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Ramírez-Ruiz RD, Quintillá M, Sandoval M, León L, Costa JM, Quer M. Current opinion on laryngeal electromyography. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2024; 75:148-154. [PMID: 37913988 DOI: 10.1016/j.otoeng.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/03/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE This study evaluates expert opinion on laryngeal electromyography (LEMG). METHODS A cross-sectional design was used to conduct an online survey of LEMG experts in 2021. They were questioned about the number LEMG performed annually, type of electrodes used, sector worked in, pain during the test, placement of the needle electrodes, interpretation of electrical muscle parameters, diagnosis of neuromuscular injury, prognostic sensitivity in vocal fold paralysis (VFP), laryngeal dystonia, tremor and synkinesis and quantifying LEMG. RESULTS Thirty-seven professionals answered (23 Spanish and 14 from other countries), with a response rate of 21.56%. All physicians used LEMG. 91.9% had one- or two-years' experience and 56.8% performed 10-40 LEMG per year. 70.3% were otolaryngologists and 27%, neurologists. In 89.1% of cases, a team of electrodiagnostic physician and otolaryngologist performed LEMG. 91.3% of Spanish respondents worked in Public Health, 7.14% of other nationalities; 37.8% in a university department. Bipolar concentric needles electrodes were used by 45.9% and monopolar concentric by 40.5%. 57% professionals considered good patients' tolerance to the test. LEMG sensitivity was regarded as strong, median and interquartile range were 80.0 [60.0;90.0] to diagnose peripheral nerve injuries, less for other levels of lesions, and strong to evaluate prognosis, 70.0 [50.0;80.0]. Respondents believe locate the thyroarytenoid and the cricothyroid muscles with the needle, 80.0 [70.0;90.0], as opposed to 20.0 [0.00;60.0] the posterior cricoarytenoid. The interpretation of the electrical parts of the LEMG was strong, 80.0 [60.0;90.0]. LEMG identify movements disorders, 60.0 [20.0;80.0], and synkinesis, 70.0 [30.0;80.0]. The professionals prefer quantitative LEMG, 90.0 [60.0;90.0]. CONCLUSIONS The experts surveyed consider LEMG that is well tolerated by patients. The insertional and spontaneous activity, recruitment and waveform morphology can be assessed easily. LEMG is mainly useful in the study of peripheral nerve injuries, and its value in VFP prognosis is considered strong.
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Affiliation(s)
| | - Mariam Quintillá
- Department of Neurology, Hospital Moisès Broggi de Sant Joan Despí, Barcelona, Spain
| | - Marta Sandoval
- Department of Otolaryngology, Hospital Clínico, Barcelona, Spain
| | - Lucía León
- Department of Neurology, Hospital Moisès Broggi de Sant Joan Despí, Barcelona, Spain
| | | | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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Moorthy V, Alagarsamy S, Mehrolia S, Jeevananda S. The use of self-protective measures to prevent COVID-19 spread: an application of the health belief model. PSYCHOL HEALTH MED 2023; 28:2977-2992. [PMID: 36582073 DOI: 10.1080/13548506.2022.2162935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/13/2022] [Indexed: 12/31/2022]
Abstract
This study uses a health belief model to examine the preventive behavioral orientation or self-protective measures adopted by people in the face of the current COVID-19 pandemic. A total of 603 participants were selected from the city of Bangalore, India. The data was collected through an online survey with participants' age varying between 17 and 54 and mean as 23 years (SD = 4.32). The findings revealed that perceived barrier has significant negative impact, while perceived threat, perceived consequences, perceived benefits, community and individual self-efficacy, and general health cues have a positive influence on an individual's intention to follow self-protective measures against COVID-19. Based on the constructs of the health belief model, this study proposes multiple health-related interventions to reduce the spread of COVID-19.
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Affiliation(s)
- Vasudevan Moorthy
- School of Business and Management, Christ University, Bangalore, India
| | - Subburaj Alagarsamy
- School of Business, Manipal Academy of Higher Education - Dubai Campus, International Academic City, United Arab Emirates
| | - Sangeeta Mehrolia
- School of Business and Management, Christ University, Bangalore, India
| | - S Jeevananda
- School of Business and Management, Christ University, Bangalore, India
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Majangara Karaga R, Archary P, Gwet Bell E, Khrouf M, Loto O, Wada I, Dyer S. The status of ART in the public health sector in Africa: a multi-country survey. Reprod Biomed Online 2023; 47:103213. [PMID: 37236886 DOI: 10.1016/j.rbmo.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 05/28/2023]
Abstract
RESEARCH QUESTION What is the current availability of treatment with assisted reproductive technology (ART) in the public sector in Africa, and what are the facilitators and barriers towards its provision? DESIGN Cross-sectional quantitative and qualitative data were collected in two phases from February 2020 to October 2021. Key informants were identified from countries known to provide ART in Africa based on data from the African Network and Registry for Assisted Reproductive Technology and the 2019 Surveillance from the International Federation of Fertility Societies. Quantitative data were collected via a structured questionnaire (Phase 1); public centre-specific quantitative and qualitative data were then collected via a semi-structured questionnaire followed by a virtual interview (Phase 2). Data were analysed descriptively. RESULTS Informants from 18 countries reported the existence of 185 ART centres in 16 countries. Twenty-four centres (13.0%) in 10 of 16 countries (62.5%) were public. The majority of public centres (20/22 [90.9%]) reporting on ART performed <500 ART cycles per annum. Although public institutions covered most of the cost for ART, copayments from patients were universally required. The number of ART cycles per annum was inversely correlated to the copayment. Lack of policy and legislation, high costs and bureaucratic obstacles were identified by participants as the leading challenges in the delivery of public service ART. CONCLUSION Lack of public ART services leads to chronic and profound health inequities. Enablers of public service ART in the region are the same known to support ART services in general, namely policy and legislation, appropriate funding and good health service infrastructure. Addressing these requires the collated efforts of many stakeholders.
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Affiliation(s)
- Rumbidzai Majangara Karaga
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Paversan Archary
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; African Network and Registry for Assisted Reproductive Technology, Cape Town, South Africa
| | - Ernestine Gwet Bell
- Groupe Interafricain d'Etude, de Recherche et d'Application sur la Fertilité, Lome, Togo
| | - Mohamed Khrouf
- Groupe d'Etude de la Fertilité de la Société Tunisienne de Gynécologie Obstétrique, Tunis, Tunisia
| | - Olabisi Loto
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife, Nigeria; Association for Fertility and Reproductive Health, Lagos, Nigeria
| | - Ibrahim Wada
- Association for Fertility and Reproductive Health, Lagos, Nigeria
| | - Silke Dyer
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; African Network and Registry for Assisted Reproductive Technology, Cape Town, South Africa
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Zanello E, Vecchi R, Zamagni G, Biagi MC, Bruno I, Cragnolin E, Danielli E, Paoletti S, Rabusin M, Ronfani L, Pessa Valente E. Measuring Knowledge of Healthcare Providers on Pediatric Palliative Care with an Online Questionnaire Based on the National Core Curriculum in Italy. Healthcare (Basel) 2023; 11:1971. [PMID: 37444805 DOI: 10.3390/healthcare11131971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
There is a lack of highly reliable tools evaluating healthcare professionals' competences on Pediatric Palliative Care (PPC) and Pain Therapy (PT). The aim of this study is to document the development of an online questionnaire to assess Perceived, Wished and Actual Knowledge of healthcare workers on PPC/PT. The tool was built on the basis of the Italian Society for Palliative Care PPC Core Curriculum (CC) for physicians, nurses and psychologists. Face validity, internal consistency and the underlying structure were evaluated after a field testing in a referral hospital, Friuli-Venezia Giulia, Italy. One hundred five respondents completed the questionnaire. High internal consistency for both scales of Perceived and Wished Knowledge was found (α = 0.95 and α = 0.94, respectively). Psychologists reported higher levels of self-Perceived skills on the psychosocial needs of the child and family at the end of life (p = 0.006), mourning (p = 0.003) and ethics and deontology in PT/PC (p = 0.049). Moreover, when Actual Knowledge was tested, they also provided the highest number of correct answers (p = 0.022). No differences were found by profession for Wished Knowledge. The questionnaire showed promising psychometric properties. Our findings suggest the need of continuous training in this field and identify contents to be addressed in future training programs.
