Average Correct Response Research Articles

Assessment of knowledge gaps and perceptions about COVID-19 among health care workers and general public-national cross-sectional study.

Background and Aims:COVID-19 has impacted everyone's life and livelihood in one way or the other. Individual response to measures taken to control the rapid spread of this disease depend on their knowledge and perceptions. Hence, we proposed to evaluate responses about COVID-19 among the health care workers (HCWs) as well as general public participants (GPPs).Material and Methods:This was a cross-sectional, observational survey conducted during the peak of the pandemic. The 35-items questionnaire was prepared using Google forms and distributed through e-mails and social media.Results:The 1,026 responses comprised of 558 HCWs (54.4%) and 468 GPPs (45.6%). The most reliable source of information was TV news for 43% GPPs, whereas it was HCWs/Local health authorities for 36.8% HCWs. HCWs had sufficient knowledge regarding COVID-19, while it was relatively low among GPPs (average correct response 65% and 53%, respectively). Intra-group analysis with respect to age, sex, qualification, and socioeconomic status showed that knowledge about mode of transmission by airborne aerosols was significantly low with respect to qualification among GPPs while younger age group (<40 years) HCWs had significantly more knowledge about mode of transmission and asymptomatic carriers. Paranoia of contracting the infection was significantly higher in GPPs with upper and middle socioeconomic status and younger HCWs.Conclusion:HCWs had moderate level of knowledge, whereas GPPs had low to moderate knowledge, with large scope of improvement in both groups. Continued education, both at professional and community level will not only be helpful but also necessary to improve knowledge, avert negative attitudes and control the devastating pandemic.

Knowledge and opinions regarding BRCA1 and BRCA2 genetic testing among primary care physicians

BRCA1 and BRCA2 (BRCA1/2) testing is standard for individuals with personal and/or family history suggestive of hereditary breast and ovarian cancer syndrome. The indications for testing have been expanding. To accommodate the need, incorporation of cancer genetic services into the practice of non-genetic healthcare providers should be considered. We carried out a survey to evaluate the knowledge and opinions regarding BRCA1/2 testing among primary care providers. The survey was sent to 245 Obstetrics/Gynecology and 97 Family Medicine physicians in the UPMC network. Eighty-six completed the survey between July 2015 and September 2015. The average correct responses to knowledge questions was 73%. A few respondents reported being completely confident, and ~50% reported being somewhat confident, in providing BRCA1/2-related information. Respondents selected genetic specialists and oncologists as the most qualified to provide cancer genetic services. Several perceived barriers and motivating factors to the implementation of BRCA1/2 testing in primary care were identified. The findings from this study suggested that primary care providers were not uniformly ready to provide BRCA1/2 genetic testing. Availability of professional society guidelines and evidence of testing's usefulness might motivate the incorporation of BRCA1/2 genetic testing into primary care practices. These findings would help guide future educational efforts to promote provision of cancer genetic services by non-genetic professionals.

A patient’s decision aid for vascular access placement in the emergency department

Vascular access device placement is one of the most routinely performed procedures in the emergency department. Despite its high usage, most patients have limited knowledge about vascular access device placement. Patient decision aids have been utilized heavily in non-emergency department settings to provide basic clinical information regarding a patient's medical care options. In this study, we investigated whether exposure to a patient decision aid on vascular access devices and patients' experiences with vascular access devices would influence their vascular access device preference during an acute care episode. Patients in this institutional review board-approved study were enrolled prospectively in the emergency department at a busy level 1 trauma institution. A patient decision aid on vascular access device was constructed using criteria developed by the International Patient Decision Aid Standards. All participants were exposed to the patient decision aid and were asked to complete two questionnaires, and two tests. Fifty subjects (50) were enrolled prospectively in the emergency department. The mean pretest score was 17.2% (95% confidence interval, 0.54-1.18), while the mean post-test score was 72.4% (95% confidence interval, 3.15-4.09). We found that patients who were exposed to the patient decision aid preferred landmark-based peripheral intravenous lines over ultrasound-guided peripheral intravenous lines in this data set. The result from this analysis indicated that most patients visiting the emergency department are not knowledgeable about their options related to vascular access device placement. The observed increase in the average correct responses on the post-test indicates that a patient decision aid can be an effective educational tool in the emergency department.

