriers, particularly among non-generalists, may compromise the physician's ability to diagnose and manage depression.

Depression↗
PubMed1998

[Visiting nurses' self evaluation of their professional skills and knowledge related to care management].

Evaluation methods for assessing professional skills and knowledge has become very important in this age of cooperation and coordination of health-social professionals. We have developed conceptual framework as well as practical methods to assess professional skills and knowledge for health-social professions' interrelationship. The purpose of this study is to clarify the visiting nurses' self evaluation of their professional skills and knowledge related to care management. Subjects (238 visiting nurses) and controls (894 other kinds of health-social professionals) were asked to answer a questionnaire on "Evaluation of professional skills and knowledge", which had 3 mainstreams--basic skills and knowledge, management skills and knowledge, and general evaluation. Each subscale included essential items for professional skills and knowledge, covering all health-social professions. Results of investigation showed that more than 98.2% of visiting nurses agreed to the framework of this evaluation and items. Differences in evaluation according to kinds of profession were few. The structure of items related to professional knowledge and skills were clearly shown by cluster analysis, and coefficient alphas were more than 0.95 for each subscale. In conclusion, this evaluation would be practical for visiting nurses. "Evaluation of professional skills and knowledge" will be useful for visiting nurses to facilitate their coordination with other kinds of professionals on the job and they will also be able to utilize it in educational situations.

Clinical Competence↗
PubMed1997

A general model for the adaptive function of self-knowledge in animals and humans.

This article offers a general definition of self-knowledge that embraces all forms and levels of self-knowledge in animals and humans. It is hypothesized that various levels of self-knowledge constitute an ordinal scale such that each species in a lineage displays the forms of self-knowledge found in related species as well as new forms it and its sister species may have evolved. Likewise, it is hypothesized that these various forms of levels of self-knowledge develop in the sequence in which they evolved. Finally, a general hypothesis for the functional significance of self-knowledge is proposed along with subhypotheses regarding the adaptive significance of various levels of self-knowledge in mammals including human and nonhuman primates. The general hypothesis is that self-knowledge serves as a standard for assessing the qualities of conspecifics compared to those of the self. Such assessment is crucial to deciding among alternative reproductive and subsistence strategies. The qualities that are assessed, which vary across taxa, range from the size and strength of the self to its mathematical or musical abilities. This so-called assessment model of self-knowledge is based on evolutionary biological models for social selection and the role of assessment in animal communication.

Adaptation, Psychological↗
PubMed2000

Acquiring generic knowledge.

Generic knowledge is knowledge about kinds of things. The existence of generic knowledge poses a difficult acquisition problem: how do we acquire knowledge about kinds of things if we have experience with only a limited number of examples of the kinds in question? The problem is exacerbated by the fact that we sometimes acquire generic knowledge on the basis of experience with only a single instance of the kind. In this review, it is argued that there is a formal system for common-sense conception that underlies the acquisition of an important class of generic knowledge. Generic knowledge acquired through the use of the formal system represents the stable knowledge we have about kinds of things. It complements, rather than replaces, the statistical and causal (mechanistic) knowledge acquired through the use of other learning mechanisms.

Journal Article↗
PubMed1987

A functional analysis of phonological knowledge and generalization learning in misarticulating children.

It has been suggested that a child's productive phonological knowledge may be one factor that potentially accounts for individual differences in generalization learning observed among phonologically disordered children (Dinnsen & Elbert, 1984; Elbert, Dinnsen, & Powell, 1984). This paper evaluates the hypothesis that productive phonological knowledge influences generalization. Three related studies involving 6 functionally misarticulating children were conducted. In the first study, a description of each child's phonological system was developed using procedures of standard generative analysis. Based upon these descriptions, each child's productive phonological knowledge of his or her own sound system was determined and then ranked on a continuum ranging from "most" to "least" knowledge relative to the adult target. The second study implemented an experimental treatment program based upon each child's productive phonological knowledge, with treatment sounds selected directly from each child's continuum of knowledge. The third study reassessed each child's productive phonological knowledge following treatment. The results of these three studies indicated that a child's productive phonological knowledge of the sound system influenced the overall amount of generalization learning. However, the extent of generalization learning was associated with the point on the knowledge continuum at which treatment was initiated. These findings are discussed with reference to individual differences in generalization learning.

