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PubMed2006

Randomised controlled trial on whether advance knowledge of prostate-specific antigen testing improves participant reporting of unprotected sex.

OBJECTIVES: To determine whether the process of informing research participants that they would be tested for the presence of a biological marker of semen exposure would reduce bias in their reports of unprotected sex. METHODS: A randomised trial of 210 female sex workers from Mombasa, Kenya, was conducted, where half the group had advance knowledge (via the request for informed consent) that they would be tested for prostate-specific antigen (PSA) in their vaginal fluid before they reported on sex and condom use for the past 48 h. The other half were invited to participate (via additional informed consent) in the test for PSA after they had already consented to be questioned and reported on these sexual behaviours. A trained nurse instructed participants to self-swab to collect vaginal fluid specimens, which were tested for PSA using ELISA. RESULTS: Reporting of unprotected sex did not differ between those with advance knowledge of the test for PSA and those without this knowledge (14.3% v 11.4%, respectively; p = 0.27). Surprisingly, more women with advance knowledge (15.8%) had discrepant self reports and PSA results than women without advance knowledge (9.1%); however, the difference was not statistically significant (OR 1.9; 95% CI 0.8 to 4.5). CONCLUSIONS: Knowing that one's answers to a questionnaire could be verified with a biological marker of semen exposure did not make respondents more likely to report unprotected sex.

Body Fluids↗
PubMed2004

Public experiences, knowledge and expectations about medical genetics and the use of genetic information.

OBJECTIVE: The objectives of this study were (1) to explore public experiences, genetic knowledge, expectations of future medical genetic developments, and the attitudes towards the use of genetic information, and (2) to determine whether there are subject characteristics associated with these variables. METHODS: Participants (n = 1,308, age > or = 25 years) of a Dutch consumer panel were sent a questionnaire, specifically designed for this study. RESULTS: Response was 63% (817/1,308). A minority of respondents reported to know someone with a hereditary disease (34%) or to have used a genetic test (8%). Overall, 57% perceived a lack of genetic knowledge. In multivariate analyses, high self-rated knowledge, younger age, having heard of genetic testing, high educational level, female gender, having children living at home, being a health professional, and familiarity with genetic testing were positively associated with genetic knowledge. Future expectations of the consequences of developments in medical genetics varied between the subjects. The great majority expected great benefits for medical practice such as an increasing use of genetic aspects of disease for diagnosis or prevention. One fifth, mainly older people, anticipated a negative impact of genetic developments on society. The results also show that most people are reserved to share their genetic information with others, especially with regard to the wider public domain (e.g. industry and insurers) and employers. Remarkably, respondents were more willing to share their genetic information with scientific researchers (68%) than with their relatives (54%). CONCLUSION: This study suggests that although one fifth anticipates negative consequences of genetic developments, the great majority has high expectations about the increasing use of genetics in prevention, diagnosis and treatment of diseases. In developing educational programmes about genetic innovations in medicine, policymakers will have to take into account pre-existing lay knowledge, views and expectations of different groups of citizens towards these developments.

Adult↗
PubMed2006

Public knowledge and public trust.

As health care applications derived from human genetics research are likely to move increasingly from 'clinic to community', there is growing interest not just in how patients understand and take up health-related genetic information but also in the views of the wider population, as well as a range of professional groups. In this paper, issues relating public knowledge and public trust are raised and discussed in an attempt to move forward debates about public involvement in genomic research and the role of sociologists within interdisciplinary teams. As the field of public understanding of science has developed, we have seen a shift from a focus on the lack of scientific literacy as problem to a recognition of the range of different knowledges that people have and use as they confront science and technology in their everyday lives. As a mood for dialogue pervades many institutions in their relations with 'publics', attention must now be paid to the way in which knowledge and expertise is expressed, heard and acted upon in dialogic encounters. There is increasing concern about public trust in science and calls to increase public confidence, particularly through more open engagement with a range of publics. However, lack of trust or loss of confidence may be constructed as problems rather than reflecting empirical reality, where more complex relationships and attitudes prevail. Lack of trust is often privatized, deeply rooted in lived experience and routinely managed. Trust relations are generally characterized by ambivalence, uncertainty and risk, and are always provisional. Drawing on selected literature and empirical research to review and illustrate this field, this paper argues that scepticism or ambivalence on the part of publics are not necessarily problems to be overcome in the interest of scientific progress, but rather should be mobilized to enhance open and public debates about the nature and direction of genomics research, medicine, and the related social and ethical issues. Just as there can be no resolute expression of public knowledge or public opinion, it is unlikely that there is a resolute expression of public trust in genomics. However, ambivalence and scepticism can be harnessed as powerful resource for change, whether through the mobilization of public knowledges or the development of greater reflexivity within scientific institutions. This demands a sharing of power and greater public involvement in the early stages of policy formation and scientific and medical agenda setting.

