A Qualitative Study to Appraise Patients and Family Members Perceptions,Knowledge, and Attitudes towards Venous Thromboembolism Risk

Objective

This study aimed to examine perception, knowledge and concerns developed by patients and their family as regards venous thromboembolism (VTE) risk.

Methods

We conducted a qualitative study. Participants were: (1) patients with unprovoked VTE with either factor V Leiden mutation or G20210A prothrombin gene mutation or not; and (2) their first-degree relatives. Interviews took place mostly at Brest University Hospital. Participants produced narratives of the patient’s illness, stressing their perception of the disorder, its mechanisms, etiology, circumstances and risk factors. Interviews were audiotaped and transcribed verbatim. On an ongoing basis, central themes were identified and data from narratives were categorized by these themes.

Results

A total of ten patients and 25 first-degree relatives were interviewed. Analyses of patient’s narratives suggested 4 main themes: (1) concerns about initial symptoms and suspicion of VTE. The longer the duration of the initial phase, the more likely anxiety took place and persisted after diagnosis; (2) underestimation of potential life-threatening episode once being managed in emergency; (3) possible biographical disruption with inability to cope with the event; and (4) secondary prevention attitudes motivated by remains of the episode and favoring general prevention attitudes. Analyses of the first-degree relatives narratives suggested 3 main themes: (1) common interpretation of the VTE episode shared within the family; (2) diverse and sometimes confusing interpretation of the genetic status; and, (3) interpretation of clinical signs linked to VTE transmission within the family.

Conclusions

Construction of the risk of VTE is based on patient’s initial experience and shared within the family. Collection of narratives illustrates the gap between these perceptions and current medical knowledge. These results support the need to collect the perceptions of the VTE episode and its consequences, as a prerequisite to any health education process.     

Knowledge and Perceptions of,and Attitudes to,Bats by People Living around Arabuko-Sokoke Forest,Malindi-Kenya

Bat populations continue to decline worldwide because of myriad human activities. To enhance bat conservation, human behavior needs to change. Such change can occur, in part, through an understanding of what motivates human actions toward bats. We used a Bat Attitude Questionnaire (BAQ) to investigate attitudes toward bats in people (n = 394) living around Arabuko-Sokoke Forest (ASF), Kenya. Belief in myths seemed to prevail among those surveyed and that these myths were significantly associated with low tolerance of bats (ordinal regression, p < 0.05). Older and more educated people reported more positive attitudes toward bats than others. Multiple linear regression revealed that females showed more negative attitudes toward, and more belief in, myths about bats than males (both p < 0.01). Ordinal regression showed that hostile behavior toward bats was more common among males (p < 0.001). Nearly one-third of the respondents reported actively killing bats or destroying bat roosts. A similar proportion did not see any benefits of bats to humans, while the majority of respondents associated bats with the destruction of farmers’ fruits. To address prevailing negative attitudes about bats, we recommend conducting evening school-based bat study tours, specifically targeting youths in schools around the forest, to examine whether physical contacts with bats would help positively influence human attitudes toward bats. Additionally, since mango (Mangifera indica) farming is an important source of income to people around ASF, an assessment of the quantity of mangoes destroyed by bats would be important to determine whether there is a need for controlling bat access to crops through appropriate schemes.     

Advanced Cancer Patient Knowledge of and Attitudes towards Tumor Molecular Profiling

Limited research has indicated that despite their overwhelming interest in tumor molecular profiling (MP),¹ cancer patients have poor knowledge about MP. The current study aimed to investigate demographic and psychological predictors of knowledge and perceived importance of MP in an advanced cancer patient cohort. Eligible participants had advanced solid cancers of any histological type with sufficient accessible tissue for MP and were enrolled in the Molecular Screening and Therapeutics (MoST) Program. A questionnaire was completed by 1074 participants (91% response rate) after consent, prior to undergoing MP. Overall, participants had poor to moderate knowledge of MP, yet perceived MP to have high importance. Higher education, speaking English at home, and greater satisfaction with the decision to undergo MP were associated with higher knowledge scores. More negative attitudes towards uncertainty, greater self-efficacy to cope with results, and lower perceived likelihood of cancer progression were associated with greater perceived importance of MP. Less educated participants and those who do not speak English at home will need clear explanations, visual aids and ample opportunity to ask questions about MP at the time of their decision-making. Clinicians also need to consider psychological factors relevant to patients' decision to pursue MP. Given the increased awareness of and demand for cancer genomic information and the rapidly changing nature of the actionability of MP, these findings will help inform an important ongoing debate on how to facilitate ethical and informed consent and manage patient expectations about personalized treatments.     

