Browsing by Subject "Attitude"
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Item Open Access Barriers of Implementing Guideline Recommendations of Cardiovascular Risk Management of Hypertension Among Dutch Health Professionals(2018) Jiang, MengsiBackground: Hypertension presents a public health challenge globally, both in developing and developed countries such as the Netherlands. Complications of hypertension accounted for a total number of 10.46 million deaths every year in the world, and disability-adjusted life years associated with high blood pressure is 143.0 million in 2015. Among Dutch people aged between 30 and 70, 31.4% suffer from hypertension. Dutch guideline recommendations for treating patients with SBP between 160 and 180 mmHg is unique: low-risk patients are recommended without BP lowering medication, and middle-risk patients should be treated only in the presence of other risk-increasing factors. For these two groups of patients, guidelines from other countries, like United Kingdom and the United States, suggests “lifestyle advice with prompt drug initiation”. This study explores attitudes of health professionals, the target users of the unique Dutch guideline, towards the risk table and two guideline recommendations of commencing antihypertensive drug treatment for low- and middle-risk patients. In addition to health professionals’ attitude, this study also explores their perceived application barriers of the risk table. The risk table and two recommendations are only a small part of the CVRM guideline. This study focused on the risk table and the two recommendations because these are the guidance for treating hypertension patients.
Methods: A cross-sectional, mixed-method study was conducted in the Netherlands, mainly in Amsterdam. A total of 77 online questionnaires in English were conducted among health professionals in the Netherlands, while 13 face-to-face in-depth interviews in English were conducted among participants in Amsterdam. All participants completed the online questionnaire that assessed their knowledge, attitude, and practice of the Dutch General Practitioner’s Society (Nederlands Huisartsen Genootschap NHG) CVRM guideline and the risk table, as well as their attitude towards the two recommendations of antihypertensive drug prescription for low- and middle-risk patients. The in-depth interview aimed to further explore barriers of applying the risk table and the reasons for their attitude towards the two recommendations.
Results: Majority of our survey respondents have positive attitudes towards the NHG CVRM guideline in general and the risk table. Knowledge and attitude are not barriers of applying NHG CVRM guideline. All the respondents reported that they knew the existence of the guideline, and almost all of them (97%) agreed that they knew the guideline content. 92% respondents think that NHG CVRM guidelines are valuable, and 92% report that they believe NHG guidelines are well-supported by scientific evidence. Despite that only 3.9% participants reported they did not apply the risk table to every patient, health professionals perceived lacking important risk factors as an important barrier of applying the risk table.
Regarding attitudes towards pharmacological treatment for low- and middle-risk patents, 66% agreed that middle-risk patients required drug treatment only in the event of risk-increasing factors and SBP > 140mmHg and/or LDL> 2.5 mmol/L, 58% agreed low-risk patients rarely required drug treatment. The most reported reasons to follow the unique recommendations include: follow the guideline, clinical uncertainty of the persistency of the elevated BP, perceived patient attitude and drug adherence, and drug burden. Confusion of guideline interpretation for treatment advice on low-risk patient with SBP over 180 mmHg is detected in this study.
A significant relationship existed between attitudes towards lowering current treatment threshold and sex (p=.011). Female health professionals were more likely to agree with lowering treatment threshold compared to male.
Conclusions: Knowledge is not a barrier of applying NHG CVRM guideline, and attitudes towards the guideline are found to be generally positive. The highest perceived barriers to applying the risk table is lack of important risk factors, for example SES, ethnicity, psychological factors, physical exercise, BMI, family history of CVD, and chronic conditions like chronic kidney diseases and autoimmune disease. Most participants agree that low-risk patients rarely require drug treatment, and middle-risk patients require drug treatment only in the event of risk-increasing factors and SBP> 140mmHg and/or LDL> 2.5 mmol/L. The most reported reasons to follow the unique recommendations include: follow the guideline, clinical uncertainty of the persistency of the elevated BP, perceived patient attitude and drug adherence, and drug burden. Confusion of guideline interpretation for treatment advice on low-risk patient with SBP over 180 mmHg is detected in this study.