889 Enhancing Radiation Safety During Fluoroscopy Procedures in Endoscopy Units

INTRODUCTION: Fluoroscopy is an imaging technique often used in gastroenterology for endoscopic retrograde cholangiopancreatography (ERCP) procedures, subjecting the endoscopist and staff to radiation. Many studies have proposed best practices around behavior, choices, and equipment that attenuate radiation exposure. Gastrointestinal society guidelines also recommend measuring and documenting fluoroscopy time as an important quality metric for ERCP. Our goal was to ensure adequate safety precautions and reporting are adhered to by gastroenterology (GI) staff during fluoroscopy. METHODS: We performed baseline assessments of adherence to radiation safety protocols for fluoroscopy, interviewed interventional radiologists, and reviewed the medical literature to guide development of our intervention. We created an educational presentation on radiation safety and equipment handling with survey administration before and after. The first 4 questions used a Likert scale (1 = poor, 5 = excellent) to assess knowledge of and adherence to various aspects of radiation safety, while the latter 4 were multiple-choice questions regarding content. Second, we designated a radiation safety officer (RSO) to assess yearly reports. Lastly, we created a template with fluoroscopy time and dose recording. All interventions were delivered from 10/1/18 – 10/11/18. We reviewed post-ERCP notes to assess adherence. RESULTS: 17 individuals responded to pre- and post-intervention surveys (Table 1). Before the intervention, the first four questions had an average rating of 4.1 (SD of 0.70) and last four questions had an average correct response of 48% (SD of 20%); after the intervention, the average increased to 4.6 (SD of 0.17) and 93% (SD of 11%). We reviewed post-ERCP notes from 8/1/18 – 9/30/18 (n = 11) and found recording of the fluoroscopy time and radiation dose at baseline was 3%. After intervention, review of all post-ERCP notes from 10/1/18 – 5/31/19 (n = 94) showed recording to range from 86% - 100%. CONCLUSION: Initial audits showed a lack in radiation safety knowledge resulting in poor adherence to radiation safety protocols and documentation among GI staff at our tertiary care center. Interventions on education and facilitating documentation with templates can improve the quality of ERCPs and safe radiation practices dramatically.

Improving Guideline-Recommended Management of Iron Deficiency in Patients with CHF: An Online Educational Intervention

BackgroundIron deficiency (ID), independent of anemia is a common co-morbidity present in patients with chronic heart failure (CHF). However, routine screening of ID, independent of anemia in patients with CHF is lacking in clinical practice worldwide despite guideline-recommendations, and, as a consequence, many patients who develop ID are not optimally managed.PurposeTo determine if an online continuing professional development (CPD) intervention could improve knowledge/competence and confidence of cardiologists and primary care physicians related to guideline-recommended diagnosis and management of iron deficiency in the setting of CHF.MethodsCardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 5 mini lectures with synchronized slides by expert faculty on evidence-based diagnosis and treatment of iron deficiency. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. Cramer's V was used to assess level of educational effect. The activity launched on March 1, 2019 and data were collected through March 25, 2019.ResultsOverall significant improvements were seen after education for both cardiologists (N=285; P <.001; considerable educational effect, V=.245) and primary care physicians (N=309; P <.001; extensive educational effect, V=.324). Pre-assessment, the average correct response rate was 65% for cardiologists increasing to 86% post-assessment, and 50% for primary care physicians, increasing to 81%. Significant improvements were observed in cardiologists’ and primary care physicians’ knowledge and competence related to the guideline-recommended treatment of ID in the setting of CHF (Table).As a result of the education, 34% of cardiologists and 41% of primary care physicians reported greater confidence in ability to effectively treat ID at the earliest opportunity in patients with CHF.ConclusionThe statistically significant improvements observed in this intervention demonstrate the benefits of using video-based mini lectures with slides to increase knowledge, competence and confidence of cardiologists and primary care physicians and suggest that this type of intervention has the potential to positively impact recognition and guideline-recommended treatment of ID in patients with CHF. Iron deficiency (ID), independent of anemia is a common co-morbidity present in patients with chronic heart failure (CHF). However, routine screening of ID, independent of anemia in patients with CHF is lacking in clinical practice worldwide despite guideline-recommendations, and, as a consequence, many patients who develop ID are not optimally managed. To determine if an online continuing professional development (CPD) intervention could improve knowledge/competence and confidence of cardiologists and primary care physicians related to guideline-recommended diagnosis and management of iron deficiency in the setting of CHF. Cardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 5 mini lectures with synchronized slides by expert faculty on evidence-based diagnosis and treatment of iron deficiency. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. Cramer's V was used to assess level of educational effect. The activity launched on March 1, 2019 and data were collected through March 25, 2019. Overall significant improvements were seen after education for both cardiologists (N=285; P <.001; considerable educational effect, V=.245) and primary care physicians (N=309; P <.001; extensive educational effect, V=.324). Pre-assessment, the average correct response rate was 65% for cardiologists increasing to 86% post-assessment, and 50% for primary care physicians, increasing to 81%. Significant improvements were observed in cardiologists’ and primary care physicians’ knowledge and competence related to the guideline-recommended treatment of ID in the setting of CHF (Table). As a result of the education, 34% of cardiologists and 41% of primary care physicians reported greater confidence in ability to effectively treat ID at the earliest opportunity in patients with CHF. The statistically significant improvements observed in this intervention demonstrate the benefits of using video-based mini lectures with slides to increase knowledge, competence and confidence of cardiologists and primary care physicians and suggest that this type of intervention has the potential to positively impact recognition and guideline-recommended treatment of ID in patients with CHF.