Attitudes toward Placebo-Controlled Clinical Trials of Patients with Schizophrenia in Japan

Background

Although the use of placebo in clinical trials of schizophrenia patients is controversial because of medical and ethical concerns, placebo-controlled clinical trials are commonly used in the licensing of new drugs.

Aims

The objective of this study was to assess the attitudes toward placebo-controlled clinical trials among patients with schizophrenia in Japan.

Method

Using a cross-sectional design, we recruited patients (n = 251) aged 47.7±13.2 (mean±SD) with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were admitted to six psychiatric hospitals from December 2013 to March 2014. We employed a 14-item questionnaire specifically developed to survey patients'' attitudes toward placebo-controlled clinical trials.

Results

The results indicated that 33% of the patients would be willing to participate in a placebo-controlled clinical trial. Expectations for improvement of disease, a guarantee of hospital treatment continuation, and encouragement by family or friends were associated with the willingness to participate in such trials, whereas a belief of additional time required for medical examinations was associated with non-participation.

Conclusions

Fewer than half of the respondents stated that they would be willing to participate in placebo-controlled clinical trials. Therefore, interpreting the results from placebo-controlled clinical trials could be negatively affected by selection bias.     

Pesticide Risk Perceptions,Knowledge, and Attitudes of Operators,Workers, and Residents: A Review of the Literature

The literature on the risk perceptions, knowledge levels, and attitudes of operators, workers, and residents in relation to non-dietary exposure to agricultural pesticides is reviewed. No literature was identified in relation to bystander exposure. Research has primarily been conducted on participants in developing countries and migrant workers in the United States. For operators and workers, illiteracy, poverty, and a perception that exposure to pesticides is an inevitable part of their work results in limited adoption of safety precautions while using and storing pesticides. As a result, risk communication activities aimed at operator and workers need to take account of the wider socioeconomic and cultural conditions in which workers and operators are working and living. There is less research focused on residents’ and bystanders’ perceptions, attitudes, and behaviors. The lack of European data in general, and residents’ and bystanders’ data in particular, represents a knowledge gap that is pertinent to emerging EU legislation requiring residents’ and bystanders’ inclusion in pesticide risk assessment. This review provides a comprehensive overview that can assist policy-makers, and risk communicators in the development of targeted training and awareness-raising material for operators, workers, bystanders, and residents. Areas for future research are suggested.     

Knowledge and Perceptions about Clinical Trials and the Use of Biomedical Samples: Findings from a Qualitative Study in Rural Northern Ghana

IntroductionClinical trials conducted in sub-Saharan Africa have helped to address the prevalent health challenges. The knowledge about how communities perceive clinical trials is however only now evolving. This study was conducted among parents whose children participated in past clinical trials in northern Ghana to assess their knowledge and perceptions of clinical trials and the use of biomedical samples.MethodThis was a qualitative study based on eighty in-depth interviews with parents. The participants were randomly selected from among parents whose children were enrolled in a clinical trial conducted in the Kassena-Nankana districts between 2000 and 2003. The interviews were transcribed and coded into emergent themes using Nvivo 9 software. The thematic analysis framework was used to analyze the data.ResultsStudy participants reported that clinical trials were carried out to determine the efficacy of drugs and to make sure that these drugs were suitable for human beings to use. The conduct of clinical trials was perceived to have helped to reduce the occurrence of diseases such as malaria, cerebrospinal meningitis and diarrhea. Quality of care was reported to be better in clinical trials than in the routine care. Parents indicated that participation in clinical trials positively influenced their health-seeking behavior. Apprehensions about blood draw and the use to which samples were put were expressed, with suspicion by a few participants that researchers sold blood samples. The issue of blood draw was most contentious.ConclusionParents perception about the conduct of clinical trials in the study districts is generally positive. However, misconceptions made about the use of blood samples in this study must be taken seriously and strategies found to improve transparency and greater community acceptability.     

