HIV/AIDS knowledge among undergraduate university students: implications for health education programs in Ghana

Background

Globally, the spread of HIV/AIDS remains on the rise especially among adolescents who are at increased risk of infection. Sexual behavioural change remains one of the most effective ways of preventing further transmission among this vulnerable group.

Objective

To evaluate HIV/AIDS knowledge among undergraduate students'' and how it can be used in HIV prevention strategies in Ghana.

Methods

A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a tertiary institution in Accra, Ghana.

Results

The mean age of the respondents was 23 years. Although the mean score of the participants'' responses to 12 HIV/AIDS knowledge questions was 7.7 of 12 points, there was an inconsistent level of AIDS knowledge with significant gender difference. While students could identify the transmission modes and preventive measure, they were less knowledgeable about the causative agent of AIDS. Majority of the students reported having received AIDS information from both print and electronic media, but few of them received such information from parents. Although over 90% of the students knew where to access VCT services, 45% of them have not had HIV test.

Conclusion

The data underscore the urgent need for HIV/AIDS-related health education and prevention efforts targeting university students as well as younger age groups in Ghana     

Unmodified electroconvulsive therapy: changes in knowledge and attitudes of Nigerian medical students

Background

The relevance of ECT as a treatment option for some psychiatric disorders continues to generate debate in professional and lay circles. Scientific evidence as to the effectiveness of ECT (with anaesthesia) abounds. In some developing countries, the process of change towards the full implementation and use of modified ECT has been slow. The unmodified format is still used for largely economic reasons despite the ethical concerns it raises.

Objective

We assessed the effect of an intervention (60 minute lecture on ECT, viewing a live ECT session, following up a patient who had received ECT) during a clinical psychiatry rotation, on medical students'' knowledge of and attitude toward unmodified electroconvulsive therapy

Method

A 14-item self administered questionnaire was administered to 5^th year medical students at the commencement of their psychiatry rotation, then 4 weeks later to assess knowledge of and attitudes toward unmodified ECT

Results

There were significant improvements in knowledge and change in attitude measures to myth about ECT following our intervention. However, viewing live unmodified ECT sessions did not improve the students'' acceptability of the procedure.

Conclusion

Exposure of medical students to ECT and lectures are important in changing negative attitudes during clerkships and should be incorporated in their teaching curriculum. We may infer that future psychiatrists would prefer the modified form of ECT and acceptability would be better with this format.     

Tackling malaria,village by village: a report on a concerted information intervention by medical students and the community in Mifumi,Eastern Uganda

Background

Can an information intervention facilitated by information technology and carried out by an interdisciplinary team comprising medical students, technical experts, and the community itself make a positive contribution in reducing the burden of malaria at the village level?In Mifumi village in Eastern Uganda, MIFUMI Project, Makerere University College of Health Sciences Community Based Education and Service program (COBES), and the U.S. National Library of Medicine carried out a series of activities between 2007 and 2010.

Methods

The team surveyed the community''s knowledge of malaria prevention and treatment; implemented a health information intervention using tutorials in a variety of media; and observed the community''s use of previously distributed insecticide treated nets (ITNs) using a digital pen application.

Results

As a result of concerted education and outreach, the village residents have a good understanding of malaria prevention and treatment seeking behaviors. Leveraging the power of information technology and interdisciplinary teamwork, medical students and the denizens of a rural community were able to engage in an interactive experience of health education and promotion.

Conclusion

Preliminary observations suggest that a health information intervention in concert with a collaborative community effort of education and prevention can build capacity within a community to take control of its own health.     

Knowledge and utilization of malaria control measures by pregnant and newly delivered mothers in Ibadan, Nigeria

Background

The World Health Organisation (WHO) guidelines for the control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp). Despite this the uptake is poor.

Objective

To describe the malaria prevention measures utilized by these women in this environment.

