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Open Access April 10, 2025

Assessment of the Knowledge, Attitude, and Practice of Sokoine University Students Regarding Endocrine Disruptors Coming from Plastic Chemicals

Abstract Objective: The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. Methodology: A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. Results: The findings indicate that the participants possessed an [...] Read more.
Objective: The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. Methodology: A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. Results: The findings indicate that the participants possessed an average degree of knowledge 50.2 ± 3.85 with the main emphasis of awareness being generic concepts rather than specific substances. Regarding the potential health impacts of endocrine-disrupting chemicals present in plastics, respondents' attitudes ranged from fair to positive, with a mean score of 3.5 ±0.09 indicating a fair attitude overall. Conclusion: It is important to practice polite behavior and increase public awareness of safe plastic disposal methods. Surprising only 38.0% of the participants mentioned that they refrain from heating their food in plastic containers to reduce their exposure to plastics. Students' practices revealed a notable dependence on plastic products despite their awareness of the concerns surrounding endocrine disruptors, as most of them reported using plastic water bottles, plastic cups, and plastic bags almost always. Additionally, only 20.7% of the respondents consistently implemented strategies to prevent exposure to endocrine-disrupting chemicals. Recommendation: The study recommended increasing the use of cleaner plastic substitutes and improving educational programs to convert information into practical actions. Policies that encourage environmentally friendly behavior and raise public awareness of safe plastic disposal techniques should be put into practice.
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Open Access August 23, 2023

Determinants and Satisfaction Outcomes of Pregnancy Care in China: The Case of Ghanaian Women in Zhenjiang

Abstract The concept of maternity care satisfaction focuses on women's expectations and results in women having a positive attitude about the care received during pregnancy, childbirth and after birth. The proportion of births to Ghanaian migrant mothers in China is increasing, and there is an increasing demand for information regarding their reproductive health. To reduce maternal and neonatal morbidity [...] Read more.
The concept of maternity care satisfaction focuses on women's expectations and results in women having a positive attitude about the care received during pregnancy, childbirth and after birth. The proportion of births to Ghanaian migrant mothers in China is increasing, and there is an increasing demand for information regarding their reproductive health. To reduce maternal and neonatal morbidity and death rates, it is crucial for foreign women who use maternity services to be satisfied with their care. Ghanaian women's birth experiences in China might be harmed by language and cultural disparities. Little is known about their experiences in China's homogeneous society. A survey of 317 postnatal Ghanaian foreigners in Zhenjiang, China provided the study's data and was analyzed using IBM SPSS Statistics 25. The results showed that (76%) of postnatal foreigners were satisfied with delivery care. Though the satisfaction level was high, respondents raised the issues of poor communication (62.8%) and high cost of delivery care (52.4%) as some of the general experiences they faced. Healthcare providers’ strengthening routine monitoring of maternal and newborn health programs will help deliver more woman-centered care.
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Case Study
Open Access September 05, 2022

Comparison of Concept about Good Death and View of Life and Death among Japanese, Korean, and American at COVID-19

Abstract From 2020 to 2022 the Covid-19 was spread and many people died. Death is near to everyone. The aim of the study was to investigate differences of concept of good death and view of life and death cross cultural. Participants were 92 Japanese, 110 Korean and 100 American who were ordinary people. We used the Good Death questionnaire to measure desirable death and the Death Attitude Inventory to [...] Read more.
From 2020 to 2022 the Covid-19 was spread and many people died. Death is near to everyone. The aim of the study was to investigate differences of concept of good death and view of life and death cross cultural. Participants were 92 Japanese, 110 Korean and 100 American who were ordinary people. We used the Good Death questionnaire to measure desirable death and the Death Attitude Inventory to measure view of life and death. Participants completed both questionnaires. As for Good Death, Japanese and Korean regarded “not being burden to others” as important the most, and American regarded “feeling that one’s life is worth living” as important. The scores of “unawareness of death” and “religious and spiritual comfort” of Korean were the highest, following American, and Japan. As for the Death Attitude Inventory, the score of American was higher than Japanese and Korean totally. The scores of “Death as release” or “Death Avoidance” of American were the highest. These results suggest that although Japanese and Korean regard “Not being burden to others” as important in common, Korean regard religious and spiritual comfort as important. American may avoid to think of death and regard it as release. We can make use of these cultural differences in clinical situation.
Article
Open Access March 29, 2025

How Stigma Affects Patients Seeking Help for Drug Addiction

Abstract Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research [...] Read more.
Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.
Essay
Open Access March 22, 2025

I Am My Peers: How Social Ties Influence E-Cigarette Attitudes, Policy Support, and Use

Abstract Background: Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward [...] Read more.
Background: Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward e-cigarettes and influencing use behaviors. However, the relative influence of different social ties—parents, siblings, and friends—on e-cigarette attitudes and use remains unclear. Objective: This study utilizes data from the SMOKES study to compare the influence of e-cigarette use within different social network sections—parents, friends, and siblings—on personal e-cigarette attitudes and use among college and university students. Methods: Using a cross-sectional survey of college and university students, we examined the associations between e-cigarette use within different social networks and individual e-cigarette attitudes and use. Multivariate regression models assessed the strength of these associations, adjusting for key demographic and behavioral covariates. Results: Findings indicate that among college and university students, the strongest influence on both e-cigarette attitudes and use comes from friends who use e-cigarettes. In contrast, parental and sibling e-cigarette use showed weak or non-significant effects. These results suggest that peer influence, rather than family influence, plays a dominant role in shaping e-cigarette-related behaviors and perceptions in young adults. Conclusion: This study underscores the importance of peer influence in e-cigarette uptake and attitudes among college and university students. Public health interventions aimed at reducing e-cigarette use in this population should consider targeting peer networks rather than focusing solely on family-based influences.
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Article
Open Access March 11, 2025