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Affiliation(s)
- Elisa Zanello
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | | | - Giulia Zamagni
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Maria Celeste Biagi
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Irene Bruno
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Elisa Cragnolin
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Elisabetta Danielli
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Silvia Paoletti
- ANVOLT Trieste-Associazione Nazionale Volontari Lotta Contro i Tumori, 34135 Trieste, Italy
| | - Marco Rabusin
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health IRCSS "Burlo Garofolo", 34137 Trieste, Italy
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Bangash H, Elsekaily O, Saadatagah S, Sutton J, Johnsen P, Gundelach JH, Kamzabek A, Freimuth R, Caraballo PJ, Kullo IJ. Clinician Perspectives on Clinical Decision Support for Familial Hypercholesterolemia. J Pers Med 2023; 13:929. [PMID: 37373918 DOI: 10.3390/jpm13060929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023] Open
Abstract
Familial Hypercholesterolemia (FH) is underdiagnosed in the United States. Clinical decision support (CDS) could increase FH detection once implemented in clinical workflows. We deployed CDS for FH at an academic medical center and sought clinician insights using an implementation survey. In November 2020, the FH CDS was deployed in the electronic health record at all Mayo Clinic sites in two formats: a best practice advisory (BPA) and an in-basket alert. Over three months, 104 clinicians participated in the survey (response rate 11.1%). Most clinicians (81%) agreed that CDS implementation was a good option for identifying FH patients; 78% recognized the importance of implementing the tool in practice, and 72% agreed it would improve early diagnosis of FH. In comparing the two alert formats, clinicians found the in-basket alert more acceptable (p = 0.036) and more feasible (p = 0.042) than the BPA. Overall, clinicians favored implementing the FH CDS in clinical practice and provided feedback that led to iterative refinement of the tool. Such a tool can potentially increase FH detection and optimize patient management.
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Affiliation(s)
- Hana Bangash
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Omar Elsekaily
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Joseph Sutton
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905, USA
| | - Paul Johnsen
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905, USA
| | - Justin H Gundelach
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Arailym Kamzabek
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Freimuth
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Pedro J Caraballo
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Gonda Vascular Center, Mayo Clinic, Rochester, MN 55905, USA
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Choong DS, Tan NC, Koh YLE, Leong CK, Sankari U, Koh KH. Osteoporosis management by primary care physicians in Singapore: a survey on osteoporosis guidelines utilisation and barriers to care. Arch Osteoporos 2023; 18:72. [PMID: 37209254 DOI: 10.1007/s11657-023-01283-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
This study seeks to understand the knowledge/utilisation of osteoporosis guidelines among PCPs in Singapore, their confidence in and barriers to osteoporosis management. Knowledge and usage of guidelines was associated with confidence in management. Effective guideline adoption is therefore crucial. PCPs also need systemic support to overcome barriers to osteoporosis care. PURPOSE Primary care physicians (PCPs) are at the forefront of offering osteoporosis screening and treatment. However, osteoporosis remains under-treated in primary care, despite the existence of osteoporosis clinical practice guidelines for PCPs. This study aims to determine the self-reported knowledge and utilisation of local osteoporosis guidelines and associated sociodemographic factors and to determine the confidence and barriers to osteoporosis screening and management among PCPs in Singapore. METHODS An anonymous web-based survey was conducted. PCPs in public and private practice were invited to participate in the self-administered survey via e-mail and messaging platforms. Chi-square test was performed for bivariate analysis; multivariable logistic regression models were used for factors with p value < 0.2. RESULTS Three hundred thirty-four complete survey datasets were processed for analysis. Two hundred fifty-one PCPs (75.1%) had read the osteoporosis guidelines. 70.5% self-reported good knowledge, and 74.9% use the guidelines. PCPs who self-reported good guideline knowledge (OR = 5.84; 2.96-11.49) and utilisation (OR = 4.54; 2.21-9.34) were more likely to perceive confidence in osteoporosis management. PCPs' perception that patients had other medical priorities during the consultation (79.3%) was the commonest barrier to screening. Limited anti-osteoporosis medication (54.1%) in the practice was a hindrance to management. Polyclinic-based PCPs frequently cited the lack of consultation time as a barrier; more systemic barriers were faced by PCPs in private practices. CONCLUSION Most PCPs know and use the local osteoporosis guidelines. Knowledge and usage of guidelines was associated with confidence in management. Strategies to address the prevalent barriers to osteoporosis screening and management faced by PCPs are needed.
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Affiliation(s)
- Derek Shangxian Choong
- SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
| | - Yi Ling Eileen Koh
- SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Choon Kit Leong
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
- Mission Medical Clinic, Singapore, Singapore
| | - Usha Sankari
- SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
| | - Kim Hwee Koh
- SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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De Kok IJ, Redmond CC, Weintraub JA, Clark WA. Clinician perspectives on implementation of digitally fabricated complete dentures: A national survey of prosthodontists. J Prosthet Dent 2023:S0022-3913(23)00189-0. [PMID: 37105823 DOI: 10.1016/j.prosdent.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
STATEMENT OF PROBLEM Research on implementation factors for digitally fabricated complete dentures is sparse. PURPOSE The purpose of this survey of prosthodontists was to explore the current usage of conventionally and digitally fabricated complete dentures and to identify factors that may impact their use. MATERIAL AND METHODS A confidential cross-sectional survey consisting of 20 questions was conducted in 2019 using the Qualtrics Research Suite. The survey was distributed via electronic mail to all 1820 members of the American College of Prosthodontics. Frequency distributions, chi-squared tests, and Fisher exact tests were used to analyze the data and compare subgroups (α=.05). RESULTS The response rate was 16.8% (N=305). A total of 31.5% of respondents were implementing digitally fabricated complete dentures, 36.6% were interested in learning and/or incorporating them, 37.7% reported that they had not tried them, and 12.7% had tried them but were not interested in using them again. When asked which factors were important when considering the implementation of digitally fabricated complete dentures, 55.8% indicated laboratory costs, 72.1% total chair time spent, and 81.9% patient satisfaction. Prosthodontists who graduated from dental school after about 1991 were more interested in learning about and incorporating digitally fabricated complete dentures than earlier graduates (P=.02). CONCLUSIONS The survey results indicate that prosthodontists are implementing digitally fabricated complete dentures in clinical practice but not at the rate that might be expected of a technology that has been available for nearly a decade. Factors reported to matter in the decision to implement this technology were decreased time, overall cost, and improved patient satisfaction.
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Affiliation(s)
- Ingeborg J De Kok
- Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Jane A Weintraub
- R. Gary Rozier and Chester W. Douglass Distinguished Professor, Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wendy A Clark
- Clinical Associate Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Nunes LO, Castanheira ERL, Sanine PR, Akerman M, Nemes MIB. Performance assessment of primary health care facilities in Brazil: Concordance between web-based questionnaire and in-person interviews with health personnel. PLoS One 2023; 18:e0281085. [PMID: 36730170 PMCID: PMC9894387 DOI: 10.1371/journal.pone.0281085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
This study is a concordance analysis comparing answers to two external assessment tools for Primary Health Care (PHC) facilities that use two different data collection methodologies: (a) external assessment through structured interviews and direct observation of facilities conducted by the National Program for Improvement of Access and Quality of Primary Care (AE-PMAQ-AB), and (b) a computerized web-based self-administered questionnaire for Assessment of the Quality of Primary Health Care Services (QualiAB). The two surveys were answered by 1,898 facilities located in 437 municipalities in the state of São Paulo, Brazil, between 2017 and 2018. Both surveys aimed to assess the management and organization of PHC facilities. A total of 158 equivalent questions were identified. The answers were grouped by thematic similarity into nine domains: Territory characteristics; Local management and external support; Structure; Health promotion, disease prevention, and therapeutic procedures; Attention to unscheduled patients; Women's health; Children's health; Attention to chronic conditions; and Oral health. The results show a high level of concordance between the answers, with 81% of the 158 compared questions showing concordance higher than 0.700. We showed that the information obtained by the web-based survey QualiAB was comparable to that of the structured interview-based AE-PMAQ-AB, which is considered the gold standard. This is important because web-based surveys are more practical and convenient, and do not require trained interviewers. Online assessment surveys can allow immediate access to answers, reports and guidelines for each evaluated facility, as provided by the QualiAB system. In this way, the answers to this type of survey can be directly employed by users, allowing the assessment to fulfill all phases of an assessment process.
