Desire For More Information Research Articles

Sexual Health for Patients With an Implantable Cardioverter Defibrillator

Studies examining the quality of life of implantable cardioverter defibrillator (ICD) patients have consistently demonstrated that ICD patient quality of life is at least equal to, if not better than, that of patients treated with medications alone.1 Quality of life may be related in part to the patient's ability to resume “pre-ICD” activities; however, sexual activity is rarely included as part of the patient education process. Sexual functioning has not been well studied in ICD patients, but preliminary research has suggested that patients commonly express concerns about fear of ICD shock during sex, varying interest and pattern of sexual activity, and a desire for more information and sexual counseling.2 The purpose of this Cardiology Patient Page is to identify typical issues related to sexual functioning in ICD patients and offer possible strategies for effective management. Despite limited research regarding the social functioning of ICD patients, our collective clinical experience suggests that common barriers exist when it comes to addressing their sexual health. The following sections detail specific barriers to healthy sexual functioning for ICD patients and proposed strategies for overcoming those barriers. ### Communication Between Patients and Healthcare Providers Although some people may believe that sex, love, and intimacy are subjects not to be discussed with others, sexual activity is highly relevant to your health and well-being and is an absolutely appropriate topic of discussion with your doctor. Unfortunately, research has shown a lack of adequate communication about sex between cardiovascular patients and their healthcare providers. Despite estimates that >75% of patients with cardiovascular disease experience some type of difficulty with sexual functioning,3 a lack of communication between patients and doctors persists. Research has shown that 98% of patients reported that they believed their cardiologists should discuss sexual functioning with them; however, only 15% of …

New Influenza A/H1N1 (“Swine Flu”): information needs of airport passengers and staff

Please cite this paper as: Dickmann et al. (2010) New Influenza A/H1N1 (“Swine Flu”): information needs of airport passengers and staff. . Influenza and Other Respiratory Viruses 5(1), 39–46. Background Airports are the entrances of infectious diseases. Particularly at the beginning of an outbreak, information and communication play an important role to enable the early detection of signs or symptoms and to encourage passengers to adopt appropriate preventive behaviour to limit the spread of the disease. Objectives To determine the adequacy of the information provided to airport passengers and staff in meeting their information needs in relation to their concerns. Methods At the start of the influenza A/H1N1 epidemic (29–30 April 2009), qualitative semi‐structured interviews (N = 101) were conducted at Frankfurt International Airport with passengers who were either returning from or going to Mexico and with airport staff who had close contact with these passengers. Interviews focused on knowledge about swine flu, information needs and fear or concern about the outbreak. Results The results showed that a desire for more information was associated with higher concern – the least concerned participants did not want any additional information, while the most concerned participants reported a range of information needs. Airport staff in contact with passengers travelling from the epicentre of the outbreak showed the highest levels of fear or concern, coupled with a desire to be adequately briefed by their employer. Conclusions Our results suggest that information strategies should address not only the exposed or potentially exposed but also groups that feel at risk. Identifying what information these different passenger and staff groups wish to receive will be an important task in any future infectious disease outbreak.

Knowledge, satisfaction with information, decisional conflict and psychological morbidity amongst women diagnosed with ductal carcinoma in situ (DCIS)

ObjectiveTo assess knowledge, satisfaction with information, decisional conflict and psychological morbidity amongst women diagnosed with ductal carcinoma in situ (DCIS) and to explore the factors associated with less knowledge and greater confusion about DCIS. MethodsA cross-sectional survey of women diagnosed with DCIS in Australia (N=144). ResultsThis study found misunderstanding and confusion amongst women diagnosed with DCIS and a desire for more information about their breast disease. Approximately half of participants worried about their breast disease metastasizing; approximately half expressed high decisional conflict; 12% were anxious and 2% were depressed. Logistic regression analysis demonstrated that worry about dying from the breast disease was significantly associated with not knowing that DCIS could not metastasize (OR 3.9; 95% CI 1.03–14.25); and confusion about whether DCIS could metastasize was significantly associated with dissatisfaction with information (OR 12.5; 95% CI 3.8–40.2). ConclusionGood communication about how DCIS differs from invasive breast cancer is essential to alleviating the confusion and worry amongst women with DCIS. Practice implicationsRecommendations about how best to communicate a diagnosis of DCIS, including the uncertainties, are needed to guide health professionals to promote better understanding about DCIS and increase the well-being of women with DCIS.

