BACKGROUND & AIMS: :Patients with HIV/AIDS are likely to have numerous interactions with health care providers (HCPs) during the course of their disease. Research has shown that satisfaction with one's HCP is related to better medication adherence in patients with HIV/AIDS. Although a patient's attitude toward his or her HCP is important, little has been done to assess how it relates to appointment attendance. The current study assessed how attitudes toward HCPs as well as social support and depression relate to outpatient appointment attendance. Further, this study used a newly developed, psychometrically valid scale to assess specific patient attitudes toward HCPs including those related to disease stigma. Participants were predominantly low-income African American men (N = 109) recruited from a public southern HIV clinic. Analyses indicated that attitudes toward HIV HCPs, social support, and medication status but not depression or satisfaction with social support were associated with appointment attendance.

背景与目标： : 艾滋病毒/艾滋病患者在患病过程中可能会与医疗保健提供者 (hcp) 发生许多互动。研究表明，对HCP的满意度与HIV/AIDS患者更好的药物依从性有关。尽管患者对HCP的态度很重要，但几乎没有采取任何措施来评估其与预约出勤的关系。当前的研究评估了对hcp以及社会支持和抑郁的态度与门诊预约出勤之间的关系。此外，这项研究使用了新开发的，心理测量有效的量表来评估患者对hcp的特定态度，包括与疾病污名有关的态度。参与者主要是从南方公立HIV诊所招募的低收入非裔美国人 (N = 109)。分析表明，对HIV hcp的态度，社会支持和药物状况，但对抑郁或对社会支持的满意度与预约出勤有关。

BACKGROUND & AIMS: :Chronic sleep restriction is a common experience; and while it has negative physiological effects, little is known about how it affects human behavior. To date, no study has investigated whether chronic sleep restriction can influence implicit attitudes (e.g., towards a race). Here, in a randomized, counterbalanced crossover design, we subjected participants to 3 weeks of chronic sleep restriction in the lab (i.e., 3 weekly cycles of 5 nights of 4 hours of sleep per night followed by 2 nights of 8 hours of sleep) and found evidence for an increased negative implicit bias towards Arab Muslims. No indicators of an implicit bias were found in these same individuals when they were rested (during a counterbalanced 3-week period of 8 hours time in bed per night). These findings suggest that chronic sleep restriction may "unmask" implicit racial or ethnic biases that are otherwise inhibited when in a rested state. Because chronic sleep restriction is prevalent among many occupations that routinely interact with ethnic minorities in potentially high-conflict situations (e.g., police officers), it is critical to consider the role that restricted sleep may play in exacerbating negative implicit attitudes and their potential for provoking unintentional and potentially harmful behavioral consequences.

背景与目标： : 慢性睡眠限制是一种常见的体验; 尽管它具有负面的生理影响，但对它如何影响人类行为知之甚少。迄今为止，还没有研究研究慢性睡眠限制是否会影响内隐态度 (例如，对种族)。在这里，在随机，平衡交叉设计中，我们使参与者在实验室中接受了3周的慢性睡眠限制 (即，每周3个周期，每5个晚上，每晚4个小时的睡眠，然后是2个晚上8个小时的睡眠)，并发现了对阿拉伯穆斯林的负面隐性偏见增加的证据。在这些人休息时 (在每晚卧床8小时的平衡3周内)，没有发现隐性偏见的指标。这些发现表明，慢性睡眠限制可能会 “掩盖” 隐性的种族或种族偏见，而这些偏见在休息状态下会受到抑制。由于慢性睡眠限制在许多职业中普遍存在，这些职业在潜在的高冲突情况下经常与少数民族互动 (例如，警察)，因此至关重要的是要考虑睡眠限制在加剧消极的内隐态度及其潜在的潜在影响中发挥的作用。引发无意的和潜在的有害行为后果。

BACKGROUND & AIMS: :Do free will beliefs influence moral judgments? Answers to this question from theoretical and empirical perspectives are controversial. This study attempted to replicate past research and offer theoretical insights by analyzing World Values Survey data from residents of 46 countries (n = 65,111 persons). Corroborating experimental findings, free will beliefs predicted intolerance of unethical behaviors and support for severe criminal punishment. Further, the link between free will beliefs and intolerance of unethical behavior was moderated by variations in countries' institutional integrity, defined as the degree to which countries had accountable, corruption-free public sectors. Free will beliefs predicted intolerance of unethical behaviors for residents of countries with high and moderate institutional integrity, but this correlation was not seen for countries with low institutional integrity. Free will beliefs predicted support for criminal punishment regardless of countries' institutional integrity. Results were robust across different operationalizations of institutional integrity and with or without statistical control variables.