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Affiliation(s)
- Luceime Olivia Nunes
- Departament of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | | | - Patricia Rodrigues Sanine
- Graduate Program in Public Health, Medical School - Botucatu, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Marco Akerman
- Department of Politics, Management and Health, School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil
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Abdelazeem B, Hamdallah A, Rizk MA, Abbas KS, El-Shahat NA, Manasrah N, Mostafa MR, Eltobgy M. Does usage of monetary incentive impact the involvement in surveys? A systematic review and meta-analysis of 46 randomized controlled trials. PLoS One 2023; 18:e0279128. [PMID: 36649255 PMCID: PMC9844858 DOI: 10.1371/journal.pone.0279128] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Surveys are an effective method for collecting a large quantity of data. However, incomplete responses to these surveys can affect the validity of the studies and introduce bias. Recent studies have suggested that monetary incentives may increase survey response rates. We intended to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of monetary incentives on survey participation. METHODS A systematic search of electronic databases was conducted to collect studies assessing the impact of monetary incentives on survey participation. The primary outcome of interest was the response rates to incentives: money, lottery, and voucher. We used the Cochrane Collaboration tool to assess the risk of bias in randomized trials. We calculated the rate ratio (RR) with its 95% confidence interval (95% CI) using Review Manager Software (version 5.3). We used random-effects analysis and considered the data statistically significant with a P-value <0.05. RESULTS Forty-six RCTs were included. A total of 109,648 participants from 14 countries were involved. The mean age of participants ranged from 15 to more than 60 years, with 27.5% being males, 16.7% being females, and the other 55.8% not reported. Our analysis showed a significant increase in response rate in the incentive group compared to the control group, irrespective of the incentive methods. Money was the most efficient way to increase the response rate (RR: 1.25; 95% CI: 1.16,1.35; P = < 0.00001) compared to voucher (RR: 1.19; 95% CI: 1.08,1.31; P = < 0.0005) and lottery (RR: 1.12; 95% CI: 1.03,1.22; P = < 0.009). CONCLUSION Monetary incentives encourage the response rate in surveys. Money was more effective than vouchers or lotteries. Therefore, researchers may include money as an incentive to improve the response rate while conducting surveys.
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Affiliation(s)
- Basel Abdelazeem
- McLaren Health Care, Flint, Michigan, United States of America
- Michigan State University, East Lansing, Michigan, United States of America
| | | | | | | | | | - Nouraldeen Manasrah
- Detroit Medical Center/Sinai Grace Hospital, Detroit, Michigan
- Wayne State University, Detroit, Michigan, United States of America
| | - Mostafa Reda Mostafa
- Rochester Regional/Unity hospital, Rochester, New York, United States of America
| | - Mostafa Eltobgy
- The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
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Llor C, Cordoba G, de Oliveira SM, Bjerrum L, Moragas A. Antibiotic deprescribing: Spanish general practitioners' views on a new strategy to reduce inappropriate use of antibiotics in primary care. Eur J Gen Pract 2022; 28:217-223. [PMID: 36314609 PMCID: PMC9629099 DOI: 10.1080/13814788.2022.2130887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND A doctor may recommend that a patient stop an antibiotic course before its scheduled completion time if further treatment may cause more harm than benefit. OBJECTIVES This study explores general practitioners' (GP) opinions about the use of antibiotic deprescribing (AD) in general practice. METHODS A cross-sectional, questionnaire-based study answered from February to March 2022. GPs (n = 6,083) affiliated with the largest Spanish scientific society of primary care were invited to participate. The survey included two statements related to use and fourteen views about AD rated by GPs using a 5-item Likert scale. RESULTS Eleven hundred and seven doctors completed the surveys (18.2%), of whom 92.5% (95% confidence interval [CI] 90.8-94%) reported having used the AD strategy in their practice at least once. GPs felt very confident in using a deprescribing strategy in patients with common cold and influenza (97.6% and 93.5%, respectively) but less with acute bronchitis (45.5%); 12.1% (95% CI, 10.2-14.2%) considered this practice harmful to patients. Respondents reported using AD more frequently when they initiated the antibiotic course (96.8%; 95% CI, 95.5-97.7) than when the treatment was initiated by another doctor (52.3%; 95% CI, 49.3-55.3%). However, doctors aged >60 years were more prone to use AD compared with younger colleagues (64.5% vs. 50%; p < 0.005). CONCLUSION The GPs in this study employ the strategy of AD. Nonetheless, essential differences lie in their views of the way the strategy is used. Further studies are warranted to explore the beliefs behind these perceptions and promote wider use of AD by GPs.
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Affiliation(s)
- Carl Llor
- Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark.,Health Centre Via Roma, University Institute in Primary Care Research Jordi Gol i Gurina, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Barcelona, Spain
| | - Gloria Cordoba
- International Centre for Antimicrobial Resistance Solutions (ICARS), Denmark.,Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Sandi Michele de Oliveira
- Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Lars Bjerrum
- Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Ana Moragas
- Jaume I Health Centre, University Rovira i Virgili, Tarragona, Spain
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Trevisan MD, Knorst MR, Baptista RR. Perfil da fisioterapia na reabilitação de indivíduos com doença de Alzheimer: um estudo transversal. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016629042022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
RESUMO O estudo analisou o perfil de atuação dos fisioterapeutas do Rio de Janeiro (RJ) e do Rio Grande do Sul (RS) no manejo da pessoa com doença de Alzheimer (DA). Foram obtidas 256 respostas a um questionário enviado via endereço eletrônico dos Conselhos Regionais de Fisioterapia e Terapia Ocupacional das regiões 2 (RJ) e 5 (RS) - CREFITOS 2 e 5 -, entre março e dezembro de 2020. O questionário tinha 36 perguntas fechadas, cujas variáveis foram agrupadas em: (1) caracterização da amostra; (2) dados específicos sobre a profissão de fisioterapeuta; e (3) questões relacionadas à DA. Neste artigo serão analisadas apenas as questões relacionadas à DA. Todas as questões eram de múltipla escolha, com 2 até 15 opções de resposta. A maioria dos respondentes (88,3%) já atendeu paciente com DA, mas 50,8% fariam uma revisão de literatura para atender novamente esses pacientes. O principal objetivo relatado no manejo do indivíduo com DA foi “retardar a progressão das perdas motoras”. As condutas foram significativamente diferentes conforme a fase da doença (p<0,001). Mais de 85% citaram como benefício que a fisioterapia “retarda a dependência física”. Este estudo deixa evidente a necessidade de mais pesquisas que abordem especificamente as fases intermediária e avançada da DA, pois, até o momento, a literatura se mostra inconclusiva e com pouca evidência em relação à fisioterapia no manejo dessas pessoas, impossibilitando a criação de manuais e/ou padronização de condutas específicas a cada estágio da doença.
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Trevisan MD, Knorst MR, Baptista RR. Profile of physical therapy in the rehabilitation of individuals with Alzheimer’s disease: a cross-sectional study. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016629042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
ABSTRACT This study analyzes the working profile of physical therapists from the states of Rio de Janeiro (RJ) and Rio Grande do Sul (RS) in the management of people with Alzheimer’s disease (AD). A total of 256 responses were obtained to a questionnaire sent via the electronic address of the Regional Councils of Physical Therapy and Occupational Therapy (CREFITOS) 2 (RJ) and 5 (RS), from March to December 2020. The questionnaire comprises 36 closed questions, the variables of which were grouped into: (1) sample characterization; (2) specific data on the profession of physical therapist; and (3) issues related to AD. In this article, only issues related to AD will be analyzed. All questions were multiple choice with 2 to 15 options of answer. Most respondents (88.3%) had already treated patients with AD, but 50.8% needed to review the literature to assist these patients. The main objective reported in the management of the individual with AD was to “delay the progression of motor losses.” The practices were significantly different according to the stage of the disease (p<0.001). More than 85% of the participants cited as a benefit that physical therapy “delays physical dependence.” This study shows the need for further studies that specifically address the intermediate and advanced stages of AD since the current literature is inconclusive and with little evidence regarding physical therapy in the management of this population, making it impossible to create manuals and /or standardization of specific practices for each stage.