The effect of architecture staff in activate the technology of digital education in the Iraqi school of architecture

Many researches assigned the importents of enhance the architectural education movement. It is obvious that these studies have elaborated in their interest in architectural curriculum and teaching methodm in addition to the important of qualifying the staff to cover these changes. Most of these studies couldn't define a specific solutions to improve teachers method to lead the digital education According to this the research problem was defined as: "There is no comprehensive study clear the real attitude of the architectural teachers in Iraqi schools of architecture from the digital teaching…within the vocabulary of (digital knowledge– desire for more information about digital knowledge - the attitude of digitalizing architectural curriculum between accepting and denying – employing this technolgly on selected sample)". Thus the research goal is defined as: "Give a clear vision about architectural teacher attitude in Iraqi schools of architecture in relating to to discover his real preparation to employ his knowledge using the digital technology in developing the architectural education in general, and applying their concepts in department of architecture in particular. In order to "built the propitiate mechanism in which may be used to activate this technique in Iraqi schools of architecture ". Reviewing architectural teaching curriculum and the degree which it may send for the digital education vocabulary, and define the most important ways to employ them , reviewing the studies about the reality of digital learning in Iraqi schools of architectural and analyzing the results and compare them between the architectural schools attitude the conclusions and recommendations in order to qualify them in activating the digital education technique in these schools

Perceptions of the risks and benefits of fish consumption: Individual choices to reduce risk and increase health benefits

Studies of fish consumption often focus on awareness of and adherence to advisories, how much fish people eat, and contaminant levels in those fish. This paper examines knowledge and accuracy of risks and benefits of fish consumption among fishers and other recreationists in the New York Bight, indicative of whether they could make sound dietary decisions. While most respondents knew about health risks (70%) and benefits (94%) of consuming fish, far fewer could name specific risks and benefits. Less than 25% of respondents mentioned mercury and less than 15% mentioned that pregnant women and children were at risk. Far fewer people mentioned polychlorinated biphenyls (PCBs). Nearly 70% said it was healthy to eat fish, and 45% were aware that fish were rich in healthful oils. Despite the lack of details about what specific risks and benefits of fish, well over a third did not feel they needed more information. Other respondents had basic questions, but did not pose specific questions about the fish they caught or ate that would have clarified their individual risk-balancing decisions. Knowledge of which fish were high in contaminants did not match the mercury or PCB levels in those fish. There was a disconnect between the information base about specific risks and benefits of fish consumption, levels of mercury and PCBs in fish, and the respondent's desire for more information. These data indicate that respondents did not have enough accurate information about contaminants in fish to make informed risk-balancing decisions.

Poster 1: Survey of Clinical Trial Interest and Literacy in Huntington Support Groups: Northwest Pilot Project

Background There has been no systematic measure of level of awareness, interest, preferences, or knowledge base regarding clinical research among Huntington families. Objective To determine the extent of clinical trial interest and literacy, and to assess response following clinical research education within a cohort of Huntington support group members in the Pacific Northwest. Methods Surveys were administered to members of six Huntington support groups before and after a clinical research educational session. Survey questions assessed levels of awareness, interest, clinical trial literacy, and factors influencing participation. All responses were anonymous. Results Ninety-nine support group members, including an HD group consisting of symptomatic, gene-positive premanifest, and gene untested (49) and caretakers (50), participated in the survey. Desire for more information was high (80%), as was interest in clinical trial participation (75%), which increased after education (85%). The greatest concerns included drug safety (50%) and time missed from work (30%). Incentives that would increase participation included assistance from a knowledgeable patient advocate (65%), reimbursement travel expenses (45%), and Saturday assessments (40%). Clinical trial literacy was very low in all parameters tested; however, significant learning occurred in concepts relating to criteria, placebo, blinding, patient rights, and consent procedures, but not in understanding of trial phases and medical care during clinical trials. Though not originally planned as a goal in this project, 7 support group participants were recruited for TRACK-HD. Conclusions Similar to survey results in other disease populations, there is low awareness and high interest in clinical trial participation among this Huntington's cohort. Drug safety was the most frequent concern. Assistance from a patient advocate was the most highly rated incentive to increase participation. Though clinical trial literacy is low, it improved significantly after a single educational session. Education in support groups is a mechanism that can increase clinical trial participation.

