Preclinical obesity curriculum: audit, implementation, and evaluation.

BACKGROUND: This study aimed to (1) evaluate the current status of obesity education at Case Western Reserve University School of Medicine (CWRU) (2), introduce a comprehensive first-year curriculum on obesity, and (3) assess the impact of the curriculum on self-reported attitudes and knowledge regarding obesity among first-year medical students. METHODS: The preclinical curriculum at CWRU was reviewed to determine the degree of coverage of Obesity Medicine Education Collaborative (OMEC) competencies for healthcare professionals, and recommendations were provided for revising the curriculum to better adhere to these evidence-based competencies. A survey on obesity attitudes and knowledge was given before and after the implementation of the new curriculum to measure intervention-related changes. Changes in obesity attitudes and knowledge were compared (1) before and after the intervention for the class of 2025 and (2) after the intervention for the class of 2025 to a historical cohort that did not receive the intervention. RESULTS: Among the 27 competencies examined in the audit, 55% were unmet and 41% were partially met. Of 186 first-year medical students (M1s), 29 (16%) completed the baseline survey and 26 (14%) completed the post-intervention survey. Following the intervention, there was a notable improvement in attitudes and knowledge regarding obesity. Specifically, there was a significant decrease in the belief that obesity is caused by poor personal choices, and knowledge of obesity in fourteen out of fifteen areas showed significant improvement from pre- to post-intervention. Additionally, obesity attitudes and knowledge were significantly better post-intervention when compared to the historical cohort. CONCLUSIONS: The improvements made to the preclinical curriculum through this project improved obesity attitudes and knowledge among first-year medical students. This method provides a practical approach for evaluating and enhancing obesity education in medical school curricula.

Attitudes, Knowledge, Risk Perception of Antimicrobial Resistance and Antibiotic Use Behaviors: A Cross-Sectional Survey in a Young Adult Population.

Background: The emergence and spread of bacterial resistance to antibiotics is a major threat to global public health. There is strong evidence that the general public plays a role in the emergence and spread of antimicrobial resistance. Objective: In this study, the impact of attitudes, knowledge, and risk perception of antimicrobial resistance on students' antibiotic use behaviors was investigated. Methods: A cross-sectional survey was conducted using a questionnaire with a sample of 279 young adults. Descriptive analysis and hierarchical regression analyses were used to analyze the data. Results: The results indicated that positive attitudes, a minimal level of knowledge about antimicrobial resistance, and awareness of the seriousness of this phenomenon have a positive influence on the appropriate use of antibiotics. Conclusions: Overall, the results of this study highlight the need for awareness campaigns that provide the public with accurate information about the risks associated with antibiotic resistance and appropriate antibiotic use.

Managing Pain in People with Cancer-a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public.

Cancer pain is a common symptom experienced by patients, caused either by the disease or its treatment. Morphine remains the most effective and recommended treatment for cancer pain. However, cancer patients still do not receive appropriate management for their pain, and under-treatment is common. Lack of knowledge and negative attitudes towards cancer pain and analgesia among professionals, patients and family caregivers are reported as one of the most common barriers to effective cancer pain management (CPM). To systematically review research on the nature and impact of attitudes and knowledge towards CPM, a systematic literature search of 6 databases (the Cochrane library, MEDLINE, PsycINFO, CINAHL, Web of Science and EMBASE) was undertaken in July 2018. Additionally, hand-searching of Google, Google Scholar and reference lists was conducted. The inclusion criteria were adult (18-65 years of age), studies which included attitudes and knowledge towards CPM, studies written in English, published literature only and cross-sectional design. Included studies were critically appraised by two researchers independently using the Joanna Briggs Institute Analytical Cross Sectional Studies Assessment (JBI-ACSSA). A total of 36 studies met the inclusion criteria. The main finding was that among professionals, patients, caregivers and the public there were similar attitudinal barriers to effective CPM. The most commonly cited barriers were fear of drug addiction, tolerance of medication and side effects of opioids. We also found differences between professional groups (physicians versus nurses) and between different countries based on their potential exposure to palliative care training and services. There are still barriers to effective CPM, which might result in unrelieved cancer pain. Therefore, more educational programmes and training for professionals on CPM are needed. Furthermore, patients, caregivers, and the public need more general awareness and adequate level of knowledge about CPM.

