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PubMed2006

Game theory and human evolution: a critique of some recent interpretations of experimental games.

Economists and psychologists have been testing Nash equilibrium predictions of game theory models of human behavior. In many instances, humans do not conform to the predictions. These results are of great interest to biologists because they also raise questions about well-known ESS models of cooperation. Cooperation in certain one-shot, anonymous interactions, and a willingness to punish others at a net cost to oneself are some of the most intriguing deviations from standard theory. One proposed explanation for these results that is receiving increasing attention invokes the cultural group selection of 'other regarding' social norms. We critically review this explanation. We conclude that experimental results reveal limits in two implicit models of cognitive structure commonly employed by economists and evolutionary biologists.

Altruism↗
PubMed2003

Sexual media use by young adults in Hong Kong: prevalence and associated factors.

The prevalence of sexual media use, and factors associated with it, among Chinese young adults were studied in Hong Kong. Questions on use of sexual media were asked as part of a youth sexuality study conducted by the Family Planning Association in 1996. In a population-based cross-sectional study, 517 men and 447 women aged 18-27 years completed an anonymous structured self-administered questionnaire. The overall prevalence [95% confidence interval (CI)] of ever purchased or rented any type of sexual media was 57.8% (54.7-60.9). More men (70.2%; 95% CI: 66.3-74.2) than women (43.4%; 95% CI: 38.8-48.0) used sexual media. Of 31 independent variables tested by stepwise logistic regression, seven variables significantly predicted sexual media use: age (adjusted odds ratio OR = 1.5 for 21-24 and 1.8 for 25-28, versus 20 or below), male gender (OR = 3.0), number of sexual partner (OR = 2.2 for one and 2.8 for two or more partners), masturbation in the past week (OR = 3.2), being out of school (OR = 1.5), quarrel with family member in past 6 months (OR = 1.8), and religion (OR = 1.6 for no religion and 3.4 for traditional Chinese religion, versus Christians) (all adjusted OR:p < 0.05).

Adult↗
PubMed2004

Teaching research methodology in medical schools: students' attitudes towards and knowledge about science.

OBJECTIVE: To explore the relationship between teaching scientific methodology in Year 2 of the medical curriculum and student attitudes towards and knowledge about science and scientific methodology. DESIGN: Anonymous questionnaire survey developed for this purpose. SETTING: Zagreb University School of Medicine, Croatia. PARTICIPANTS: A total of 932 students (response rate 58%) from all 6 years were invited to participate. MAIN OUTCOME MEASURES: Score on attitude scale with 45 Likert-type statements and score on knowledge test consisting of 8 multiple choice questions. RESULTS: The average attitude score for all students was 166 +/- 22 out of a maximum of 225, indicating a positive attitude towards science and scientific research. The students' average score on the knowledge test was 3.2 +/- 1.7 on 8 questions. Students who had finished Year 2 had the highest mean attitude (173 +/- 24) and knowledge (4.7 +/- 1.7) scores compared with other year groups (P < 0.001, anova and Tukey posthoc test). For students who had attended a mandatory Year 2 course on the principles of scientific research in medicine (Years 3 to 6), multiple linear regression analysis showed that knowledge test score (B = 3.4; SE = 0.4; 95% confidence interval 2.5-4.2; P < 0.001) and average grades (B = 7.6; SE = 1.5; 95% CI 4.6-10.6; P < 0.001) were significant predictors of attitude towards science, but not sex or failure to pass a year (B = - 0.6; SE = 1.7; 95% CI - 3.9-2.6; P = 0.707; and B = - 3.1; SE = 1.9; 95% CI - 6.8-5.7; P = 0.097, respectively). CONCLUSION: Medical students have generally positive attitudes towards science and scientific research in medicine. Attendance of a course on research methodology is related to a positive attitude towards science.

Biomedical Research↗
PubMed2006

Perceived risk and worry about prostate cancer: a proposed conceptual model.