Attitude↗
PubMed2003

How effective are "community" stroke screening programs at improving stroke knowledge and prevention practices? Results of a 3-month follow-up study.

BACKGROUND AND PURPOSE: Community stroke screening is a commonly used prevention strategy to identify and educate those at risk. Although the goal of this approach is to reduce the overall occurrence of stroke, its long-term benefit remains unknown. The purpose of this study was to determine whether attendance of a stroke screening changes knowledge or prevention practices in persons at risk for stroke 3 months later. METHODS: A stroke screening event was held following the National Stroke Association guidelines, with health screening, counseling, and education. Knowledge about stroke was measured by a questionnaire before and after the event. At 3 months, attendees identified at risk for stroke were contacted by telephone to determine their retained knowledge and any specific actions taken as a result of the health counseling. RESULTS: At 3 months, 78 persons were contacted. Knowledge of stroke warning signs increased from 59% to 94% after screening but decreased to 77% at 3 months. At 3 months, 73% had done nothing to change their health practices. CONCLUSIONS: Community stroke screening has modest effects on health behavior, knowledge of stroke risk factors, and warning signs.

California↗
PubMed2002

Stroke awareness and knowledge retention in children: The Brain Child Project.

BACKGROUND AND PURPOSE: Efforts at public education to improve adults' response to stroke symptoms continue to be disappointing, and very little has been developed to improve the knowledge base of children regarding brain attacks. Children may be able to exert a positive influence on adult behavior and to learn positive healthcare habits, which will also influence their own health. METHODS: A total of 561 children enrolled in grades kindergarten through eighth (K-8), participated in The Brain Child Project, which included (1) assessment of their knowledge of stroke awareness (including initiation of the emergency medical system [EMS]) using a multiple-choice questionnaire, (2) attendance at a multimedia educational program designed to increase stroke knowledge, followed by (3) immediate administration of the same questionnaire, and (4) a final administration of the same questionnaire 10 days later to measure retention of acquired learning. RESULTS: The results showed that these children had a limited understanding of stroke, but with a brief educational program, all grades significantly increased their scores on the average from 64% to 82%. The loss of knowledge between the posttest and the retention test was negligible. CONCLUSIONS: The results of this study indicate that through brief education, children show significant improvement in their knowledge of and response to brain attacks. Future efforts in this direction may positively affect stroke prevention, response and outcomes. A national program could be implemented in the school systems much like heart disease programs, with the ultimate goal of greater public awareness and prevention of stroke.

Child↗
PubMed2006

Patterns of regional brain hypometabolism associated with knowledge of semantic features and categories in Alzheimer's disease.

The study of semantic memory in patients with Alzheimer's disease (AD) has raised important questions about the representation of conceptual knowledge in the human brain. It is still unknown whether semantic memory impairments are caused by localized damage to specialized regions or by diffuse damage to distributed representations within nonspecialized brain areas. To our knowledge, there have been no direct correlations of neuroimaging of in vivo brain function in AD with performance on tasks differentially addressing visual and functional knowledge of living and nonliving concepts. We used a semantic verification task and resting 18-fluorodeoxyglucose positron emission tomography in a group of mild to moderate AD patients to investigate this issue. The four task conditions required semantic knowledge of (1) visual, (2) functional properties of living objects, and (3) visual or (4) functional properties of nonliving objects. Visual property verification of living objects was significantly correlated with left posterior fusiform gyrus metabolism (Brodmann's area [BA] 37/19). Effects of visual and functional property verification for non-living objects largely overlapped in the left anterior temporal (BA 38/20) and bilateral premotor areas (BA 6), with the visual condition extending more into left lateral precentral areas. There were no associations with functional property verification for living concepts. Our results provide strong support for anatomically separable representations of living and nonliving concepts, as well as visual feature knowledge of living objects, and against distributed accounts of semantic memory that view visual and functional features of living and nonliving objects as distributed across a common set of brain areas.