Compliance of amblyopic patients with occlusion therapy: A pilot study

Background:Increasing evidence shows that good compliance with occlusion therapy is paramount for successful amblyopia therapy.Purpose:To study the degree of compliance and explore factors affecting compliance in patients undergoing occlusion therapy for amblyopia in our practice.Design:Nonrandomized clinical intervention study.Materials and Methods:A total of 31 families with a child (aged 2-12 years), undergoing unilateral amblyopia treatment at the pediatric ophthalmology clinic of Sultan Qaboos University Hospital, Oman, were recruited for this one month study. Parents were interviewed and completed a closed-ended questionnaire. Clinical data including, visual acuity, refraction, diagnosis and treatment, for each patient was collected from the hospital chart and was entered in a data collection sheet. Compliance with occlusion therapy was assessed by self-report accounts of parents and was graded into good, partial, or poor. Association between various factors and degree of compliance was studied using logistic regression modeling.Results:Only 14 (45%) patients showed good compliance to occlusion therapy. 17 (55%) patients were noncompliant. Improvement in visual acuity strongly correlated with compliance to patching (P = 0.008). Other variables that were studied included, age at onset of therapy; gender; degree of amblyopia; type of amblyopia; use of glasses; and compliance with glasses. These did not emerge as significant predictors of compliance. All but one family with poor compliance stated that the main challenge in following the recommendation to patch for requisite hours was in getting their child to cooperate. Only in one instance, the family cited nonavailability of patches as the main hindrance to compliance. 10/31 (32%) families expressed a desire for more information and 18/31 (58%) parents did not understand that amblyopia meant decreased vision.Conclusion:Poor compliance is a barrier to successful amblyopia therapy in our practice. Improvement in visual acuity is associated with better compliance with patching. Parents find it difficult to comprehend and retain verbal explanations of various components regarding occlusion therapy for amblyopia. Future study with a larger sample of patients is recommended to investigate the factors affecting compliance with amblyopia therapy and determine predictors for poor compliance.

Recent Advances in Anaesthesia and Intensive Care–Volume 24

First published in 1932 as Recent Advances in Anaesthesia and Analgesia (Including Oxygen Therapy), the book’s title has changed over the years culminating in this 24th edition, Recent Advances in Anaesthesia and Intensive Care. This well organized 250-page text includes topics of interest to both general and specialist anesthesia practitioners, as well as to practitioners with an interest in critical care. The following topics are covered in the book’s 13 chapters: the role of cardiopulmonary exercise testing in the preoperative evaluation of surgical patients, esophagectomy for cancer, vascular surgery, anesthesia for the elderly, deaths following anesthesia, pelvic and acetabular trauma, echocardiography, levosimendan, critical care outreach, critical care and biological disasters, evaluating clinical performance, non-technical skills and anesthesia, and simulators in anesthetic training to enhance patient safety. With its focus on up-to-date information and important concepts, the chapter regarding the role of cardiopulmonary exercise testing in the preoperative evaluation of surgical patients presents an excellent overview of the method to assess a patient with limited cardiopulmonary physiological reserve who requires major surgery. I found this chapter to be particularly interesting and relevant given the increasing severity of comorbid illnesses and complex surgical procedures, and the results of the recent POISE trial and other perioperative trials. This chapter will be a helpful guide for managing the complex surgical patient and for administering limited intensive care resources. I must admit I had a desire for more information and wished this chapter was lengthier and more detailed. The chapters dealing specifically with anesthesia in relation to esophagectomy, vascular surgery, pelvic trauma, and the elderly are well written up-to-date reviews. The focus of the chapter specific to medication is on levosimendan for the treatment of acute decompensating congestive heart failure. The chapter regarding advances in critical care medicine covers the expanding role of echocardiography from the operating room to the intensive care unit. It includes a discussion by critical care outreach and medical emergency teams regarding the controversy within the current literature, and it incorporates a review of severe acute respiratory syndrome and pandemic planning. The final three chapters evaluate clinical performance, reduction of harm, and simulation to enhance training. In summary, Recent Advances in Anaesthesia and Intensive Care encompasses a wide range of topics, from the pre-admission clinic, to the operating room, to the intensive care unit, to quality improvement. The book is directed more towards the anesthesiologist who is an intensivist rather than towards other medical specialties. Its focus is on preparing the critically ill patient for surgery, and it includes relevant sections for all persons involved with the critically ill patient, including medical emergency teams and those engaged in simulation. The chapters are short, easy to read, well researched, and well written. For a speedy and succinct read, this book would be an excellent addition to your library.