Prostate cancer is one of the most common forms of cancer among American men, and worry about the disease has psychological, behavioral, and biological consequences. To better understand prostate cancer-specific worry, the authors tested a model of the interrelationships among family history of prostate cancer; perceived risk of and worry about prostate cancer; and perceived risk of and worry about other diseases. Men who attended prostate cancer-screening appointments at a general urology practice (n=209) were given a brief anonymous self-report measure. Structural equation modeling (LISREL) results indicated: (1) perceived risk of prostate cancer mediated the relationship between family history of prostate cancer and prostate cancer worry; (2) perceived risk of other diseases increased perceived risk of prostate cancer; and (3) prostate cancer worry and increased other disease worry.

Adult↗
PubMed1999

HIV sero-prevalence among tuberculosis patients in Kenya.

OBJECTIVE: To determine HIV seroprevalence among tuberculosis patients and the burden of HIV attributable tuberculosis among notified patients in Kenya. DESIGN: A cross-sectional anonymous unlinked HIV seroprevalence survey. SETTING: Tuberculosis diagnostic clinics of the National Leprosy Tuberculosis Programme in 19 districts. SUBJECTS: One thousand nine hundred and fifty-two newly notified tuberculosis patients. INTERVENTIONS: Selection and registration of eligible subjects followed by obtaining 5 ml of full blood for haemoglobin testing and separation of serum for HIV testing by ELISA. MAIN OUTCOME MEASURES: HIV seroprevalence per district and burden of HIV attributable tuberculosis among tuberculosis patients. RESULTS: A total of 1,952 eligible patients were enrolled. The weighted seroprevalence in the sample was 40.7% (range 11.8-79.6% per district). The seroprevalence was significantly higher among females and patients with sputum-smear negative tuberculosis. Chronic diarrhoea, female sex, oral thrush and a negative sputum were independent risk factors for HIV infection. The Odds ratio for HIV infection in female tuberculosis patients aged 15-44 years, was 5.6 (95% CI 4.5-6.9) compared with ante-natal clinic attenders. The population attributable risk was 0.22 in 1994. CONCLUSION: The HIV epidemic has had a profound impact on the tuberculosis epidemic in Kenya and explains about 41% of the 94.5% increase of registered patients in the period 1990-1994 and 20% of all registered patients in 1994. Repetition of the survey with inclusion of a more representative control group from the general population may provide a more accurate estimation of the burden of HIV attributable tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed1999

HIV seroprevalence & awareness about AIDS among pregnant women in rural areas of Pune district, Maharashtra, India.

The present unlinked anonymous study was done among sexually active rural women to assess the extent of spread of HIV and its awareness. Peripheral blood samples were collected on filter paper strips from 1251 pregnant women residing in villages in three Primary Health Centres in Pune district of Maharashtra. Elutes were tested for HIV antibodies in two different ELISA systems. Awareness on HIV/AIDS was assessed using a structured questionnaire. Fifteen (1.2%) samples were detected to be HIV seropositive. HIV seroprevalence was significantly higher among villages situated close to highways (P < 0.025). Majority (> 95%) of the participating women were housewives. Although 70 per cent were aware of the existence of AIDS, only 33 per cent knew about all the main modes of HIV transmission. Their main sources of information on AIDS were health camps, health workers (70%) and television (45%). Awareness was associated with higher level of literacy (P < 0.001). Many women had misconceptions about the modes of spread of HIV. Greater emphasis needs to be placed on instituting long-term and sustainable strategies to create awareness among young couples with an emphasis on involvement of health workers in rural areas.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Genetic analysis of the atrial natriuretic peptide gene in essential hypertension.