Aged↗
PubMed2005

A multimedia violence prevention program increases pediatric residents' and childcare providers' knowledge about responding to childhood aggression.

A pre-post knowledge test using alternate forms was used to determine if a multimedia violence prevention program can increase knowledge about management of childhood aggression. The participants were pediatric residents and childcare workers who attended lectures about aggression management in young children. The intervention was a presentation of a 30 minute CD-ROM program, Play Nicely, which teaches how to manage aggression in young children ages 1 to 7 years. A pretest and posttest multiple-choice knowledge assessment that focused on the program's most important recommendations was administered. Childcare workers and pediatric residents had significantly increased knowledge scores after viewing the CD-ROM demonstration (F=6.8, p = 0.01). Childcare workers' scores improved by 2.6 points (p< 0.001) and residents' scores by 3.8 points (p< 0.001). A relatively short CD-ROM can improve knowledge about how to manage aggression in young children, indicating its usefulness as a violence prevention resource.

Aggression↗
PubMed1997

Factors affecting women's knowledge of antenatal serum screening.

Antenatal screening for fetal anomaly is offered routinely in Glasgow. This study assessed pregnant women's knowledge of the test and implications of results. Questionnaires were completed by 574 women. Knowledge of the nature and uses of the test was superior to earlier studies Two-thirds knew that screening was undertaken for Down's syndrome, and 81% for spina bifida. The majority were aware of the sample used, ages invited and gestation at which it was undertaken. Knowledge of the likely results and implications was poorer. Three-quarters were unaware that 10% of results would suggest an increased risk. Half did not realise that positive results could occur without fetal abnormality, or negative results could be falsely reassuring. Socioeconomic deprivation was associated with poorer knowledge but not lower uptake. Written information was associated with superior knowledge and higher uptake. Leaflets should be provided prior to booking, at which time resultant queries can be answered.

Adolescent↗
PubMed2003

The relation between education, knowledge and action for better waste management in Poland.

In recent years a significant increase in municipal solid waste (MSW) amount has been noted in Poland, and yet there is no fully efficient system for its treatment. Undertaking projects for rational MSW management requires considering both technical facilities and social barriers (waste reduction, re-use and segregation in households). In Poland, attempts to educate and mobilise society to segregate recyclables have not yet produced satisfactory results. Society's awareness in this field needs to be raised. The purpose of this study was to determine the level of knowledge and understanding about MSW management and the relationship between knowledge possessed and actions undertaken for various residential age groups in two Polish provinces. In all groups, 30% of the respondents showed a satisfactory level of knowledge, whilst an equally small number of individuals had undertaken actions for MSW management at home; people with a higher level of knowledge undertook such actions slightly more often. No significant differences between the provinces were found, but residents of town, where waste segregation has been introduced simultaneously with an information campaign, showed a higher level of knowledge. The study points to the need to further educate people about MSW, and to encourage the teaching of pro-environmental attitudes.

Adolescent↗
PubMed2000

Knowledge, attitude and practice of smoking among university students of allied health sciences in Japan.

A study was conducted to determine the knowledge, attitude and practice (KAP) of cigarette smoking among freshman students of Tokyo Metropolitan University of Health Sciences. Students were categorized as 'ever-smoker' or 'nonsmoker'. 18.3% of the 356 subjects were categorized as 'ever-smoker'. The two categories were then compared to determine significant differences in health knowledge, attitudes towards health and smoking, smoking perceptions and preferences, knowledge on the economic impact of tobacco and attitudes towards tobacco control measures. In most cases, significant differences were found between the two groups. However, concerning knowledge on the economic impact of tobacco, the majority of both ever-smokers and nonsmokers had poor knowledge. Increased tobacco control education and related efforts are needed as is further research in determining the factors or influences that shape the significant differences found. Such information will be invaluable in formulating appropriate tobacco control measures for the future.

Adult↗
PubMedDate not supplied

Self-reported practice, confidence, and knowledge about palliative care of nurses in a Japanese Regional Cancer Center: longitudinal study after 1-year activity of palliative care team.