A-54 Greater Time Spent Watching TV is Related to Worse Real-Time Neurocognitive Performance in Older Adults With and Without HIV

Abstract Objective There is a need to identify determinants of neurocognitive impairment among older persons living with HIV (PLHIV). Utilizing smartphone-based Ecological Momentary Assessment (EMA) and mobile cognitive testing, we examined the relationships between daily life activities and real-world neurocognitive performance among older PLHIV and HIV-uninfected adults. Method Ninety-one participants (58 PLHIV; Mage = 59.4, SD = 6.4), 70.3% male, 65.9% non-Hispanic white, completed four smartphone-based EMA surveys of daily activities and one mobile color-word interference test (mCWIT) per day for 14 days. Daily activities were grouped into five categories: activities of daily living (ADLs, IADLs), cognitively demanding activities, socially-engaging activities, physical activity (PA), and passive leisure activity (watching TV). Data was collapsed across the 14 days to examine between-person effects of the proportion of time reportedly spent on each activity on neurocognitive outcomes (the average correct responses and completion time for the mCWIT). Results No effect was found for engaging in activities by HIV status; however, PLHIV had significantly longer times on the mCWIT compared to persons without HIV (t = 2.49; 95% CI: 0.60, 5.37; p = 0.02). In a multivariable regression model accounting for HIV status, a greater proportion of time spent watching TV was associated with slower average mCWIT performance (beta = 9.41; 95% CI: 1.88,17.0; p = 0.01). There were no relationships between other domains of daily life activities and mCWIT performance. Conclusion Our findings provide evidence that more time spent watching TV is associated with slower mCWIT performance. Future work examining the time-lagged relationships between these variables is needed to understand whether watching TV decreases real-time neurocognitive performance.

P125: Faculty development in the age of competency-based medical education: a national, cross-sectional needs assessment for Canadian emergency medicine faculty

Introduction: In July 2018, Emergency Medicine (EM) transitioned to the Royal College of Physicians and Surgeons of Canada's (RCPSC) Competence by Design (CBD) training framework. In anticipation of CBD implementation, we conducted a nation-wide needs assessment of EM faculty and senior residents to understand their attitudes towards CBD, workplace-based assessments (WBA) and overall educational needs. Methods: A multi-site, cross-sectional digital survey was conducted in winter 2018 with a sample of EM faculty and senior residents across RCPSC EM programs in Canada. Recruitment was via program director nomination. Survey domains included baseline perceptions about CBD, attitudes toward implementation, perceived/prompted and unperceived faculty development needs. Microsoft Excel was used to calculate descriptive statistics. This study was reviewed by the Hamilton Integrated Research Ethics Board.A multi-site, cross-sectional digital survey was conducted in winter 2018 with a sample of EM faculty and senior residents across RCPSC EM programs in Canada. Recruitment was via program director nomination. Survey domains included baseline perceptions about CBD, attitudes toward implementation, perceived/prompted and unperceived faculty development needs. Microsoft Excel was used to calculate descriptive statistics. This study was reviewed by the Hamilton Integrated Research Ethics Board. Results: Between February-April 2018, 47 participants (40 faculty, 7 residents) completed the survey (58.8% response rate). Most respondents (89.4%) thought learner feedback should be provided on each shift; 55.3% believed they provided adequate feedback. Time constraints, learner disinterest and fear of assessment repercussions were the top three barriers to providing good feedback. A majority of respondents (78.7%) thought that the ED provided above average opportunities for direct observation and 91.5% were confident of incorporating WBAs into their practice. 44.7% reported that CBD will not impact patient care; 17.0% perceived it may have a negative impact. 55.3% felt that CBD will lead to improved feedback for trainees. The top areas for faculty development were: feedback delivery, completing WBAs, resident promotion decisions, and receiving feedback on teaching. Only 25.5% were interested in learning about CBD, although the average of correct responses on the CBD knowledge test was 44.6%. Conclusion: EM is well-situated to transition to CBD given clinicians’ positive attitudes towards feedback, direct observation, WBAs, and opportunities for direct observation. Threats to CBD implementation are concerns about effects on patient care and trainee education, and skepticism regarding effects on feedback quality. Faculty development should concentrate on further developing clinical teaching and supervision skills, focusing on feedback and WBAs.