Evidence-Based Curricular Content Improves Student Knowledge and Changes Attitudes towards Transgender Medicine

Objective: Previous studies have demonstrated that the addition of transgender medicine content to a medical school curriculum increased students' comfort and willingness to treat transgender patients. We aimed to demonstrate that (1) evidence-based curricular content would improve knowledge of and change attitudes towards transgender medicine, and (2) students would consider cross-sex hormone therapy a legitimate treatment option for transgender patients.Methods: Curricular content with a focus on the biologic evidence for the durability of gender identity was added to the first-year medical program at Boston University School of Medicine. Immediately before and after exposure to the content, students were presented with an assessment of their knowledge of the etiology of gender identity.Results: Immediately following exposure to the content, a significant number of students changed their answer regarding the etiology of gender identity so that the number of correct responses increased from 63% (n = 56) to 93% (n = 121) (P<.001). For transgender treatment, the number of correct responses increased from 20% (n = 56) before exposure to the content to 50% (n = 121) following exposure (P<.001).Conclusion: The addition of transgender medicine content to a medical school curriculum with a focus on the biologic evidence for a durable gender identity is an effective means of educating students about the etiology of gender identity and the appropriateness of cross-sex hormone therapy as a treatment for transgender patients.     

Knowledge,Attitudes and Perceptions Regarding Endemic Vivax Malaria in Inhabitants and Patients in Two Cities of Northern Gyeonggi-do,Korea, 2020

An understanding of the knowledges, attitudes and perceptions of different populations is key for public health policy makers. Here, a survey was performed on knowledge, attitudes, and perceptions about malaria diagnosis, prevention, control, and treatment. The 407 survey participants included both uninfected inhabitants and patients from 2 cities (Gimpo- and Paju-si) of Northern Gyeonggi-do, known as high-risk areas for vivax malaria. We used community-based study design and non-probability sampling method using the primary data. Association between variables were tested using χ²-tests. In general, the information on malaria reported by the participants in this study was unsystematic and included inaccurate details. The knowledge of malaria symptoms, identified as headache, chills and fever, was high, but the surveyed community lacks knowledge of the specific medications used for malaria treatment, with a large number of respondents having no knowledge of any form of medication. Survey questions with high correct answer rates included questions about easy treatment of malaria in Korea, the high daytime activity of malaria-borne mosquitoes, and the infection risk posed by outdoor activities. However, a large portion of the respondents was unable to provide simple medical and biological information about the disease. This study aimed to comprehensively evaluate the knowledge, attitude, and practical behavior of the surveyed community with respect to malaria and the implications reported here could be applicable to other malaria endemic areas in Korea.     

Attitudes,Perceptions, and Practices Among Endocrinologists Managing Obesity

ObjectiveObesity has been globally recognized as a critically important disease by professional medical organizations, in addition to the World Health Organization and American Medical Association, but health care systems, medical teams, and the public have been slow to embrace this concept.MethodsThe American Association of Clinical Endocrinology staff drafted a survey, and 2 endocrinologists independently reviewed the survey’s questions and modified the survey instrument. The survey included questions related to practice and patient demographics, awareness about obesity, treatment of obesity, barriers to improving obesity outcomes, digital health, cognitive behavioral therapy, lifestyle medicine, antiobesity medications, weight stigma, and social determinants of health. The survey was emailed to 493 endocrinologists, with 305 (62%) completing the study.ResultsOf the responders, 98% agreed that obesity is a disease, whereas 2% neither agreed nor disagreed. Of the respondents, 53% were familiar with the term “adiposity-based chronic disease” and 13% were certified by the American Board of Obesity Medicine. Of the respondents, 57% used published obesity guidelines as a resource for treating patients with obesity. Most endocrinologists recommended dietary and lifestyle changes, but fewer prescribed an antiobesity medication or recommended bariatric surgery. American Board of Obesity Medicine-certified endocrinologists were more likely to use a multidisciplinary approach.ConclusionSelf-reported knowledge and practices in the management of obesity highlight the importance of a multimodal approach to obesity and foster collaboration among health care professionals. It is necessary to raise awareness about obesity among clinicians, identify knowledge gaps, and create educational tools to address those gaps.     

Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities

BackgroundPharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country.AimTo explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt.MethodologyPerspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software.FindingsThe majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients’ health.ConclusionsPharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians.     