Articulation Disorders↗
PubMed2003

A study to evaluate the pain knowledge of two sub-populations of final year nursing students: Australia and Philippines.

BACKGROUND: Pain management is an essential and important aspect of nursing care. Deficits in pain knowledge and attitudes continue to be reported despite a growth of educational programmes. A lack of basic knowledge of pain at an undergraduate level may limit nurses from effectively developing their knowledge after graduation. AIM OF THE STUDY: To assess the type and level of knowledge of basic aspects of pain mechanisms and treatment principles in complete classes of final year nurses, at three nursing schools. METHOD: Data were collected in 1999, from 150 students (81 Australian and 69 Philippine) via a 23-item pain knowledge test questionnaire, previously used to assess undergraduate health professionals including nurses. RESULTS: The mean score of concordant answers for all students was 38.6%, scores ranged from 0% to 70%, 95% Confidence Interval of the mean was 36-41%. There were few significant differences between the groups for individual questions and no significant difference in overall mean scores. Common questions answered poorly included those related to complex regional pain syndrome, pharmacology and central sensitization. Most students perceived their undergraduate pain education to be minimal. Thirty-six per cent of Australian students compared with 50% Filipino students perceived their pain knowledge was adequate for their clinical needs. Additionally, most students believed that graduating doctors should be able to answer the test questions correctly. CONCLUSION: The results demonstrate consistently low levels of knowledge and also knowledge gaps about basic pain mechanisms, terms and treatment amongst these three final year nursing classes. Such information is useful to define levels of basic knowledge about this topic, and can be explored further as to whether some or all of these facts are deemed necessary for inclusion in nursing curriculum by reference to documents such as the International Association for the Study of Pain curriculum.

Australia↗
PubMed2002

Predictive validity of a written knowledge test of skills for an OSCE in postgraduate training for general practice.

PURPOSE: To examine the validity of a written knowledge test of skills for performance on an OSCE in postgraduate training for general practice. METHODS: A randomly-selected sample of 47 trainees in general practice took a knowledge test of skills, a general knowledge test and an OSCE. The OSCE included technical stations and stations including complete patient encounters. Each station was checklist rated and global rated. RESULTS: The knowledge test of skills was better correlated to the OSCE than the general knowledge test. Technical stations were better correlated to the knowledge test of skills than stations including complete patient encounters. For the technical stations the rating system had no influence on the correlation. For the stations including complete patient encounters the checklist rating correlated better to the knowledge test of skills than the global rating. CONCLUSION: The results of this study support the predictive validity of the knowledge test of skills. In postgraduate training for general practice a written knowledge test of skills can be used as an instrument to estimate the level of clinical skills, especially for group evaluation, such as in studies examining the efficacy of a training programme or as a screening instrument for deciding about courses to be offered. This estimation is more accurate when the content of the test matches the skills under study. However, written testing of skills cannot replace direct observation of performance of skills.

Clinical Competence↗
PubMed2003

Does problem-based learning lead to deficiencies in basic science knowledge? An empirical case on anatomy.

INTRODUCTION: Problem-based learning (PBL) is supposed to enhance the integration of basic and clinical sciences. In a non-integrative curriculum, these disciplines are generally taught in separate courses. Problem-based learning students perceive deficiencies in their knowledge of basic sciences, particularly in important areas such as anatomy. Outcome studies on PBL show controversial results, sometimes indicating that medical students at PBL schools have less knowledge of basic sciences than do their colleagues at more traditional medical schools. We aimed to identify differences between PBL and non-PBL students in perceived and actual levels of knowledge of anatomy. METHODS: Samples of Year 4 students in all eight medical schools in the Netherlands completed a questionnaire on perceived knowledge and took part in a computerised anatomy test consisting of both clinically contextualised items and items without context. RESULTS: Problem-based learning students were found to have the same perceived level of anatomy knowledge as students at other medical schools. Differences in actual levels of knowledge were found between schools. No significant effects on knowledge levels were found for PBL schools versus non-PBL schools. CONCLUSION: The results of this study show that PBL does not result in a lower level of anatomy knowledge than more traditional educational approaches. It remains to be ascertained whether the levels students attain are adequate. Subjects for further study are the desired level of anatomy knowledge at the end of undergraduate medical education and the effectiveness of basic science learning within a clinical context and with repetition over the course of the curriculum.

