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Correlates of accurate knowledge of cancer.

Knowledge acquisition, although a prerequisite of preventive behavior, has been a neglected area of research. Mass communication research shows that audience characteristics explain most of the variation in knowledge acquistion. Since cancer information is mainly disseminated via the media, we hypothesized that the same audience characteristics would be related to accuracy of cancer knowledge. Bivariate and multivariate associations between the hypothesized variables and a cancer knowledge score were tested using a three-stage random sample of Los Angeles County (N = 931). Smoking status, education, degree of cancer worry, health improvement behavior, ethnicity, age, household size, and frequency of health worry were related to knowledge accuracy. An examination of the underlying dimensions of cancer knowledge revealed three beliefs about cancer: smoking causes cancer; cancer can be cured; and the environment does not cause cancer. Smoking status, ethnicity, health improvement behavior, and worry about cancer and health were associated with the belief that smoking causes cancer. The independent variables in this study were not significantly related to the other two beliefs. These results conform with the general predictions of mass communication research. We conclude that targeting of cancer information and particular uses of media could raise the general level of cancer knowledge.

Adolescent↗

How do physicians react to new knowledge: the experience of Jonathan Hutchinson 1828-1913 with comments on its relevance today.

BACKGROUND: In the late 20th century, physicians are being challenged to absorb new knowledge at an ever-increasing pace. OBJECTIVE: This article will review the acquisition of new knowledge by Sir Jonathan Hutchinson, a prominent Victorian surgeon in the 19th century. At that time, new knowledge was presented much more slowly. How well Hutchinson absorbed new knowledge will be outlined and, in the light of his background and training, what events were there that either helped or hindered this process. CONCLUSION: Assuming good physical and mental health, age and basic training are often important in how physicians react to new knowledge; the timing of the release of new knowledge also plays a role. Training in the basic attributes of scientific medicine as well as continuing medical education will help in the processing of new knowledge. One common response by physicians to the increasing load of new information is the narrowing of the individual's field of expertise.

Attitude of Health Personnel↗

Assessing practice nurses' change in nutrition knowledge following training from a primary care dietitian.

The expanding role of the Primary Health Care Team (PHCT) has led to more opportunities to offer dietary advice to patients. However, members of the PHCT appear to lack nutritional knowledge and confidence when giving dietary advice. This work assesses the changes in Practice Nurses' (PNs) nutrition knowledge and confidence when giving dietary advice to patients, following training from a dietitian. Base line nutrition knowledge of PNs and their confidence when giving dietary advice was assessed in 30 GP Practices by questionnaire. Following Practice-based training from a dietitian, change in knowledge and confidence was assessed using the same questionnaire. Paired and unpaired analysis was carried out on the PN's knowledge and confidence scores respectively. Nutrition knowledge increased significantly after training. The mean difference (95% confidence interval) pre- and post-training was 11.6 (7.8, 15.4). After training 88% of PNs reported having good or excellent confidence compared with 27% before training (chi-squared test p < 0.001). Nutrition training from a dietitian improves nutrition knowledge of PNs. It also improves their confidence and is recommended to support their role in providing accurate and consistent dietary advice to patients.

Chi-Square Distribution↗

Knowledge and behavior of Nigerian dentists concerning the treatment of children with special needs.

BACKGROUND: Children with special needs (CSN) are reported to receive less adequate dental care due to various behavioral problems and barriers created by dental professionals. This study was carried out to determine the knowledge and behaviour of Nigerian dentists concerning the treatment of CSN. METHODS: Questionnaires consisting of open and closed ended questions requesting socio-demographic information, type of practice, undergraduate and postgraduate training, self-rated knowledge and behaviour concerning care of CSN, were hand delivered to 359 dentists in the 3 geographical zones of Nigeria over a period of 8 weeks. Responses were compared across age groups, gender, type of practice and training received. RESULT: Two hundred and eighty questionnaires were returned completed, constituting 79.9% response rate. Most of the respondents were aged 30-39 years (44.3%). There were more males (56.1%) and more recent graduates of 10 years and below (78.5%). Over 80% of respondents had treated children with disabilities, those with physical disabilities being most encountered. Only 19.3% of respondents rated their knowledge of management of CSN as adequate, with no significant difference across age groups and gender, but with a significantly higher number of older graduates reporting to have adequate knowledge (p < 0.05). Those who had undergraduate training in care of CSN were 69.5% compared with only 12.8% who had post graduate training. Only 11.8% rated their undergraduate training as adequate. Thirty seven percent of respondents rated the CSN they had treated as very challenging. A higher proportion of older graduates (of more than 10 years post graduation) and those who rated their undergraduate training as inadequate used sedation and general anaesthesia. Seventy one percent of respondents were willing to treat CSN, with no significant difference across age groups, gender and training, but with a significantly higher percentage among those who had rated their knowledge as adequate. Most of those who were unwilling to treat CSN felt their management was tedious and challenging. CONCLUSION: From this study, very few dentists reported to have adequate knowledge of management of CSN, irrespective of age, gender and place of practice. A significant number of those with more experience rated their knowledge as adequate. Although most dentists rated the children's behaviour as challenging, they indicated their willingness to treat them in their practices.