背景与目标： : 自由意志信仰会影响道德判断吗？从理论和实证的角度回答这个问题是有争议的。本研究试图通过分析来自46个国家 (n = 65,111人) 的居民的世界价值调查数据来复制过去的研究并提供理论见解。证实了实验结果，自由意志信念预测了对不道德行为的不容忍以及对严厉刑事处罚的支持。此外，自由意志信念与对不道德行为的不容忍之间的联系受到国家机构完整性差异的调节，机构完整性的定义是国家对公共部门负责的程度，无腐败。自由意志信念预测了机构完整性高和中等国家的居民对不道德行为的不容忍，但是对于机构完整性低的国家却没有这种相关性。自由意志信念预测，无论国家的机构完整性如何，都将支持刑事处罚。在机构完整性的不同操作中，无论有无统计控制变量，结果都是稳健的。

BACKGROUND & AIMS: BACKGROUND:The reasons for low adherence to cereal dietary guidelines are not well understood but may be related to knowledge, attitudes, beliefs and perceived barriers. This study aims to assess trends in cereal foods consumption, intention to change and factors associated with intake among Western Australian (WA) adults 18 to 64 years. METHOD:Cross-sectional data from the 1995, 1998, 2001, 2004, 2009, and 2012 Nutrition Monitoring Survey Series involving 7044 adults were pooled. OUTCOME VARIABLES:types and amount of cereals (bread, rice, pasta, and breakfast cereal) eaten the day prior. Attitudes, knowledge, intentions, weight status and sociodemographic characteristics were measured. Descriptive statistics, multiple binary logistic and multinomial logistic regressions assess factors associated with consumption. RESULTS:Bread (78%) was the most commonly consumed cereal food. The proportion eating bread decreased across survey years (Odds Ratio OR = 0.31; 95% Confidence Interval; 0.24-0.40 in 2012 versus 1995), as did the amount (4.1 slices of bread in 1995 to 2.4 in 2012). The odds of consuming whole-grain cereal foods increased since 2009 (OR = 1.27; 1.02-1.58 versus 1995 p < 0.05). The likelihood of trying to eat less cereal food in the past year was greater in 2012 compared to 1995 (Relative Risk Ratio RRR 10.88; 6.81-17.4). Knowledge of cereal recommendations decreased over time (OR = 0.20; 0.15-0.27 in 2012 versus 1995 p < 0.001). Overweight and obese respondents were more likely than healthy weight respondents to have tried to eat less cereals (RRR 1.65; 1.22-2.24 and 1.88; 1.35-2.63 respectively). 'I already eat enough' was the main barrier (75% in 1995 to 84% in 2012 (p < 0.001)). CONCLUSIONS:WA adults are actively reducing the amount of cereal foods they eat and intake is associated with a misperception of adequacy of intake. Nutrition intervention is needed to increase awareness of the health benefits of cereal foods, particularly whole-grains, and to address barriers to incorporating them daily. TRIAL REGISTRATION:Not applicable.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:To examine attitudes to the Mental Capacity Act's new statutory Independent Mental Capacity Advocate (IMCA) service in England and Wales and consider the implications for its delivery. METHODS:Quantitative data describing all referrals to the seven pilot IMCA services (January 2006-March 2007) and qualitative data from semi-structured interviews with 18 doctors, 21 senior nurses and one discharge planning manager in four general hospitals in England. RESULTS:Of 127 hospital-based referrals to the seven pilot IMCA services, 29 (23%) were for patients facing serious medical treatments, 52% of whom were judged to lack decision-making capacity due to a learning disability; ninety-eight (77%) were for patients facing a change of accommodation upon hospital discharge, 62% of whom were elderly and lacked capacity due to dementia. While aware of the potential benefits of the IMCA service, clinicians were generally negative about the contribution advocates could make to patients' medical care and thought they could only contribute usefully in a minority of ethically complicated decisions. In contrast, they were more positive about the involvement of advocates in hospital discharge decisions and hoped that they would improve current discharge practice. CONCLUSIONS:Clinicians held ambivalent attitudes towards the involvement of a statutory IMCA service in medical decisions, reflecting beliefs that the service was largely impractical and unnecessary given current procedures for making medical decisions in patients' 'best interests'. Conversely, clinicians were more likely to support advocacy in discharge decisions because they believed that non-medically qualified advocates could make a valuable contribution to decisions that were seen as predominantly social and where practice was frequently considered deficient. By holding these beliefs, clinicians are failing to have due regard for the IMCA service as a statutory measure for safeguarding patients' interests.

