A world-wide internet survey of public knowledge about tuberculosis

Four simple multiple-choice questions about tuberculosis (TB) were posted on a non-medical internet site for a 2-month period. A total of 564 responses were received. Sixty-two were excluded as individuals had made multiple attempts at the questions. Sixty-five per cent of responses were from North America, 14.5% from Europe and 12% from Australia and New Zealand, with only a small number of responses from Africa, the Indian subcontinent and South America. Of the respondents 49.5% correctly answered that cough is the commonest symptom of TB, 45% knew that TB was transmitted mainly by air-borne droplets, 37.8% knew that TB was caused by a bacterium. Only 19.5% knew that the most important risk factor for developing TB was HIV infection and only 4% answered all questions correctly. This survey suggests that knowledge about tuberculosis is limited in computer-literate individuals throughout the world.     

Lack of knowledge about smoking-related risks for diseases in the general public in Japan]

Cigarette smoking is the primary preventable cause of various diseases and death. Smoking has been causally related to lung cancer, other malignancies, atherosclerosis, coronary heart disease, and chronic obstructive pulmonary disease. There have been few studies, however, of whether the ordinary citizen in Japan understand the risks of serious diseases caused by smoking. Four hundred and thirty six people attended a seminar of respiratory diseases entitled "Cigarette smoking and lung cancer; prevention and treatment of asthma; senile care and prevention of pneumonia". After the seminar, unsigned questionnaires were filled out by 403 of those in attendance. Three hundred eighty nine (165 males and 224 females) respondents correctly answered the questionnaires, and these were analyzed in the study. Attendants comprised 243 who had never smoked (63%), 99 former smokers (25%), and 39 current smokers (10%). Three hundred forty seven attendants (89%) answered that smoking is harmful to the health, and 371 (95%) that it is causally related to lung cancer. In contrast, lower numbers of attendants answered that smoking is causally related to other diseases: pulmonary emphysema, 65% of the responses; chronic bronchitis, 68%; laryngeal cancer, 77%; myocardial infarction, 53%; and atherosclerosis, 49%. Of the 39 current smokers, 27 answered that they would stop smoking after the seminar. Although many people partly understand the risks of smoking, they do not have a clear knowledge of the risks of diseases besides lung cancer. Education about the risks of smoking and about smoking cessation is required.     

Patient knowledge and attitudes about antiviral medication and vaccination for influenza in an internal medicine clinic.

BACKGROUND: Despite the introduction of Centers for Disease Control and Prevention guidelines for their use, antiviral medications for influenza remain underutilized. Our objective in this study was to describe beliefs, attitudes, and knowledge regarding antiviral medication and vaccination for influenza among patients in an internal medicine clinic. METHODS: We conducted a cross-sectional survey of adult patients in an internal medicine clinic from April through June 2006. RESULTS: Two-hundred eighty patients completed the survey. Fifty-five percent received influenza vaccination for the most recent influenza season. Overall antiviral knowledge was poor. Of 8 antiviral knowledge questions, the mean percentage of correct answers was 40%; 1 (<1%) of the patients answered all questions correctly, and 47 (18%) answered all questions incorrectly. Only 37 (13%) of the patients reported calling their physician within 48 h after the onset of influenza-like symptoms. Patients with conditions associated with a high risk of complications from influenza were no more likely than other patients to be more knowledgeable about antiviral medication, nor were they more likely to report calling their physician within 48 h after symptom onset or to report receipt of influenza vaccination for the previous influenza season. Only 90 (37%) of the respondents were willing to pay >$20 for antiviral medication, although 205 (84%) were willing to pay something. CONCLUSIONS: Patients are ill-informed about antiviral medication and its benefits, and medication costs may present a barrier to treatment. Physicians should discuss antiviral medication with patients who are at high risk for complications from influenza before the influenza season, and education programs for physicians and patients should be developed.     

Dissemination of reproductive health knowledge by questions and answers through telephone hotline: a feasibility study in Myanmar

This study was conducted to determine the feasibility of disseminating reproductive health (RH) information to the general public of Myanmar in a confidential, anonymous and interactive way through a telephone hotline. We carried out a cross-sectional study using a short questionnaire interview with the RH hotline callers and analyzing sample audio recordings of conversations. The hotline was advertised in print media. It was answered by trained hotline responders (medical doctors) of Department of Madical Research (Lower Myanmar) (DMR-LM). There were 743 calls during six months, from all 14 States and Divisions. Most of the calls were from Yangon, Mandalay and Bago Division. Both male (48%) and female (52%) callers used the hotline. The majority of callers (74%) were between 25 and 45 years old; 21% were young people (15-25 years old). Married people (81%) used the hotline more than singles (19%). Most of the callers (91%) had a high school to graduate education level. The most frequently asked topics were infertility (23%), birth spacing (22%), sexual problems (13%) and adolescent health, including reproductive function (12%). The anonymity of the callers, the non-judgmental attitudes of the responders and the use of media for publicity appeared to facilitate the use of the hotline by the public. More linkages with service entry points, enhancement of communication skills, sexual counselling training and use of media can improve topic coverage and utilization of the reproductive health hotline.     