Assessment of the Knowledge Regarding Diabetes of Patients with Treatment Resort due to this Disease

Introduction: Diabetes is the only non-infectious disease recognized by the United Nations (UN) as an epidemic of the 21st century. An underrated factor in the prevention of diabetes is common knowledge about the causes of this disease and associated prevention. Awareness of symptoms, treatment and complications associated with it is a very important element in the fight against this disease and is important in achieving therapeutic goals and prevention of complications. The aim of the study was to acquire the patients’ knowledge about the disease for which they were directed to treatment resort. Material and Methods: The study was conducted among 100 people hospitalized due to diabetes and/or obesity at the Metabolic Rehabilitation Clinic of the 22nd Military Health Resort and Rehabilitation Hospital in Ciechocinek. A dedicated questionnaire was constructed for the study, consisting of 39 questions related to the issues that constitute the scope of the educational programme that the patients of the Clinic undertake. Based on the data from the completed questionnaire, patients’ knowledge about diabetes and obesity was evaluated. Results: The average of correct responses was 49%. No statistically significant differences in the number of correct responses were observed depending on the age of the respondents (p=0,121), sex (p=0,868), residence (p=0,806) and the presence of complications of diabetes (p=0,928). Those who did not have any accompanying disease had a higher knowledge (at the limit of statistical significance p=0,086) than those who were suffering from additional medical conditions. A statistically significant relationship was documented between knowledge of the respondents and their education (higher education – percentage of correct responses 56% vs. elementary education 31%, p=0.001). Conclusions: There were no statistically significant relationships between the patient’s knowledge and gender, age, place of residence, presence of complications or accompanying diseases. A relationship was found between the patient’s knowledge about the disease and education. The patients’ knowledge about the disease is low and requires intensive educational activities implemented as systemically and systematically as possible.

Improving Management of Diabetic Dyslipidemia—Effect of Online CME

Introduction: Although statins represent the cornerstone of dyslipidemia treatment, certain statins may increase the incidence of new-onset diabetes mellitus (DM). This study was conducted to determine if online continuing medical education (CME) could improve knowledge/competence of diabetologists/endocrinologists (D/E) and primary care physicians (PCPs) in tailoring statin therapy to reduce the risk for DM. Methods: Physicians participated in at least one of two 30-minute video-based online CME activities. The activities addressed educational themes related to effects of statins on lipid metabolism and tailoring statin therapy to reduce the risk of DM. 6 matching pre-education/post-education questions associated with these themes were analyzed by comparing participant responses from pre- to post-education using a repeated-pairs design. For all questions combined, the McNemar’s chi-square test was used to assess differences from pre- to post-assessment. Results: Significant improvements (P &amp;lt; .05) were seen after education across both CME activities for D/E (N=438) and PCPs (N=1023). For all questions combined, average relative improvements in knowledge/competence were 44% for D/E and 73% for PCPs (P&amp;lt;.05). Pre-assessment, the average correct response rate was 43% for D/E and 48% for PCPs, while post-assessment average correct response rates were 62% and 83%, respectively. Significant improvements were observed (all P&amp;lt;.05): effect of statins on glucose metabolism: 49% relative improvement among D/E (43% vs. 64%) and 103% improvement among PCPs (37% vs. 75%). Tailoring statin therapy to reduce the risk of DM: 64% improvement among D/E (50% vs. 82%). Conclusions: This study demonstrates the success of online CME on improving knowledge/competence of D/E and PCPs regarding tailoring lipid-lowering strategies in high-risk patients. Properly implemented, this type of intervention can translate into improvements in guideline-based patient care and improve long-term outcomes for at-risk patients. Disclosure J. Spyropoulos: None. C.S. Healy: None.