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Derricks V, Mosher J, Earl A, Jayaratne TE, Shubrook JH. Real and Perceived Discordance in Physicians and U.S. Adults' Beliefs Regarding the Causes and Controllability of Type 2 Diabetes. HEALTH COMMUNICATION 2022; 37:1264-1275. [PMID: 33622109 PMCID: PMC8380747 DOI: 10.1080/10410236.2021.1885775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Discordance between physicians and patients' health beliefs can impede health communication efforts. However, little research considers physicians' perceptions of patient beliefs, despite the importance of perceptions in shaping communication. In the current work, we examine instances of actual and perceived discordance between physicians and U.S. adults' beliefs regarding the causes and controllability of type 2 diabetes. 229 family physicians completed an online survey measuring their health beliefs and perceptions of their patients' beliefs. Physicians' responses were contrasted against beliefs from a national survey sample of 1,168 U.S. adults. T-tests assessed whether (a) physicians' beliefs diverged from the national sample's beliefs (actual discordance), (b) physicians perceived that their health beliefs diverged from their patients' beliefs (perceived discordance), and (c) physicians' perceptions of patient beliefs diverged from the national sample's beliefs (accuracy of perceived discordance). Findings revealed evidence of actual discordance; compared to the national sample, physicians were more likely to attribute type 2 diabetes to genes (versus lifestyle factors) and perceived greater control over developing diabetes. Moreover, although physicians perceived discordance between their own and their patients' beliefs, data from the national sample suggested that these gaps were less substantial than physicians expected. In particular, findings showed that physicians generally overestimated discordance, expecting that people would be less likely to (1) attribute the development of diabetes to lifestyle factors (versus genes), and (2) perceive control over developing diabetes, than was actually reported. Implications of actual and perceived discordance for effective health communication and patient education are discussed.
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Affiliation(s)
- Veronica Derricks
- Indiana University – Purdue University Indianapolis, Department of Psychology, Indianapolis, Indiana, USA
- University of Michigan, Department of Psychology, Ann Arbor, Michigan, USA
| | - Jeremy Mosher
- Touro University California, College of Osteopathic Medicine, Vallejo, California, USA
| | - Allison Earl
- University of Michigan, Department of Psychology, Ann Arbor, Michigan, USA
| | - Toby E. Jayaratne
- University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
| | - Jay H. Shubrook
- Touro University California, College of Osteopathic Medicine, Vallejo, California, USA
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Mehdizadeh M, Fallah Zavareh M, Nordfjaern T. Explaining trip generation during the COVID-19 pandemic: A psychological perspective. JOURNAL OF TRANSPORT & HEALTH 2022; 26:101390. [PMID: 36091182 PMCID: PMC9444181 DOI: 10.1016/j.jth.2022.101390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 04/13/2022] [Accepted: 05/08/2022] [Indexed: 05/11/2023]
Abstract
Introduction The present study investigated the extent of reduction in the generation of non-essential trips (i.e., for shopping, personal, social, and entertainment reasons) due to the COVID-19 pandemic and the role of psychological factors (including deliberate planning and personal moral obligations) in explaining the change. Method We collected data through an internet survey conducted from April to June 2020. We recruited the respondents (N = 369) from a young segment of the population in Iran. The hypothesised model framework included the components of the theory of planned behaviour (including attitudes, subjective norms, perceived behavioural control, and intention to reduce non-essential trips) along with personal moral obligation. The framework also consisted of socio-demographic characteristics of age, gender, income, car ownership and trip distance. A structural equation model was developed to explain trip reduction at an aggregated level for four non-essential trip purposes (i.e., shopping, personal, social, and entertainment). In the aggregated model, trip-reducing behaviour represents the change in the number of trips for all non-essential purposes. We also tested the same framework, to explain trip reduction for each of the trip purposes, separately. Results On average, the study participants reduced their non-essential trips by 60% during the pandemic compared with in the pre-COVID-19 period. Men were less likely than women to reduce the rate of their trips during the pandemic. The SEM demonstrated that the theory of planned behaviour predicted trip-generation behaviour during the abnormal situation represented by the pandemic. Perceived behavioural control both directly and indirectly impacted trip reduction. However, personal moral obligations failed to provide a direct explanation for trip generation reduction. According to the hypothesised model, the results for different trip purposes were also mostly in line with those from the aggregated model. Conclusions The findings imply that participants in our sample made deliberate and planned psychological decisions (aligned with the theory of planned behaviour) regarding potential travel behavioural decisions during the COVID-19 pandemic. The findings also highlighted that perceived behavioural control grows in importance alongside growth in difficult circumstances.
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Affiliation(s)
- Milad Mehdizadeh
- Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway
| | - Mohsen Fallah Zavareh
- Kharazmi University, Department of Civil Engineering, Faculty of Engineering, Tehran, Iran
| | - Trond Nordfjaern
- Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway
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Anderson JM, Johnson A, Rauh S, Johnson B, Bouvette M, Pinero I, Beaman J, Vassar M. Perceptions and Opinions Towards Data-Sharing: A Survey of Addiction Journal Editorial Board Members. THE JOURNAL OF SCIENTIFIC PRACTICE AND INTEGRITY 2022; 2022:10.35122/001c.35597. [PMID: 38804666 PMCID: PMC11129878 DOI: 10.35122/001c.35597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background We surveyed addiction journal editorial board members to better understand their opinions towards data-sharing. Methods Survey items consisted of Likert-type (e.g., one to five scale), multiple-choice, and free-response questions. Journal websites were searched for names and email addresses. Emails were distributed using SurveyMonkey. Descriptive statistics were used to characterize the responses. Results We received 178 responses (of 1039; 17.1%). Of these, 174 individuals agreed to participate in our study (97.8%). Most respondents did not know whether their journal had a data-sharing policy. Board members "somewhat agree" that addiction journals should recommend but not require data-sharing for submitted manuscripts [M=4.09 (SD=0.06); 95% CI: 3.97-4.22]. Items with the highest perceived benefit ratings were "secondary data use (e.g., meta-analysis)" [M=3.44 (SD=0.06); 95% CI: 3.31-3.56] and "increased transparency" [M=3.29 (SD=0.07); 95% CI: 3.14-3.43]. Items perceived to be the greatest barrier to data-sharing included "lack of metadata standards" [M=3.21 (SD=0.08); 95% CI: 3.06-3.36], "no incentive" [M=3.43 (SD=0.07); 95% CI: 3.30-3.57], "inadequate resources" [M=3.53 (SD=0.05); 95% CI: 3.42-3.63], and "protection of privacy"[M=3.22 (SD=0.07); 95% CI: 3.07-3.36]. Conclusion Our results suggest addiction journal editorial board members believe data-sharing has a level of importance within the research community. However, most board members are unaware of their journals' data-sharing policies, and most data-sharing should be recommended but not required. Future efforts aimed at better understanding common reservations and benefits towards data-sharing, as well as avenues to optimize data-sharing while minimizing potential risks, are warranted.
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Affiliation(s)
| | | | - Shelby Rauh
- Center for Health Sciences, Oklahoma State University
| | | | | | | | - Jason Beaman
- Center for Health Sciences, Oklahoma State University
| | - Matt Vassar
- Center for Health Sciences, Oklahoma State University
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Valente EP, Covi B, Mariani I, Morano S, Otalea M, Nanu I, Nanu MI, Elden H, Linden K, Zaigham M, Vik ES, Kongslien S, Nedberg I, Costa R, Rodrigues C, Dias H, Drandić D, Kurbanović M, Sacks E, Muzigaba M, Lincetto O, Lazzerini M. WHO Standards-based questionnaire to measure health workers' perspective on the quality of care around the time of childbirth in the WHO European region: development and mixed-methods validation in six countries. BMJ Open 2022; 12:e056753. [PMID: 35396296 PMCID: PMC8995570 DOI: 10.1136/bmjopen-2021-056753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers' perspective. DESIGN Mixed-methods study. SETTING Six countries of the WHO European Region. PARTICIPANTS AND METHODS The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries. RESULTS The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach's alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet's AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording. CONCLUSIONS Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire's use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC. TRAIL REGISTRATION NUMBER NCT04847336.