Atrial natriuretic peptide (ANP) plays an important role in the regulation of blood pressure through sodium-water homoeostasis. Accordingly, several investigators have raised the question of whether the gene encoding ANP is involved in the aetiology of essential hypertension or related phenotypes such as salt sensitivity. Most of the studies have used anonymous polymorphic markers of the gene, and made inconclusive claims about the disease relevance of ANP. Therefore, in order to find sequence variations with potential functional significance and to characterize the pattern of linkage disequilibrium between polymorphisms, we screened a 3368-bp genomic fragment of ANP. Subsequently we tested the association of detected polymorphisms with plasma ANP levels and with hypertension status. Two new polymorphisms were identified, in the 5'-untranslated region and exon 1 respectively, as well as three previously reported polymorphisms in intron 2 and exon 3. When analysed in 102 healthy normotensive subjects, none of the polymorphisms appeared to significantly affect plasma ANP levels. A case-control study in a Japanese population (255 hypertensive and 225 normotensive individuals) revealed a marginally significant association (P=0.026) between an ANP polymorphism located in the 5'-untranslated region (C-664G) and hypertension, but no association for the other polymorphisms. Each of the uncommon variants has an allele frequency of less than 10% in Japanese people, which may have hampered our detection of a significant association between ANP variants and hypertension status (and plasma ANP levels). The pathophysiological relevance of ANP, however, needs to be further defined in relation to hypertension-associated phenotypes, and also should be examined in different ethnic groups.

Aged↗
PubMed1992

Prevalence of bloodborne infective agents among people admitted to a Canadian hospital.

OBJECTIVE: To determine the prevalence rates of hepatitis B surface antigen (HBsAg) and antibodies to the human immunodeficiency virus (anti-HIV) and the hepatitis C virus (anti-HCV) among people admitted to an urban Canadian hospital. DESIGN: Anonymous unlinked serosurvey. SETTING: A 420-bed teaching hospital in Toronto. PARTICIPANTS: All 3000 patients admitted to the hospital on weekdays from January to June 1990. An attempt was made to exclude those who were readmitted during the study period. INTERVENTIONS: Serum samples from all the patients were tested for HBsAg and anti-HIV, and 1306 samples were also tested for anti-HCV by means of enzyme immunosorbent assays; reactions were confirmed by means of specific antibody neutralization or immunoblot assay. MAIN RESULTS: The prevalence rates of HBsAg, anti-HIV and anti-HCV were 2.1% (95% confidence interval [CI] 1.6% to 2.6%), 0.6% (95% CI 0.3% to 0.9%) and 0.5% (95% CI 0.1% to 0.9%) respectively. CONCLUSIONS: This is the first report defining rates of infection with these bloodborne agents among patients admitted to a Canadian hospital. The observed rates likely reflect the patient population served by our hospital and do not necessarily apply to other Canadian centres. The results support the use of universal precautions in health care settings.

Adolescent↗
PubMed2004

What do young people from Mostar, Bosnia and Herzegovina know about contraception and sexual health?

AIM: To determine the knowledge of adolescents living in Mostar, Bosnia and Herzegovina, about contraception and sexual health. METHODS: We used an anonymous questionnaire to survey a random sample of 120 high school students, 60 from two general high schools and 60 from a vocational school. There were 30 male and 30 female students aged 15-17 years from each type of school. The questionnaire consisted of 24 questions: 17 tested the students' knowledge on the menstrual cycle, contraception, emergency contraception, and sexually transmitted diseases (STDs), and six inquired how they obtained the information on these issues. Student t-test was used to test for score differences between male and female students, and between general high school and vocational school students in their general and specific knowledge. Pearson's r coefficient was used to test the correlation between average grades and knowledge. RESULTS: Female students had greater general knowledge (t=3.69, df=118, p<0.001), knowledge on contraception (t=3.66, df=118, p<0.001), and knowledge on STDs (t=2.71, df=118, p=0.008) than their male peers. General high school students also had greater general knowledge (t=2.44, df=118, p=0.016), and knowledge on contraception (t=2.18, df=118, p=0.031) or STDs (t=2.36, df=118, p=0.020) than their vocational school peers. Major sources of information were magazines (69%), TV/radio (50%), school (37%), and friends (36%). The most common reason that kept our examinees from obtaining information on these issues was shame (52%). The two most common contraception methods known to them were a condom (82%) and contraception pill (77%), whereas 17% of all students were unfamiliar with any contraception method. When asked what could be done to improve their knowledge on sexuality, contraception, and STDs, most students opted for the inclusion of sexual education into the school curricula. CONCLUSION: Female students knew more about contraception and sexual health than their male peers. Young people should be provided with more information on sexual health.

