Men’s knowledge and attitudes about cervical cancer screening in Kenya

Background

A number of studies have identified male involvement as an important factor affecting reproductive health outcomes, particularly in the areas of family planning, antenatal care, and HIV care. As access to cervical cancer screening programs improves in resource-poor settings, particularly through the integration of HIV and cervical cancer services, it is important to understand the role of male partner support in women’s utilization of screening and treatment.

Methods

We administered an oral survey to 110 men in Western Kenya about their knowledge and attitudes regarding cervical cancer and cervical cancer screening. Men who had female partners eligible for cervical cancer screening were recruited from government health facilities where screening was offered free of charge.

Results

Specific knowledge about cervical cancer risk factors, prevention, and treatment was low. Only half of the men perceived their partners to be at risk for cervical cancer, and many reported that a positive screen would be emotionally upsetting. Nevertheless, all participants said they would encourage their partners to get screened.

Conclusions

Future interventions should tailor cervical cancer educational opportunities towards men. Further research is needed among both men and couples to better understand barriers to male support for screening and treatment and to determine how to best involve men in cervical cancer prevention efforts.

     

Effect of a school-based nutrition education program on adolescents’ nutrition-related knowledge,attitudes and behaviour in rural areas of China

Objectives

This study aimed at examining the effect of the nutrition education program on adolescents’ knowledge, attitudes and behaviour in relation to nutrition in rural China.

Methods

A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to the school conducting nutrition education (NE school), or to the Control school, in Mi Yun County, Beijing. From each school 65 seventh-grade students were randomly selected to participate in the study. Nutrition-related knowledge, attitudes and behaviour were measured at pre- and post-intervention surveys with the same instrument. The nutrition education lasted for 6 months.

Results

After the intervention, more students in NE school knew the main function of dairy products and vegetables, which micronutrient is rich in dairy products and beans, and in meat, and the symptom of food poisoning, than those in Control school. The rate of students who thought nutrition is very important to health, and foods with an expired date should be thrown away in NE school was higher than that in Control school (93.8 vs. 80.3 and 92.3 vs. 78.7 %, respectively). The rate of students who ate vegetables and breakfast everyday in NE school was higher than that in Control school (96.9 vs. 80.3, and 89.2 vs. 75.4 %, respectively). (p < 0.05).

Conclusions

This nutrition education programme is effective in improving adolescents’ knowledge, attitudes, and behaviour in relation to nutrition; therefore, the nutrition education with interactive and innovative intervention components is strongly recommended for future nutrition promotion programmes for adolescents.     

Nurses’ attitudes toward parent participation: Personal and professional characteristics

A nonrandom sample of 273 registered nurses completed a questionnaire that included the Parent Participation Attitude Scale and a personal and professional data section. Analysis of variance indicated that subjects who were married, were parents, were nursing supervisors, had a collegiate nursing education, or worked in Hospital 1 or 4 had more positive attitudes toward parent participation than did subjects who did not possess these characteristics. Further study of nurses from 28 hospitals found that head nurses, nursing supervisors, nurses with a professional nursing education, and nurses with a master's degree in nursing had significantly more accepting attitudes than did nurses without these characteristics.     

Australian beef industry worker’s knowledge,attitudes and practices regarding Q fever: A pilot study