Processing genuine and nongenuine smiles as social response to personal performance: An event-related brain potential (ERP) study.

We investigated the processing of faces with different smile expressions according to a context of personal performance. Individual judgments of smile happiness were collected to assess the processing of different types of smile when these were presented as a social response in a cognitive conflict task. Two main factors were considered: (a) Expression characteristics of the smile were manipulated: that is, happy (happy-happy), neutral (neutral-happy), or sad (sad-happy) eyes were morphed in faces with smiling mouth; (b) The performance context in which the smiling face appeared as social response (after fast, average, or slow correct response). Participants rated happy-happy faces the happiest followed by neutral-happy faces, then sad-happy faces (happy-happy > neutral-happy > sad-happy). Moreover, faces were rated more happy after fast responses as compared with average or slow responses (fast > average > slow). In addition to subjective ratings, we recorded the electroencephalography (EEG) and calculated event-related brain potentials (ERPs). The ERPs showed modulations of early visual potentials according to the expression characteristics of the face. The P1 was larger for sad-happy than neutral-happy faces. Moreover, the relationship between performance and face had a significant impact on the early posterior negativity (EPN), an ERP component associated with emotion processing. Faces elicited the largest EPN amplitude after average and slow responses as compared with fast responses. These results show that smile processing and interpretation are determined both by the distinctive perceptual features of the smile expression and by the performance context in which the smiling face occurs. (PsycINFO Database Record

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre-defined 2D multiplane cone beam computed tomography reconstructions.

Osseous changes in temporomandibular joint disorders (TMD) are common indications for cone beam computed tomography (CBCT). The number of such cases is increasing while a number of qualified oral radiologists is limited. This study investigated the usefulness of a training programme for general dental practitioners (GDPs) regarding temporomandibular joint (TMJ) osseous changes detection in CBCT images. We selected CBCT images of 35 TMD cases and chose 5 of them to use in training 7 GDPs on detecting osseous changes in the TMJ. In evaluation directly following training, GDPs assessed the 30 remaining cases. Three qualified radiologists served as reference standard. A 2-month follow-up of training comprising evaluation of the same cases. The cases are assessed according to Ahmad etal (Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 107, 2009, 844) protocol of TMJ osseous changes in CBCT images. Sensitivity and specificity of the CBCT protocol were high, except for some criteria that did not appear in the cases. Average observer sensitivity was 65% while specificity was 87%. Average correct individual response rate was 84%. Mean agreement among the GDPs was 73%. Observer performance had improved at the 2-month follow-up. The present educational programme could be a helpful material on recognising possible osseous changes of TMJ and it can be used as a part of a training programme for GDP and for specialist candidates.

Evaluation of the Combined Effects of Heat and Lighting on the Level of Attention and Reaction Time: Climate Chamber Experiments in Iran.

Heat exposure and unsuitable lighting are two physical hazardous agents in many workplaces for which there are some evidences regarding their mental effects. The purpose of this study was to assess the combined effect of heat exposure and different lighting levels on the attention rate and reaction time in a climatic chamber. This study was conducted on 33 healthy students (17 M/16 F) with a mean (±SD) age of 22.1 ± 2.3 years. The attention and reaction time test were done by continuous performance test and the RT meter, respectively, in different exposure conditions including the dry temperatures (22°C and 37°C) and lighting levels (200, 500, and 1500 lux). Findings demonstrated that increase in heat and lighting level caused a decrease in average attention percentage and correct responses and increase in commission error, omission error, and response time (P < 0.05). The average of simple, diagnostic, two-color selective, and two-sound selective reaction times increased after combined exposure to heat and lighting (P < 0.05). The results of this study indicated that, in job task which requires using cognitive functions like attention, vigilance, concentration, cautiousness, and reaction time, the work environment must be optimized in terms of heat and lighting level.

