Lower Knowledge Scores Research Articles

LBPS 02-23 KNOWLEDGE, ATTITUDE AND PRACTICE ON DIABETIC FOOT CARE AMONG GENERAL PRACTITIONERS IN MALAYSIA

Objective: This study was done to assess the knowledge, attitude and practices of general practioners (GPs) in managing diabetic foot and to identify factors associated with the knowledge, attitude and practice (KAP). Design and Method: This was a cross sectional study of GPs working in Johor Bahru and Kota Tinggi in Johor and Kuantan in Pahang. Using convenience sampling, 462 GPs were selected and requested to answer a set of questions. The questionnaire which was developed based on the National CPG 2004 underwent content validity and reliability analysis. It contains the demographic profiles and information on the respondents’ clinical experience, 15 items on knowledge, 14 items on attitude (4 items on physical barrier, 3 items on support barrier and 7 items on psychological readiness) and 10 items on practice Higher scores for each subscale indicate higher knowledge, barrier, readiness and practice respectively. Results: There were 286 GPs participated in the study. There was low knowledge score and the mean total score was 11.7Y[REPLACEMENT CHARACTER]Y1.8 out of 15. General practitioners with age less than 55 years old (ρY=Y0.05) and had seen diabetic patient less than 100 patients per months (ρY=Y0.36) were psychological ready to manage diabetic foot ulcer. However, they had barrier in physical (ρY=Y0.05) and supports (ρY=Y0.007) in managing diabetic foot ulcer. The practice of general practitioners in managing diabetic foot ulcer were not satisfactory and not optimal (ρY=Y0.04). Conclusions: Overall, there was low level of knowledge and proper diabetic foot management among the selected GPs. Although they were psychologically ready to manage the diabetic foot, the physical barriers such limited time and trained nurses and absence of supportive environment may hinder them to provide the best service to diabetic patients. Therefore, it is recommended for the GPs to have continuous medical education and audits at intervals in order to improve the health outcomes of diabetic patients.

Factors associated with lipid goal attainment among acute coronary syndrome patients.

BackgroundThe incidence of acute coronary syndrome (ACS), one of the most common cardiovascular diseases, is high. Lipid goal attainment is one of the important factors to reduce the risk of recurrent heart attack. Identification of factors influencing lipid goal attainment such as age, female, race, underlying comorbidities, intensity of lipid-lowering therapy, patients’ knowledge, and patients’ belief about medicine would be beneficial in achieving the lipid goal. This study is aimed to determine lipid profile attainment and prescribing pattern of lipid-lowering therapy as well as to identify factors influencing lipid profile attainment among ACS patients.Patients and methodsThis researcher-assisted cross-sectional survey was carried out at a cardiology clinic in a tertiary hospital from March to May 2015.ResultsA total of 101 ACS patients were involved in this study. The mean values for low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol levels were 2.75 (0.82) mmol/L and 1.14 (0.27) mmol/L, respectively, while the median value for triglyceride level was 2.75 (0.82) mmol/L. Only 15.8% of our participants achieved the targeted LDL-C. Simvastatin 20 mg was the most common regimen prescribed. Predictors for better LDL-C attainment were younger age (β=−0.228; P=0.032) and higher knowledge score (β=−0.255; P=0.049), while predictors for high-density lipoprotein cholesterol attainment were male (β=0.268; P=0.006), smoking (β=−0.192; P=0.045), and higher knowledge score (β=−0.195; P=0.039). Smoking (β=−0.361; P<0.0001) was the only predictor for higher triglyceride level.ConclusionYounger age, female, lower knowledge score, and smoking status are good predictors for lipid attainment among ACS patients.