BackgroundQ fever is a vaccine-preventable zoonotic infection with potentially severe health outcomes and high economic costs that affects agricultural workers, including beef and cattle industry workers, however this population historically have sub-optimal vaccine uptake.ObjectiveTo gather quantitative and qualitative pilot data from Australian beef industry workers on their knowledge, attitudes and practices around Q fever and Q fever vaccination.MethodsA mixed methods approach was used to ascertain the Q fever disease risk perception and vaccination behavior of a purposive convenience sample of beef industry workers attending an industry expo in Rockhampton, Queensland, Australia between May 7th and 9th, 2018.ResultsThe quantitative survey response rate was 83% (n = 86). More than 70% of respondents reported exposure to known Q fever risk factors. Eighty six percent were aware of Q fever, the self-reported uptake of Q fever vaccine was 27% and 9% reported undertaking testing which showed evidence of previous infection. Five main themes emerged from the qualitative data: “Finding the time” among other life priorities to attend a doctor for a vaccine; “Employer responsibility” to provide the vaccine; “My doctor knows me” and could suggest Q fever vaccination; “Assigning Risk” across a range of attitudes, including thinking it would not happen to them, ‘fatalism’, and knowing the danger but taking the risk anyway; and “The Need for Outreach” vaccine delivery services in their communities.SignificanceThese data suggest that a coordinated public health approach to testing and vaccine provision, coupled with an awareness campaign among regional doctors to prompt them to routinely ask patients about their Q fever risk and vaccination history, should form part of a broad approach to Q fever control and prevention.     

Nurses’ and physicians’ attitudes about women abuse: The effects of gender and professional role

The apathy encountered by battered women when they seek help from medical and other professions has been attributed to patriarchal norms and victim‐blaming. Because of their place in the medical hierarchy this study hypothesized that: a) nurses would have more sympathetic attitudes toward battered women than physicians; and b) professional roles and not gender would explain the differences. The findings supported the first but not the second hypothesis. Nurses were less likely to believe that wife‐beating is justified and that victims are responsible for the abuse. Women, regardless of profession, were more sympathetic than men. Nurses and physicians with the most liberal attitudes about women's roles were least likely to blame victims. Those with the most intensive training on the topic held victims less responsible and were more willing to help them.     

Does the heartbeat award scheme change employees' dietary attitudes and knowledge?

The Heartbeat Award scheme (HBA) aims to encourage provision and promotion of healthier food choices in catering premises and has been operating in Leicestershire since its launch in England in 1990. This study assessed if the scheme changes dietary attitudes and knowledge of employees in HBA premises. A longitudinal survey of employees in six workplaces was conducted using a structured questionnaire. Employees were investigated before the scheme was implemented and 6 months afterwards. Using a series of validated questions that assessed predisposing and enabling psycho-social factors. Four workplaces with the HBA (N= 453) were compared with two comparison workplaces (N= 124). Nutritional knowledge did not change significantly as a result of the scheme. Employees at HBA workplaces had noticed healthy eating information and acknowledged that it was easier to eat a healthy diet at work after the scheme had been introduced. There was some evidence that the intervention had a maintenance effect in understanding of healthy eating messages, and could act as a buffer to negative external influences. Overall, the scheme was successful in raising awareness of healthy eating in the workplace, but not in enhancing predisposing factors.     

Midwives’ knowledge,attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

IntroductionDespite the enormous benefits of childhood and maternal immunisation to individual and population health, the uptake of maternal vaccines during pregnancy remains suboptimal. Midwives are a trusted information source for parents and play an important role in the provision of immunisation information. Understanding midwives’ attitudes and vaccine knowledge, along with their confidence to discuss maternal and childhood immunisation with parents, is key to reducing parental decisional conflict and achieving immunisation goals.MethodsAn online study was conducted to investigate midwives’ knowledge and attitudes towards maternal and childhood vaccination along with their confidence to answer parents' vaccine-related questions. Midwives were recruited by email via the midwifery peek body, the Australian College of Midwives.ResultsA total of 359 midwives completed the online survey. The majority of midwives supported maternal (influenza 83%, pertussis 90.5%) and childhood immunisation (85.8%); however, 69.4% of respondents wanted further training about immunisation. Midwives who felt their midwifery education adequately covered immunisation were more confident advising parents about maternal (p = 0.007) and childhood immunisation (p < 0.001). Similarly, Midwives were significantly more likely to confidently advise parents about maternal (p < 0.001) and childhood immunisations (p < 0.001) if they had completed a specific immunisation training course outside of their midwifery course.ConclusionMost midwives working in Australia support vaccination. However, access to contemporary, culturally appropriate education that enables midwives to engage confidently with parents about immunisation is lacking. Education based on a women-centred approach within the pre-registration curriculum along with continuing professional development programs could enable midwives to reduce the evidence to practice gap by increasing vaccine uptake.     