PARTAKE Survey of Public Knowledge and Perceptions of Clinical Research in India

Background

A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE – Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program.

Objective

To study public knowledge and perceptions of clinical research.

Methods

A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India.

Results

Interviewees were 18–84 old (mean: 39.6, SD±16.6), 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware): ‘research benefits society’ (94.1%/3.5%/2.3%), ‘the government protects against unethical clinical research’ (56.7%/26.3%/16.9%), ‘research hospitals provide better care’ (67.2%/8.7%/23.9%), ‘confidentiality is adequately protected’ (54.1%/12.3%/33.5%), ‘participation in research is voluntary’ (85.3%/5.8%/8.7%); ‘participants treated like ‘guinea pigs’’ (20.7%/53.2%/26.0%), and ‘compensation for participation is adequate’ (24.7%/12.9%/62.3%).

Conclusions

Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation), and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants) and exhibits some distrust in the conduct and reporting of clinical trials. Larger, cross-cultural surveys are required to inform educational programs addressing these issues.     

Public Knowledge of,and Attitudes to,Frogs in Colombia

ABSTRACT

People's response to the decline of biodiversity and their support for conservation measures depends on their knowledge of biodiversity and their attitudes to local species. This study is one of the first to investigate public knowledge of, and attitudes to, frogs in South America. We chose two study regions, the semi-urban region of Pensilvania and the rural region of Florencia. In spring 2011, 565 individuals completed a written questionnaire and a subsequent picture test. Overall, the public's attitudes to, and knowledge of frogs, were rather poor. Direct experiences and community elders were the major source of knowledge of frogs for participants in Florencia, whereas electronic media was the main source of knowledge in Pensilvania. Most participants felt that frogs are of high conservation value and important for medical and ecological purposes. The more strongly participants agreed that frogs are useful, of medicinal value, and beautiful, the more strongly they agreed that they should be conserved. Our results indicate that conservation education activities in schools and elsewhere are needed to improve people's knowledge of, and attitudes to, frogs. More positive attitudes toward local amphibian species might lead to an appreciation of their value and willingness to conserve them.     

Slovakian Pupils' Knowledge of,and Attitudes toward,Birds

ABSTRACT

As the world's biodiversity is being destroyed, costs for nature protection activities increase. One proposed way to increase people's pro-environmental attitudes is to increase their knowledge base. It has been suggested that knowledge and attitudes are related, but no consensus in this field yet exists. Thus, the investigation of the relationship between attitudes and knowledge has valuable implications for nature protection programs. In this paper, we investigated relationships between Slovakian grammar school pupils' attitudes to, and knowledge of, birds (n = 402 participants aged 10–19 years). We found that factual knowledge about birds was positively related to pupils' attitudes toward birds. Interestingly, younger pupils had better knowledge of birds than older pupils. Regarding attitudes, higher scores were registered for the Concern for Birds and Avoidance of Birds dimensions than the Interest in Birds dimension. Females showed more positive attitudes in the Avoidance of Birds dimension compared with males, and bird owners scored higher in the Interest in Birds dimension and lower in the Concern for Birds dimension compared with non-bird owners. Implications for nature protection programs are discussed.     

Student Perceptions of,and Attitudes toward,Bats in Barak Valley,Assam, India

Bats are commonly found all over the world and provide significant ecosystem services. These animals are facing serious threats due to various anthropogenic activities, including hunting. Additionally, bats are often not particularly well liked due to their non-aesthetic characteristics. A positive attitude to these animals is essential to protect them through appropriate conservation measures involving public intervention. Current high school students are the conservationists of the future, and the extent of support for bat conservation received from this and future generations is dependent upon their attitude toward these animals. It is therefore important to assess their perceptions of bats so that appropriate awareness programs can be devised, and negative attitudes (if any) rectified. The present study aimed to understand this aspect in order to provide inputs for shaping positive attitudes toward bat conservation. The study was undertaken in Barak Valley, Assam, India, where 65 bat colonies had already been recorded. A total of 3,059 high school students from 36 schools situated in their vicinity were questioned using a close-ended questionnaire to determine their perceptions. The responses received were divided among three categories: familiarity with bats, opinion on bats, and attitudes toward conservation, and were ranked on a scale of 10, based on selected aspects. Most students were awarded a score of four, indicating an average knowledge and opinion of bats. These findings suggest that awareness programs are urgently needed in schools to improve the general knowledge of and attitudes toward bats, and to inspire the next generation of bat conservationists.     