背景与目标：

BACKGROUND & AIMS: :Autopsy rates remain disturbingly low in nursing homes despite the fact that 1 of 5 deaths occurs in this setting. To determine the autopsy rate for nursing homes, we analyzed all deaths occurring in New York State nursing homes from 1980 to 1984. Of 58,985 nursing home deaths, autopsies were performed in only 499 cases (0.8%). In comparison to the general nursing home population, autopsied residents were more likely to be male and never married and less likely to be widowed. Of 110 practicing nursing home physicians surveyed, 19% believed autopsies had little if any value in the nursing home population, whereas 71% saw autopsy as a valuable tool but rarely requested one. Fewer than 1 in 10 physicians routinely discussed autopsies with patients and/or families before death. Perceived obstacles included the emotional lability of patients and families and a lack of financial reimbursement. Concerns over religious objections, funeral delays, and unnecessary mutilation were cited by fewer than one third of respondents. Facilitation of consent, physician education, and cost sharing may all contribute to enhanced rates of autopsies in the future.

背景与目标： : 尽管5例死亡中有1例发生在这种情况下，疗养院的尸检率仍然低得令人不安。为了确定疗养院的尸检率，我们分析了1984年1980年在纽约州疗养院发生的所有死亡。在58,985例疗养院死亡中，只有499例 (0.8% 例) 进行了尸检。与一般疗养院人口相比，经过尸检的居民更有可能是男性且从未结婚，也不太可能丧偶。在接受调查的110名执业疗养院医生中，19% 人认为尸检对疗养院人群几乎没有价值，而71% 人认为尸检是一种有价值的工具，但很少要求尸检。在死亡前，只有不到十分之一的医生与患者和/或家属进行常规尸检。感知到的障碍包括患者和家人的情绪不安和缺乏经济补偿。不到3分之1的受访者提到了对宗教异议，葬礼延误和不必要的肢解的担忧。同意的便利，医师教育和费用分担都可能有助于将来提高尸检率。

BACKGROUND & AIMS: BACKGROUND:Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. METHODS:Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. RESULTS:The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. CONCLUSION:Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.

背景与目标：

BACKGROUND & AIMS: :We examined whether constructs outlined in self-determination theory (Deci & Ryan, 2002), namely, autonomy-supportive and controlling motivational climates and autonomous and controlled motivation, were related to attitudes toward performance-enhancing drugs (PEDs) in sport and drug-taking susceptibility. We also investigated moral disengagement as a potential mediator. We surveyed a sample of 224 competitive athletes (59% female; M age = 20.3 years; M = 10.2 years of experience participating in their sport), including 81 elite athletes. Using structural equation modeling analyses, our hypothesis proposing positive relationships with controlling climates, controlled motivation, and PEDs attitudes and susceptibility was largely supported, whereas our hypothesis proposing negative relationships among autonomous climate, autonomous motivation, and PEDs attitudes and susceptibility was not supported. Moral disengagement was a strong predictor of positive attitudes toward PEDs, which, in turn, was a strong predictor of PEDs susceptibility. These findings are discussed from both motivational and moral disengagement viewpoints.

背景与目标： : 我们研究了自我决定理论 (Deci & Ryan，2002) 中概述的结构，即自主支持和控制动机气候以及自主和控制动机，是否与运动和药物对提高表现药物 (ped) 的态度有关吸毒易感性。我们还调查了道德脱离作为潜在调解人的情况。我们调查了224名竞技运动员 (59% 名女性; M年龄 = 20.3岁; M = 10.2年参加运动的经验) 的样本，其中包括81名精英运动员。使用结构方程模型分析，我们的假设提出了与控制气候，受控动机以及PEDs态度和敏感性之间的正相关关系，而我们的假设提出了自主气候，自主动机以及PEDs态度和敏感性之间的负相关关系，则没有得到支持。道德脱离是对ped积极态度的有力预测因素，而这反过来又是ped易感性的有力预测因素。从动机和道德脱离的角度讨论了这些发现。