Evaluation of Wondfo influenza A&B fast test based on immunochromatography assay for rapid diagnosis of influenza A H1N1

Influenza viruses cause significant morbidity and mortality in both children and adults during local outbreaks or epidemics. Therefore, a rapid test for influenza A&B would be useful. This study was conducted to evaluate the clinical performance of the Wondfo influenza A&B test for rapid diagnosis of influenza A H1N1 Infection. The rapid testing assay could distinguish infection of influenza A and B virus. The reference viral strains were cultured in MDCK cells while TCID50 if the viruses were determined. The analytical sensitivity of the Wondfo kit was 100 TCID50/ml. The Wondfo kit did not show cross reactivity with other common viruses. 1928 suspected cases of influenza A (H1N1) virus infection were analyzed in the Wondfo influenza A&B test and other commercially available products. Inconsistent results were further confirmed by virus isolation in cell culture. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100%, 98.23%, 92.45%, and 100% for flu A, and 96.39%, 99.95%, 98.77%, and 99.84% for flu B respectively. 766 suspected cases of influenza A (H1N1) virus infection were analyzed in the Wondfo influenza A&B test and RT-PCR. The sensitivity, specificity, PPV and NPV were 56.5%, 99.75%, 99.52% and 71.04% for flu A, 25.45%, 99.86%, 93.33% and 94.54% for flu B respectively. These results indicate that the Wondfo influenza A&B test has high positive and negative detection rates. One hundred fifty-six specimens of influenza A (H1N1) confirmed by RT-PCR were analyzed by the Wondfo influenza A&B test and 66.67% were positive while only 18.59% were positive by the reference kit. These results indicate that our rapid diagnostic assay may be useful for analyzing influenza A H1N1 infections in patient specimen.     

Development of universal influenza vaccines based on influenza virus M and NP genes

Purpose

Vaccination is the safest and most effective measure against influenza virus infections. However, traditional influenza vaccines cannot respond effectively to an unforeseen epidemic or pandemic caused by a virus with antigenic drifts or antigenic shifts. Therefore, developing a universal influenza vaccine (UIV) that induces broad-spectrum and long-term immunity has become a major trend in influenza vaccine research and development.

Methods

This article reviews the development of UIVs based on these conserved influenza virus proteins.

Results and Conclusion

The matrix protein (M1, M2) and nucleoprotein (NP) of influenza viruses have highly conserved sequences, and they become the major target antigens of current UIV studies.     

Evaluation of the knowledge and manner of workers of workplaces in Tokat about the ban on restriction of indoor smoking

To evaluate the knowledge and manner of cafe, pub and restaurant (with/without alcohol) workers in our city center about the ban on restriction of indoor smoking. To determine the preparation about the ban, smoking characteristics of workers, the knowledge on passive smoking. A questionnaire was performed to workers. The type of workplace, the number of workers, existence of a restriction of indoor smoking, any preparation about the ban were asked. The job of worker, whether the worker has a knowledge on the ban or not, the idea of the workers on the necessity and practicability of the ban were asked. Smoking history and the knowledge about passive smoking of workers were recorded. Fagerstrom nicotine dependent test (FNDT) was performed to smokers. Eighty four work places with 568 workers included in the study. The questionnaire was performed to 337 workers whose mean age was 29.1/years. 292 of workers were male. 190 of cases were current smokers. 166 of cases (49.3%) know the meaning of passive smoking. Alcohol offering was made at 8 of workplaces. Smoking was forbidden in 20 of workplaces. A preparation was performed about the ban in 30 of (46.9%) other workplaces. 88.4% of workers have knowledge on the ban, 64.7% of them know the punishment of the noncompliance of the ban. 81.3% of the workers believe the necessity and 45.7% of them believe the practicability of the ban. Smokers and especially who's FNBT > 5 have a stronger belief on the necessity and practicability of the ban. We determined that the preparation about the ban was inadequate although there was an little time for the put into practice the law. So we think that the controls of workplaces should be happened frequent.     