Adolescent↗
PubMed2003

Overall HIV-1 prevalence in pregnant women over-estimates HIV-1 in the predominantly rural population of Afar Region.

The appropriateness of sentinel sero-surveillance based upon ante-natal clinic (ANC) attendees to estimate HIV-1 prevalence in the general population has been questioned. In Ethiopia, where the population is heterogeneous and where economic and practical barriers to ANC attendance exist, problems of extrapolation may be exacerbated. We planned an unlinked anonymous sero-survey which included data on basic population characteristics to investigate whether sero-surveillance data from ANCs in Afar Region might be taken to represent the situation among the general population of the Region. 371 pregnant women attending Dubti Hospital and Assayta Health Centre were tested for HIV-1 (using a single ELISA test) and active syphilis (RPR test). Socio-demographic characteristics were collected for each woman. Of the women tested, 278 (75%) were 28 years of age or younger. Two hundred eighty (76%) were urban residents and 237 (64%) described themselves as being of Amhara ethnicity. Overall, 73 (19.7%) were HIV-1 positive, but prevalence was three times higher among the 237 women of Amhara ethnicity compared to the 112 of Afar ethnicity (24.9% vs 8.0%, p < 0.001), and almost three times higher for urban compared to rural residents (23.2% vs 8.8%, p < 0.001). Positive RPR results were strongly associated with HIV-1 infection (OR 3.37, 95% CI 1.47-7.71). According to the Demographic and Health Survey (DHS) 2000, only 4.5% of the population of Afar Region is of Amhara ethnicity, and 7.8% urban residents. We have demonstrated that basing ANC sero-surveillance in urban areas of Afar Region over-samples urban residents of Amhara ethnicity and yields a major over-estimation of overall HIV-1 prevalence for the Region. Reliable estimation of HIV-1 prevalence in Afar Region will require more flexible strategies that permit sampling of rural Afar residents.

AIDS Serodiagnosis↗
PubMed2005

Nurses' attitudes towards computers: cross sectional questionnaire study.

AIM: To estimate the attitudes of hospital nurses towards computers and the influence of gender, age, education, and computer usage on these attitudes. METHODS: The study was conducted in two Croatian hospitals where integrated hospital information system is being implemented. There were 1,081 nurses surveyed by an anonymous questionnaire consisting of 8 questions about demographic data, education, and computer usage, and 30 statements on attitudes towards computers. The statements were adapted to a Likert type scale. Differences in attitudes towards computers were compared using one-way ANOVA and Tukey-b post-hoc test. RESULTS: The total score was 120+/-15 (mean+/-standard deviation) out of maximal 150. Nurses younger than 30 years had a higher total score than those older than 30 years (124+/-13 vs 119+/-16 for 30-39 age groups and 117+/-15 for>39 age groups, P<0.001). Nurses with a bachelor's degree (119+/-16 vs 122+/-14, P=0.002) and nurses who had attended computer science courses had a higher total score compared to the others (124+/-13 vs 118+/-16, P<0.001). Nurses using computers more than 5 hours per week had higher total score than those who used computers less than 5 hours (127+/-13 vs 124+/-12 for 1-5 h and and 119+/-14 for <1 hour per day, P<0.001, post-hoc test). CONCLUSION: Nurses in general have positive attitudes towards computers. These results are important for the planning and implementing an integrated hospital information system.

Adult↗
PubMed2005

Comparisons of Physicians' and Nurses' Attitudes towards Computers.