Developing an 'interactive' booklet on respiratory tract infections in children for use in primary care consultations.

To construct a systematic process for developing an 'interactive' booklet for use in primary care consultations and to use this process to develop a booklet on respiratory tract infections in children. Booklet development occurred through a number of stages, which included: expert group brainstorming and literature review, professional graphic design, readability assessment, and consultation with users. Consultation was achieved through the use of focus groups and interviews with parents, focus groups and independent booklet review by general practitioners, and booklet review and feedback by paediatricians. All development stages led to meaningful enhancements to the booklet. Consultation with parents demonstrated a desire for more information than anticipated, with a particular emphasis on the interpretation of signs and symptoms, and the recognition of serious illness. General practitioners contributed to the design and clarity of the booklet and helped to ensure that it would be acceptable for use within consultations. Written material needs to be developed in a systematic way and include consultation with the intended users. Focus groups are a valuable tool for consulting with consumers and practitioners in this regard. The process described can be used as a guide for those wishing to develop similar written materials.

Assessing Students' Learning Needs and Attitudes: Considerations for Gerontology Curriculum Planning

ABSTRACT The growing number of older adults with multiple healthcare needs underscores the importance of teaching gerontological content to students in healthcare fields. To effectively accomplish this educational goal, it is essential to consider students' attitudes and learning needs related to caring for elderly persons. The purpose of this study was to identify prelicensure undergraduate nursing students' (N = 200) perceived learning needs and attitudes toward older adults. Current knowledge of gerontology and attitudes were correlated with multiple variables including comfort and confidence in caring for older persons. Students identified their desire for more information on selected topics such as supportive resources for elders and their caregivers. Students who intended to learn more about gerontological nursing chose more topics; the two most commonly chosen topics were end-of-life issues and specific disorders. The data from this study can be used to design courses and curricula related to the care of elderly persons. Similar approaches to obtain student input can be adopted in designing other gerontology curricula.

Sodium dietary restriction, knowledge, beliefs, and decision‐making behavior of older females

The purposes of this qualitative/descriptive study were to (a) explore experiences and decision-making behaviors associated with adoption of a sodium-restricted diet (SRD) among older women with hypertension or heart failure and (b) identify healthcare system and contextual factors that facilitate or impede adherence to SRD. Participants were 33 single older women, aged 65-98 years, residing in three congregate living facilities in the high-risk "coronary valley" area of the United States. A semistructured interview format was employed with three focus groups. The audio-taped transcribed data were content analyzed for themes by the researchers with the assistance of ATLAS.Ti computer software. Predominant themes were lack of SRD education by healthcare providers, a desire for more information about sodium, including the use of alternative herbal seasonings, and large-print informational materials. Eating alone with no motivation to cook and share meals was a contextual barrier to healthy nutrition. To prevent costly hospitalizations and rehospitalization from nonadherence to SRD, clinicians need to provide more structured SRD education supplemented with printed brochures. Exploring the client's nutritional social setting may improve SRD adherence.