Predictors of knowledge about malaria in India

BACKGROUND & OBJECTIVES: Reduction of malarial morbidity and mortality is important to meet the overall objectives of reducing poverty and has been included in the Millennium Development Goals. To achieve these targets it is imperative to have active community participation to control malaria. Community participation in turn depends on people's knowledge and attitude towards the disease.This study was conducted to examine the factors that predict the knowledge of Indian population regarding malaria. A questionnaire based cross-sectional survey was conducted for data collection. RESULTS: Data were collected from 15,750 adult respondents using a pre-tested questionnaire representing urban, rural, tribal and slum population from 21 states. Knowledge about various aspects of malaria was tested using a structured questionnaire. Logistic regression analysis was applied to determine predictors of knowledge about etiology, clinical features, mode of transmission, prevention and control. INTERPRETATION & CONCLUSION: Common predictors of correct knowledge about etiology and clinical features of malaria were male sex and college education. Female sex, illiteracy and tribal population were more likely to have been associated with wrong beliefs about fatality of malaria. Being tribal respondent was the single most important predictor of inadequate knowledge. Similarly, use of smoke for killing of adult mosquito was predicted by rural or slum residence and illiteracy. All findings were based on logistic regression analysis. Geographical variations also influenced knowledge about malaria. It may be inferred that improvement in knowledge, attitude and practices related to malaria may be attained only after looking at its predictors at micro level. However, a strategic framework at national level is certainly needed to provide directions at local level.     

Hostellers' knowledge of transmission and prevention of avian influenza when travelling abroad

BACKGROUND: Little is known about hostellers' knowledge of transmission and prevention of avian influenza when travelling abroad. This study was designed to investigate these in the Australian context. METHODS: In 2006, hostellers attending a travellers' information evening in Brisbane, Queensland, were asked to complete self-administered questionnaires. RESULTS: Forty-two questionnaires (60.8%) were returned. Over two-thirds of attendees were females (71.4%, 30). About two-thirds of the hostellers attending the travellers' information evening reported being aged 29 years or younger (64.2%, 27). On a five-point rating scale, the median rating of hostellers indicated that they were moderately concerned about avian influenza (3.0) with the range being 1-5. About one-fifth of hostellers did not know or were not sure what the source of avian influenza infection in humans was and most of this group also did not know how bird flu was prevented (p<0.05). Almost all hostellers (40, 95.2%) responded to the question concerning the source of infection for avian influenza. Nominated sources of infection included handling sick poultry (69.0%, 29), eating poultry (45.2%, 19), contact with humans who have avian influenza (38.1%, 16), and handling healthy poultry (26.2%, 11). More than four-fifths 35 (83.3%) of hostellers responded to the question concerning precautions against avian influenza. Nominated precautions included hand washing (28.6%, 12), avoiding birds (23.8%, 10), avoiding affected areas (14.3%, 6), not eating poultry (7.1%, 3), and avoiding poultry droppings (7.1%, 3). Hand washing was the only measure to prevent bird flu that was significantly more likely to be nominated following the travel health lecture (p<0.05). CONCLUSIONS: Hostellers attending the travellers' information night in Australia reported having moderate concern about avian influenza. They also had a variable knowledge of the sources of infection of avian influenza. Most hostellers correctly identified infected poultry as a source; however, human-to-human transmission as the predominant current source of avian influenza infections in humans was incorrectly identified by nearly two-fifths of hostellers. Although hostellers responded positively to hand washing advice provided in the travel health lecture, reinforcement of other possible measures to prevent avian influenza, particularly the possible role of antiviral drugs, may be needed.     

基于知识图谱的生物医学信息可视化研究进展

信息可视化是应用相关分析软件对大量文献数据信息绘制科学知识图谱,从而清晰、准确地揭示知识领域的内在联系,发掘科技研究热点和研究前沿的一种新的方法。该文概述了信息可视化知识图谱的概念、特点和常用软件,并总结信息可视化知识图谱在生物医学领域的研究进展,为该技术在医学领域的进一步应用奠定基础。     