Animal Welfare Knowledge,Attitudes, and Practices of Stockpersons in Kenya

The stockpersons handling the transportation of animals between farms and slaughterhouses are rarely assessed for their animal welfare knowledge, attitudes, and practices (KAP). Thus, this investigation presents a unique opportunity to study these interactions. Herein, a cross-sectional survey was carried out among 266 stockpersons in 10 Kenyan livestock markets to determine their animal welfare KAP. The survey questionnaire was based on Kenya’s Regulations for Animal Transport (Act No: CAP. 360-L.N. 119/1984). Mean percentage scores for knowledge, attitudes, and practices were 78.0 ± 14.1, 75.6 ± 16.0, and 64.5 ± 17.6, respectively. From the responses to statements related to animal husbandry, practices of the housing of unfamiliar groups of animals, cooperation with other stakeholders, and stress caused to animals during handling, it was found that stockpersons’ animal welfare KAP was inadequate. Women aged > 50 years or having more than 10 years of experience had significantly higher levels of animal welfare KAP (p < 0.05). In conclusion, although Kenyan stockpersons may score adequately on the parameters of animal welfare knowledge and attitudes, their followed practices are poor, which may possibly be influenced by gender, age, or level of experience.     

Body Size Perceptions and Eating Attitudes in Elderly Men

The majority of studies on eating attitudes, dieting and body size perceptions have focused on young adults and women. This study examined these attitudes in 334 black and white men, ages 55 to 98 years, who were members of the Charleston Heart Study cohort. Associations of the eating attitude variable with race, education and weight status were examined. Eighty-two percent of the overweight white men studied had dieted to lose weight, whereas only 49% of slimmer white men had dieted. In contrast, overweight black men did not diet more than slimmer black men. Overall black men dieted less than white men (37% reported dieting). Black men who were high school graduates were 1.3 times more likely to have dieted than were less educated black men. Overweight white men were over twice as likely as slimmer white men to feel guilty after overeating. This difference was not found in overweight versus slimmer black men. Education was not associated with measured body mass index (BMI) or perceived or ideal body size. However, there were some racial differences in these variables. White men preferred to be slightly thinner than black men (ideal BMI 25.6 vs. 26.1 kg/m²), and the difference between actual and desired BMI was 0.6 kg/m² greater in white than in black men. These results indicate that effects of race and weight status on eating restraint and body size perceptions seen in younger subjects and in women are also present, at least to some degree, in elderly men.     

Behaviors and Attitudes towards Semi-Owned Cats

ABSTRACT

The intentional provision of food, medical treatment and shelter by humans for a cat that is not considered to be owned by the individual is defined as “semi-ownership.” The aim of this study was to explore the prevalence of such behaviors and the attitudes held by individuals who engage in them. The sample, comprising 424 residents from rural and non-rural Victoria, Australia, were surveyed in relation to their ownership status, practices, and attitudes towards companion animals. The findings revealed that 22% of the sample engaged in one or more cat semi-ownership behaviors; primarily feeding. Cat semi-ownership was associated with positive feelings towards cats, and the belief that cats are independent. Opportunities to engage cat semi-owners in education programs that promote responsible companion animal ownership behaviors were evident.     

Attitudes towards Muslims and fear of terrorism

This article looks at explanatory approaches of fear of terrorism. Until now, empirical studies looking at determinants of fear of terrorism have used the theoretical framework from the field of research regarding fear of crime. We argue that the cognitive link between terrorism and Islam is currently so strong that explanatory models should include measures of attitudes towards Muslims. On an argumentative level, the fear of crime theoretical framework is unconvincing. Our empirical analysis using structural equation modelling shows that fear of terrorism shares almost no determinants with the fear of violent crime. Negative attitudes towards Muslims are the strongest determinant of fear of terrorism and totally mediate all other effects. Discussions about tackling the issue of fear of terrorism should consider these findings as solutions may otherwise be inappropriate, at best. At worst, solutions based on an improper understanding of the determinants of fear of terrorism may serve only to exacerbate the problem.