Taiwanese farm workers’ pesticide knowledge,attitudes, behaviors and clothing practices

The purpose of this study was to assess Taiwanese fruit farm workers’ knowledge, attitudes, behaviours, and clothing practices regarding pesticide activities. Seventy-seven fruit farm workers from four districts of Tainan City, Taiwan completed the questionnaire. Results indicated that farmer workers had a good overall level of knowledge of the adverse effects of pesticides on human health and most had experienced symptoms of pesticide poisoning. Farm workers’ attitudes toward pesticide use and handling indicated that they saw pesticides useful in controlling pests. Farm workers indicated the limited availability of comfortable clothing designed for a hot and humid climate while still providing sufficient protection was the main reason for not wearing personal protective clothing (PPC) and personal protective equipment (PPE). Emphasis on safety precautions is needed when using pesticides, and the importance of PPC and PPE is essential for the health of farm workers.     

Cumulative Lead Exposure and Age at Menopause in the Nurses’ Health Study Cohort

Background: Early menopause has been associated with many adverse health outcomes, including increased risk of cardiovascular disease morbidity and mortality. Lead has been found to be adversely associated with female reproductive function, but whether exposures experienced by the general population are associated with altered age at menopause has not been explored.Objective: Our goal was to assess the association between cumulative lead exposure and age at natural menopause.Methods: Self-reported menopausal status and bone lead concentration measured with K-shell X-ray fluorescence—a biomarker of cumulative lead exposure—were obtained from 434 women participants in the Nurses’ Health Study.Results: The mean (± SD) age at natural menopause was 50.8 ± 3.6 years. Higher tibia lead level was associated with younger age at menopause. In adjusted analyses, the average age of menopause for women in the highest tertile of tibia lead was 1.21 years younger (95% CI: –2.08, –0.35) than for women in the lowest tertile (p-trend = 0.006). Although the number of cases was small (n = 23), the odds ratio for early menopause (< 45 years of age) was 5.30 (95% CI: 1.42, 19.78) for women in the highest tertile of tibia lead compared with those in the lowest tertile (p-trend = 0.006). There was no association between patella or blood lead and age at menopause.Conclusions: Our results support an association between low-level cumulative lead exposure and an earlier age at menopause. These data suggest that low-level lead exposure may contribute to menopause-related health outcomes in older women through effects on age at menopause.Citation: Eum KD, Weisskopf MG, Nie LH, Hu H, Korrick SA. 2014. Cumulative lead exposure and age at menopause in the Nurses’ Health Study Cohort. Environ Health Perspect 122:229–234; http://dx.doi.org/10.1289/ehp.1206399     

Nurses’ ethical reasoning in cases of physical restraint in acute elderly care: a qualitative study

In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses’ decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a nuanced and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses’ reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009–April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses’ decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly.     

Stakeholders’ perception of the nutrition and health claim regulation

Abstract

In 2007, the Nutrition and Health Claim Regulation (NHCR) entered into force, which required scientific substantiation of health claims. In the field of antioxidants, most proposed claims were negatively assessed by the European Food Safety Authority (EFSA). This study reviews the perception of the NHCR of 14 Dutch stakeholders to unravel the grounds for disproving the putative health claims. Most claims are shown to be refused based on the quality of scientific substantiation, due to usage of scientific methods on which no consensus has been reached and the differences in expectations and requirements. Three themes exemplify the need for improvement in applying the NHCR: (i) enforcement; (ii) methodology; and (iii) perceived impact of the NHCR. With highly diverging perceptions of stakeholders, the current effectiveness of the NHCR can be questioned. The views of different stakeholders on these themes help to focus the discussion on the NCHR in capturing health effects.     