Understanding of Severe Sepsis and Septic Shock Among Emergency Department and Intensive Care Unit Medical Officers in a Developing Country Nepal: A Survey Study

Introduction Severe sepsis and septic shock is a major cause of morbidity and mortality. The burden is higher and the outcome is dismal in the low and middle income countries.Objective This study aims to evaluate the knowledge about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal. It is a cross-sectional survey study.Methodology The medical officers working in emergency department and intensive care unit were asked to fill up the survey questionnaire, which contained the questions related to the demographics of the participant, about the knowledge of sepsis and the hindrances behind the effective management of septic patients. The percentage of correct answers for each question and average correct response for all the questions were analyzed.Results Seventy medical officers from twenty-four hospitals across the country were enrolled in the study. Among them, 39 were working in the emergency department and 31 were working in the intensive care unit. For the individual questions, the percentage of correct answers varied from 8.57% to 82.86% (average 48.16%). As per the response of the participants, lack of knowledge about sepsis and management guidelines, lack of experience for management of sepsis and lack of investigation facilities were considered to be the major barriers for effective management of septic patients.Conclusions Knowledge and understanding about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal is sub-optimal. To improve the outcome of septic patients, efforts should be made to increase the understanding among these first-line health care workers by implementing regular and mandatory training programs.Birat Journal of Health Sciences 2016 1(1): 47-50

Results of a Pilot Fourth year Medical Student Elective in Antimicrobial Stewardship

BackgroundAntimicrobial stewardship (AS) is not currently a formal part of the medical school curriculum. We hypothesized that presenting the topic to medical students can raise awareness of the effects of inappropriate antibiotic prescribing.MethodsA fourth-year medical student elective was created that included microbiological, clinical, and multidisciplinary elements. Week 1: Understand mechanisms of bacterial resistance and clinical implications. Week 2: Rotate on Infectious Disease (ID) Consult Service. Complete Wake Forest and CDC online study modules. Michigan Medicine faculty recently created new AS modules; these were reviewed and feedback was provided. Week 3: Meet with ID pharmacists and attend AS and Patient Safety Effectiveness Program meetings. Review the process behind creating AS guidelines and antibiograms. Week 4: Give a presentation to the third-year medical students at University of Michigan Medical School. Have the class complete pre- and post- surveys (before and after the presentation, respectively) of nine questions regarding important topics in AS.ResultsThe presentation created featured an innovative antibiotic-antimicrobial dating application model that was used to teach important AS scenarios. 96 third-year medical students completed the pre-survey and 62/96 completed the post-survey. The average correct response for multiple-choice questions on the pre-survey was 3.34/8 (42%) and 5.18/8 (65%) on the post-survey. Twenty-one/96 (22%) who took the pre-survey responded that they did not know what AS is, compared with 1/62 (1.6%) in the post-survey.ConclusionHaving an interdisciplinary clerkship for medical students to explore and learn about AS could have large impact, though sustainability is unknown. In this cohort, a focused social media savvy review helped medical students learn basic elements of AS, demonstrated by the improvement in student scores on the subsequent surveys. As patient and staff education becomes a requirement of AS programs, medical student education should be incorporated as well.Disclosures All authors: No reported disclosures.

Trends and determinants of HIV/AIDS knowledge among women in Bangladesh.

BackgroundGlobally, women share an indiscriminate burden of the HIV epidemic and the associated socioeconomic consequences. Previous studies have demonstrated a positive correlation between levels of HIV knowledge with its prevalence. However, for Bangladesh such evidence is non-existent. In this study, we aimed to explore the extent of HIV knowledge in relation to the socio-demographic variables such as age, region, area of residence i.e., urban or rural, wealth index and education, and investigate the factors influencing the level of HIV knowledge among Bangladeshi women.MethodsWe used data from the Bangladesh Demographic and Health Survey (BDHS) survey conducted in 2011. In total 12,512 women ageing between 15 and 49 ever hearing about HIV regardless of HIV status were selected for this study. HIV knowledge level was estimated by analyzing respondents’ answers to a set of 11 basic questions indicative of general awareness and mode of transmission. Descriptive statistics, cross-tabulation and multinominal logistic regression were performed for data analysis.ResultsLittle over half the respondents had good knowledge regarding HIV transmission risks. The mean HIV knowledge score was −0.001 (SD 0.914). Average correct response rate about mode of transmission was higher than for general awareness. Educational level of women and sex of household head were found to be significantly associated with HIV knowledge in the high score group. Those with no education, primary education or secondary education were less likely to be in the high score group for HIV knowledge when compared with those with higher than secondary level of education. Similarly those with male as household head were less likely to be in the higher score group for HIV knowledge.ConclusionsLevel of HIV knowledge among Bangladeshi women is quite low, and the limiting factors are rooted in various demographic and household characteristics. Education and sex of the household head have been found to be significantly correlated with the level of HIV knowledge and propound sound grounds for their incorporation in the future HIV prevention strategies. Education of women may also have wider ramifications allowing reduction in gender inequality, which in turn favors higher knowledge about HIV.