Before starting the implementation of integrated hospital information systems, the physicians' and nurses' attitudes towards computers were measured by means of a questionnaire. The study was conducted in Dubrava University Hospital, Zagreb in Croatia. Out of 194 respondents, 141 were nurses and 53 physicians, randomly selected. They surveyed by an anonymous questionnaire consisting of 8 closed questions about demographic data, computer science education and computer usage, and 30 statements on attitudes towards computers. The statements were adapted to a Likert type scale. Differences in attitudes towards computers between groups were compared using Kruskal-Wallis and Mann Whitney test for post-hoc analysis. The total score presented attitudes toward computers. Physicians' total score was 130 (97-144), while nurses' total score was 123 (88-141). It points that the average answer to all statements was between "agree" and "strongly agree", and these high total scores indicated their positive attitudes. Age, computer science education and computer usage were important factors witch enhances the total score. Younger physicians and nurses with computer science education and with previous computer experience had more positive attitudes towards computers than others. Our results are important for planning and implementation of integrated hospital information systems in Croatia.

Attitude of Health Personnel↗
PubMed2000

Incidental prenatal detection of an Xp deletion using an anonymous primer pair for fetal sexing.

We report on the incidental prenatal detection of an interstitial X-chromosomal deletion in a male fetus and his mother by fetal sexing with a primer pair recognizing an X-Y homologous locus (DXYS19), formerly unassigned on the X chromosome. The proband asked for prenatal diagnosis because of her elevated age and risk of Duchenne muscular dystrophy (DMD). Prior to molecular genetic testing for DMD, fetal sexing was carried out on DNA prepared from cultured amniocytes. PCR analysis revealed the expected Y-chromosomal product, but did not show the constitutive X-chromosomal fragment. The absence of the X-chromosomal fragment in the fetus and on one X chromosome of the mother was confirmed by Southern hybridization of HindIII restricted DNA with probe pJA1165 (DXYS19). DXYS19X was mapped to Xp22.3 by combining several approaches, including: (1) analysis of somatic cell hybrid lines containing different fragments of the human X chromosome; (2) Southern hybridization of a yeast artificial chromosome (YAC)-filter panel provided by the Resource Center/Primary Database (RZPD); (3) FISH analysis; and (4) re-evaluation of two patients with interstitial deletions in Xp22.3. The extent of the deletion in the fetus was estimated by further markers from Xp22.3 and found to include the STS gene. Mental retardation could not be excluded since some mentally retarded patients exhibit overlapping deletions.

Adult↗
PubMed1998

[Smoking in health care workers. Identification of related factors].

The objective of this study was to determine the epidemiology of smoking among health care givers in our setting and to describe their characteristics. We gave an anonymous questionnaire to 566 health care workers in the Valencian Community (248 physicians, 212 nurses and 106 aides). The results were as follows. Physicians: 46.4% were smokers, 25.4% were non smokers and 28.2% were ex-smokers. Most (69.3%) smoked 11 to 20 cigarettes/day. Low scores on Fagerström's test were recorded for 93%, and 57.3% have tried to quit smoking more than 5 times. The likelihood of being and ex-smoker increased with age (r = 0.158; p = 0.012) and with the number of attempts to quit (r = 0.170; p = 0.021). Nurses: 34.4% were smokers, 36.3% were non smokers and 29.2% were ex-smokers. The degree of nicotine addiction was low for 91.8% and 83% of the smokers and ex-smokers had tried at least once to quit smoking. Aides: 32% were smokers, 42.5% were non smokers and 25.5% were ex-smokers. The degree of addiction was low for 79.4% and 78.7% had tried to quit smoking at least once. The likelihood of being an ex-smoker increased with the number of attempts at quitting (r = 0.448; p = 0.000). In conclusion, we found that rate of smoking was higher than expected for persons who understand the related problems. The low level of physical addiction and the high number of times the subjects had tried to stop smoking suggest the need to create a program specifically to help health care workers in this respect.

Adult↗
PubMed2000

Knowledge, beliefs and behavior related to oral health among Tanzanian and Ugandan teacher trainees.