Pharmacological Neuroenhancement: teachers’ knowledge and attitudes–Results from a survey study among teachers in Germany

Background

Pharmacological neuroenhancement (PN) is a topic of increasing importance. Its prevalence rates range from 1 % to more than 20 %. Students are a group that shows exceptionally high prevalence rates. However, little is known about teachers’ knowledge, management, attitudes and ethical judgements regarding PN.

Methods

A web-based survey containing 40 closed questions was developed. All teachers working at all private and public schools in Mecklenburg-Vorpommern, a state in northeastern Germany, were invited to participate after their respective school offices were contacted by telephone, email and mail.

Results

In total, 255 teachers participated in the survey. Of those, 73.3 % had already heard about PN in general, and 68.2 % had heard about PN in students. Their sources of knowledge were digital media such as TV (73.8 %) and the internet (40.6 %) and print media (64.7 %); their own students informed 29.9 % of the teachers about PN in general and 35.6 % of them about PN among students. Furthermore, 34.9 % of the surveyed teachers were convinced that PN substance use was ineffective in general, and 51.8 % of the surveyed teachers believed that PN substances were ineffective in achieving better grades. Only 1.2 % thought that none of the so-called PN substances could lead to addiction, and 37.6 % would classify PN substance use as general drug misuse. The highest values regarding risk of addiction were observed for illicit drugs. The prevalence of PN substance use was evaluated to be very low and to be significantly higher in male, highly skilled and college/university students. In total, 1.6 school lessons per year were used to discuss PN. Finally, 55.7 % of the surveyed teachers believed that performance-enhancing substances should be forbidden at schools.

Conclusion

Teachers, as an integral part of the education of children and adolescents, often know about PN substances and mostly refuse their use being afraid about the risk of addiction. However, regarding effects as well as side effects of PN substances, teachers have very different opinions. Furthermore, they seem to underestimate the prevalence among their students and broach the topic infrequently. Teachers should be sensitized for high prevalence rates and should broach the topic of PN more frequently to their students to prevent potential misuse of PN substances.

     

Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour?

The status and explanatory role of nutrition knowledge is uncertain in public health nutrition. Much of the uncertainty about this area has been generated by conceptual confusion about the nature of knowledge and behaviours, and, nutrition knowledge and food behaviours in particular. So the paper describes several key concepts in some detail. The main argument is that 'nutrition knowledge' is a necessary but not sufficient factor for changes in consumers' food behaviours. Several classes of food behaviours and their causation are discussed. They are influenced by a number of environmental and intra-individual factors, including motivations. The interplay between motivational factors and information processing is important for nutrition promoters as is the distinction between declarative and procedural knowledge. Consideration of the domains of nutrition knowledge shows that their utility is likely to be related to consumers' and nutritionists' particular goals and viewpoints. A brief survey of the recent literature shows that the evidence for the influence of nutrition knowledge on food behaviours is mixed. Nevertheless, recent work suggests that nutrition knowledge may play a small but pivotal role in the adoption of healthier food habits. The implications of this overview for public health nutrition are: (i) We need to pay greater attention to the development of children's and adults' knowledge frameworks (schema building); (ii) There is a need for a renewed proactive role for the education sector; (iii) We need to take account of consumers' personal food goals and their acquisition of procedural knowledge which will enable them to attain their goals; (iv) Finally, much more research into the ways people learn and use food-related knowledge is required in the form of experimental interventions and longitudinal studies.     

Changes in knowledge, attitudes and behaviors of Italian university students regarding contraceptive methods and STDs (1998–2008): a cross-sectional study

Aim

The aim of the study is to evaluate changes in opinions and behaviors of university students about sexual attitudes, use and effectiveness of contraceptive methods and sexually transmitted diseases (STDs).