Medical Students' Knowledge, Familiarity, and Attitudes towards Hematopoietic Stem Cell Donation: Stem Cell Donation Behaviors

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for patients with blood disorders and genetic diseases. Approximately 70% of the HSCTs currently performed in the United States use stems cells from an unrelated donor who donated voluntarily. Medical students (MS) are a young, diverse, influential population whose willingness to engage in altruistic acts, such as donating stem cells, may be correlated with knowledge on the topic. A literature gap exists in MS perspectives towards HSCT and the bone marrow registry (BMR) and prior studies suggest that misconceptions about donation deter MS from participation on the BMR, which may decrease opportunities to educate other potential donors. We performed a cross-sectional survey among the 4-year cohort of MS at Mayo Medical School in Rochester, Minnesota. The questionnaire evaluated multiple areas including whether MS were current members of the BMR and/or prior blood donors, MS current knowledge on donor eligibility (DE) and the donation process (DP), MS familiarity with HSCT and the DP, and MS attitudes towards joining the BMR and towards donating stem cells. The responses were analyzed and assessed alongside a self-reported, standardized scale measuring students' altruistic behaviors. There were 99 out of 247 potential respondents (40%), with 45% (n = 44) of MS in preclinical years 1 or 2, 37% (n = 37) in clinical years 3 or 4, and 18% (n = 18) in research or alternative portions of their training, of which 43% (n = 41) in total were current BMR members. BMR status correlated positively with prior blood donation (P = .015) and female sex (P = .014). Respondents had a 57.7% and 63.7% average correct response rate regarding knowledge of DE and DP, respectively, with knowledge of DE not surprisingly higher in BMR members (P < .0001). The majority of MS surveyed, 68% (n = 65), had learned about HSCT during medical school. BMR status correlated with the following attitudes towards donating stem cells: lower concern with all evaluated aspects of HSCT—time, cost, pain, and side effects (for all subsections, P < .05) but not with the altruism score (P = .32). The mean altruism score for respondents was 59.9 ± 11.3 (of a possible 100 points) with no significant difference in age, race, sex, level of training, or participation in the BMR. Altruism scores did not directly correlate with lower concern with aspects of time, cost, and pain of HSCT but did with long-term side effects (P = .021). This latter correlation was regardless of BMR status. Among MS, positive predictors for participation in the BMR included prior blood donation and female sex. BMR status did not ensure knowledge of all aspects of donating stem cells, but it correlated with less concern regarding the DP and was unrelated to altruism score. Improving knowledge gaps regarding the BMR and HSCT for the next generation of physicians and health care providers through expanded medical education curriculum may be beneficial to for the recruitment and retention of donor populations to the BMR.

Nurses' Knowledge and Performance of Pain Management at a General hospital

Purpose: This study was done to describe level of knowledge and performance of pain management by nurses in general hospitals. Methods: The study was conducted from August 1 to 28, 2014 with 141 nurses from a general hospital in B city. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficient with SPSS 20.0. Results: Average correct response rate for knowledge was 62.7%, indicating poor knowledge of pain management. Mean score for knowledge of pain management was 31.33±3.24 out of 50(general knowledge about pain 14.02±2.18 out of 20, knowledge on use of analgesics 9.21±1.97 out of 20, knowledge on analgesic classification 8.16±1.00 out of 10). Mean score for performance of pain management was 3.19±.44 out of 4. There was significant difference in knowledge of pain management by age. Performance of pain management differed significantly according to age and type of working unit. No significant relationship was found between knowledge and performance of pain management. Conclusion: These findings show that nurses who have good knowledge do not always have good performance of pain management. Therefore, it is necessary to develop new strategies to promote performance as well as continued pain management education to increase ability of nurses to manage pain.