Methods

Information was obtained from consented pregnant and newly delivered women on their socio-demographic characteristics, knowledge and use of malaria chemoprophylaxis

Results

One Thousand three hundred thirty (1330) pregnant and newly delivered women in 132 facilities within the Ibadan metropolis were surveyed. The mean age of the respondents was 29. 67 years (±5.21). The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. Only 28.2% were using ITNs in the index pregnancy, and 67.2% of the women had had a drug administered for prophylactic purposes in the index pregnancy.

Conclusion

This study demonstrates awareness but poor use of control measures. Additionally, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.     

A Survey of Pediatricians in Private Practices Who Participated in Community-Based Clerkships: An Intellectual, Inspirational and Professional Growth Experience

Purpose

To examine how pediatricians in private practices are affected by the process of training medical students in their clinics as part of a community-based clerkship program.

Materials and Methods

In 2007, a questionnaire was sent to 35 pediatricians who had provided private clinical settings for clerkship training for the previous 3 years. The questionnaire covered a number of points, including the pediatricians'' motivation to join and/or reasons to quit the program; if there were changes seen in their stress levels while supervising students; changes in their treatment procedures or attitudes because of the students'' presence; responses of patients and/or their guardians in regard to have medical students treating them, and whether the doctors were inspired to grow professionally by participating in the program.

Results

Of the 35 pediatricians, 31 (88.5%) responded. Eighteen respondents (58%) selected ''responsibility to cooperate with medical school'' as a reason to participate. Fifteen physicians (48.3%) answered that the clerkship program had a positive impact on their treatment procedures and their attitude towards patients.

Conclusion

Based on the pediatricians'' responses, the community-based clerkship program may instill intellectual inspiration and promote professional growth among the pediatricians in private practices, resulting in potentially better treatment for patients.     

Healthcare providers' attitudes and perceptions in infection diagnosis and antibiotic prescribing in public health institutions in Lesotho: a cross sectional survey

Background

The decision to prescribe antibiotics and the selection of an appropriate antibiotic are important in the treatment of infectious diseases. As any human decision, it can be influenced by individual attitudes and perceptions.

Objectives

To assess the attitudes and perceptions of healthcare providers regarding antibiotic prescribing and the use of laboratory results in infection diagnosis.

Methods

A cross sectional survey in five selected Health Service Areas (HSAs) in the Southern Africa country of Lesotho. The questionnaires were self-administered to 67 healthcare providers in public health institutions within the selected HSAs. Data were analyzed using Fisher''s exact test or the McNemar Test for dependent proportions.

Results

51 surveys were returned (39 medical doctors, 12 nurses). Respondents typically practiced in urban settings, worked with both inpatients and outpatients, had over 10 years experience, and attended to at least 26 patients per day. We identify several inappropriate practices related to the use of on-site microbiology laboratories. For example, only 17% always send a sample for microscopic identification prior to prescribing antibiotics and only 32% always send a sample for culture sensitivity tests. Delays in obtaining laboratory results and high patient workloads were cited as reasons for under-utilization of laboratory facilities. Nearly all respondents recognize the need for guidelines and further training in antibiotic prescribing.

Conclusion

Healthcare providers demonstrated attitudes and perceptions in antibiotic prescribing or use of laboratory derived information in infection diagnosis that could have negative impacts on antibiotic prescribing.     

Actual and perceived substance use of health science students at a university in the Western Cape, South Africa

Background

Substance use among youth is a worldwide epidemic that impacts negatively on the health sector as well as the family and society. Early student life is a time of tremendously high motivation to conform to the behaviours, values, and attitudes that are valued by the youth culture. They observe their peers'' behavior and alter their own behaviour with their peers'' norms and expectations. This compliance with perceived peer norms can however lead to increased smoking, alcohol and drug use.

Objectives

To determine and analyze risky and health promoting behaviour of health science students at a university in the Western Cape, South Africa. In this paper the association between actual risk and perceived risk for substance is discussed.

Methods

A self-administered questionnaire containing items from both the NCHRBS and the ACHA-NCHA were administered to 201 health science students at a South African university.