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Affiliation(s)
- Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sandra Morano
- Medical School and Midwifery School, Genoa University, Genoa, Italy
| | - Marina Otalea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
| | - Ioana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Micaela Iuliana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mehreen Zaigham
- Department of Obstetrics and Gynecology - Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital, Malmö, Sweden
| | - Eline Skirnisdottir Vik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sigrun Kongslien
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ingvild Nedberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Raquel Costa
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Human-Environment Interaction Lab, Universidade Lusófona, Porto, Portugal
| | - Carina Rodrigues
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Heloísa Dias
- Regional Health Administration of the Algarve, IP (ARS - Algarve), Albufeira, Portugal
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Moise Muzigaba
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ornella Lincetto
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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Forgeron PA, Dick BD, Chambers C, Cohen J, Lamontagne C, Finley GA. Are They Still Friends? Friendship Stability of Adolescents With Chronic Pain: 1-Year Follow-Up. FRONTIERS IN PAIN RESEARCH 2022; 2:767236. [PMID: 35295468 PMCID: PMC8915730 DOI: 10.3389/fpain.2021.767236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Most adolescents identify their best friend as their main source of social support. Adolescents with chronic pain (ACP) report the loss of friendships due to pain. Friendships protect against loneliness and depression, yet adolescents with pain experience increased levels of loneliness and depression compared to peers. This longitudinal study examines the friendship stability of dyads that included an adolescent with chronic pain compared to non-pain friendship dyads as well as the factors contributing to a friendship breakup. Eighty-three participants from 61 same-sex friendship dyads across 3 sites participated in a 1-year follow-up survey designed to capture friendship features, indices of social-emotional well-being, pain characteristics, and friendship stability. Chi-square, repeated measures ANOVA, and logistic regression were used to analyze the data. Dyads that included an ACP experienced higher rates of friendship breakup. The shorter length of friendship and having chronic pain predicted a friendship breakup at time 2. ACP continues to experience worse scores on indices of social-emotional well-being that are not predicted with a friendship breakup. Understanding what contributes to positive long-term friendships for those with pain may inform strategies to maintain and improve friendships for those with pain and who experience social challenges.
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Affiliation(s)
- Paula A. Forgeron
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Department of Anesthesia, Dalhousie University, Halifax, NS, Canada
- Children's Hospital of Eastern Ontario's Research Institute, Ottawa, ON, Canada
- *Correspondence: Paula A. Forgeron
| | - Bruce D. Dick
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Christine Chambers
- Pediatrics and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Psychology, Dalhousie University, Halifax, NS, Canada
| | - Janice Cohen
- Behavioural Neurosciences and Consultation Liaison Team, Mental Health, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Christine Lamontagne
- Children's Hospital of Eastern Ontario's Research Institute, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Gordon Allen Finley
- Department of Anesthesia, Dalhousie University, Halifax, NS, Canada
- Psychology, Dalhousie University, Halifax, NS, Canada
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Fallah Zavareh M, Mehdizadeh M, Nordfjærn T. Demand for mitigating the risk of COVID-19 infection in public transport: The role of social trust and fatalistic beliefs. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2022; 84:348-362. [PMID: 34963755 PMCID: PMC8695128 DOI: 10.1016/j.trf.2021.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 05/25/2023]
Abstract
The rapid surge of COVID-19 cases worldwide drew attention to COVID-19 infection as a new source of risk in transport. The virus introduced a need for viral transmission mitigation as a major priority when selecting a mode of travel, and caused a significant drop in public transport use. The recovery of public transport use in the post-COVID period requires that the transport authorities favourably address people's demand for mitigation of the risk of COVID-19 transmission in public transport. The present study aims to explore the role of risk perception, worry and priority of COVID-19 risk reduction along with fatalistic beliefs and public trust in authorities in explaining public demand for risk mitigation. The present study is among the first to investigate the role of fatalistic beliefs, social trust and risk perception for public transport and public demand for risk mitigation. The link between priority of infection prevention and demand for risk mitigation has also been less explored in public transport research. An online survey was conducted among university students in Iran between 19th April and 16th June 2020, during the first wave of the pandemic, when the country was a major epicentre of the disease. A total of 271 out of 370 respondents whose dominant mode on university travels was public transport were included in the analysis. Results of structural equation modelling confirmed the paradox of trust, indicating that social trust is negatively associated with perceived risk of COVID-19 infection, which in turn may lead people to place less importance on COVID-19 prevention as a priority in travel mode choice, and consequently demand less risk mitigation efforts to prevent COVID-19 infection in public transport. Dissimilar to trust, however, the results revealed no relationship between fatalistic beliefs and risk perception, but a significant direct effect of fatalistic beliefs on demand for risk mitigation. To reinforce public demand for mitigating the risk of COVID-19 in public transport, the study calls on policymakers to exploit public trust resources for more effective risk communication, through disseminating the gradually accumulating evidence-based information regarding the infectivity and the virulence of COVID-19 and the scientific risk of infection. The study also underlined the potential importance of considering fatalistic beliefs when developing effective risk communication policies and practices to enhance public support for COVID-19 risk mitigation in public transport.
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Affiliation(s)
- Mohsen Fallah Zavareh
- Department of Civil Engineering, Kharazmi University, Faculty of Engineering, Tehran, Iran
| | - Milad Mehdizadeh
- Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway
| | - Trond Nordfjærn
- Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway
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Cook E, Scantlebury A, Booth A, Turner E, Ranganathan A, Khan A, Ahuja S, May P, Rangan A, Roche J, Coleman E, Hilton C, Corbacho B, Hewitt C, Adamson J, Torgerson D, McDaid C. Surgery versus conservative management of stable thoracolumbar fracture: the PRESTO feasibility RCT. Health Technol Assess 2021; 25:1-126. [PMID: 34780323 DOI: 10.3310/hta25620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is informal consensus that simple compression fractures of the body of the thoracolumbar vertebrae between the 10th thoracic vertebra and the second lumbar vertebra without neurological complications can be managed conservatively and that obvious unstable fractures require surgical fixation. However, there is a zone of uncertainty about whether surgical or conservative management is best for stable fractures. OBJECTIVES To assess the feasibility of a definitive randomised controlled trial comparing surgical fixation with initial conservative management of stable thoracolumbar fractures without spinal cord injury. DESIGN External randomised feasibility study, qualitative study and national survey. SETTING Three NHS hospitals. METHODS A feasibility randomised controlled trial using block randomisation, stratified by centre and type of injury (high- or low-energy trauma) to allocate participants 1 : 1 to surgery or conservative treatment; a costing analysis; a national survey of spine surgeons; and a qualitative study with clinicians, recruiting staff and patients. PARTICIPANTS Adults aged ≥ 16 years with a high- or low-energy fracture of the body of a thoracolumbar vertebra between the 10th thoracic vertebra and the second lumbar vertebra, confirmed by radiography, computerised tomography or magnetic resonance imaging, with at least one of the following: kyphotic angle > 20° on weight-bearing radiographs or > 15° on a supine radiograph or on computerised tomography; reduction in vertebral body height of 25%; a fracture line propagating through the posterior wall of the vertebra; involvement of two contiguous vertebrae; or injury to the posterior longitudinal ligament or annulus in addition to the body fracture. INTERVENTIONS Surgical fixation: open spinal surgery (with or without spinal fusion) or minimally invasive stabilisation surgery. Conservative management: mobilisation with or without a brace. MAIN OUTCOME MEASURE Recruitment rate (proportion of eligible participants randomised). RESULTS Twelve patients were randomised (surgery, n = 8; conservative, n = 4). The proportion of eligible patients recruited was 0.43 (95% confidence interval 0.24 to 0.63) over a combined total of 30.7 recruitment months. Of 211 patients screened, 28 (13.3%) fulfilled the eligibility criteria. Patients in the qualitative study (n = 5) expressed strong preferences for surgical treatment, and identified provision of information about treatment and recovery and when and how they are approached for consent as important. Nineteen surgeons and site staff participated in the qualitative study. Key themes were the lack of clinical consensus regarding the implementation of the eligibility criteria in practice and what constitutes a stable fracture, alongside lack of equipoise regarding treatment. Based on the feasibility study eligibility criteria, 77% (50/65) and 70% (46/66) of surgeons participating in the survey were willing to randomise for high- and low-energy fractures, respectively. LIMITATIONS Owing to the small number of participants, there is substantial uncertainty around the recruitment rate. CONCLUSIONS A definitive trial is unlikely to be feasible currently, mainly because of the small number of patients meeting the eligibility criteria. The recruitment and follow-up rates were slightly lower than anticipated; however, there is room to increase these based on information gathered and the support within the surgical community for a future trial. FUTURE WORK Development of consensus regarding the population of interest for a trial. TRIAL REGISTRATION Current Controlled Trials ISRCTN12094890. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 62. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Elizabeth Cook
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Alison Booth
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Emma Turner
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Almas Khan
- Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, UK
| | - Sashin Ahuja
- Cardiff & Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Peter May
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Amar Rangan
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Jenny Roche
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Belén Corbacho
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Joy Adamson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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Gulati M, Peterson LA, Mihailidou A. Assessment of blood pressure skills and belief in clinical readings. Am J Prev Cardiol 2021; 8:100280. [PMID: 34729545 PMCID: PMC8546363 DOI: 10.1016/j.ajpc.2021.100280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022] Open
Abstract
Background Accurate blood pressure (BP) measurement is essential for the diagnosis and management of hypertension. In clinical practice, BP is estimated using noninvasive methods with significant variability of application of guidelines in clinical practice, impacting the accuracy and certainty of BP measurements. Objective We sought to assess how BP is measured in clinical practice. Methods A survey was administered through professional societies that included predominantly cardiologists. Assessment of adherence to guideline recommendations for BP assessment was measured and compared to the level of confidence in clinic BP measurement. Results There were 571 surveys completed. The majority of respondents were cardiologists (61.1%), with 47 preventive cardiologists. BP was routinely checked in both arms by 53% at the initial visit, 48% check BP once each visit, and 64% wait 5 min before initial BP assessment. Automated BP assessment is used by 58% respondents. The majority (83%) trust their BP readings, and those who trust their BP readings are more likely to perform the initial BP assessment themselves, compared to those who do not trust the clinic BP readings (30.2% vs. 13.6%, P = 0.009). Accurate BP measurement is performed by 23% of cardiologists, and more likely performed accurately by a preventive cardiologist (38.3%) compared with other cardiologists (20.0%, P = 0.007). Accurate BP measurement is more likely for those who perform the initial BP themselves rather than any other staff (36.8% vs. 17.9%; P<0.001); and for those who repeat BP manually (80% vs. 54%; P<0.001), compared to those who do not measure BP accurately. Despite the inaccuracy of BP measurement, there is a high level of confidence in the BP readings. Conclusions Accurate BP assessment continues to remain suboptimal in clinical practice. Reliability of BP assessment requires education, identifying barriers to implementation of recommendations and engagement of the entire team to improve BP assessment.