Subjects and methods

The study was carried out through three surveys in 1998, 2003 and 2008. A self-completion questionnaire, divided into three major sections, was administered. The groups were analyzed with the Chi-square test and the multiple logistic regression analysis; the significance level was set at p?<?0.05.

Results

Contraceptive methods were not used by 12.0, 12.5, and 16.2 % of the sample in 1998, in 2003 and 2008 respectively. The condom was the most common method used by responders, followed by the pill; both methods of birth control are also considered the most effective. In 2008, students demonstrated to have a good knowledge about STDs transmission through sexual intercourse and contraceptive use was higher among responders with multiple partners (p?=?0.028), lower in smokers (p=?0.003) and female gender (p?=?0.001).

Conclusion

The results highlight the necessity to activate programs on sex education, on the use of contraceptives and STD prevention. Peer education should also be considered.     

Health Behavior Theory and cumulative knowledge regarding health behaviors: are we moving in the right direction?

Although research on Health Behavior Theory (HBT) is being conducted at a rapid pace, the extent to which the field is truly moving forward in understanding health behavior has been questioned. This issue is examined in the current article. First, we discuss the problems within the HBT literature. Second, we discuss the proliferation of HBT and why theory comparison is essential to this area of research. Finally, we reflect on ways that the field might move forward by suggesting a new agenda for HBT research. It is argued that increased recognition of the similarity of health behavior constructs as well as increased empirical comparisons of theories are essential for true scientific progress in this line of inquiry.     

Maternal knowledge of nutrition,problem‐solving abilities and the introduction of complementary foods into infants’ diets

The purpose of the present study was to identify variables (maternal knowledge and problem‐solving ability) associated with the early introduction of complementary foods (i.e. foods other than breastmilk or formula) into infants’ diets. Ninety‐eight primarily African‐American mothers who presented to an urban, ambulatory care clinic in the Midwest completed questionnaires. Maternal knowledge regarding doctors’ recommendations for complementary feeding was associated with when mothers introduced solids (r = 0.25, p < .05), cow’s milk (r = 0.35, p < .05), juice (r = 0.42, p < .001) and water (r = 0.38, p < .001). Maternal nutrient knowledge was associated with when cow’s milk (r = 0.37, p < .05) and fruit drink/soda (r = 0.52, p < .01) were introduced. The quality of maternal problem‐solving was associated with when mothers introduced fruit drink/soda (r = 0.34, p < .05). Results underscore the role that healthcare professionals play in complementary feeding.     

Parental attitudes and decision-making regarding MMR vaccination in an anthroposophic community in Sweden – A qualitative study

Measles outbreaks occur regularly throughout Europe, up to 31 500 cases in the previous year, particularly where there are pockets of populations with lower vaccination coverage than the recommended ≥95%. Anthroposophic communities in Europe are one of several groups with relatively low vaccination coverage. In Sweden, outbreaks of measles and rubella were reported from an anthroposophic community. Thus the aim of this qualitative study was to explore facilitators and barriers to MMR vaccination among parents living in anthroposophic communities in Sweden. Twenty parents living in an anthroposophic community were interviewed, focusing on their views and decisions on MMR vaccination. The interviews were analyzed using qualitative content analysis. Two overarching views of health emerged, differentiating broadly parents who vaccinate vs. parents who do not vaccinate. Four themes describing parental attitudes toward measles vaccination were developed and three of these, the conformers, the pragmatists and the attentive delayers describe different approaches toward vaccinations among those who actually vaccinate. The last theme, promoters of natural immunity, represents those postponing or refusing vaccination beyond childhood. This study suggests that there is a spectrum of parental beliefs regarding MMR vaccination in this anthroposophic community. Interventions specifically targeted to the anthroposophic community and strengthening health workers capacity for a constructive dialog on vaccine's benefit and risks may contribute to higher vaccination coverage. This is believed to minimize the risk of future epidemics and contribute to the WHO European Region's goal of eliminating measles.