Journal Article↗

Counselling and knowledge about contraceptive mode of action among married women; a cross-sectional study.

BACKGROUND: Family planning counselling which covers knowledge transfer about contraceptive mode of action, by enabling informed choice, improves compliance to and efficiency of contraceptive methods. The objective of this study was to investigate associations between family planning counselling, counsellor and correct knowledge about mode of action of modern contraceptive methods among married women. METHODS: For this cross-sectional study, stratified (according to current modern contraceptive method in use) random sampling was performed from the registries of two primary health care centres. Main outcomes were; prevalence of family planning counselling, professional background of the counsellor and correct knowledge about mode of action. A semi-structured questionnaire developed by the researchers was applied via face-to-face interview. The answers about mode of action were categorized as correct vs. incorrect by consensus rating. RESULTS: Prevalence of counselling and correct knowledge about mode of action was 49.0% and 39.3%, respectively. Higher educated women were significantly more likely to know the mode of action (p < 0.001). Being counselled by a physician (54.1%, n = 120) was not associated with correct knowledge about mode of action (p = 0.79). Non-barrier method users were less educated (p = 0.001), more often counselled (60.8% vs. 8.0%) and less knowledgeable (p < 0.001) about mode of action of their contraceptive method, compared to condom users. Nevertheless, counselled non-barrier method users were significantly more likely to know the correct mode of action of their chosen method (p = 0.021) than counselled condom users. CONCLUSION: The beneficial effect of counselling on knowledge about mode of action of the more complicated, medical (non-barrier) contraceptive methods suggests that the use of family planning counselling services in primary health care should be promoted; furthermore, counselling strategies and content should be re-structured for better efficacy.

Journal Article↗

Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study.

BACKGROUND: Late presentation of patients at advanced stages when little or no benefit can be derived from any form of therapy is the hallmark of breast cancer in Nigerian women. Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in populations of the developing countries that hitherto enjoyed low incidence of the disease. Worried by this prevailing situation and with recent data suggesting that health behavior may be influenced by level of awareness about breast cancer, a cross-sectional study was designed to assess the knowledge, attitude and practices of community-dwelling women in Nigeria towards breast cancer. METHODS: One thousand community-dwelling women from a semi-urban neighborhood in Nigeria were recruited for the study in January and February 2000 using interviewer-administered questionnaires designed to elicit sociodemographic information and knowledge, attitude and practices of these women towards breast cancer. Data analysis was carried out using Statistical Analysis Software (SAS) version 8.2. RESULTS: Study participants had poor knowledge of breast cancer. Mean knowledge score was 42.3% and only 214 participants (21.4%) knew that breast cancer presents commonly as a painless breast lump. Practice of breast self examination (BSE) was low; only 432 participants (43.2%) admitted to carrying out the procedure in the past year. Only 91 study participants (9.1%) had clinical breast examination (CBE) in the past year. Women with higher level of education (X2 = 80.66, p < 0.0001) and those employed in professional jobs (X2 = 47.11, p < 0.0001) were significantly more knowledgeable about breast cancer. Participants with higher level of education were 3.6 times more likely to practice BSE (Odds ratio [OR] = 3.56, 95% Confidence interval [CI] 2.58-4.92). CONCLUSION: The results of this study suggest that community-dwelling women in Nigeria have poor knowledge of breast cancer and minority practice BSE and CBE. In addition, education appears to be the major determinant of level of knowledge and health behavior among the study participants. We recommend the establishment and sustenance of institutional framework and policy guidelines that will enhance adequate and urgent dissemination of information about breast cancer to all women in Nigeria.

Journal Article↗

Tools for knowledge acquisition within the NeuroScholar system and their application to anatomical tract-tracing data.