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Nath TK, Paul A, Sikdar D, Mahanta J, Paul S, Amin MR, Chowdhury S, Bhuiyan MNH, Rob MA, Rahim A, Islam MK, Sharif MM, Navaneetham K. Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh. BMC Health Serv Res 2021; 21:1079. [PMID: 34635110 PMCID: PMC8504780 DOI: 10.1186/s12913-021-07071-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background The safety of health care workers (HCWs) in Bangladesh and the factors associated with getting COVID-19 have been infrequently studied. The aim of this study was to address this gap by assessing the capacity development and safety measures of HCWs in Bangladesh who have been exposed to COVID-19 and by identifying the factors associated with respondents’ self-reported participation in capacity development trainings and their safety practices. Methods This cross-sectional study was based on an online survey of 811 HCWs working at 39 dedicated COVID-19 hospitals in Bangladesh. A pretested structured questionnaire consisting of questions related to respondents’ characteristics, capacity development trainings and safety measures was administered. Binary logistic regressions were run to assess the association between explanatory and dependent variables. Results Among the respondents, 58.1% had been engaged for at least 2 months in COVID-19 care, with 56.5% of them attending capacity development training on the use of personal protective equipment (PPE), 44.1% attending training on hand hygiene, and 35% attending training on respiratory hygiene and cough etiquette. Only 18.1% reported having read COVID-19-related guidelines. Approximately 50% of the respondents claimed that there was an inadequate supply of PPE for hospitals and HCWs. Almost 60% of the respondents feared a high possibility of becoming COVID-19-positive. Compared to physicians, support staff [odds ratio (OR) 4.37, 95% confidence interval (CI) 2.25–8.51] and medical technologists (OR 8.77, 95% CI 3.14–24.47) were more exhausted from working in COVID-19 care. Respondents with longer duty rosters were more exhausted, and those who were still receiving infection prevention and control (IPC) trainings were less exhausted (OR 0.54, 95% CI 0.34–0.86). Those who read COVID-19 guidelines perceived a lower risk of being infected by COVID-19 (OR 0.44, 95% CI 0.29–0.67). Compared to the respondents who strongly agreed that hospitals had a sufficient supply of PPE, others who disagreed (OR 2.68, 95% CI 1.31–5.51) and strongly disagreed (OR 5.05, 95% CI 2.15–11.89) had a higher apprehension of infection by COVID-19. Conclusion The findings indicated a need for necessary support, including continuous training, a reasonable duty roster, timely diagnosis of patients, and an adequate supply of quality PPE. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07071-2.
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Affiliation(s)
- Tapan Kumar Nath
- School of Environmental and Geographical Sciences, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Alak Paul
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh.
| | - Dwaipayan Sikdar
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chittagong, Bangladesh
| | - Janardan Mahanta
- Department of Statistics, University of Chittagong, Chittagong, Bangladesh
| | - Sujat Paul
- Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
| | - Md Robed Amin
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Shahanara Chowdhury
- Department of Obstetrics and Gynaecology, Chittagong Medical College, Chittagong, Bangladesh
| | | | - Md Abdur Rob
- Senior Consultant (Medicine), Chattogram General Hospital, Chittagong, Bangladesh
| | - Abdur Rahim
- Junior Consultant (Medicine), Kuwait Bangladesh Friendship Government Hospital, Dhaka, Bangladesh
| | - Md Khairul Islam
- Junior Consultant, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | | | - Kannan Navaneetham
- Department of Population Studies, University of Botswana, Gaborone, Botswana
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22
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Barnes RY, van Rensburg AJ, Raubenheimer JE. Referral practices of medical practitioners in central South Africa to physiotherapy services for patients living with musculoskeletal conditions. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1563. [PMID: 34693070 PMCID: PMC8517772 DOI: 10.4102/sajp.v77i1.1563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/08/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Musculoskeletal diseases (MSDs) are a major cause of disability worldwide. It is essential to address effective MSD management, including appropriate referrals to physiotherapists and other healthcare professionals. Limited information is available regarding the referral practices of medical practitioners for patients with MSD. The doctors' referral practices to physiotherapists can impact the patient population and the South African health system. OBJECTIVES To investigate or understand the referral practices of medical practitioners in Bloemfontein, South Africa, to physiotherapy services, for individuals living with MSD. METHOD A quantitative study approach, implementing a semi-structured questionnaire, was used. Forty-nine participants completed the questionnaire. RESULTS The referral of patients with MSDs by medical practitioners to physiotherapy services varied and multidimensional factors influenced their referral practices. Medical practitioners were unsure of the specific role played by physiotherapists in the management of individuals living with MSD. A need for improved relationships and communication between medical practitioners and physiotherapists was identified. CONCLUSIONS Medical practitioners regularly referred individuals living with MSD to physiotherapists, but referral practices should be optimised in terms of evidence-based practice and the use of specialised physiotherapy services. In an attempt to decrease the burden of MSD, adequate awareness should be created for improved referral practices between medical practitioners and physiotherapists. CLINICAL IMPLICATIONS Collaborative development of detailed guidelines for apt, evidence-based referrals should be developed, to ensure early detection and management of individuals living with MSD. Health care professionals should be educated and encouraged to refer individuals living with MSD to physiotherapists for appropriate management with clinical benefits including improvement of HRQOL and cost effectiveness of this management not only to the individual but also to the health system in South Africa. Physiotherapists should try to communicate their role in the treatment of individuals living with MSD to medical practitioners for the benefit of the patient.