Results

When perceptions of typical student behaviour were compared to actual reported behaviour, overestimated consumption patterns for the typical student was found for smoking, alcohol and drug use.

Conclusion

The misperceptions of peer norms have important educational or prevention program implications. These findings clearly indicate that educational and awareness programs regarding alcohol and drug use should take perceptions of peer alcohol and drug use into consideration.     

Knowledge,attitudes & barriers to condom use among female sex workers and truck drivers in Uganda: a mixed-methods study

Background

There is limited documentation on knowledge, attitudes and barriers to condom use among female sex workers (FSWs) and truck drivers (truckers).

Objective

To explore knowledge, attitudes and barriers to condom use among FSWs and truckers operating along major transport corridors in Uganda

Methods

Structured questionnaires were administered to explore FSWs'' and truckers'' knowledge of and attitudes towards condom use among 259 FSWs and 261 truckers. Qualitative data were collected on barriers to condom use using focus group discussions. Quantitative data were analyzed using SPSS while qualitative data were audio-recorded, transcribed and thematically analyzed.

Results

Condom knowledge was high with 97% of FSWs and 95% of truckers agreeing with the statement, “using condoms properly and consistently reduces risk of HIV infection”. Attitudes towards condom use were generally favorable with 91% of FSWs and 82% of truckers agreeing with the statement, “condom use is the best method of HIV prevention”. Qualitative findings show that poverty, refusal to use condoms by male partners, alcohol use before sex and beliefs that condoms ‘kill the mood for sex’ remain key barriers to consistent condom use.

Conclusions

Consistent condom use among FSWs and truckers is still hampered by economic and relationship factors.     

Level of knowledge about anaphylaxis and its management among health care providers

Objectives:

This study was conducted to assess the level of knowledge of health care providers regarding anaphylaxis and its management at a tertiary care teaching hospital.

Materials and Methods:

A pretested structured questionnaire was administered to interns, MBBS Phase II students, and nursing students. The subjects were asked to answer the questionnaire, which included questions regarding anaphylaxis and its management.

Results:

Of 265 subjects, 151 (56.9%) of subjects answered correctly that adrenaline is the first line of drug for the treatment of anaphylaxis. Among 151 subjects, 40 (26.4%) answered the correct dose of adrenaline, of which 25 (16.5%) subjects selected intramuscular injection as the most appropriate route of administration. Medical students'' performance was better than interns and nursing students on questions regarding dose, route, and site of adrenaline administration.

Conclusion:

Knowledge regarding the management of anaphylaxis was inadequate in almost all the health care providers who were included in the study. Improved education and training of health care providers are necessary for better management of anaphylaxis.     

Counselling at primary health facilities and level of knowledge of antenatal attendees and their attitude on prevention of Mother to Child Transmission of HIV in Dar-es salaam,Tanzania

Background

Children living with HIV worldwide majority are infected through mother to child transmission of HIV (MTCT) acquired during pregnancy. Knowledge, attitude and behavioral changes are pivot tools towards success of any interventions.

Objectives

To determine the effectiveness of counseling on HIV done in primary health facilities (PHF), level of knowledge gained and attitude changes towards PMTCT.

Methods

A cross sectional study assessing pregnant women''s knowledge and their attitude towards PMTCT was conducted in Temeke district from October 2010 to Jan 2011 using a structured questionnaire.

Results

A total of 383 antenatal attendees were referred to Temeke district for management after counselled and tested for HIV in PHFs. Majority (86.9%) had primary education and good knowledge on MTCT. Correct timing of ARVs prophylaxis (15.7%) as preventive measures for MTCT was poor. Education and employment were associated with good knowledge on MTCT of HIV. Women had positive attitudes towards HIV counseling and testing, but stigma was a barrier to disclosure of one''s serostatus.

Conclusion

There is knowledge gap in routine PMTCT counseling among antenatal attendees in our PHFs. Effective counseling on PMTCT in the PHFs will bridge the identified knowledge gap and help in reduction of pediatric HIV.     