BACKGROUND: Knowledge bases that summarize the published literature provide useful online references for specific areas of systems-level biology that are not otherwise supported by large-scale databases. In the field of neuroanatomy, groups of small focused teams have constructed medium size knowledge bases to summarize the literature describing tract-tracing experiments in several species. Despite years of collation and curation, these databases only provide partial coverage of the available published literature. Given that the scientists reading these papers must all generate the interpretations that would normally be entered into such a system, we attempt here to provide general-purpose annotation tools to make it easy for members of the community to contribute to the task of data collation. RESULTS: In this paper, we describe an open-source, freely available knowledge management system called 'NeuroScholar' that allows straightforward structured markup of the PDF files according to a well-designed schema to capture the essential details of this class of experiment. Although, the example worked through in this paper is quite specific to neuroanatomical connectivity, the design is freely extensible and could conceivably be used to construct local knowledge bases for other experiment types. Knowledge representations of the experiment are also directly linked to the contributing textual fragments from the original research article. Through the use of this system, not only could members of the community contribute to the collation task, but input data can be gathered for automated approaches to permit knowledge acquisition through the use of Natural Language Processing (NLP). CONCLUSION: We present a functional, working tool to permit users to populate knowledge bases for neuroanatomical connectivity data from the literature through the use of structured questionnaires. This system is open-source, fully functional and available for download from [1].

Journal Article↗

Decisional role preferences, risk knowledge and information interests in patients with multiple sclerosis.

OBJECTIVE: Shared decision making is increasingly recognized as the ideal model of patient-physician communication especially in chronic diseases with partially effective treatments as multiple sclerosis (MS). To evaluate prerequisite factors for this kind of decision making we studied patients' decisional role preferences in medical decision making, knowledge on risks, information interests and the relations between these factors in MS. METHODS: After conducting focus groups to generate hypotheses, 219 randomly selected patients from the MS Outpatient Clinic register (n = 1374) of the University Hospital Hamburg received mailed questionnaires on their knowledge of risks in MS, their perception of their own level of knowledge, information interests and role preferences. RESULTS: Most patients (79%) indicated that they preferred an active role in treatment decisions giving the shared decision and the informed choice model the highest priority. MS risk knowledge was low but questionnaire results depended on disease course, disease duration and ongoing immune therapy. Measured knowledge as well as perceived knowledge was only weakly correlated with preferences of active roles. Major information interests were related to symptom alleviation, diagnostic procedures and prognosis. CONCLUSION: Patients with MS claimed autonomous roles in their health care decisions. The weak correlation between knowledge and preferences for active roles implicates that other factors largely influence role preferences.

Adult↗

University students' knowledge of STDs: labels, symptoms and transmission.

A sample of 630 Victorian university students, aged between 17 and 24, completed a questionnaire on knowledge of sexually transmitted diseases (STDs). Overall students demonstrated moderate levels of knowledge about the names of diseases which are transmitted by sexual contact, symptoms and medical facts and transmission modes of common STDs. However, they had more knowledge about the labels than they did about symptoms and transmission modes and were misinformed about certain clinical aspects of STDs. It was found that the different levels of knowledge varied with the type of STD. Knowledge about symptoms of transmission did not correlate with a disease's incidence or clinical aspects. Sexual experience and having an Australian born mother correlated with higher scores. This study suggests that young people do not have high levels of knowledge about common STDs they may encounter. Identification of a label is of limited personal value if there is no concurrent knowledge about disease transmission and prognosis.

Adolescent↗

Knowledge and attitude of healthy high school students toward bronchial asthma and asthmatic pupils.

One hundred sixteen healthy high school pupils were interviewed and completed a questionnaire concerning their knowledge about asthma and their attitude towards asthmatic peers. They were compared with 35 asthmatic pupils studying at the same school. The level of knowledge was quite satisfactory, with the knowledge of the asthmatic pupils being somewhat higher than that of the healthy pupils, but without statistical significance. There was a correlation with the age of the pupils in both groups (p < 0.0001). The source of pupils' knowledge came principally from the media (television and newspapers), the family (talking with parents), treating physicians, and school nurses. The healthy pupils displayed less tolerance toward the asthmatic disease and its limitations on activity than that displayed by the asthmatic pupils (p < 0.001). A correlation was found between the level of knowledge and attitude, with an increased level of knowledge implying a more tolerant attitude. A correlation was also found between tolerant attitudes and increasing age, increasing parental education, and the pupils' behavior marks. The recommendation of the survey is to improve the instruction regarding bronchial asthmatic diseases with classes taught by physicians or nurses. By increasing the knowledge of the healthy pupils at school, their attitudes will be more tolerant and positive toward the asthmatic pupils.

Adolescent↗

Contextualizing the politics of knowledge: physicians' attitudes toward medicinal plants.