ALS patients request more information about cognitive symptoms

Once thought to impact only voluntary motor function, ALS/Motor neuron disease (MND) is now seen as a multi-system disorder in which a minority of patients experience mild cognitive dysfunction or frontotemporal dementia. Despite clinical guidelines advocating supplying complete information to patients, educational materials on ALS often state that the mind is unaffected. We sought to establish how much patients and caregivers understand about ALS, what they have been told to expect by their physician, and if they would have appreciated more complete information. A two-part survey was administered online. An 'ALS quiz' gauged participants' knowledge of physical and psychological aspects of ALS. A second questionnaire assessed which symptoms patients had discussed with their clinician and explored patients' desire to receive information on psychological effects. A total of 247 ALS patients and 87 caregivers participated. Participants knew less about psychological symptoms than physical ones (72% correct responses versus 82%; paired t((333)) = -5.04, P < 0.001). Patients commonly reported being told by their doctor about physical symptoms such as problems walking (85%) or stiffness/cramps (74%) but not psychological issues like emotional lability (46%) or cognitive change (11%). The majority of patients (62%) and carers (71%) indicated a desire to be informed that cognitive change or dementia might occur. ALS is a multi-system disorder. However, despite a desire for more information from patients and their carers, healthcare professionals continue to primarily address only the physical consequences of the disease.

Beliefs about health and illness postpartum in women born in Sweden and the Middle East

Objective to explore beliefs about health and illness three months postpartum in women born in Sweden and the Middle East, and to study whether they perceive gestational diabetes mellitus ( GDM) as a prediabetic condition. Design an explorative study using semi-structured interviews 3 months postpartum. Setting in-hospital diabetes specialist clinic in Sweden. Participants interviews three months after birth. Consecutive sample of women with GDM; 13 born in Sweden and 14 born in the Middle East. Measurement and findings irrespective of origin, health was focused on well-being and being able to care for the baby. Many Middle Eastern women did not know how long GDM would last or said that they had been informed by staff about its transience. They worried about still having diabetes mellitus ( DM), which directed them to self-monitoring of blood glucose and the desire for health-care staff to verify the disease. They showed tendencies to dietary changes. Swedish-born women feared development of type 2 DM and had undertaken active health-related behaviour. Key conclusions beliefs about health and illness differ, change and affect awareness of risk and self-care practice postpartum. Swedish women showed high risk awareness with changes in life style and the desire for more information to avoid developing DM. Middle Eastern women showed increased risk awareness and sought help from staff in checking whether GDM was present in the postpartum period. Implications for practice it is important to recognise that Middle Eastern women, in contrast to Swedish-born women, have not incorporated the message that GDM is a risk marker for future development of DM. Health professionals have a significant role in supporting women and their families undergoing the transition to motherhood, particularly migrants in a new country. Identifying individual beliefs is of crucial importance. Pre-existing baby health clinics can be developed to address mothers’ needs as well as the health of the baby.

“That’s Like an Act of Suicide” Patients’ Attitudes Toward Deactivation of Implantable Defibrillators

ObjectiveTo understand potential patient barriers to discussions about implantable cardioverter defibrillator (ICD) deactivation in patients with advanced illness.DesignQualitative focus groups.ParticipantsFifteen community-dwelling, ambulatory patients with ICDs assigned to focus groups based on duration of time since implantation and whether they had ever received a shock from their device.ApproachA physician and a social worker used a predetermined discussion guide to moderate the groups, and each session was audiotaped and subsequently transcribed. Transcripts were analyzed using the method of constant comparison.ResultsNo participant had ever discussed deactivation with their physician nor knew that deactivation was an option. Patients expressed a great deal of anxiety about receiving shocks from their device. Participants discussed why they needed the device and expressed desire for more information about the device; however, they would not engage in conversations about deactivating the ICD. One patient described deactivation “like an act of suicide” and all patients believed that the device was exclusively beneficial. Patients also expressed a desire to have their physician make the decision about deactivation.ConclusionsNone of the patients in our study knew that they might need to deactivate their ICD as their health worsens. These community-dwelling outpatients were not willing to discuss the issue of ICD deactivation and their attitudes about deactivation might impede patients from engaging in these conversations. These findings are in contrast to findings in other advance care planning research and may be related to the unique nature of the ICD.