Oncology Nurses Knowledge and Attitudes Regarding Cancer Pain Management.

Oncology nurses play a crucial role in cancer pain management and must be highly informed to ensure their effective practice in the cancer setting. The aim of this study was to determine the baseline level of knowledge and attitudes of oncology nurses regarding cancer pain management. A cross-sectional survey research design was employed. The sample comprised 58 cancer nurses working in Shahid Sadoughi hospital, Yazd, Iran. The ''Nurses Knowledge and Attitudes Survey Regarding Pain'' (NKAS) tool and a demographic form were utilized to ascertain the knowledge and attitudes of oncology nurses working in oncology settings. The average correct response rate for oncology nurses was 66.6%, ranging from 12.1% to 94.8%. The nurses mean score on the knowledge and attitudes survey regarding pain management was 28.5%. Results revealed that the mean percentage score overall was 65.7%. Only 8.6% of nurse participants obtained a passing score of 75% or greater. Widespread knowledge deficits and poor attitudes were noted in this study, particularly regard pharmacological management of pain. The present study provides important information about knowledge deficits in pain management among oncology nurses and limited training regarding pain management. Our results support the universal concern of inadequate knowledge and attitudes of nurses regarding cancer pain. It is suggested educational and quality improvement initiatives in pain management could enhance nurses knowledge in the area of pain and possibly improve practice.

Skin cancer preventative behaviors in state park workers: a pilot study.

Considering the potential for occupational sun exposure among state park workers, the purpose of this pilot study was to identify skin cancer knowledge, health beliefs, self-efficacy, and sun protection behaviors (SPBs) among state park employees. The current study used a cross-sectional survey research design with state park workers in a Southern state. Of the 94 possible employees who could have participated in the study, 87 completed the survey. Assessment of the participants' skin cancer knowledge demonstrated an average correct response rate of 68.8 %. While the vast majority (87.4 %) believed that skin cancer is a serious disease, a minority (42.5 %) believed they would develop skin cancer sometime during their lifetime, and even fewer (35.6 %) believed their risk was higher than average. Collectively, workers reported low levels of SPBs. The most commonly reported barriers to sun protection were "inconvenient," "too hot to wear," and "forget to protect." Half of the participants (50.6 %) were highly confident in their ability to wear long pants while in the sun. About the same proportion of participants was highly confident they could wear a wide-brimmed hat (21.8 %) and sunscreen (20.7 %). Based on available evidence, a need exists to develop individual and worksite programs and interventions to increase skin cancer prevention behaviors among this occupational group. This data could serve as a baseline to monitor and evaluate the efficacy of these interventions.

Knowledge and Attitudes about Pain Management: A Comparison of Oncology and Non-Oncology Jordanian Nurses

Optimal pain management is one of the most important aspects of patient care. Nurses play a pivotal role effective in pain management. The aim of this study is explore and describe oncology and non-oncology Jordanian nurses’ knowledge and attitudes regarding pain management. The study sample consisted of 263 nurses from three hospitals in Jordan. The Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKASRP) was used to measure the nurses’ pain management knowledge and attitudes. Of the nurses who participated in the study, 64% were between the ages of 21 and 32 years, with a mean age of 30.9 years (SD 5.7). A total of 89% of the nurses had a baccalaureate degree. The mean years of nursing experience were 7.3 (SD 5.3). The average correct response rate was 42.7%, ranging from 10.5% to 75%. Out of the 40 pain knowledge questions assessed, the mean number of correctly answered questions was 17.1 (SD 5.0), with a range of 4 to 30. No significant differences between nurses’ characteristics and pain knowledge were found. Nurses’ pain knowledge differed significantly according their educational level (P = 0.020), previous pain education related to cancer (P < 0.007), regular cancer pain care (P = 0.010), knowledge score and attendance of conferences related to pain management (P = 0.002), knowledge score and in-services training, modules, protocols and other knowledge and skills related to pain management (P = 0.004), knowledge score and nurses’ rate of their experience with pain (P < 0.001), and adequate professional training preparation in regard to pain management (P < 0.001). The present study in Jordan provides important information about knowledge deficits in pain management. Pain education content and allocated hours in nursing curricula need to be evaluated for their adequacy and reformed accordingly. In addition, regular courses on pain management for nurses within their clinical setting are highly recommended.