BACKGROUND & AIMS: PURPOSE:The aim of the study was to examine reproductive health attitudes and behaviors related to contraception use, provider counseling, parenthood goals, and fertility preservation (FP) in TNB adolescents. METHODS:A 24-item survey was administered to 44 TNB adolescents aged 12-19 years. RESULTS:Contraceptive use was variable even among the 46% who reported sexual activity. Half denied or were unsure if they had been offered options from their provider to prevent sexually transmitted infections, and more than one third denied or were unsure about the offer of pregnancy prevention options. Importantly, the majority did not desire more information about contraceptive options. Few used FP, although many thought their feelings about parenthood may change in the future. CONCLUSIONS:TNB adolescents are at risk for sexually transmitted infections, unplanned pregnancies, and future infertility, yet many do not desire more information about contraception or FP. Tailored counseling strategies should be developed and researched to protect this vulnerable group of youth.

背景与目标：

BACKGROUND & AIMS: :An amendment to this paper has been published and can be accessed via a link at the top of the paper.

背景与目标： : 本文的修正案已经发表，可以通过本文顶部的链接进行访问。

BACKGROUND & AIMS: OBJECTIVES:To test an educational intervention designed to improve lactation knowledge, attitudes, and beliefs of NICU nurses and to improve their intentions to provide mothers with lactation support. DESIGN:Quasi-experimental, time-series pretest/posttest. SETTING:NICU of a Midwestern, free-standing, tertiary-care children's hospital. PARTICIPANTS:Convenience sample of 64 NICU nurses and 2 separate convenience samples of mothers of infants hospitalized in the NICU (n=19 and 13, respectively). METHODS:Nurses were measured on study outcomes at multiple time points, beginning with 2 weeks before and ending at 3 months after attendance to a 4-hour educational program. Mothers were sampled before and 3 months after the intervention. MAIN OUTCOME MEASURE(S):Nurses' lactation knowledge, attitudes, beliefs, and intentions to support lactation and mothers' perceptions of lactation support in the NICU. RESULTS:Findings suggest that this educational intervention was effective for improving NICU nurses' lactation knowledge and attitudes, and that these improvements were maintained over time. Further, the supportive atmosphere for lactation in this NICU significantly improved following the implementation of the educational intervention for nurses. CONCLUSION:Intermittent, short educational programs which include practical how-to's and motivational encouragement for staff may provide the empowerment nurses need in order to be supportive of lactation.

背景与目标：

BACKGROUND & AIMS: :During a longitudinal evaluation of a pre-qualifying interprofessional curriculum, health and social care students completed questionnaires concerning communication and teamwork skills and interprofessional learning and working. Data were collected on entry to their educational programme, during the second year of study, at qualification and after 9-12 months' qualified practice. This paper presents results from practice data from 414 professionals; 275 were educated on the interprofessional curriculum, 139 on previous uniprofessional curricula. The former were more confident at qualification about their communicative skills, their interprofessional relationships and other professionals' interaction, and showed positive correlations between perceptions of their relevant skills and their interprofessional relationships. They were also more positive about their interprofessional relationships than practitioners educated on uniprofessional curricula. Age and previous experience of higher education influenced professionals' attitudes negatively: mature individuals may require more support when entering the workforce. Between qualification and practice, respondents from the interprofessional cohorts grew more critical of interprofessional education. However, experience of interprofessional education appears to produce and sustain positive attitudes towards collaborative working, suggesting that individuals' perceptions of their own educational experience are inadequate as an evaluative measure of interprofessional learning initiatives. This study reinforces the argument for including IPE in pre-qualifying curricula.

背景与目标： : 在对资格预审的跨专业课程进行纵向评估期间，卫生和社会护理学生完成了有关沟通和团队合作技能以及跨专业学习和工作的问卷调查。在学习的第二年，获得资格以及9-12个月的合格实践后，收集了有关进入其教育计划的数据。本文介绍了来自414专业人员的实践数据的结果; 275接受了跨专业课程的教育，139以前的单专业课程。前者对他们的沟通能力，专业间关系和其他专业人士的互动能力更有信心，并且对其相关技能的看法与专业间关系之间表现出正相关。与接受单专业课程教育的从业人员相比，他们对专业间关系也更加积极。年龄和以前的高等教育经验对专业人士的态度产生了负面影响: 成熟的人进入劳动力市场时可能需要更多的支持。在资格和实践之间，来自跨专业人群的受访者对跨专业教育提出了更高的批评。但是，跨专业教育的经验似乎会产生并维持对协作工作的积极态度，这表明个人对自己的教育经验的看法不足以作为跨专业学习计划的评估措施。这项研究强化了将IPE纳入资格预审课程的论点。