Evaluation of overdose prevention trainings in New York City: Knowledge and self-efficacy among participants 12 months after training

ABSTRACTBackground: Prevention of unintentional opioid overdose deaths is effective through overdose prevention trainings (OPTs), in which laypersons are taught overdose response through six actions. This longitudinal study examines trainee knowledge 12 months after OPT completion. Methods: Participants were enrolled following OPT at six sites. At the 12-month follow-up, participants were asked to name the drug overdoses that naloxone reverses and name overdose response actions. A 6-point scale was created and was comprised of the number of correct overdose response actions mentioned (check breathing; administer sternum rub; call 911; give rescue breathing; administer naloxone; put victim in recovery position). Mean knowledge was compared by participant sociodemographic characteristics, confidence, and site of OPT training (indoors versus outdoors). Results: Of 344 OPT participants, 273 were reached at 12 months. Nearly all (99%) participants identified that naloxone reverses heroin overdoes; 77% identified that naloxone reverses opioid analgesics overdoses; and 68% identified that naloxone reverses methadone overdoses. Overdose response actions most frequently mentioned were giving naloxone (86%) and calling 911 (76%). The remaining four actions were mentioned by less than 40% of participants. Overall mean knowledge score was 2.7 out of 6. Mean knowledge scores were higher for college graduates than those with less than college education (3.2 vs 2.6, P < 0.001), for those who felt very confident (mean score [ms] = 2.9), compared to somewhat confident (ms = 2.4) and a little or not at all confident (ms = 1.5) in their ability to reverse an overdose (P < .001), and for indoor-training recipients (3.0 vs 2.5, P = 0.02). There were no differences in mean knowledge scores for trainees by age, race, or gender. Conclusions: These findings suggest the need for several improvements in OPT curriculum, including emphasis on naloxone reversal of opioid analgesic and methadone overdoses, and all 6 rescue actions. Lower knowledge scores among outdoor-trained participants likely reflect session brevity, suggesting that outdoor trainings need to be enhanced.

Agricultural Knowledge and Perceptions Among Students Enrolled in Agriscience Programs in Texas Counties Bordering Mexico

Hispanics are rapidly becoming the predominant ethnic group in Texas. While many secondary agriculture programs have seen increased participation by Hispanic students, in comparison to the demographics of Texas secondary school enrollment, Hispanics are underrepresented in agricultural education. As a result, agricultural education programs should continue to become more diverse and provide curriculum engaging to a wide variety of students. The purpose of this descriptive, correlational study was to determine the agricultural literacy rates and perceptions of agriculture among Hispanic and non-Hispanic high school agriculture students enrolled in agriculture programs in Texas counties bordering Mexico. Results showed both groups have agricultural literacy rates congruent with previous studies; however, Hispanic students tended to have lower knowledge scores in all areas except agricultural career knowledge, as well as lower perceptions of agriculture. Agricultural career knowledge scores were the lowest area for all respondents. Recommendations include: 1) more research should be conducted to better determine levels of agricultural literacy in minority agricultural education students in Texas and other areas, and 2) more emphasis on agricultural career knowledge should be incorporated into agriscience courses to better inform students about postsecondary education and career options within the agricultural industry.

Diabetes knowledge in nursing homes and home-based care services: a validation study of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel.

BackgroundProviding high-quality diabetes care in nursing homes and home-based care facilities requires suitable instruments to evaluate the level of diabetes knowledge among the health-care providers. Thus, the aim of this study was to examine the psychometric properties of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel.MethodsThe study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and one home-based care facility in Norway. We examined the reliability and content and construct validity of the Michigan Diabetes Knowledge Test.ResultsThe items in both the general diabetes subscale and the insulin-use subscale were considered relevant and appropriate. The instrument showed satisfactory properties for distinguishing between groups. Item response theory-based measurements and item information curves indicate maximum information at average or lower knowledge scores. Internal consistency and the item-total correlations were quite weak, indicating that the Michigan Diabetes Knowledge Test measures a set of items related to various relevant knowledge topics but not necessarily related to each other.ConclusionsThe Michigan Diabetes Knowledge Test measures a broad range of topics relevant to diabetes care. It is an appropriate instrument for identifying individual and distinct needs for diabetes education among nursing personnel. The knowledge gaps identified by the Michigan Diabetes Knowledge Test could also provide useful input for the content of educational activities. However, some revision of the test should be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-016-0159-1) contains supplementary material, which is available to authorized users.