A test of knowledge about prostate cancer screening

BACKGROUND: Although the benefits of prostate cancer screening are uncertain and guidelines recommend that physicians share the screening decision with their patients, most U.S. men over age 50 are routinely screened, often without counseling. OBJECTIVE: To develop an instrument for assessing physicians' knowledge related to the U.S. Preventive Services Task Force recommendations on prostate cancer screening. PARTICIPANTS: Seventy internists, family physicians, and general practitioners in the Los Angeles area who deliver primary care to adult men. MEASUREMENTS: We assessed knowledge related to prostate cancer screening (natural history, test characteristics, treatment effects, and guideline recommendations), beliefs about the net benefits of screening, and prostate cancer screening practices for men in different age groups, using an online survey. We constructed a knowledge scale having 15 multiple-choice items. RESULTS: Participants' mean knowledge score was 7.4 (range 3 to 12) of 15 (Cronbach's alpha=0.71). Higher knowledge scores were associated with less belief in a mortality benefit from prostate-specific antigen (PSA) testing (r=-.49, P<.001). Participants could be categorized as low, age-selective, and high users of routine PSA screening. High users had lower knowledge scores than age-selective or low users, and they believed much more in mortality benefits from PSA screening. CONCLUSIONS: Based on its internal consistency and its correlations with measures of physicians' net beliefs and self-reported practices, the knowledge scale developed in this study holds promise for measuring the effects of professional education on prostate cancer screening. The scale deserves further evaluation in broader populations.     

基于倾向值匹配研究低温对流行性感冒的影响

目的 分析重庆市流感发病趋势,探讨低温对流感发病率的独立影响,为制定流感的防控措施和策略提供参考。方法 基于重庆市2010-2015年流感报告发病数据与同期气象资料,以温度为自变量、日流感发病率为因变量,均衡气压、气流等混杂因素,进行卡钳值为0.1的倾向值匹配,建立均衡混杂因素后的负二项回归模型。结果 2010-2015年间重庆市流感流行强度总体有上升趋势(χ²=38.61,P<0.001);混杂气象因素在经倾向值匹配后的模型中得到平衡,负二项回归模型在χ检验、偏差、调整偏差、AIC、AICC上均优于匹配前的对应模型;且日最低气温越低,流感日发病率越高。结论 气象因素对流感发病影响有滞后性;匹配前采用负二项回归控制混杂因素可能会低估温度对流感发病的影响;倾向值匹配后的负二项回归模型预测流感发病率,其结果更可靠;此外,低温可能是导致流感发病率增加的一个重要气象因子。     

A definition for influenza pandemics based on historical records

Objective

To analyse the records of past influenza outbreaks to determine a definition for pandemics.

Methods

Analysis of publications of large outbreaks of influenza which have occurred since 1889/90, and to match the results against the current definitions of an influenza pandemic.

Results

According to the general understanding of a pandemic, nine outbreaks of influenza since 1889/90 satisfy the definition; however, for two of these, occurring in 1900 and 1933, the data are limited. The special condition for an influenza pandemic requires, in one definition, that the virus strain responsible could not have arisen from the previous circulating strain by mutation; and in the second, that the new strain be a different subtype to the previously circulating strain. Both these restrictions deny pandemic status to two, and possibly three, influenza outbreaks which were pandemics according to the more general understanding of the term. These observations suggest that a re-evaluation of the criteria which define influenza pandemics should be carried out.

Conclusion

The contradiction outlined above brings the previous definitions of an influenza pandemic into question; however, this can be resolved by defining an influenza pandemic by the following criteria. Thus, an influenza pandemic arises at a single, specific place and spreads rapidly to involve numerous countries. The haemagglutinin (HA) of the emergent virus does not cross-react serologically with the previously dominant virus strain(s), and there is a significant lack of immunity in the population against the emergent virus. These three criteria are interlinked and can be determined early to alert authorities who could respond appropriately. Other criteria associated with pandemics are necessarily retrospective, although important and valid. The implications of this definition are discussed.     

Evaluation of influenza virus type A detection kit

We evaluated a new Influenza Virus Type A Detection Kit (InfluA-AD "Seiken") and compared it to virus isolation and RT-PCR using throat swab specimens. Our results were as follows: 1) From 13 specimens in which Influenza virus type A was isolated, InfluA-AD "Seiken" detected 12 while RT-PCR detected 9. 2) From 7 specimens in which Influenza virus type B was isolated, InfluA-AD "Seiken" detected 0 while RT-PCR detected 1. 3) From 2 specimens in which Adeno virus was isolated, InfluA-AD "Seiken" detected 0 and RT-PCR detected 0. 4) From 28 specimens in which no virus was isolated, InfluA-AD "Seiken" detected 6 while RT-PCR detected 8. InfluA-AD "Seiken" showed a sensitivity of 92.3% and specificity of 83.8% when compared to virus isolation. We conclude that the new test will be useful for the diagnosis of Influenza virus type A infection particularly in big commercial laboratories.     

Evaluation of a geriatric inpatient influenza immunization program

This study evaluated a hospital influenza immunization program for inpatients aged ≥65 years during the 2008-2009 influenza season. Of the 520 inpatients in this age group, 45.0% had documented eligibility screening and 23.1% received vaccination in the hospital. Staff and physicians participating in interviews felt that standardizing processes and improving documentation could help enhance the existing program.