BACKGROUND & AIMS: BACKGROUND:Maternal mortality, of which 6.7% is attributable to abortion complications, remains high in Mozambique. The objective of this paper is to assess the level of induced abortion at the community, as well as to assess awareness of and attitudes towards the new abortion law among women of reproductive age in suburban areas of Maputo and Quelimane cities. METHODS:A cross-sectional household survey among women aged 15-49 years in Maputo and Quelimane cities was conducted using a multi-stage clustered sampling design. Data on sociodemographic characteristics, maternal outcomes, contraceptive use, knowledge and attitudes towards the new abortion law were collected. Bivariate and multiple logistic regression analysis using the complex samples procedure in SPSS were applied. RESULTS:A total of 1657 women (827 Maputo and 830 Quelimane) were interviewed between August 2016 and February 2017. The mean age was 27 years; 45.7% were married and 75.5% had ever been pregnant. 9.2% of the women reported having had an induced abortion, of which 20.0% (17) had unsafe abortion. Of the respondents, 28.8% knew the new legal status of abortion. 17% thought that the legalization of abortion was beneficial to women's health. Having ever been pregnant, being unmarried, student, Muslim, as well as residing in Maputo were associated with higher odds of having knowledge of the new abortion law. CONCLUSION:Reports of abortion appear to be low compared to other studies from Sub-Saharan African countries. Furthermore, respondents demonstrated limited knowledge of the abortion law. Social factors such as education status, religion, residence in a large city as well as pregnancy history were associated with having knowledge of the abortion law. Only a small percentage of women perceived abortion as beneficial to women's health. There is a need for widespread sensitization about the new law and its benefits.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:This study aims to establish the Knowledge, Attitudes and Practices (KAP) of the general population (people with and without diabetes) towards diabetes. The study will examine (a) recognition and understanding of causes, prevention and treatment strategies of diabetes; (b) identify the knowledge gaps and behavioural patterns that may hamper diabetes prevention and control; (c) stigma towards and stigma perceived by people with diabetes and (d) awareness of anti-diabetes campaigns. METHODS AND ANALYSIS:The study is a nationwide, cross-sectional study of Singapore's general population aged 18 years and above (n=3000), comprising Chinese, Malay, Indian and other ethnic groups, who can understand English, Chinese, Malay or Tamil language. The sample was derived using a disproportionate stratified sampling using age and ethnicity. The proportion of respondents in each ethnic group (Chinese, Malay and Indian) was set to approximately 30%, while the proportion of respondents in each age group was set around 20% in order to ensure a sufficient sample size. The respondents will be administered questionnaires on diabetes KAP, stigma towards diabetes, lifestyle, diet and awareness of local anti-diabetes campaigns. The analysis will include descriptive statistics and multiple logistic and linear regression analyses to determine the socio-demographic correlates of correct recognition of diabetes, help-seeking preferences, as well as overall knowledge and attitudes among those with and without diabetes. We will consider a p value ≤0.05 as significant. ETHICS AND DISSEMINATION:This study protocol has been reviewed by the Institutional Research Review Committee and the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref 2018/00430). The results of the study will be shared with policymakers and other stakeholders. There will be a local mass media briefing to disseminate the findings online, in print and on television and radio. The results will be published in peer-reviewed journals and presented in scientific meetings.

背景与目标：

BACKGROUND & AIMS: : Background: Despite the demonstrated benefits of diabetes device use, uptake of insulin pumps and continuous glucose monitors (CGMs) remains quite low. The current study aimed to identify profiles of parents of youth with type 1 diabetes based on their attitudes toward diabetes-specific technology and barriers to diabetes technology uptake. Methods: Online survey data were collected from 471 parents in the T1D Exchange Clinic Network (child's age = 12.0 ± 3.2 years; diabetes duration = 7.0 ± 2.9 years; A1c = 8.4% ± 1.3; 75% using insulin pump; 27% using CGM). Results: K-means cluster analyses revealed five parent profiles: Embracers (50.7%), Burdened (15.7%), Hopeful but Hassled (14.2%), Distrusting (12.7%), and Data Minimalists (6.6%). ANOVAs and chi-square tests identified differences between groups based on diabetes distress, worry over hypoglycemia, device use, and demographic characteristics. Conclusions: Providers encouraging device uptake may benefit from tailoring their approaches based on these distinct groups and their corresponding concerns and needs.

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