Satisfaction of the Referring Physician

Utilization of endoscopic ultrasonography (EUS) is becoming more widespread. Largely in control of use of EUS, as a primary consumer of EUS, are the physicians who refer patients. This quality control study aimed to uncover remedial impediments to ideal utilization of EUS. Two thousand patient EUS reports, all by one endoscopist, were screened. One hundred forty referring physicians were identified. One hundred of these physicians completed extensive feedback survey questionnaires. Overall satisfaction with EUS procedures was generally high. The level of satisfaction was comparable to satisfaction with gastroscopy procedures, both being significantly higher than for endoscopic retrograde cholongio-pancreatography. Sixty-nine percent of the physicians indicated their desire for more information regarding EUS, this being significantly higher among residents (vs. specialists). The open access system in current practice was seen as acceptable by less than half of physicians, both from the community and from within the hospital. Waiting time for EUS procedures and for biopsy results were rated as acceptable within the hospital, but more often as too long for outpatients. Overall satisfaction with EUS procedures is high. More information should be brought to the referring physicians, in print and lectures. Improving communication and interacting with endoscopist-initiated feedback led to improved feelings of teamwork, uncovered remedial weak points in the EUS service, and was thus found to be valuable.

Determinants and patient-reported long-term outcomes of physician empathy in oncology: A structural equation modelling approach

Objective The aim of the present cross-sectional study was to explore patient- and physician-specific determinants of physician empathy (PE) and to analyse the influence of PE on patient-reported long-term outcomes in German cancer patients. Methods A postal survey was administered to 710 cancer patients, who had been inpatients at the University Hospital Cologne (response rate 49.5%). PE was measured with the German translation of the consultation and relational empathy (CARE) measure, and patient-reported long-term outcomes were assessed using the major (ICD-10) depression inventory (MDI) and the EORTC quality of life (Qol) questionnaire QLQ-C30. Hypotheses were tested by structural equation modelling. Results PE had (a) a moderate indirect effect on “depression” and a smaller indirect effect on “socio-emotional-cognitive Qol” by affecting “desire for more information from the physician regarding findings and treatment options” and (b) a moderate indirect effect on “socio-emotional-cognitive Qol” and a smaller effect on “depression” via “desire for more information about health promotion”. The determinant with the greatest importance was “patient-perceived general busyness of hospital staff”: it had a strong negative influence on PE, indirectly influencing “desire for more information from the physician regarding findings and treatment options” and also patients’ “depression”. Conclusion PE seems to be an important pre-requisite for information giving by physicians and through this pathway having a preventive effect on depression and improving Qol. Conversely, physicians’ stress negatively influences these relationships. Practice implications The research findings suggest that reducing physicians’ stress at the organizational and individual may be required to enhance patient–physician communication. Empathy, as an outcome-relevant professional competence needs to be assessed and developed more intensively in medical students and physicians.

1114 POSTER Determinants and patient-reported long-term outcomes of physician empathy in oncology: A structural equation modelling approach

Objective: The aim of the present cross-sectional study was to explore patient- and physician-specific determinants of physician empathy (PE) and to analyse the influence of PE on patient-reported long-term outcomes in German cancer patients. Methods: A postal survey was administered to 710 cancer patients, who had been inpatients at the University Hospital Cologne (response rate 49.5%). PE was measured with the German translation of the consultation and relational empathy (CARE) measure, and patient-reported long-term outcomes were assessed using the major (ICD-10) depression inventory (MDI) and the EORTC quality of life (Qol) questionnaire QLQ-C30. Hypotheses were tested by structural equation modelling. Results: PE had (a) a moderate indirect effect on ‘‘depression’’ and a smaller indirect effect on ‘‘socio-emotional-cognitive Qol’’ by affecting ‘‘desire for more information from the physician regarding findings and treatment options’’ and (b) a moderate indirect effect on ‘‘socio-emotionalcognitive Qol’’ and a smaller effect on ‘‘depression’’ via ‘‘desire for more information about health promotion’’. The determinant with the greatest importance was ‘‘patient-perceived general busyness of hospital staff’’: it had a strong negative influence on PE, indirectly influencing ‘‘desire for more information from the physician regarding findings and treatment options’’ and also patients’ ‘‘depression’’. Conclusion: PE seems to be an important pre-requisite for information giving by physicians and through this pathway having a preventive effect on depression and improving Qol. Conversely, physicians’ stress negatively influences these relationships. Practice implications: The research findings suggest that reducing physicians’ stress at the organizational and individual may be required to enhance patient–physician communication. Empathy, as an outcome-relevant professional competence needs to be assessed and developed more intensively in medical students and physicians. # 2007 Elsevier Ireland Ltd. All rights reserved.