Item Open Access Conservatives, liberals, and "the negative".(Behav Brain Sci, 2014-06) Charney, EvanThe authors connect conservatism with aversion to negativity via the tendentious use of the language of threats to characterize conservatism, but not liberalism. Their reliance upon an objective conception of the negative ignores the fact that much of the disagreement between liberals and conservatives is over whether or not one and the same state of affairs is negative or positive.Item Open Access Evaluating Current Attitudes towards Snakes in the Nicholas School of the Environment’s (NSOE) Environmental Master's Student Community(2017-04-28) Calderon-Arrieta, DiegoSnake populations have been found to be on the decline both globally and in the United States. As these populations have continued to decline, particularly in the American Midwest, cropland and agricultural plots have begun to develop, which have become an inviting place for agricultural pests like insects and rodents. Rodents have been deemed one of the largest threats to global and national food security, and snakes can serve as a great natural pest control mechanism. However, people’s diverse attitudes and exaggerated concerns can be a great barrier to the acceptance of snakes protecting the welfare of humankind. Previous literature has documented factors shaping attitudes towards snakes among laypeople and undergraduate students. My research project will instead evaluate current attitudes towards snakes among the Nicholas School of the Environment (NSOE) master’s student community and explore methods that can be implemented to ameliorate anxieties about snakes. This is a community worth exploring, because these are future policymakers and conservation planners whose decisions will likely broadly impact populations of snakes, and it is important that they keep their attitudes towards snakes separate from what management recommendations they give about them. Using an online survey and ordered logistic regression models, I demonstrated that – compared to natural science-focused students – students not pursuing a natural-science focused concentration are less likely to indicate higher levels of positive attitudes towards snakes. The survey also indicates that there is high demand for seminars like learning how to handle snakes safely or general knowledge about them. Future researchers will have to measure these methods’ respective efficacies in reducing negative views towards snakes in this particular population. For the benefit of humankind and snakes alike, NSOE students should develop more conservation-driven views of snakes to protect snakes from unnecessary persecution and humans from snake-induced stress.Item Open Access Feeling superior is a bipartisan issue: extremity (not direction) of political views predicts perceived belief superiority.(Psychological science, 2013-12) Toner, Kaitlin; Leary, Mark R; Asher, Michael W; Jongman-Sereno, Katrina PAccusations of entrenched political partisanship have been launched against both conservatives and liberals. But is feeling superior about one's beliefs a partisan issue? Two competing hypotheses exist: the rigidity-of-the-right hypothesis (i.e., conservatives are dogmatic) and the ideological-extremism hypothesis (i.e., extreme views on both sides predict dogmatism). We measured 527 Americans' attitudes about nine contentious political issues, the degree to which they thought their beliefs were superior to other people's, and their level of dogmatism. Dogmatism was higher for people endorsing conservative views than for people endorsing liberal views, which replicates the rigidity-of-the-right hypothesis. However, curvilinear effects of ideological attitude on belief superiority (i.e., belief that one's position is more correct than another's) supported the ideological-extremism hypothesis. Furthermore, responses reflecting the greatest belief superiority were obtained on conservative attitudes for three issues and liberal attitudes for another three issues. These findings capture nuances in the relationship between political beliefs and attitude entrenchment that have not been revealed previously.Item Open Access Knowledge and Attitudes toward HIV and People Living with HIV (PLWH) among Public Health Midwives in the Galle District, Sri Lanka(2017) Suk, JihyeBackground: Even though a recent increase in HIV prevalence has been noticed in Sri Lanka, not many studies have been done there relating to HIV/AIDS. In particular, little is known about HIV-related stigma among healthcare workers, which has been identified as an obstacle to addressing the HIV epidemic. To examine this issue, this study first aimed to assess knowledge and attitudes of PHMs, the frontline community health workers in Sri Lanka. Second, the study examined the factors associated with their knowledge and attitudes. Lastly, the study examined the association of demographic information, knowledge, and attitudes with extra precautionary behaviors. Methods: Two hundred and ninety-one PHMs were recruited for this cross-sectional study. The study team visited each of the 20 Medical Officers of Health areas (MOH: administrative division) in the Galle District and surveyed PHMs during their monthly meetings. The study utilized two questionnaires to assess knowledge (16 items), attitudes and stigma (37 items). After assessing the PHMs knowledge and attitudes, the study explored the association of demographic information with knowledge and attitudes, and then examined how such individual factors, knowledge, and attitudes were associated with extra precautionary behaviors. Results: PHMs’ knowledge level was good (79.9% of answers were correct) but could be improved. Those more knowledgeable about HIV and with higher education demonstrated a more positive attitude towards PLWH. A more negative attitude was associated with having a stronger intention to engage in extra precautionary behaviors. Conclusions: As PHMs are community health workers whose attitude can potentially influence to the general public’s point of view, they need further HIV training to improve their knowledge so as to better educate the community. By reducing the PHMs misperceptions about HIV, they may develop a more positive attitude and thus help reduce stigma towards PLWH.
Item Open Access People believe it is plausible to have forgotten memories of childhood sexual abuse.(Psychon Bull Rev, 2007-08) Rubin, David C; Berntsen, DorthePezdek, Blandon-Gitlin, and Gabbay (2006) found that perceptions of the plausibility of events increase the likelihood that imagination may induce false memories of those events. Using a survey conducted by Gallup, we asked a large sample of the general population how plausible it would be for a person with longstanding emotional problems and a need for psychotherapy to be a victim of childhood sexual abuse, even though the person could not remember the abuse. Only 18% indicated that it was implausible or very implausible, whereas 67% indicated that such an occurrence was either plausible or very plausible. Combined with Pezdek et al.s' findings, and counter to their conclusions, our findings imply that there is a substantial danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy.Item Open Access Some Things Are Better Left Unsaid: How Word of Mouth Influences the Speaker(2009) Moore, Sarah GossConsumers frequently share stories about consumption experiences with others through word of mouth (WOM). Past research has focused on how hearing WOM influences the listener; I examine how sharing WOM influences the speaker. My proposed model outlines variables that determine storytelling language, predicts how specific language influences speakers' evaluations of experiences, and identifies the process through which language influences speakers. I test this model in five experimental studies and in a field study using Amazon.com data. I find that stories containing relatively more explaining language influence speakers through a process of sense-making. Sense-making helps consumers understand and recover from experiences by allowing them to figure out why experiences occurred and why they liked or disliked them. Making sense of experiences through explaining language has several consequences for consumers. Explaining language can cause paradoxical effects of WOM in terms of consumers' evaluations of experiences and their intentions to repeat and recommend experiences. Explaining positive experiences can decrease speakers' evaluations of experiences, making experiences less positive and decreasing consumers' willingness to repeat and recommend these experiences. Conversely, explaining negative experiences can increase speakers' evaluations of experiences, making experiences less negative and increasing consumers' willingness to repeat and recommend these experiences. In addition, making sense of and explaining experiences decreases consumers' intentions to spread future word of mouth about their experiences.