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Affiliation(s)
- Roline Y Barnes
- Department of Physiotherapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Alida Janse van Rensburg
- Department of Physiotherapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Jacques E Raubenheimer
- Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
- Discipline of Bioinformatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Au S, Bellato V, Carvas JM, Córdoba CD, Daudu D, Dziakova J, Eltarhoni K, El Feituri N, Fung ACH, Fysaraki C, Gallo G, Gultekin FA, Harbjerg JL, Hatem F, Ioannidis A, Jakobsen L, Clinch D, Kristensen HØ, Kuiper SZ, Kwok AMF, Kwok W, Millan M, Milto KM, Ng HJ, Pellino G, Picciariello A, Pronin S, van Ramshorst GH, Ramser M, Jiménez-Rodríguez RM, Sainz Hernandez JC, Samadov E, Sohrabi S, Uchiyama M, Wang JHS, Younis MU, Fleming S, Alhomoud S, Mayol J, Moeslein G, Smart NJ, Soreide K, Teh C, Verran D, Maeda Y. Global parental leave in surgical careers: differences according to gender, geographical regions and surgical career stages. Br J Surg 2021; 108:1315-1322. [PMID: 34467970 DOI: 10.1093/bjs/znab275] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/24/2021] [Accepted: 07/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is a lack of information regarding the provision of parental leave for surgical careers. This survey study aims to evaluate the experience of maternity/paternity leave and views on work-life balance globally. METHODS A 55-item online survey in 24 languages was distributed via social media as per CHERRIES guideline from February to March 2020. It explored parental leave entitlements, attitude towards leave taking, financial impact, time spent with children and compatibility of parenthood with surgical career. RESULTS Of the 1393 (male : female, 514 : 829) respondents from 65 countries, there were 479 medical students, 349 surgical trainees and 513 consultants. Consultants had less than the recommended duration of maternity leave (43.8 versus 29.1 per cent), no paid maternity (8.3 versus 3.2 per cent) or paternity leave (19.3 versus 11.0 per cent) compared with trainees. Females were less likely to have children than males (36.8 versus 45.6 per cent, P = 0.010) and were more often told surgery is incompatible with parenthood (80.2 versus 59.5 per cent, P < 0.001). Males spent less than 20 per cent of their salary on childcare and fewer than 30 hours/week with their children. More than half (59.2 per cent) of medical students did not believe a surgical career allowed work-life balance. CONCLUSION Surgeons across the globe had inadequate parental leave. Significant gender disparity was seen in multiple aspects.
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Affiliation(s)
- S Au
- NHS Education for Scotland, Edinburgh, UK
| | | | | | - C D Córdoba
- University of Lausanne, Lausanne, Switzerland
| | - D Daudu
- Faculty of Health and Medical Sciences, University of Western Australia, Australia
| | - J Dziakova
- Hospital Clinico San Carlos, IDISSC, Madrid, Spain
| | | | | | - A C H Fung
- Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
| | - C Fysaraki
- Urology Department, Mid Yorkshire Hospitals NHS Trust, UK
| | - G Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - F Ayca Gultekin
- General Surgery Department, Zonguldak Bulent, Ecevit University School of Medicine, Zonguldak, Turkey
| | - J L Harbjerg
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - F Hatem
- Glasgow Royal Infirmary, Glasgow, UK
| | | | - L Jakobsen
- UiT, The Arctic University of Norway, University Hospital of North Norway, Tromso, Norway
| | - D Clinch
- Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - H Ø Kristensen
- Department of Surgery, Research Unit C119, Aarhus University Hospital, Palle Juul-Jensens, Aarhus N, Denmark
| | - S Z Kuiper
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | | | - W Kwok
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M Millan
- Coloproctology Unit, Department of Surgery, La Fe University Hospital, Valencia, Spain
| | - K M Milto
- NHS Education for Scotland, Edinburgh, UK
| | - H J Ng
- Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, UK
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Picciariello
- Department of Emergency and Organ Transplantation, University 'Aldo Moro' of Bari, Italy
| | - S Pronin
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Ramser
- Department of Surgery, Solothurner Spitäler SoH, Bürgerspital Solothurn, Solothurn, Switzerland
| | | | - J C Sainz Hernandez
- Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Mexico City, Mexico
| | - E Samadov
- Surgical Department, LEYLA Medical Centre, Baku, Azerbaijan
| | | | - M Uchiyama
- Showa University School of Medicine, Tokyo, Japan
| | - J H-S Wang
- Australasian Students' Surgical Association, New Zealand
| | - M U Younis
- Mediclinic City Hospital, Dubai, United Arab Emirates
| | - S Fleming
- Barts and the London School of Medicine and Dentistry, London, UK
| | - S Alhomoud
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - J Mayol
- Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense, Madrid, Spain
| | - G Moeslein
- Ev. Bethesda Khs Duisburg, University of Witten, Herdecke, Germany
| | - N J Smart
- Royal Devon & Exeter Hospital & University of Exeter Medical School, Exeter, UK
| | - K Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - C Teh
- Department of Surgery, Makati Medical Centre, Makati, Philippines.,Department of General Surgery, National Kidney & Transplant Institute, Quezon City, Philippines
| | - D Verran
- Ramsey Health Care, Sydney, Australia
| | - Y Maeda
- Department of Colorectal Surgery, Western General Hospital and University of Edinburgh, Edinburgh, UK
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Tomio AA, Dottori M, Hesse E, Torrente F, Flichtentrei D, Ibanez AM. Behavioural insights (BI) for childhood development and effective public policies in Latin America: a survey and a randomised controlled trial. BMJ Open 2021; 11:e047925. [PMID: 34373303 PMCID: PMC8354254 DOI: 10.1136/bmjopen-2020-047925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We developed (a) a survey to investigate the knowledge of childhood health experts on public policies and behavioural insights (BI), as well as its use in Latin American and the Caribbean countries (LACs), and (b) an intervention (randomised controlled trial) to test the influence of nudges on the effect of a simulated public health programme communication. PARTICIPANTS AND SETTINGS A total of 2003 LACs childhood health professionals participated in the study through a Hispanic online platform. PRIMARY AND SECONDARY OUTCOMES We used regression models analysing expertise-related information, individual differences and location. We extracted several outcome variables related to (a) 'Public Policy Knowledge Index' based on the participants' degree of knowledge on childhood health public policies and (b) BI knowledge, perceived effectiveness and usefulness of a simulated public programme communication. We also analysed a 'Behavioural Insights Knowledge Index' (BIKI) based on participants' performance in BI questions. RESULTS In general, health professionals showed low BI knowledge (knowledge of the term BI: χ2=210.29, df=1 and p<0.001; BIKI: χ2=160.5, df=1 and p<0.001), and results were modulated by different factors (age, academic formation, public policy knowledge and location). The use of BI principles for the communication of the public programme revealed higher impact and clarity ratings from professionals than control messages. CONCLUSIONS Our findings provide relevant knowledge about BI in health professionals to inform governmental and non-governmental organisations' decision-making processes related with childhood public policies and BI designs.
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Affiliation(s)
- Andrea A Tomio
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina
| | - Martin Dottori
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires, Argentina
| | - Eugenia Hesse
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires, Argentina
| | - Fernando Torrente
- Institute of Cognitive and Translational Neurosciences, CONICET-Favaloro University-INECO Foundation, Buenos Aires, Argentina
| | | | - Agustin M Ibanez
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute (GBHI), UCSF, San Francisco, California, USA
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
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Shelton N, Munro N, Keep M, Starling J, Tieu L. Clinical practices of speech-language pathologists working with 12- to 16-year olds in Australia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:394-404. [PMID: 33624563 DOI: 10.1080/17549507.2020.1820576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: The current landscape of speech-language pathology (SLP) services for 12- to 16-year olds in Australia remains largely unchartered. Implementing the Speech Pathology 2030 vision necessitates mapping current services, and gaps in services, provided by speech-language pathologists (SLPs). However, the last survey of Australian SLPs' practices with young people was conducted in 2005. The aim of this study was to bridge the service delivery information gap.Method: Ninety-six SLPs working with 12- to 16-year olds in Australia completed an anonymous online survey consisting of binary choice, multiple choice, and Likert scale questions. A theoretical approach to service delivery based on response to intervention models underpinned question design.Result: SLP clinical practices remain traditional, following an impairment/diagnostic model. Additionally, there is an inequitable provision of SLP services across states/territories of Australia, according to whether or not there is government provision for SLP services in public schools.Conclusion: The results suggest a need for standard government provision of SLP services across Australia to ensure equity of access. These findings inform our understanding of contemporary assessment and intervention practices of SLPs working with 12- to 16-year olds in Australia.