Knowledge and skill deficits about palliative care in medical professionals are among the most common barriers to quality palliative care. This study in a Japanese regional cancer center was conducted to clarify nurses' self-reported practices, confidence, and knowledge, and the changes in these parameters after the 1-year educational and clinical activity of a palliative care team. Questionnaires were distributed to 134 nurses before and after a palliative care team conducted 6-topic educational programs and clinical consultation activity throughout the year. The nurses were asked to report their practices, confidence, and knowledge about palliative care in 5 fields (pain, dyspnea, delirium, communication, and dying-phase). In some areas of palliative care, hospital nurses did not adhere to recommended practices, had knowledge deficits, and were not generally confident with palliative care practices. However, daily palliative care team activities, including educational programs and clinical consultation service, could improve their practice and knowledge levels.

Analysis of Variance↗
PubMed2006

Knowledge of school nurses in the U.K. regarding sexual health education.

In the U.K., a current government health strategy indicates that school nurses should be key contributors to sexual health education because they have access to the school-age population. However, there appears to be little research that investigates whether school nurses are the most appropriate health care professionals or indeed have sufficient knowledge to contribute to this topic in the schools. The purpose of this study was to examine the sexual health knowledge of school nurses, using a survey to assess school nurses employed in a large central region of the U.K. The results suggest that although their general knowledge of the topic was adequate, school nurses have insufficient knowledge to effectively teach about sexually transmitted infections or emergency contraception. This has implications for school nursing because it appears that school nurses may have inadequate knowledge about sexual health to contribute to sex education in schools.

Adult↗
PubMed1997

The impact of the Wellness Guide/Guía on Hispanic women's well-being-related knowledge, efficacy beliefs, and behaviors: the mediating role of acculturation.

This study examined how acculturation mediated the impact of the California Wellness Guide/La Guía del Bienestar on Hispanic women's knowledge, efficacy beliefs, and behaviors. Knowledge gaps were found between acculturated and less acculturated women. Acculturated mothers had more confidence in their abilities to acquire wellness-related information both before and after Guide/Guía distribution and also had more assistance-seeking efficacy. Guide/Guía recipients were more knowledgeable, had greater confidence in their knowledge and their abilities to acquire information, and possessed better information acquisition strategies than nonrecipients. The publication also enhanced low-acculturated recipients' assistance-seeking self-efficacy. High-acculturated and low-acculturated recipients of the Guide/Guía were equally likely to have retained and used their copies, to anticipate using the publication in the future, and to have made a change in behavior as a result of the guide. Finally, the Guide/Guía did not increase the knowledge gap between high- and low-acculturated guide recipients.

Acculturation↗
PubMed2005

A description of physical therapists' knowledge in managing musculoskeletal conditions.

BACKGROUND: Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. METHODS: This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. RESULTS: Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. CONCLUSION: The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions.

Adult↗
PubMed2005

Comparison of knowledge scores of medical students in problem-based learning and traditional curriculum on public health topics.

BACKGROUND: The purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics. METHODS: We planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56) were the pioneers educated with PBL curriculum since the 1997-1998 academic year. The sixth year students (traditional education group, n = 78) were the last students educated with traditional education methods. We prepared 25 multiple-choice questions in order to assess knowledge scores of students on selected subjects of Public Health. Our data were collected in year 2002. RESULTS: Mean test scores achieved in PBL and traditional groups were 65.0 and 60.5 respectively. PBL students were significantly more successful in the knowledge test (p = 0.01). The knowledge scores of two topics were statistically higher among PBL students. These topics were health management and chronic diseases. CONCLUSION: We found that mean total evaluation score in the PBL group was 4.5 points higher than in the traditional group in our study. Focusing only on the knowledge scores of students is the main limitation of our study. Upon the graduation of the first PBL students in the 2002-2003 academic year, we are planning additional studies regarding the other functions of a physician such as skill, behaviour and attitude.

Adult↗
PubMed2006

Knowledge loss of medical students on first year basic science courses at the University of Saskatchewan.