This article examines how a group of public health physicians in the urban Amazon values medicinal plant knowledge. As biomedical health care providers, physicians routinely draw on scientific plant knowledge. At the same time, as residents of the Amazon and health care providers to the poor, they are aware of and sometimes participate in local systems of plant knowledge. When discussing medicinal plant use, physicians repeatedly mention three themes: science, superstition, and biopiracy. The way in which physicians construct and negotiate these themes is part of the process of maintaining and legitimating their expertise and authority. This analysis finds that context is key to understanding whether, when, and why physicians value certain bodies of knowledge. Locally, in clinics, scientific plant knowledge is constructed as superior. In a global context, however, local plant knowledge is explicitly valued. This situational valuation/devaluation of plant knowledge relates to the positions of power physicians occupy in each context.

Attitude of Health Personnel↗

Concept mapping of movement-related knowledge.

Concept mapping was developed by Novak and Gowin in 1984 as a technique to examine an individual's knowledge-base in a given domain. In the motor domain, however, with a heavy emphasis on automated and tacit knowledge there may not be a base of information which can be verbally reported. 52 subjects with similar academic backgrounds were asked to explain all they knew about the concept of movement, and these reports were transcribed and assessed by four judges. Subjects also completed a pattern-recognition task related to procedural knowledge for movement. Over-all, the judges were able to identify a clear hierarchy in the levels of movement-related knowledge, suggesting that this technique may be useful in research on movement. However, this declarative knowledge appeared to be distinct from associated procedural knowledge, supporting Anderson's (1982) theory and the need for several tools to provide a more complete reflection of the knowledge base in a particular domain.

Acceleration↗

Knowledge jobs--how to manage without burnout?

The working world is progressing from the industrial era to the era of knowledge. The critical factor of success in work is shifting from machines to the human mind. All work that essentially uses and produces knowledge during and as a result of the work process can be defined as knowledge work. Knowledge jobs involve many health-promoting features, but stress and burnout may be caused by the rapid increase in the knowledge-intensity of work, new job demands, and emerging new professional subcultures emphasizing excessive commitment to work. Very little empirical evidence is available on these developments. Much more research is needed to understand the essential features of knowledge work, the change in organizational cultures, and the values guiding this process from the point of view of human resources. Research is also needed to develop organizational strategies for the prevention of stress and burnout in knowledge jobs.

Administrative Personnel↗

Knowledge-based interpretation of toxoplasmosis serology test results including fuzzy temporal concepts--the ToxoNet system.

Transplacental transmission of Toxoplasma gondii from an infected, pregnant woman to the unborn that occurs with a probability of about 60 percent [1] results in fetal damage to a degree depending on the gestational age. The computer system ToxoNet processes the results of serological antibody tests having been performed during pregnancy by means of a knowledge base containing medical knowledge on the interpretation of Toxoplasmosis serology tests. By applying this knowledge ToxoNet generates interpretive reports consisting of a diagnostic interpretation and recommendations for therapy and further testing. For that purpose it matches the results of all serological investigations of maternal blood with the content of the knowledge base returning complete textual interpretations for all given findings. The interpretation algorithm derives the stage of maternal infection from these that is used to infer the degree of fetal threat. To consider varying immune responses of particular patients, certain time intervals have to be kept between two subsequent tests in order to guarantee a correct interpretation of the test results. These time intervals are modelled as fuzzy sets, since they allow the formal description of the temporal uncertainties. ToxoNet comprises the knowledge base, an interpretation system, and a program for the creation and modification of the knowledge base. It is available from the World Wide Web by starting a standard browser like the Internet Explorer or the Netscape Navigator. Thus ToxoNet supports the physician in Toxoplasmosis diagnostics and in addition allows to adopt the way of making decisions to the characteristics of the particular laboratory by modifying the underlying knowledge base.

Algorithms↗

Smoking behaviour and knowledge in high school students in Riyadh and Belfast.

UNLABELLED: Smoking is one of the risk factor associated with onset, severity and progression of periodontal disease. AIM: The aim of the study was to examine the smoking behaviour and dental health knowledge of high school students in Riyadh and Belfast. MATERIALS AND METHODS: Eight schools from Riyadh and 6 from Belfast were randomly selected by cluster distribution sampling method. Two hundred and ninety students from Riyadh and 144 from Belfast were included giving an overall response rate of 85%. The age range was between 16-17 years. A questionnaire was used to assess demography, smoking habits, dental health knowledge and oral hygiene practices. RESULTS: The results showed that 18% of students were smokers; 24% in Belfast and 15% in Riyadh (x2 (1) = 4.29: P = 0.04). 24% of students in Belfast and 56% in Riyadh smoked at least 1 cigarette per day. 61% of students had bleeding gums although 85% stated that they brushed their teeth at least daily. Bleeding on brushing was common with 53% of Belfast students compared with 65% from Riyadh. Students in Belfast (2.51 +/- 1.15) had significantly higher mean scores for their knowledge about gum health compared with Riyadh students (2.21 +/- 1.44) (t = 2.29: P = 0.02). There was no differences in knowledge about oral health and smoking between the students. However, non-smokers from Belfast and Riyadh (3.32 +/- 1.60) had greater knowledge about oral health and smoking than those who smoked (2.81 +/- 1.45) (t = 2.73: P = 0.007). There was no difference in knowledge about gum health between smokers and non-smokers. CONCLUSIONS/RECOMMENDATIONS: Smoking is more prevalent in Belfast but more cigarettes are smoked in Riyadh. As non-smokers had greater knowledge of the ill-effects of smoking upon their oral health, there is a need to develop location specific interventions to control smoking habits in late adolescence.