Determination of attitude and knowledge of type 2 diabetic patients towards insulin therapy in Northern Cyprus.

OBJECTIVE: To determine the attitude and knowledge of type-2 diabetics related to insulin therapy. METHODS: The descriptive cross-sectional study was conducted from January to March 2014 at the Dr. Burhan Nalbantoglu Public Hospital, Nicosia in the Turkish Republic of Northern Cyprus, and comprised patients with type-2 diabetes. The Likert scale was used to score participants' response to questions using the following scoring system: 0 (disagree), 1 (neutral) and 2 (agree). The minimum scoring value for all the questions combined was 0 whereas the maximum scoring value was 50. Patients' attitudes were classified as either high, medium or low based on scores between 0-16, 17-33 and 34-50, respectively. SPSS 16 was used for data analysis. RESULTS: Of the 271 participants, 165(60.9%) were female and 106(39.1%) male. The overall mean age was 60.3±32.4 years. Moreover, 136(50.3%) participants had a medium attitude and knowledge score towards insulin therapy. men scored significantly better than females (p<0.05). Only 25(9.2%) participants had a high score towards insulin therapy. CONCLUSIONS: The participants were found to have an inadequate attitude and knowledge response to insulin therapy.

Associations between non-discrimination and training policies and physicians' attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals.

BACKGROUND: Some physicians lack knowledge and awareness about health issues specific to sexual and gender minority (SGM) individuals. To help improve this, hospitals have implemented policies that mandate non-discrimination and training to promote sexual and gender minority health. There is limited evidence about how such policies relate to physicians' knowledge, attitudes, and gender and sexual minority affirmative practices. METHOD: A random sample of 1000 physicians was recruited from a complete list of physicians affiliated with one of two university Hospitals located in Tennessee and 180 physicians completed the survey concerning attitudes and knowledge about SGM individuals. Physicians were affiliated with either Hospital A that had not implemented policies for non-discrimination and training, or Hospital B that did. RESULTS: Physicians held different attitudes about SGM patients than non-patients. Physicians affiliated with Hospital A held more negative attitudes about SGM individuals who were non-patients than physicians affiliated with Hospital B. There were no differences between the two hospitals in physicians' attitudes and knowledge about SGM patients. CONCLUSION: Policies that mandate non-discrimination and training as they currently exist may not improve physicians' attitudes and knowledge about SGM individuals. Additional research is needed to understand how these policies and trainings relate to physicians' SGM affirmative practices.

Beliefs about COVID-19 testing and treatment: A national survey of Black and White adults.

Objectives: Knowledge, access, and use of testing and antiviral treatments is critical to managing and mitigating the continuing burden of the novel Corona Virus (COVID-19) in the United States. This study measured knowledge, attitude, behaviors, and self-reported barriers towards COVID-19 testing and outpatient anti-viral medications (OPA) treatments among Black and older individuals who face greater hospitalization and mortality from the disease. Study design: Cross-sectional structured survey. Methods: Respondents were randomly selected from an opt-in national panel in December 2022. Equal numbers of Black and White US adults over the age of 40 (n = 1037) completed the 42 item online survey. The main measures were key sociodemographic variables of respondents, race, age, political affiliation and COVID-19 attitudes, beliefs, testing behaviors, and knowledge and barriers to OPA access. Results: Overall, awareness and knowledge of COVID-19 outpatient treatments was low. Black respondents were more likely to test for COVID-19 than White respondents but less likely to know about OPA treatments. Insurance coverage was a significant factor in use of home tests. Knowledge of OPA treatments was low across groups. White respondents were more likely than Black respondents to be aware of OPA treatments (1.75, 95 % CI [1.31-2.33]) as were higher income respondents (1.13, 95 % CI [1.08-1.17]) and self-identified Liberals (1.79, 95 % CI [1.29-2.49]). Conclusions: Clinicians should know large numbers of patients may not be testing for COVID-19, nor are they aware of outpatient treatment options and may hold inaccurate beliefs about them. Developing culturally specific patient education materials are warranted to increase testing, utilization of vaccinations and OPAs.