Educational audit on drug dose calculation learning in a Tanzanian school of nursing

Background

Patient safety is a key concern for nurses; ability to calculate drug doses correctly is an essential skill to prevent and reduce medication errors. Literature suggests that nurses'' drug calculation skills should be monitored.

Objective

The aim of the study was to conduct an educational audit on drug dose calculation learning in a Tanzanian school of nursing. Specific objectives were to assess learning from targeted teaching, to identify problem areas in performance and to identify ways in which these problem areas might be addressed.

Methods

A total of 268 registered nurses and nursing students in two year groups of a nursing degree programme were the subjects for the audit; they were given a pretest, then four hours of teaching, a post-test after two weeks and a second post-test after eight weeks.

Results

There was a statistically significant improvement in correct answers in the first post-test, but none between the first and second post-tests. Particular problems with drug calculations were identified by the nurses / students, and the teacher; these identified problems were not congruent.

Conclusion

Further studies in different settings using different methods of teaching, planned continuing education for all qualified nurses, and appropriate pass marks for students in critical skills are recommended.     

GPs' attitudes, awareness, and practice regarding early diagnosis of dementia

Background

In primary care, the diagnosis of dementia is often delayed and the 2007 National Audit Office Report concluded action was needed to improve patient care and value for money.

Aim

To investigate the attitudes, awareness, and practice of GPs in England regarding early diagnosis and management of patients with dementia, and perceptions of local specialist services, to identify training or support needs.

Design of study

Secondary analysis of survey data that capture the above attitudes, awareness, and practice.

Setting

Online survey, targeting GP members of medeConnect.

Method

Survey data were obtained using an anonymised online self-completion questionnaire, and then analysed using standard data-analysis software.

Results

A total of 1011 GPs across the eight English regions responded. Older GPs were more confident in diagnosing and giving advice about dementia, but less likely to feel that early diagnosis was beneficial, and more likely to feel that patients with dementia can be a drain on resources with little positive outcome. Younger GPs were more positive and felt that much could be done to improve quality of life. Attitudes had no correlation with sex. GPs in general felt they had not had sufficient basic and post-qualifying training in dementia, and overall knowledge about dementia was low.

Conclusion

Much could be done to improve GPs'' knowledge of dementia, and the confidence of older GPs could be an educational resource. However, greater experience may create scepticism about early diagnosis because of the perceived poor quality of specialist services.     

Practitioners' views on managing childhood obesity in primary care: a qualitative study

Background

In 2006 the Department of Health and the National Institute for Health and Clinical Excellence (NICE) published guidance on the management of childhood obesity, for use by primary care practitioners. Little is known, however, about practitioners'' views and experiences of managing childhood obesity in primary care.

Aim

To explore practitioners'' views of primary care as a setting in which to treat childhood obesity.

Design of study

Qualitative interview study.

Setting

Primary care and other community settings based in Bristol, England.

Method

Interviews explored practitioners'' views and experiences of managing childhood obesity and their knowledge of the recent guidance provided by the Department of Health and NICE. Interviews were audiotaped and transcribed verbatim. Analysis was thematic and comparisons made both within and across the interviews.

Results

Thirty practitioners were interviewed: 12 GPs, 10 practice nurses, four school nurses, and four health visitors. Participants varied in their views about whether primary care is an appropriate treatment setting for childhood obesity. However, all described factors that limited the extent to which they could intervene effectively: a lack of expertise, resources, and contact with primary school children; the causes of childhood obesity; and the need to work with parents. It was also apparent that very few participants had knowledge of the recent guidance.

Conclusion

Practitioners do not currently view primary care as an effective treatment setting for childhood obesity and it is unlikely that the guidance from the Department of Health and NICE will have a meaningful impact on their management of this condition.     

Factors of persistence among graduates of athletic training education programs

Context:

Previous researchers have indicated that athletic training education programs (ATEPs) appear to retain students who are motivated and well integrated into their education programs. However, no researchers have examined the factors leading to successful persistence to graduation of recent graduates from ATEPs.