Adolescent↗

Comparing basic knowledge in critical care nursing between nurses from the United States and nurses from other countries.

BACKGROUND: No previous research was found that compared basic knowledge in critical care nursing among nurses from different nations. Nurses from outside the United States were invited to participate during reliability testing of the Basic Knowledge Assessment Tool, Version 5. PURPOSE: To compare basic knowledge in critical care between nurses from the United States and nurses from other countries and to measure the reliability of the Basic Knowledge Assessment Tool, Version 5. SAMPLE: Data were collected for 16 months from 682 critical care nurses: 528 from the United States and 154 from other countries. RESULTS: The Basic Knowledge Assessment Tool, Version 5, was a reliable test for all nurses studied, regardless of country of origin. The level of knowledge of nurses from English-speaking countries other than the United States did not differ from that of nurses from the United States. Scores for nurses from non-English-speaking nations were lower than scores for nurses from the United States. The largest source of variance in scores among all subjects was the length of experience in critical care nursing. CONCLUSIONS: The Basic Knowledge Assessment Tool, Version 5, is a valid and reliable tool for assessing critical care nurses from the United States and the other countries studied. Critical care nurses from English-speaking countries scored higher than nurses from countries where the primary language is not English.

Critical Care↗

Knowledge of pressure ulcers by undergraduate nursing students in Brazil.

The purpose of this study was to examine Brazilian nursing students knowledge of pressure ulcers. Third- and fourth-year undergraduate baccalaureate students at a public university in Brazil (N = 83) were asked to provide demographic information, identify extracurricular activities (eg, reading journals and articles and using the Internet to enhance comprehension of pressure ulcer care), and complete the Pressure Ulcer Knowledge Test. Students correctly answered 67.7% of the Pressure Ulcer Knowledge Test items. Students who participated in extracurricular activities and used the Internet had significantly higher Knowledge Test scores than those who did not. Readings did not significantly impact the Knowledge Test score. Generally, the students were found to have low pressure ulcer knowledge, but that educational programs and the Internet have the potential to positively impact nursing students knowledge of pressure ulcers.

Adult↗

[Adolescents' knowledge about adolescence, puberty and sexuality].

OBJECTIVE: The objective of this research was to evaluate the level of knowledge about adolescence, pubertal development and sexuality among adolescents from 10 to 14 years old at municipal public schools in Feira de Santana-Bahia, 2000. METHODS: Cross-sectional study, with a randomized and proportional sample out of a population of 6,419 students in the municipal Public System. The level of knowledge was analyzed according to age, sex and educational level. Data was collected by means of a specific confidential questionnaire, which was pre-tested. A scale of values (score--satisfactory, reasonable and unsatisfactory) was established according to the percentage and proportional number of right answers regarding general and specific topics. Statistical inference was calculated by chi-square with a significance of 5% as well as the bivariate and multivariate analysis, calculating the simple and adjusted prevalence, through stratified analysis. RESULTS: Adolescents showed unsatisfactory level of information about terms, particularly those at the age of 10 (69.2%) and 11 years (70.6%), female (61.7%) and the ones in the 4th (82.8%) and 5th (61.1%) grades. The level of knowledge according to sex, adjusted by age and educational level, showed that females are 1.3 and 1.27 times more likely to present an unsatisfactory level of knowledge than males. The level of knowledge according to educational level, adjusted by age, showed that those subjects between 4th and 5th grades are 2.32 times more likely to present an unsatisfactory level of knowledge if compared to students of 6th and 8th grades, with significant differences (p<0.05). CONCLUSIONS: The high prevalence of unsatisfactory level of knowledge with significant association between 4th and 5th grades and females points to the necessity of educative actions regarding health and sexuality in the beginning of adolescence at municipal public schools.

English Abstract↗