Cattle transporters' attitudes, indigenous knowledge, and current practices towards animal welfare, occupational well-being, and operational challenges: A survey of five regions in Ghana.

Ghana is a significant cattle producer in Africa with an estimated cattle population of 3 million in 2020 [1]. The role of transporters in linking farms to markets and slaughterhouses is crucial in the livestock value chain. However, cattle transportation subjects the animals to high levels of stress, compromising their welfare, and transporters face challenges such as long working hours and harsh conditions. The objective of this study was to explore current practices, indigenous knowledge, and operational risks pertaining to animal welfare among transporters. The study was conducted in five regions connected by the N16, N10, and N6 Highway, the primary route for cattle transportation from the Ghana-Burkina Faso border to the coastal capital of Accra. A total of 78 transporters participated in the study. Out of the 78 participants in this study, the majority of transporters were young adults (56.5%) with secondary school education (45.9%) and 0-5 years of experience (37.2%). The average distance and time for transporting cattle was 528 km and 18 h, respectively. The transporters highlighted significant challenges encountered during cattle transport, including feed and water shortage, particularly prominent during the dry season (32.1%), as well as the occurrence of diseases and mortality, particularly high during the rainy season (41%). Furthermore, vehicular breakdowns were a common issue reported by transporters, with a substantial majority (88.5%) experiencing breakdowns during their last 10 trips. The results showed that most transporters (84.7%) had limited knowledge of animal welfare and had not received any formal education on livestock transportation. Instead, they gained experience as assistants on other trucks before becoming drivers. The findings of this study highlight the need for improved welfare standards for cattle during transportation and formal training programs for transporters in animal welfare and livestock transportation.

Desire for predictive testing for Alzheimer's disease and impact on advance care planning: a cross-sectional study.

BACKGROUND: It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer's disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer's disease, and examined how using such a test may impact advance care planning. METHODS: A cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer's disease (N = 874). Subjects were asked whether they would want to take a hypothetical free and definitive test predictive of future Alzheimer's disease. Then, imagining they knew they would develop Alzheimer's disease, subjects rated the chance of completing advance care planning activities from 0 to 100. We classified a score > 50 as being likely to complete that activity. We evaluated characteristics associated with willingness to take a test for Alzheimer's disease, and how such a test would impact completing an advance directive and discussing health plans with loved ones. RESULTS: Overall, 75% (N = 648) of the sample would take a free and definitive test predictive of Alzheimer's disease. Older adults willing to take the test had similar race and educational levels to those who would not, but were more likely to be ≤75 years old (odds ratio 0.71 (95% CI 0.53-0.94)). Imagining they knew they would develop Alzheimer's, 81% would be likely to complete an advance directive, although only 15% had done so already. CONCLUSIONS: In this nationally representative sample, 75% of older adults would take a free and definitive test predictive of Alzheimer's disease. Many participants expressed intent to increase activities of advance care planning with this knowledge. This confirms high public interest in predictive testing for Alzheimer's disease and suggests this may be an opportunity to engage patients in advance care planning discussions.

Oncology Nursing Certification: Relation to Nurses' Knowledge and Attitudes About Pain, Patient-Reported Pain Care Quality, and Pain Outcomes.

PURPOSE/OBJECTIVES: To (a) compare pain knowledge and attitudes between nurses with oncology certified nurse (OCN®) status, non-OCN®-certified nurses, and nurses ineligible for certification and (b) examine the relationships among OCN® status, nurses' knowledge and attitudes about pain, patient-reported quality of nursing pain care, and pain outcomes. 
. DESIGN: Prospective, correlational survey design. Patients were nested within nurses. 
. SETTING: Six inpatient oncology units in three hospitals. SAMPLE: 91 nurses in three states (28 OCN®-certified nurses, 37 noncertified nurses, and 26 not eligible for certification). Certification status was validated for 105 nurses who were matched with a sample of 320 patients. 
. METHODS: Nurses completed a survey, and matched adult patients who were experiencing pain rated their pain care quality and pain experience during the past shift. 
. MAIN RESEARCH VARIABLES: Demographic characteristics, certification status, and responses to the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), Pain Care Quality Survey-Nursing, and modified Brief Pain Inventory (Short Form). 
. FINDINGS: OCN®-certified nurses scored significantly higher on the NKASRP (82% correct) compared to non-OCN® eligible nurses (76%) and non-OCN® ineligible nurses (74%) (p < 0.001). Only 43% overall achieved a benchmark of 80% correct. No statistically significant relationships existed between (a) certification status and pain care quality or pain outcomes or (b) NKASRP and care quality or outcomes (p > 0.05).
. CONCLUSIONS: OCN®-certified nurses' knowledge and attitudes related to pain management were superior to noncertified nurses. Neither knowledge and attitudes nor OCN® status were associated with pain care quality or pain outcomes. 
. IMPLICATIONS FOR NURSING: Knowledge is necessary but insufficient to improve patient outcomes; providing optimal pain care requires action. Sustained efforts to improve cancer pain management are indicated.