The Public's Preparedness for Hurricanes in Four Affected Regions

The purpose of this article is to look at how prepared people in communities outside the main areas devastated by Hurricanes Katrina and Rita thought they were for those storms and for major hurricanes in the near future, what factors were related to why people did not evacuate, and what concerns people had in communities that took in evacuees from the hurricanes. Telephone interviews were conducted with randomly selected adults in Baton Rouge, Houston, Dallas, and Mississippi/Alabama (excluding the immediate Gulf Coast) to assess respondents' knowledge, attitudes, and behaviors about hurricane preparedness and response to Hurricanes Katrina and Rita. The surveys found a sizeable proportion of respondents who might not, for a number of reasons, comply with future orders to evacuate. A substantial proportion reported that they were not prepared for another major hurricane and indicated a desire for more information about how to prepare for future hurricanes. In communities that reported taking in large numbers of evacuees, residents expressed concern about the impact of the evacuees on their community. Evacuating communities involves a number of concrete problems that were not adequately addressed in the cases of Hurricanes Katrina and Rita. Responses to these surveys indicate a need for more comprehensive hurricane disaster planning.

Social acceptance of carbon dioxide storage

This article discusses public acceptance of carbon capture and storage (CCS). Responses by citizens are described in relation to responses by professionally involved actors. Interviews with members of the government, industry and environmental NGOs showed that these professional actors are interested in starting up storage projects, based on thorough evaluation processes, including discussions on multi-actor working groups. As appeared from a survey among citizens living near a potential storage site ( N=103), public attitudes in general were slightly positive, but attitudes towards storage nearby were slightly negative. The general public appeared to have little knowledge about CO 2-storage, and have little desire for more information. Under these circumstances, trust in the professional actors is particularly important. NGOs were found to be trusted most, and industry least by the general public. Trust in each of the three actors appeared to depend on perceived competence and intentions, which in turn were found to be related to perceived similarity of goals and thinking between trustee and trustor. Implications for communication about CCS are discussed.

A cross-sectional study of knowledge and practice of pelvic floor exercises during pregnancy and associated symptoms of stress urinary incontinence in North-East Scotland

Objectives to establish levels of knowledge about pelvic floor exercises during pregnancy; reported practice of pelvic floor exercises in pregnancy; and prevalence of stress urinary incontinence in a sample of women in the third trimester of pregnancy. Design structured cross-sectional interview survey. Participants pregnant women over the age of 16 years and more than 30 weeks gestation attending antenatal clinics in North-East Scotland. Of 350 women who agreed to participate, 289 (82.6%) were interviewed between July 1999 and March 2000. Findings 225 women (77.9%) reported being given or obtaining information about pelvic floor exercises in the current pregnancy. Books were the most frequently mentioned source of information. Midwives were the health professionals most likely to give information about pelvic floor exercises. Younger women, first-time mothers and those from more deprived backgrounds were less likely to report having information about the exercises. A third of women ( n=90, 31.1%) said that they would have liked more information about the exercises. Practice of the exercises during pregnancy was reported by just over half the sample ( n=156, 54.0%) and more than once a day by 26.3% ( n=76). Younger women, and those from more deprived backgrounds, were less likely to report the practice of exercises. No difference was found in reported practice according to parity. More than half ( n=157, 54.3%) of the women reported incontinence during the current pregnancy. No relationship was found between reported practice of pelvic floor exercises and stress urinary incontinence. Key conclusions and implications for practice the number of women who indicated a desire for more information and the low number who reported practice of the exercises suggest that improvements could be made. The gaps in information provision and practice suggest areas for future health promotion about the exercises, particularly by midwives, as not all women are seen by a physiotherapist during pregnancy. Reported levels of incontinence during pregnancy confirm previous findings and highlight the prevalence of incontinence in pregnancy.