Objective:

To determine the factors that led students enrolled in a postprofessional education program accredited by the National Athletic Trainers'' Association (NATA) to persist to graduation from accredited undergraduate ATEPs.

Design:

Qualitative study.

Setting:

Postprofessional education program accredited by the NATA.

Patients or Other Participants:

Fourteen graduates (12 women, 2 men) of accredited undergraduate entry-level ATEPs who were enrolled in an NATA-accredited postprofessional education program volunteered to participate.

Data Collection and Analysis:

We conducted semistructured interviews and analyzed data through a grounded theory approach. We used open, axial, and selective coding procedures. To ensure trustworthiness, 2 independent coders analyzed the data. The researchers then negotiated over the coding categories until they reached 100% agreement. We also performed member checks and peer debriefing.

Results:

Four themes emerged from the data. Decisions to persist to graduation from ATEPs appeared to be influenced by students'' positive interactions with faculty, clinical instructors, and peers. The environment of the ATEPs also affected their persistence. Participants thought they learned much in both the clinic and the classroom, and this learning motivated them to persist. Finally, participants could see themselves practicing athletic training as a career, and this greatly influenced their eventual persistence.

Conclusions:

Our study gives athletic training educators insight into the reasons students persist to graduation from ATEPs. Specifically, athletic training programs should strive to develop close-knit learning communities that stress positive interactions between students and instructors. Athletic training educators also must work to present the athletic training field as exciting and dynamic.     

Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their attitude on Prevention of Mother to Child Transmission of HIV in primary health facilities in Dar es salaam,Tanzania

Background

Children living with HIV worldwide majority are infected through mother to child transmission of HIV (MTCT) acquired during pregnancy. Knowledge, attitude and behavioral changes are pivot tools towards success of any interventions.

Objectives

To determine the effectiveness of counseling on HIV done in primary health facilities (PHF), level of knowledge gained and attitude changes towards PMTCT.

Methods

A cross sectional study assessing pregnant women''s knowledge and their attitude towards PMTCT was conducted in Temeke district from October 2010 to Jan 2011 using a structured questionnaire.

Results

A total of 383 antenatal attendees were referred to Temeke district for management after counselled and tested for HIV in PHFs. Majority (86.9%) had primary education and good knowledge on MTCT. Correct timing of ARVs prophylaxis (15.7%) as preventive measures for MTCT was poor. Education and employment were associated with good knowledge on MTCT of HIV. Women had positive attitudes towards HIV counseling and testing, but stigma was a barrier to disclosure of one''s serostatus.

Conclusion

There is knowledge gap in routine PMTCT counseling among antenatal attendees in our PHFs. Effective counseling on PMTCT in the PHFs will bridge the identified knowledge gap and help in reduction of pediatric HIV.     

Socio-demographic factors affecting knowledge level of Tuberculosis patients in Rajshahi City,Bangladesh

Background

The Tuberculosis (TB) control program in Bangladesh is still unsatisfactory due to insufficient knowledge and stigma about TB. Patients with low knowledge may be at higher risk of experiencing delays in diagnosis and appropriate treatment.

Objectives

The aims of this study were to identify the knowledge levels of TB and investigate the factors associated with knowledge level among the TB patients in Bangladesh.

Methods

A cross-sectional study was conducted at Rajshahi City, Bangladesh. A total of 384 TB patients were interviewed through a pretested, structured questionnaire using purposive sampling techniques. Logistic regression analysis was used to evaluate the effects of selected socio-demographic factors on TB knowledge level.

Results

The results revealed that pulmonary TB patients had greater knowledge than that of extra-pulmonary patients, and that sex, age, educational status and TB type were significantly associated with knowledge level.

Conclusions

In general, males and young adults, ages 21–35, had greater awareness about transmission and prevention of TB than females and adults over 35. Individuals with higher education and urban area patients were comparatively better informed about TB infection. Patients with greater knowledge about TB were also less likely to experience delays in seeking treatment.     