Adult↗
PubMed1996

Expert-novice knowledge of computer programming at different levels of abstraction.

Computer programming knowledge can be classified into five levels of abstraction: objective, conceptual, functional, logical, and physical. An experiment was carried out to determine whether the mastering of knowledge at different levels of abstraction changed with the level of skill. Ten experts and ten novices in C computer programming participated in the experiment. The subjects' knowledge at the five levels of abstraction was tested through 20 multiple-choice questions. The experimental results indicated that knowledge differences between experts and novices at an abstract level or a concrete level depended on what abstract or concrete knowledge was implied. Experts had better abstract knowledge than novices at the conceptual and functional levels but not at the objective level. Experts had better concrete knowledge than novices at the physical level but not at the logical level. The classification of computer programming knowledge in levels of abstraction and the experimental results helped in clarifying a general finding from previous studies that experts had better abstract knowledge than novices.

Cognition↗
PubMed1999

Relationship between sport knowledge, sport performance and academic ability: empirical evidence from GCSE Physical Education. General Certificate of Secondary Education.

The literature concerning links between sport knowledge, sport performance and academic ability is reviewed and related to empirical evidence obtained from a GCSE examination in Physical Education, together with GCSE Mathematics and GCSE English grades. For most sports examined, there was a small but significant positive correlation between sport performance and GCSE Mathematics and English grades, confirming the findings of most previous research. Using a multilevel multivariate model, average sport performance, academic ability and sex were important explanatory variables for sport knowledge, yet only academic ability was an important explanatory variable for the concept of physical education knowledge. Ability in game sports, rather than athletics, were related to sport knowledge. Males scored higher for sport knowledge than females, after taking into account sport performance and academic ability. The effects of sport performance and academic ability on sport knowledge were stable across schools, but there was some evidence that the effect of sex varied across schools. These findings support theories of a role for sport knowledge in sport performance; that such a role should be greater in game sports; that academic ability is important for gaining such knowledge; and they highlight differences in sport knowledge between the sexes.

Achievement↗
PubMed1979

Knowledge and belief in nutrition.

In a nutrition questionnaire, subjects have been given the options of answering questions with yes, no, or don't know. From these responses it has been possible to calculate the levels of their "correct knowledge," their "perceived knowledge" (that is the knowledge that each subject believed he had) and the "accuracy of knowledge". Questions about common nutritional problems were given to physicians, medical students, nurses, and theology students. All groups had a high level of "perceived knowledge," generally greater than 80% for the questions asked, but the accuracy of the knowledge was alarmingly low. The highest level was in physicians, in whom 79% of the perceived knowledge was accurate, but in theology students only 36% of the perceived knowledge was accurate. Two thirds of the "knowledge" of nutrition held by theology students was therefore false by current scientific standards. These findings have implications for future nutrition education.

Educational Measurement↗
PubMed1996

An international comparison of knowledge levels of medical students: the Maastricht Progress Test.

The increasing international mobility of medical students has inspired the search for an international assessment format. As one step along this line, kinetics of knowledge acquisition and final cognitive levels of students were compared among one Dutch, one German and four Italian medical faculties. For this comparison, the Maastricht Progress Test (MPT) was used. For four out of the six participating faculties, it was possible to compare the level of knowledge of sixth-year students. These data showed no significant differences on the test as a whole. On the other hand, as judged from cross-sectional data on students from all study years, the kinetics of knowledge acquisition showed different trends. In one school applying problem-based learning, acquisition of knowledge by students occurred almost linearly. In another school, over the first 2 years, acquisition of knowledge occurred only in the basic sciences but not in clinical or public health/behavioural sciences. In two other schools over that same period, students seemed to gain no knowledge at all. In some faculties, a marked boost in knowledge was noted with third- or fourth-year students. These findings may be explained by peculiarities of the respective curricula, selection of students during their studies, and national or local assessment procedures. It is preliminarily concluded that the different educational approaches and assessment systems in medical education in Europe seem to have only limited influence on the final level of knowledge of the graduates. On the other hand, these differences may influence the kinetics of knowledge acquisition, especially in distinct domains like basic or clinical sciences. Therefore, the MPT may not be suitabe to solve the problem of assessment of individual international exchange students, but it may be helpful in identifying corresponding cognitive levels on, for example, basic sciences for students in different curricula.