Survey of hepatitis B knowledge and stigma among chronically infected patients and uninfected persons in Beijing, China.

Hepatitis B virus (HBV) infection carries substantial stigma in China. We surveyed HBV knowledge and stigma among chronic hepatitis B (CHB) patients and persons without HBV infection in Beijing, China. Four hundred and thirty five CHB patients and 801 controls at Peking University People's Hospital were surveyed. Chronic hepatitis B patients were older (mean 46 vs. 39 years) and more often men (71 vs. 48%) than controls. Mean knowledge score was 11.9/15 for CHB and 9.3/15 for control patients (P < 0.001). Average stigma score was 22.1/39 for CHB and 19.2/30 for control patients. Controls expressed discomfort with close contact (45%) or sharing meals with CHB patients (39%) and believed CHB patients should not be allowed to work in restaurants (58%) or childcare (44%). Chronic hepatitis B patients felt that they were undesirable as spouses (33 vs. 17%) and brought trouble to their families (58 vs. 34%) more often than controls. Despite legal prohibitions, 40% of CHB patients were required to undergo pre-employment HBV testing, and 29% of these individuals thought that they lost job opportunities because of their disease status. 16% of CHB patients regretted disclosing their HBV status and disclosure was inversely associated with stigma. Higher stigma was associated with older age, lower education and lower knowledge score among controls; and with lower education, younger age, having undergone pre-employment HBV testing and regret disclosing their HBV status among CHB patients. Despite high prevalence of CHB in China, our study shows knowledge is limited and there is significant societal and internalized stigma associated with HBV infection.

Disease-related knowledge and smoking behavior of patients with Crohn's disease

BackgroundPatients’ knowledge poses effects on quality of life, treatment adherence and coping skills in the management of Crohn's disease. Smoking is the most established risk factor and associated with a more severe course. AimsWe aimed to investigate the status of patients’ knowledge on Crohn's disease in China, and explore the relationship between patients’ knowledge and smoking behavior. MethodsWeb-based questionnaires were created including a validated Crohn's and Colitis Knowledge Score applied to all participants and the Fagerström Test for Nicotine Dependence to smokers. The sociodemographic data, disease characteristics and smoking status were recorded. Patients were enrolled through invitation emails and Internet advertising. Current and ex-smokers were re-visited 6 months after enrollment. Results923 patients completed valid questionnaires with the knowledge score of 12.18±4.61. Disease duration and educational status were independent predictors of the knowledge score by multiple linear regression analysis. The smoking rate was 8.2%. Low knowledge score was related with smoking behavior but not nicotine dependence, and smoking relapse during 6 months after enrollment. ConclusionsPatients’ education should be a priority considering its impacts on many factors including smoking. Extra attention should be given to those from countryside area or having low family income and educational achievement.

Improving Decisional Quality on Labor and Delivery

INTRODUCTION: We aim to describe decisional quality (defined by decision-specific knowledge, decisional conflict and patient satisfaction) for women whose gestational age indicated that they should have been counseled regarding birthing options. We also aim to understand how confident patients are regarding their birthing choice and predictors of decisional conflict. METHODS: A convenience sample of antepartum patients receiving care at University based clinics was selected. Patients were P0, 35 weeks or greater gestation, and without medical indication for cesarean delivery. Knowledge was measured using a new instrument developed by a multi-stakeholder panel. The SURE scale was used to measure decisional conflict. Satisfaction with care, shared decision-making, and sources of information regarding treatment decision-making was also measured. RESULTS: 91% of respondents (N=81) planned on a vaginal delivery, 7% reported they were undecided and a single respondent reported they planned to have a cesarean delivery. Overall knowledge score was 52%. Knowledge scores individually and overall did not correlate with decisional conflict, however those with lower knowledge scores were less sure that they would stay with their decision (OR 5.6). Most patients report “friends and family” as their most influential source (63%), however this was also associated with higher decisional conflict (P=.035). Patients whose providers had asked them about delivery preferences had lower decisional conflict (P=.01). CONCLUSION: This initiative provided a comprehensive assessment of knowledge areas that were deemed important for a woman in making the choice between cesarean and vaginal delivery as well as factors predictive of choice certainty. Future work to improve decisional quality is warranted.

Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care.

Objective:The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD.Methods:A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening.Results:89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients.Conclusion:Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders.

PENGETAHUAN DAN PERSEPSI MAHASISWA TENTANG KESEHATAN REPRODUKSI DAN PERMASALAHANNYA

The aims of this research are to describe the knowledge level and perception accuracy toward reproductive health among students from Yogyakarta State University (YSU). This research was an analytical survey, with crosssectional approach. Population were YSU students while respondents were taken by simple random sampling. The instruments were adapted from Pertiwi (2007) which consist of questionnaires on knowledge about reproductive health and perception towards myths around sexual health problems. Data were analysed descriptively to determine the factors involved. There were 177 males and 174 female with an average age 20 years old. The highest and the lowest knowledge score were FMIPA and FBS respectively whereas the highest and the lowest perception score were FMIPA and FIK resepctively. Factors involved in knowledge were faculty origin, sex and socioeconomic status

Influence of the Expert Effect on Cultural Models

ABSTRACTWe examined hunters’ perceptions of fauna to see if expert hunters and other hunters perceive wildlife abundance similarly. We used cultural consensus analysis (CCA) to assess the knowledge of 25 hunters in the Bolivian Amazon about the abundance of 38 animals. CCA indicated highly shared beliefs among hunters concerning wildlife abundance (average agreement = .62). However, expert hunters (as judged by their reported successful hunts of rare species, having hunted recently, and consuming more game in their diet) perceived more animals as abundant than did non-experts, although they all shared the same model. Since the expert hunters did not always agree on which species was more abundant, they had low cultural knowledge scores in CCA results. These experts may be unwilling to curtail hunting efforts on key species that they perceive to be abundant.

Knowledge and Perceptions about Colorectal Cancer in Jordan.

Colorectal cancer (CRC) is the third most common cancer globally. In Jordan, it is the number one cancer among men and the second most common cancer among women, accounting for 15% and 9.4% respectively of all male and female diagnosed cancers. This study aimed to evaluate the knowledge and perceptions about colorectal cancer risk factors, signs and symptoms in Jordan and to provide useful data about the best modes of disseminating preventive messages about the disease. A stratified clustered random sampling technique was used to recruit 300 males and 300 females aged 30 to 65 years without a previous history of CRC from four governorates in Jordan. A semi-structured questionnaire and face to face interviews were employed. Descriptive and multivariate analysis was applied to assess knowledge and perceptions about CRC. Both males and females perceived their CRC risk to be low. They had low knowledge scores about CRC with no significant gender association (P= 0.47). From a maximum knowledge score of 18 points, the median scores of males and females were 4 points (SD = 2.346, range 0-13) and 4 points (SD= 2.329, range 0-11) respectively. Better knowledge scores were associated with governorate, higher educational level, older age, higher income, having a chronic disease, having a family history of CRC, previously knowing someone who had CRC and their doctor's knowledge about their family history of CRC. There is a low level of knowledge about CRC and underestimation of risk among the study participants. This underlines the need for public health interventions to create awareness about the illness. It also calls for further research to assess the knowledge and perceptions about CRC early detection examinations in Jordan.