A qualitative assessment of Ugandan women's perceptions and knowledge of contraception.

OBJECTIVE: To determine Ugandan women's perceptions and knowledge of contraception. METHODS: Healthy prepartum women were recruited from a national referral and university teaching hospital to participate in 1 of 5 focus group discussions on contraception. Transcripts were translated and coded by 2 researchers using inductive and deductive methods. RESULTS: Forty-six women participated in the focus group discussions. The major themes that emerged were around family planning as a method to space pregnancies and manage finances, as well as men's roles in decision making regarding contraception. Notable among the many incorrect notions about adverse effects of contraception were fears about cancer and infertility. CONCLUSION: The results indicate that, among the study group of Ugandan women, decision making regarding family planning involves a complex negotiation among women, partners, and families. Furthermore, pervasive myths may hinder a woman's ability to choose safe and effective contraception. These findings are useful to healthcare providers and the greater public-health community.

The need for office systems to improve colorectal cancer screening.

UNLABELLED: Patients generally access colorectal cancer (CRC) screening through primary care physicians. National guidelines recommend CRC screening for adults beginning at age 50, yet one-third of Americans are not up to date. METHODS: A self-administered questionnaire was administered to family physicians from 16 practices in a Midwestern state who attended an information session for a randomized study to improve CRC screening. The questionnaire assessed CRC screening practices, knowledge of CRC screening guidelines, and office strategies for improving screening. RESULTS: Of 131 health care providers, 85 (65%) completed the questionnaire. Two-thirds were aware of the CRC screening guidelines; 91% knew that the follow-up interval for screening depends on the test chosen. Twenty-five percent incorrectly stated that a single-sample in-office fecal occult blood test is an acceptable screening test. Only 8% had a written policy regarding CRC screening; 18% had offices that used chart reminders; and 32% had charts organized to easily identify patient screening status. Regarding perceptions, those who agreed that they encourage their office staff to participate in screening estimated that they offer screening to more patients than those who disagreed (82.8% vs 70.2%, P < .0001); in addition, those who agreed with and tried to follow the guidelines estimated that they offer screening to more patients than those who disagreed (77.4% vs 60.5%, P = .004). CONCLUSION: Although physicians were knowledgeable about CRC screening guidelines, 25% mistakenly believed that single-sample in-office fecal testing was appropriate. There was a striking lack of office systems for identifying eligible patients and facilitating CRC screening.

Issues and potential solutions when capturing health data in rural clinics in South Africa

This paper highlights the data and information required by various International bodies, including WHO, PEPFAR, World Bank and the South African Government regarding HIV and its associated programmes and comorbidities. It explores the current collection of data in South African rural clinics and reports on the results from in-depth interviews with nurses regarding the burden of data collection and the perceptions and attitudes to electronic solutions including smart phones and tablet computers(AU)

Este artículo destaca los datos y la información requeridos por diversos organismos internacionales, como la OMS, el PEPFAR, el Banco Mundial y el Gobierno de Sudáfrica en relación con el VIH y sus programas asociados y comorbilidades. Explora la colección actual de los datos en las clínicas rurales de Sudáfrica y los informes sobre los resultados de las entrevistas en profundidad con las enfermeras con respecto a la carga de la recopilación de datos y las percepciones y actitudes hacia soluciones electrónicas, incluyendo teléfonos inteligentes y tablet PC(AU)