This study was designed to assess levels of oral health knowledge, beliefs and self-reported behavior among teacher trainees in Uganda and Tanzania. Anonymous questionnaire data were collected from trainees attending the final year at teacher training colleges in Rungwe district, Tanzania, in 1997, and in Mbale and Kampala districts of Uganda, in 1998. A total of 195 trainees from Tanzania and 225 trainees from Uganda participated. Results from Pearson's chi2 test and independent sample t tests indicated that Tanzanian students had less experience with oral impairments, were more resolutely prepared to teach about the importance of personal habits for oral health maintenance, and had higher levels of oral health knowledge than Ugandan students. Ugandan students endorsed frequent consumption of sugar products more often than their Tanzanian counterparts, but they were more diligent in visiting dentists. Most of the Tanzanian (97.4%) and Ugandan (95.6%) students reported daily toothbrushing. In both countries, beliefs about the importance of preventive behaviors for oral health were closely related to the frequency with which such habits occurred. This cross-cultural consistency highlights the importance of cognitive factors. The implications for oral health educational programs among teacher trainees across East African countries are discussed.

Adult↗
PubMed2001

Current opinion regarding indications for emergency department thoracotomy.

BACKGROUND: Emergency department thoracotomy (EDT) is a dramatic but rarely lifesaving intervention. Clinical variability regarding indications for EDT has yet to be quantified. Members of the Eastern and American Associations for the Surgery of Trauma were questioned by mail to evaluate which clinical and demographic factors influence the decision to perform EDT and whether physicians perform EDT in accordance with current practice guidelines. METHODS: A single mailing of an anonymous survey was sent to 1,124 surgeons to collect institutional and physician demographics as well as indications for EDT on the basis of variable mechanisms of trauma, duration of arrest, and signs of life (SOL). Statistical analysis included the Pearson and linear-by-linear association chi(2) tests, independent samples t test, and univariate and multivariate analyses of variance; p values of < 0.05 were considered significant. RESULTS: Completed surveys were received from 358 respondents. After 54 surveys were excluded that were incomplete, late, or from noneligible respondents, 304 surveys were analyzed. There were no significant differences in EDT indications among institutions of differing caseload volume, exposure to penetrating trauma, trauma level designation, American College of Surgeons verification status, or residency program affiliation. In addition, neither the respondent's position nor whether attendings versus residents performed the majority of EDTs influenced clinical decision-making. Performance criteria for EDT were liberal in comparison with established guidelines, especially for blunt trauma. The presence or recent loss of SOL influenced responses, but respondents varied greatly in their definition of SOL. CONCLUSION: A lack of agreement exists regarding the indications for EDT in multiple clinical scenarios as well as in defining SOL. Indications for EDT were liberal, especially for blunt trauma-related indications, and were determined by clinical parameters, not by physician or institutional factors. Our results suggest that clinical practice is at variance with Advanced Trauma Life Support guidelines. We recommend that practice guidelines for EDT be established on the basis of a consensus definition of SOL to allow for a more uniform and selective approach to EDT.

Decision Making↗
PubMed1995

[School acceptance of the theater as a method of health education].

OBJECTIVE: To find how theatre was evaluated as an instrument of Health Education by the pupil-actors of a school where a play on the European Code against Cancer was put on. DESIGN: An observational study (descriptive and crossover). SETTING: Community level. Primary Education. PARTICIPANTS: 100 pupil-actors of the 220 at a primary school in a rural area. They were selected by means of a free, voluntary and spontaneous practical theatre test. INTERVENTIONS: A theatrical show with 14 scenes was created. 8 performances, open to the public, were held in the village's Cultural Centre. MEASUREMENTS AND MAIN RESULTS: Evaluation was with a self-administered questionnaire composed for the occasion and consisting of closed multiple-choice questions. An anonymous group survey, done in class and covering each year separately, included 77 of the 100 actors. A prior pilot survey had evaluated intelligibility. The results were that 97.4% classed the experience as positive and 87% of them considered it very good. 81% had no problem at the moment of acting. 83% were helped by teachers and 81% by parents. 98% would like to do theatre again. CONCLUSIONS: Theatre is highly rated and widely accepted by children, making it a useful

Child↗