Why High Income Fails to Reduce E-Cigarette Use: The Knowledge-Attitude Paradox in the SMOKES Study

Abstract Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and [...] Read more.
Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. Objectives: This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. Methods: The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. Results: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. Conclusions: Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.
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Original Article
Open Access March 06, 2025

Tobacco-control policy support and tobacco use: SMOKES study

Abstract Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study [...] Read more.
Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study aimed to examine whether college students who use tobacco exhibit lower support for tobacco control policies compared to their non-user counterparts. Methods: We conducted a multi-center, cross-sectional study involving 2403 college students from various provinces in Iran. Tobacco use was ascertained based on self-reported consumption of cigarettes, electronic cigarettes, and hookah. Attitudes toward tobacco control policies were evaluated using a structured survey instrument, and comparative analyses were performed to assess differences in policy support between tobacco users and non-users. Results: The analysis revealed that tobacco users demonstrated significantly lower support for tobacco control policies compared to non-users. This association was consistently observed across users of cigarettes, electronic cigarettes, and hookah, suggesting a systematic pattern irrespective of the type of tobacco product used. Conclusion: These findings indicated a clear association between tobacco use and reduced endorsement of tobacco control policies among Iranian college students. These results have potential implications for public health policy, emphasizing the importance of addressing individual tobacco use behaviors in the development and implementation of tobacco control strategies. Further research is needed to elucidate the underlying mechanisms of this relationship.
Article
Open Access March 04, 2025

SMOKES: Study of Measurement of Knowledge and Examination of Support for tobacco control policies

Abstract Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study [...] Read more.
Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study (Study of Measurement of Knowledge and Examination of Support for tobacco control policies), which is conducted to evaluate tobacco use, tobacco-related knowledge and attitude, as well as support for tobacco control policies among college and university students. Methods: The SMOKES Study was designed to address significant gaps in literature by focusing on college and university students in a non-Western context. A multi-center, cross-sectional design was employed to collect data from a diverse sample of college and university students across different geographical provinces in Iran. The survey instrument incorporated a range of measures covering socio-demographic characteristics, university-related variables, family tobacco use status, personal tobacco consumption behaviors (including detailed assessments of cigarette, hookah, and electronic cigarette use), and attitudinal as well as knowledge-based assessments related to vaping. Support for tobacco control policies is also measured. Data were collected using an online survey that included self-administered questionnaires, enabling access to a large diverse sample. This study may be used to determine the prevalence of ever and current use of cigarettes, electronic cigarettes, and hookah, as well as examining the correlates of single, dual, and poly-tobacco use. The study also aims to assess the role of social determinants, attitudes, and ethnic/geographic differences in shaping these outcomes. Results: The study sample consisted of 2403 college and university students, including undergraduates enrolled in different academic programs from all faculties and disciplines. Participants were drawn from universities across 15 provinces, and 11 ethnic groups, ensuring a heterogeneous sample with respect to socio-demographic background, ethnicity, and institutional affiliation. This diversity enhances the generalizability of the findings and allows for the exploration of subgroup differences in tobacco use patterns and policy support. Conclusions: The SMOKES Study offers a framework for examining tobacco-related knowledge and the acceptability of tobacco control policies among a key part of the population, being college and university students. By providing detailed insights into the prevalence and correlates of tobacco knowledge, attitude, use, as well as the tobacco control policy support, the study lays the groundwork for tailored public health interventions and more effective tobacco regulation strategies particularly for college campuses in a non-Western setting.
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Open Access November 23, 2024

Digital Design as a Tool for Assessing Attitudes

Abstract This study investigated the use of digital design as a tool for assessing attitudes among male sex offenders by exploring how artistic expression can reveal complex emotional landscapes related to their crimes. The study utilized digital paintings, a type of digital design that involves creating artwork using digital tools and software. Digital painting tools allowed the researcher to simulate [...] Read more.
This study investigated the use of digital design as a tool for assessing attitudes among male sex offenders by exploring how artistic expression can reveal complex emotional landscapes related to their crimes. The study utilized digital paintings, a type of digital design that involves creating artwork using digital tools and software. Digital painting tools allowed the researcher to simulate traditional painting techniques, while benefiting from the flexibility and versatility of digital media. It is essential to comprehend and address offenders’ attitudes towards sexual crimes to create prevention and rehabilitation plans that work. The effectiveness of digital paintings that illustrate the consequences of sexual crimes on offender, victim and the offender’s family was examined in this study. The study examined whether exposure to these visual representations could result in a quantifiable decrease in supporting attitudes toward sexual crimes by comparing participants' pre-test and post-test attitudes using the Crime Pics II tool. There is little research on how visual cues can change offenders' attitudes and perceptions, despite the urgent need for creative evaluation techniques in this delicate field. This study adds to the continuing conversation on crime prevention and offender rehabilitation by demonstrating how well digital design can change perceptions of sexual crimes. A total of 61 male convicts of defilement and rape were purposively sampled for the study. The study utilized an art exhibition and Rapid Serial Visual Presentation format to repeatedly display digital paintings to participants aged 18-45. The artwork produced in both monochrome and polychrome schemes and in realist and surrealist styles was designed to elicit immediate emotional and cognitive responses. Qualitative and quantitative analyses of the participants' responses and reflections provided important insights into their attitudes, including sentiments of regret and guilt as well as a sophisticated awareness of the wider effects of their behaviour. Monochrome paintings tended to portray darker emotions, whereas polychrome paintings showed a wider range of emotions, including hope and recognition of the harm done. The findings demonstrate that digital design can effectively support offenders' emotional processing and self-reflection, demonstrating its potential as a helpful tool in rehabilitative and assessment contexts.
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