Perceived frequency of peer-assisted learning in the laboratory and collegiate clinical settings

Context:

Peer-assisted learning (PAL) has been recommended as an educational strategy to improve students'' skill acquisition and supplement the role of the clinical instructor (CI). How frequently students actually engage in PAL in different settings is unknown.

Objective:

To determine the perceived frequency of planned and unplanned PAL (peer modeling, peer feedback and assessment, peer mentoring) in different settings.

Design:

Cross-sectional study.

Setting:

Laboratory and collegiate clinical settings.

Patients or Other Participants:

A total of 933 students, 84 administrators, and 208 CIs representing 52 (15%) accredited athletic training education programs.

Intervention(s):

Three versions (student, CI, administrator) of the Athletic Training Peer Assisted Learning Survey (AT-PALS) were administered. Cronbach α values ranged from .80 to .90.

Main Outcome Measure(s):

Administrators'' and CIs'' perceived frequency of 3 PAL categories under 2 conditions (planned, unplanned) and in 2 settings (instructional laboratory, collegiate clinical). Self-reported frequency of students'' engagement in 3 categories of PAL in 2 settings.

Results:

Administrators and CIs perceived that unplanned PAL (0.39 ± 0.22) occurred more frequently than planned PAL (0.29 ± 0.19) regardless of category or setting (F_1,282 = 83.48, P < .001). They perceived that PAL occurred more frequently in the collegiate clinical (0.46 ± 0.22) than laboratory (0.21 ± 0.24) setting regardless of condition or category (F_1,282 = 217.17, P < .001). Students reported engaging in PAL more frequently in the collegiate clinical (3.31 ± 0.56) than laboratory (3.26 ± 0.62) setting regardless of category (F_1,860 = 13.40, P < .001). We found a main effect for category (F_2,859 = 1318.02, P < .001), with students reporting they engaged in peer modeling (4.01 ± 0.60) more frequently than peer mentoring (2.99 ± 0.88) (P < .001) and peer assessment and feedback (2.86 ± 0.64) (P < .001).

Conclusions:

Participants perceived that students engage in unplanned PAL in the collegiate clinical setting with a stronger inclination toward engagement in peer modeling. Educators should develop planned PAL activities to capitalize on the inherent desire of the students to collaborate with their peers.     

Athletic trainers' attitudes toward lesbian, gay, and bisexual National Collegiate Athletic Association student-athletes

Context:

Researchers have investigated heterosexuals'' attitudes toward homosexuals, focusing on factors such as sex, race, religion, education, and contact experiences. However, in the context of sport, this research is deficient. We found no published literature investigating athletic trainers (ATs'') attitudes toward lesbian, gay, and bisexual student-athletes (LGB).

Objective:

To determine heterosexual ATs'' attitudes toward LGB student-athletes in the National Collegiate Athletic Association.

Design:

Cross-sectional study

Setting:

E-mailed survey.

Patients or Other Participants:

A total of 964 ATs employed at member institutions.

Main Outcome Measure(s):

We measured attitudes using the Attitudes Toward Lesbian, Gay Men, and Bisexuals (ATLGB) Scale. To determine the extent to which sex, religion, and whether having an LGB friend or family member had an effect on ATs'' attitudes, we performed analysis of variance. To establish the effect of age on ATs'' attitudes, we calculated a Pearson correlation. We used an independent t test to identify differences between ATs who reported working with LGB student-athletes and ATs who did not.

Results:

With ATLGB score as the dependent factor, a main effect was noted for sex, religion, and having an LGB friend or family member (P < .01 for all comparisons). Age and total score were related (P < .01). A difference was seen in the ATLGB scores between ATs who were aware of LGB student-athletes on their teams and ATs who were not (P < .001).

Conclusions:

Many ATs hold positive attitudes toward LGB student-athletes, especially females, those who have an LGB friend or family member, and those who are aware of LGB student-athletes. Still, it is important to provide an open environment in the athletic training room for all student-athletes.