Knowledge, attitude and practices regarding tuberculosis among new pulmonary tuberculosis patients in a new urban township in India

Background: A high level of awareness of tuberculosis (TB) is very important for its prevention and control in the community. Objective: To study the knowledge, attitude, and practices regarding TB and the effect of sociodemographic characteristics. Materials and Methods: A cross-sectional study was conducted of all patients with new smear-positive pulmonary TB diagnosed between January 2012 and June 2013 at RNTCP clinic. The information was collected with reference to knowledge, attitude, and practices regarding TB (its signs and symptoms, mode of spread, cause, investigations, treatment, and prevention). Bivariate and logistics regression were applied to study the effect of sociodemographic characteristics on knowledge, attitudes, and practices regarding TB. Result: A total of 122 patients with a mean age of 29.9 years were included in the study. Persistence cough (48.4%) was the most common symptom known, 87% were aware that TB could spread to others with 56.6% being aware of airborne transmission. Misconceptions such as casual contact as a route of spread were observed. Females and those without secondary education were less aware of various aspects of TB. Of all, 32% stated government health facility as a place of choice for treatment of TB. A low knowledge score was significantly associated with young age group (P = 0.037), less education (P < 0.001), and low income (P = 0.027). A low attitude and practice score was significantly associated with less education (P = 0.002), low income (P = 0.008), and nuclear family (P = 0.008). Conclusion: The study participants had good knowledge of TB but there were several misconceptions regarding the cause of TB that need to be clarified. Community-based programs on TB awareness need to be increased among young people and less educated groups.

Effect of training on knowledge and practice of universal precautions among primary health care workers in Kaduna State, Nigeria

Background: The important role played by Primary Health Care Workers as health care providers make their safety an important health concern. Compliance with infection control guidelines and preventive measures such as Universal Precautions is critical to prevent the transmission of infectious pathogens, but such precautions are not widely used. Aim: The study assessed the effect of training on the knowledge and practice of universal precautions among Primary Health Care Workers in Kaduna State, Nigeria. Materials and Methods: A quasi-experimental study was carried out between September 2011 and May 2012 among 172 Primary Health Care Workers in two local government areas selected through a multi staged sampling technique. Preintervention data was collected from both study and control groups. Thereafter, a training intervention was carried out among the study group and after six months post-intervention data was collected in both groups. Data was analyzed using SPSS Statistics 17.0, and statistical significance was determined using t test, Chi-square test and Fishers test with P value set at < 0.05. Results: Baseline results showed low mean knowledge scores of 3.7±3.3 and 4.6±3.2 (maximum 10) and moderate mean self-reported practice scores of 33.1± 3.8 and 32.9 ± 3.7 (maximum 42) in study and control groups respectively. Observed hand washing practices were low (11.7% and 8.9%) in study and control groups. After the intervention, there were significant improvements in mean knowledge scores (p=0.0001) and mean self-reported practice scores (p=0.001) among respondents in the study group, but no improvement in scores of respondents in control group. Observed practices of Universal Precautions for both study and control groups did not change significantly after the intervention. Conclusion: The training significantly improved the knowledge and self- reported practice of Universal Precautions among Primary Health Care Workers in the study area. Keywords: Knowledge and Practice, Universal Precautions, Primary Health Care workers, Nigeria

Knowledge, attitude, and practices concerning presence of molds in foods among members of the general public in Malawi.

This study assessed knowledge, attitude, and practices (KAP) of the public in Malawi on issues related to molds in foodstuffs. A survey involving structured questionnaire was conducted with 805 respondents from seven districts of Malawi. Descriptive statistics, t tests, and analyses of variance were calculated. A majority of respondents recognized that molds were dangerous to human health (88%); however, about 50% of respondents were not informed that mold toxins are thermally stable and that they are not destroyable by normal cooking processes. About 33% of the respondents asserted that they buy moldy maize, while approximately 20% of respondents reported that they consume moldy fruits having discarded moldy fraction. There were significant differences in knowledge scores among different demographic groups. Females had significantly (p < 0.05) lower knowledge scores on issues related to molds in foods. Additionally, the respondent's location had a significant effect. However, respondent's education had subtle effect on knowledge score and the overall population's knowledge score was generally low (3.55 ± 1.32 score out of 9). Results of the study underline the need to raise public's knowledge about health risks associated with spoilage molds in food and prevention and management options.