BACKGROUND: Many senior undergraduate students from the University of Saskatchewan indicated informally that they did not remember much from their first year courses and wondered why we were teaching content that did not seem relevant to later clinical work or studies. To determine the extent of the problem a course evaluation study that measured the knowledge loss of medical students on selected first year courses was conducted. This study replicates previous memory decrement studies with three first year medicine basic science courses, something that was not found in the literature. It was expected that some courses would show more and some courses would show less knowledge loss. METHODS: In the spring of 2004 over 20 students were recruited to retake questions from three first year courses: Immunology, physiology, and neuroanatomy. Student scores on the selected questions at the time of the final examination in May 2003 (the 'test') were compared with their scores on the questions 10 or 11 months later (the 're-test') using paired samples t -tests. A repeated-measures MANOVA was used to compare the test and re-test scores among the three courses. The re-test scores were matched with the overall student ratings of the courses and the student scores on the May 2003 examinations. RESULTS: A statistically significant main effect of knowledge loss (F = 297.385; p < .001) and an interaction effect by course (F = 46.081; p < .001) were found. The students' scores in the Immunology course dropped 13.1%, 46.5% in Neuroanatomy, and 16.1% in physiology. Bonferroni post hoc comparisons showed a significant difference between Neuroanatomy and Physiology (mean difference of 10.7, p = .004). CONCLUSION: There was considerable knowledge loss among medical students in the three basic science courses tested and this loss was not uniform across courses. Knowledge loss does not seem to be related to the marks on the final examination or the assessment of course quality by the students.

Adult↗
PubMed2006

Tacit knowledge as the unifying factor in evidence based medicine and clinical judgement.

The paper outlines the role that tacit knowledge plays in what might seem to be an area of knowledge that can be made fully explicit or codified and which forms a central element of Evidence Based Medicine. Appeal to the role the role of tacit knowledge in science provides a way to unify the tripartite definition of Evidence Based Medicine given by Sackett et al: the integration of best research evidence with clinical expertise and patient values. Each of these three elements, crucially including research evidence, rests on an ineliminable and irreducible notion of uncodified good judgement. The paper focuses on research evidence, drawing first on the work of Kuhn to suggest that tacit knowledge contributes, as a matter of fact, to puzzle solving within what he calls normal science. A stronger argument that it must play a role in research is first motivated by looking to Collins' first hand account of replication in applied physics and then broader considerations of replication in justifying knowledge claims in scientific research. Finally, consideration of an argument from Wittgenstein shows that whatever explicit guidelines can be drawn up to guide judgement the specification of what counts as correctly following them has to remain implicit.Overall, the paper sets out arguments for the claim that even though explicit guidelines and codifications can play a practical role in informing clinical practice, they rest on a body of tacit or implicit skill that is in principle ineliminable. It forms the bedrock of good judgement and unites the integration of research, expertise and values.

Evidence-Based Medicine↗
PubMed2004

Knowledge of oral cancer risk factors among african americans: do nurses have a role?

PURPOSE/OBJECTIVES: To assess the knowledge of oral cancer risk factors among African Americans. DESIGN: Descriptive; guided by the Patient/Provider/System Theoretical Model for cancer screening. SETTING: Community-based primary care center in a southern state. SAMPLE: 141 African Americans. The majority was female, had a 12th grade education, and had an income less than 10,000 dollars; 25% were smokers. METHODS: Participants were asked to identify whether each of 15 factors (i.e., seven risk factors and eight nonrisk factors) increased risk for oral cancer. One point was added for each correct response; therefore, scores could range from 0-15 points. Demographic data were collected. MAIN RESEARCH VARIABLES: Knowledge of and misconceptions about oral cancer. FINDINGS: Only six participants correctly identified all of the risk factors. The majority recognized tobacco but was not as aware of the effects of the sun, alcohol, and diet. Many erroneously identified factors such as hot beverages, poor oral hygiene, spicy foods, dentures, and mouthwash as risk factors. Those with higher incomes and those who visited their dentists in the prior year had more knowledge of risk factors. No differences were found in knowledge based on age, gender, education, or smoking status. CONCLUSIONS: Some patients are less likely to routinely visit a dentist and are less knowledgeable about the risk factors for oral cancer. Many of these risk factors are modifiable; therefore, patients need to be aware of the risks and have access to effective strategies to reduce risk. IMPLICATIONS FOR NURSING: Assess risk factors, teach risk reduction, and correct misinformation. Refer patients to dental professionals. Develop community outreach to African American men at barbershops and fraternal organizations.

Adolescent↗