Creating an eLearning Resource to Improve Knowledge and Understanding of Pregnancy in the Context of HIV Infection

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby.

A Qualitative Exploration of Perceived Key Knowledge and Skills in End-of-Life Care in Dementia Patients among Medical, Nursing, and Pharmacy Students

Background: The steady increase in the number of people living and dying with dementia, coupled with the recent focus on quality of care, has highlighted the importance of dementia training for health care professionals. This exploratory study aimed to discover which skills health care students felt were important in providing quality end-of-life care to dementia patients.

Methods: Ninety-four medicine, nursing, and pharmacy students participated in a larger study using open-ended and closed questions to explore attitudes related to caring for dementia patients at the end of life. This study looks at the student responses to an open-ended question regarding the skills and knowledge they believe are needed to provide end-of-life care to dementia patients. Individual responses were reviewed by the researchers, coded into key issues, and tabulated for frequency of occurrences and group differences.

Results: Several common issues emerged: knowledge, patience, empathy, understanding, family involvement, compassion, medication knowledge, respect/patient autonomy, communication, quality of life, and patient education. Significant differences were observed among the participant groups on the following issues: Patience and understanding (pharmacy students mentioned these issues less frequently than medical and nursing students), compassion (medical students mentioned this issue more frequently than pharmacy students), and medication knowledge (pharmacy students mentioned this issue more frequently than medical and nursing students).

Conclusions: Different health care disciplines (in-training) value different skill sets for the provision of dementia care at the end-of-life. As health care education for dementia patients at the end of life is expanded, it will be important to understand which skills both patients and health care students value.

Pharmacogenomics and metastatic colorectal cancer:current knowledge and perspectives

The pharmacogenomics field is crucial for optimizing the selection of which chemotherapy regimen to use according to the patient's genomic profile. Indeed, the individual's inherited genome accounts for a large proportion of the variation in his or her response to chemotherapeutic agents both in terms of efficiency and toxicity. Patients with metastatic disease are more likely to receive different lines of chemotherapy with variable efficacy and experience some related complications. It is therefore critical to tailor the best therapeutic arsenal to improve the efficacy and avoid as much as possible related complications that are susceptible to interrupt the treatment. The pharmacogenomics approach investigates for each drug the implicated metabolic pathway and the potential personal variations in gene function. The aim of this review is to present a clear overview of the most accurate polymorphisms that have been identified as related to drug response in patients with mCRC.

Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), report 6.

AIM: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China. DESIGN: Cross-sectional case series. METHODS: Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery. RESULTS: Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity < or = 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)). DISCUSSION: Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.

Knowledge and acceptance of Human Papillomavirus (HPV) and HPV vaccination in adolescent boys worldwide: a systematic review

Aim

To determine HPV and HPV vaccine awareness, knowledge and acceptance in male adolescents worldwide.

Methods

A mixed methods systematic review was conducted. In accordance with PRISMA guidelines, relevant literature was identified through an electronic database search using specified keywords from inception to September 2015. Non-interventional studies presented in English that assessed HPV knowledge and provided data on male adolescents were included. If available, data on HPV and HPV vaccine perceptions, attitudes and/or HPV vaccine acceptance were also extracted. All studies were critically appraised to provide an indication of methodological quality. Results were compiled using a convergent synthesis.

Results

22 papers were included. The majority of studies were cross-sectional and conducted in the US and Europe. Across continents, regardless of a country’s HPV vaccination programme status, boys’ knowledge of HPV and/or HPV vaccination was generally low to moderate and significantly lower than female knowledge or awareness. There was a disagreement in the association of knowledge and vaccine acceptance, with higher knowledge not always being predictive of acceptance.

Conclusions

Comparison and synthesis of research concerning HPV knowledge and attitudes was made difficult due to the lack of universal definition of vaccine acceptance, and no universally accepted tool for its measurement or for the measurement of HPV knowledge. It is imperative that future research utilises consistent measures of HPV knowledge and attitudes to facilitate interpretation and comparison across studies internationally. Prospective longitudinal studies would be more informative providing data on factors that influenced the move from vaccine intention to uptake.

Understandings of citizenship education in Northern Ireland and the Republic of Ireland: Public discourses among stakeholders in the public and private sectors

Internationally, citizenship education has come to the fore in the past decade. It may be particularly importantwithin the context of societies with a legacy of political conflict, such as Northern Ireland and the Republic of Ireland, where it is being implemented as part of the statutory curriculum. This article explores understandingsof citizenship education among stakeholders in the private and public sectors in Northern Ireland and the Republic of Ireland with the aim to compare these with curricular conceptualizations of citizenship inboth contexts. Semi-structured interviews were conducted in both societies involving non-governmentalorganizations, political parties, trade unions and the police. Results indicated that levels of awareness aboutcitizenship education varied substantially and understandings mainly reflected current theory and curriculumpractice in citizenship. Commonalities emerged as in both societies similar key concepts were identified whiledifferences transpired over issues relating to national identity and political conflict, which may raise questionsfor history and citizenship education in both societies.