The development of a questionnaire to evaluate rheumatoid arthritis patient's knowledge about methotrexate

Assess knowledge concerning methotrexate in rheumatoid arthritis patients by means of a questionnaire. Methotrexate is the standard drug for rheumatoid arthritis treatment. It has potentially serious side effects that can be largely prevented by making sure that patients are well informed and comply with prescription guidelines. Cross-sectional survey. A questionnaire on methotrexate (mode of action, administration, drug interactions), side effects, monitoring and lifestyle implications was offered to all the rheumatoid arthritis patients treated with the drug seen between March and September 2013 in a large hospital in France. One hundred and eighty-three patients (143 women), mean age 60 (13·5) years, with a median disease duration of 12 years [7-20] and treated with methotrexate for eight years [5-13] took part. Methotrexate was identified as a disease-modifying antirheumatic drug by 78% of the patients. The weekly administration method was well assimilated (97%); 67% indicated that the rationale for folic acid was to reduce treatment toxicity. Only 21% knew that trimethoprim was contraindicated. Half were aware of the haematologic risk and 36% were aware of the risk of hypersensitivity pneumonitis. There was knowledge concerning laboratory testing (80%), but 54% thought they were only being monitored for rheumatoid arthritis activity. Only 13% of the men, but 90% of the women, of childbearing age knew that contraception was essential, and 75% indicated that alcohol consumption should be limited. A low knowledge score correlated significantly with age and low educational level. It was independent of sex, duration of treatment for rheumatoid arthritis. Rheumatoid arthritis patient's knowledge concerning methotrexate is poor, particularly for the most serious side effects (haematologic and hypersensitivity pneumonitis), interactions with trimethoprim, and in men, the need for contraception. Patient knowledge concerning methotrexate should be regularly checked and supported using the different therapeutic education tools available, especially when patients are older people and have had limited schooling.

Disaster Management and General Dental Practitioners in India: An Overlooked Resource.

To assess General Dental Practitioners' (GDPs) in India willingness to participate in disaster management and their previous training pertaining to disaster management, and to assess GDP objective knowledge, attitude, and behavior regarding disaster management. This study was a cross-sectional survey conducted on all GDPs of Jodhpur, Rajasthan, India. Willingness to participate, perceived knowledge, perceived effectiveness, objective knowledge, attitude, and behavior regarding disaster management were assessed through questionnaire method. Information also was collected regarding age, gender, religion, and residence. A total of 142 out of 180 GDPs participated in the study, representing a response rate of 79%. A majority (85%) of respondents were willing to participate in disaster management. Mean score for knowledge was 12.21%, for attitude was 33.56%, for behavior was 14.50%, and for perceived effectiveness was 9.08%. Significant correlations were observed between qualification and perceived effectiveness (P=.003), and between attitude and years of practice (P=.04). Willingness to participate in disaster management and age showed significant association (P=.000). High willingness and attitude to participate in disaster management was observed among respondents. Low knowledge and behavior scores were observed among GDPs.

Perceptions of needs related to the practice of self-care for minor illness.

The aim of this study was to describe people's perceptions of needs to feel confident in self-care for minor illnesses as well as their perceptions about supporting and obstructing factors in the practice of self-care. Minor illness constitutes a large part of primary care, and patients' attendance to doctors' appointments for minor illness has been seen to increase future attendance for the same condition. Almost half of the consultations with telenurses result in the provision of self-care advice. A cross-sectional survey. Primary data were collected using a questionnaire, and the study participants (n=315) were randomly selected from the national Swedish address register. Having knowledge and receiving health care advice and reliable information were perceived to be needs in order for participants to feel confident in self-care. Having family or friends to consult with was perceived to be a positive factor influencing confidence in self-care, especially for persons under the age of 35. Health care services were perceived to support self-care practice by offering easy access to care, giving information about self-care, and offering increased follow-up after consultations. Lack of knowledge, along with difficulties being away from work, were obstructing factors in the practice of self-care. Young age was the factor influencing people's perceptions of needs and supporting factors the most. Young age and low knowledge scores about minor illnesses were the two factors that had the most influence on perceived obstructing factors. Nurses play a major role in the promotion of self-care and in the dissemination of self-care advice. If health care services fail to meet the needs of care-seekers with minor illnesses, patients might turn to out-of-hours clinics and emergency departments for help.