Clinical Competence↗
PubMed1997

Does knowledge of drug prescribing predict drug management of standardized patients in office practice?

Drug prescribing for the elderly is an important area of medical knowledge since inappropriate prescribing may lead to significant adverse drug events. The objective of this study was to evaluate the association between knowledge of drug use and quality of drug management by general practitioners in practice. A cross-sectional study design was used to evaluate a sample of 37 GPs in practice. A set of common musculoskeletal problems was chosen to evaluate doctors' knowledge of non-steroidal anti-inflammatory drug use, while performance in practice was assessed using elderly standardized patients. The reliability of knowledge test scores was evaluated using measures of internal consistency. The relationship between knowledge of drug use and quality of therapeutic management in practice was evaluated by rank order and linear correlation analysis. Demographic characteristics of participating and non-participating doctors were similar. The reliability of the knowledge test was 0.55. The reliability of performance scores was 0.66. The correlation between overall performance on the standardized patient cases and total knowledge test score was 0.22 (95% confidence interval = 0-0.63). Knowledge test scores were poorly correlated with quality of therapeutic management in office practice. This indicates that knowledge tests alone cannot predict quality of performance with regard to drug prescribing for the elderly in primary care office practice.

Clinical Competence↗
PubMedDate not supplied

Attitudes, knowledge and blood glucose control.

The hypothesis that management-related diabetes knowledge and attitudes may be more directly related to diabetic control than general knowledge of or general attitude towards diabetes is examined. Sixty Type 1 diabetic patients were studied using an itemized knowledge questionnaire and an attitude scale measuring a general attitude to diabetes but containing a previously defined subgroup of items concerned with attitudes to management. A significant linear correlation was found between management-related knowledge (r = -0.39; p less than 0.01) and HbA1c. However, knowledge of insulin, diet, footcare, and glucose monitoring were not significantly correlated with HbA1c, poor control being associated with both very low and very high knowledge status. A significant linear correlation was found between management-related attitudes (but not general attitude) and HbA1c (r = -0.47; p less than 0.01). The multiple regression correlation between HbA1c and both management knowledge and attitudes was -0.51. Most (63%) of the association between knowledge and HbA1c was attributable to attitude. This study provides support for education strategies based upon achieving improved patient attitudes and motivation rather than comprehensive knowledge as the most effective way of improving patient diabetic control.

Adolescent↗
PubMed1991

Oral health knowledge and habits of senior elementary school students.

Despite improvements in children's dental health, and significant resource allocation to health education programs, few recent studies have investigated the associations of oral health knowledge, behaviors, and status. This study of 11-year-old children (N = 6,329) in northeastern Ontario used a supervised self-complete questionnaire and a clinical examination to gather baseline data on, and test associations of, caries and periodontal knowledge, self-reported oral health behaviors and source of knowledge, and oral health status. Results show the children had poor knowledge of caries preventive measures such as water fluoridation, dental sealants, and choice of snack foods. Periodontal knowledge was better, but children confused plaque and calculus. Respondents claimed good oral health habits, with 73 percent claiming to brush at least twice daily, 88 percent claiming to use toothpaste, 42 percent claim to floss at least twice weekly, and 84 percent claiming an annual dental visit. Children with the best knowledge claimed dentist and school as the sources. High knowledge was associated with good oral health habits (P less than .001) and low DMFT score (P less than .001). Good habits were not related to DMFT score (P = .1095). Logistic regression showed high knowledge was associated with English cultural status, urban school area, good habits, having a dental sealant, and attending a fluoride-rinse school (P less than .05). Findings suggest a need to reinforce caries preventive teaching, to investigate the effect of cultural status, dental experience, and residence status on oral health knowledge, and to further test the efficacy of different oral health education programs delivered by different sources.

Analysis of Variance↗