Barriers to Follow-Up and Strategies to Improve Adherence to Appointments for Care of Chronic Eye Diseases.

To understand factors associated with poor attendance of follow-up appointments for care of glaucoma (GL), AMD, and diabetic retinopathy (DR) in a tertiary referral center, and to identify strategies to improve adherence. Cross-sectional study of 240 adults attending follow-up appointments for GL, AMD, or DR. Cases (N = 102) were patients with poor follow-up who missed and failed to reschedule an appointment within 1 month of the recommended follow-up date during the preceding year. Controls (N = 138) were patients who completed the assigned follow-up. Data regarding the factors impacting adherence to appointments were collected via an orally administered questionnaire. Multivariate logistic regression was performed to determine factors associated with poor follow-up. In a multivariate logistic regression model, independent factors significantly associated with poor follow-up included incorrectly answering more than 50% of questions about eye disease (adjusted odds ratio [OR] = 3.24, P = 0.001), legal blindness (adjusted OR 2.64, P = 0.013), the presence of glaucomatous versus retinal disease (adjusted OR 2.06, P = 0.013), and difficulty for the study subject and/or escort taking time away from work for the appointments (adjusted OR 1.80, P = 0.049). Subjects identified the following strategies to improve follow-up: contact with others having the same eye condition (41.3%), greater education regarding eye disease (40.8%), and improved transportation services to the clinic (44.6%). Low disease knowledge scores, legal blindness, and difficulty getting time away from work for appointments adversely impacted follow-up independent of eye disease diagnosis. Improvements in patient education, transportation services, and clinic efficiency may increase adherence to recommended appointment intervals.

How knowledgeable are high school students about food safety? Results from a predominantly minority Chicago charter school

Purpose – High school students are at an age where food handling may occur for themselves and as entry level workers in food service. An estimated 21 percent of food and beverage service workers are aged 16-19 years. The purpose of this paper is to determine baseline food safety knowledge and associated factors among high school students. Design/methodology/approach – A convenience sample of 231 Chicago high school students was approached to participate in a 34-question survey to obtain information about their food safety knowledge, behaviors, and personal hygiene. Frequencies of correct answers to each knowledge question were examined to determine knowledge gaps. Bivariate analyses were performed to identify student variables associated with knowledge score and regression models were used to examine the associations between eligible factors and knowledge score. Findings – Among the 195 participating students, 70 percent described themselves as Hispanic/Latino and 15 percent as non-Hispanic Black. In all, 12 percent of the students had restaurant employment experience. The overall student mean knowledge score was 37 percent. Students demonstrated substantial knowledge gaps regarding the temperatures for cooking, mechanisms for thawing food, cross-contamination, and vulnerable populations for foodborne disease. In the final linear regression model, Hispanic ethnicity and experience cooking seafood were significantly associated with lower knowledge score and experience cooking meat and cooking alone were significantly associated with higher knowledge score (p &lt; 0.05). Research limitations/implications – Students demonstrated substantial knowledge gaps regarding the temperatures for cooking, mechanisms for thawing food, cross-contamination, and vulnerable populations for foodborne disease. In the final linear regression model, Hispanic ethnicity and experience cooking seafood were significantly associated with lower knowledge score and experience cooking meat and cooking alone were significantly associated with higher knowledge score (p &lt; 0.05). Originality/value – These data demonstrate substantial knowledge gaps in a predominantly minority high school student population. Given that high school students are a substantial proportion of the food service workforce, they are especially important to target for food safety education.