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Affiliation(s)
- Nichola Shelton
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Natalie Munro
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Melanie Keep
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Julia Starling
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lyn Tieu
- Office of the Pro Vice-Chancellor (Research & Innovation), School of Education, MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, Australia
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Croke J, Tosoni S, Ringash J. "It's good for the soul:" Perceptions of a formal junior faculty mentorship program at a large academic cancer centre. Radiother Oncol 2021; 162:119-123. [PMID: 34256081 DOI: 10.1016/j.radonc.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/23/2021] [Accepted: 07/03/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Mentorship fosters professional and personal growth; however, the components essential to program success remain unclear. Our objective was to evaluate and explore the impact of a junior faculty mentorship program within an academic radiation oncology department. MATERIALS AND METHODS In 2016, our institution implemented a junior faculty mentorship program consisting of: (1) an orientation handbook; (2) faculty development sessions; and (3) direct, one-to-one selection of a mentor. Confidentiality agreements are signed, a goals template is provided, and meeting dates are tracked. Mentors/mentees were invited to participate in a program evaluation using mixed-methodology: a questionnaire followed by a one-on-one semi-structured interview to explore perceptions of the program. Interviews were audiotaped and transcribed verbatim. Descriptive statistics summarized questionnaire results and thematic analysis summarized interview results. RESULTS Eleven junior faculty have selected 10 mentors. Of these, 17 completed the evaluation questionnaire (81%) (7 mentors, 10 mentees; 5 women, 12 men) and 13 were interviewed (62%) (5 mentors, 8 mentees; 3 women, 10 men). The majority (80%) have participated in the program for >2 years. Although most mentees report additional mentors, 30% report this as their sole mentorship relationship. Four themes emerged: (i) Components of an Ideal Mentoring Relationship, (ii) The Value of Mentorship, (iii) Sponsorship, in addition to Mentorship and (iv) Cultivating Departmental Bonds and Boundaries. CONCLUSION Implementation of a junior faculty mentorship program within an academic radiation oncology department is feasible. Participants expressed satisfaction with most formal program components. Many junior faculty have additional mentors; however, some do not, highlighting the importance of formal programs for professional development.
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Affiliation(s)
- Jennifer Croke
- Department of Radiation Oncology, University of Toronto, Canada; Radiation Medicine Program, University Health Network, Toronto, Canada.
| | - Sarah Tosoni
- Department of Radiation Oncology, University of Toronto, Canada; Radiation Medicine Program, University Health Network, Toronto, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, University of Toronto, Canada; Radiation Medicine Program, University Health Network, Toronto, Canada
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Sargent L, Taylor J, Lowe J. Barriers and facilitators to general practitioners participating in implementation research: a mixed methods systematic review protocol. JBI Evid Synth 2021; 19:1354-1361. [PMID: 34111044 DOI: 10.11124/jbies-20-00187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of the review is to critically appraise and synthesize quantitative and qualitative evidence on the barriers and facilitators to general practitioners participating in implementation research for the purposes of evaluating translation of evidence into practice. INTRODUCTION General practice is a distinct medical specialty that requires its own specific research; therefore, general practitioner participation in research is key in translating new knowledge into practice. However, recruiting general practitioners to research as participants is challenging. Understanding general practitioner behavior in relation to their participation in implementation research is critical. INCLUSION CRITERIA Implementation studies that include general practitioners in primary health care settings will be considered. This review will consider quantitative, qualitative, and mixed methods studies from developed countries investigating barriers and facilitators to general practitioners participating in implementation research. METHODS The review will be conducted in accordance with JBI methodology for mixed methods systematic reviews. The main databases accessed will be MEDLINE and Scopus, and include studies published in English between 2008 and the present. Two independent reviewers will read and screen relevant articles, assess for quality, extract study characteristics, and synthesize data. This review is taking an integrated approach involving transformed quantitative data. Primary outcome measures will include study details and outcomes related to the research question. Qualitative and transformed quantitative data will be mapped to the Theoretical Domains Framework at extraction phase. Synthesis will include identified barriers and facilitators categorized using the Theoretical Domains Framework indicators to provide future research and implementation recommendations for recruiting general practitioners to implementation research. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42020176759).
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Affiliation(s)
- Lucy Sargent
- School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Spalluto LB, Lewis JA, Stolldorf D, Yeh VM, Callaway-Lane C, Wiener RS, Slatore CG, Yankelevitz DF, Henschke CI, Vogus TJ, Massion PP, Moghanaki D, Roumie CL. Organizational Readiness for Lung Cancer Screening: A Cross-Sectional Evaluation at a Veterans Affairs Medical Center. J Am Coll Radiol 2021; 18:809-819. [PMID: 33421372 PMCID: PMC8180484 DOI: 10.1016/j.jacr.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. We evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening. METHODS We performed a cross-sectional survey of providers, staff, and administrators in radiology and primary care at a single Veterans Affairs Medical Center. Survey measures included Shea's validated Organizational Readiness for Implementing Change (ORIC) scale and Shea's 10 items to assess change valence. ORIC and change valence were scored on a scale from 1 to 7 (higher scores representing higher readiness for change or valence). Multivariable linear regressions were conducted to determine predictors of ORIC and change valence. RESULTS Of 523 employees contacted, 282 completed survey items (53.9% overall response rate). Higher ORIC scores were associated with radiology versus primary care (mean 5.48, SD 1.42 versus 5.07, SD 1.22, β = 0.37, P = .039). Self-identified leaders in lung cancer screening had both higher ORIC (5.56, SD 1.39 versus 5.11, SD 1.26, β = 0.43, P = .050) and change valence scores (5.89, SD 1.21 versus 5.36, SD 1.19, β = 0.51, P = .012). DISCUSSION Radiology health professionals have higher levels of readiness for change for implementation of LDCT screening than those in primary care. Understanding health professionals' behavioral determinants for change can inform future lung cancer screening implementation strategies.
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Affiliation(s)
- Lucy B Spalluto
- Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Vice Chair of Health Equity, Associate Director, Diversity and Inclusion Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee.
| | - Jennifer A Lewis
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Co-Director, Veterans Administration Tennessee Valley Healthcare System Lung Cancer Screening Program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Deonni Stolldorf
- Chair, Vanderbilt University School of Nursing PhD Program Evaluation Committee, Chair, Vanderbilt University Competency Exam Committee, School of Nursing, Vanderbilt University, Nashville, Tennessee
| | - Vivian M Yeh
- Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Carol Callaway-Lane
- Co-Director, Veterans Administration Tennessee Valley Healthcare System Lung Cancer Screening Program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Associate Director, Tennessee Valley Healthcare System Veterans Administration Quality Scholars Program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Renda Soylemez Wiener
- Associate Director, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, Co-Chair, VISN1 Lung Cancer Screening Council, Deputy Chair, Pulmonary Field Advisory Committee, Veterans Health Administration, Boston Massachusetts; The Pulmonary Center, Boston University Medical Center, Boston, Massachusetts
| | - Christopher G Slatore
- Medical Director, Portland VA Medical Center Unsuspected Radiologic Findings System, Health Services Research and Development, Portland Veterans Affairs Medical Center, Portland, Oregon; Co-Director, Portland VA Medical Center Lung Cancer Screening Program, Section of Pulmonary and Critical Care Medicine, Portland Veterans Affairs Medical Center, Portland, Oregon; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, Oregon
| | - David F Yankelevitz
- Director, Lung Biopsy Service, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Claudia I Henschke
- Phoenix Veterans Health Care System, Phoenix, Arizona; Director of the Early Lung and Cardiac Action Program, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Timothy J Vogus
- Deputy Director of Business Innovation, Frist Center for Autism and Innovation, Vanderbilt University, Faculty Director, Leadership Development, Owen Graduate School of Management, Vanderbilt University, Nashville, Tennessee
| | - Pierre P Massion
- Director, Cancer Early Detection and Prevention Initiative at Vanderbilt-Ingram Cancer Center, Co-Leader, Cancer Health Outcomes and Control Program, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Health Administration-Tennessee Valley Healthcare System, Medical Service, Nashville, Tennessee
| | - Drew Moghanaki
- Section Chief, Department of Radiation Oncology, Atlanta VA Medical Center, Atlanta, Georgia; Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Christianne L Roumie
- Deputy Director, VA Tennessee Valley Healthcare System VA Quality Scholars Program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Director, Vanderbilt Master of Public Health Program, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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Panakhup M, Lertpanomwan I, Pajonklaew C, Arayapisit T, Yuma S, Pujarern P, Champirat T, Buranachad N, Fuangtharnthip P, Tantipoj C. Attitude of Physicians towards Periodontal Disease and Diabetes Mellitus Screening in Dental Clinics in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5385. [PMID: 34070096 PMCID: PMC8158388 DOI: 10.3390/ijerph18105385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is one of the top causes of death in many places of the world. Diagnosing DM in the early stage is necessary to avoid severe cases and death. OBJECTIVES To evaluate the knowledge of association between DM and periodontal disease (PD) among Thai physicians and assess their attitudes towards DM screening in dental clinics in Thailand. METHODS Online survey of currently practicing physicians in Thailand was conducted on voluntary basis using the newly developed questionnaire. RESULT We received 403 responses that are statistically sufficient to represent the entire population of currently practicing physicians in Thailand. A total of 97.3% of all responses indicate that Thai physicians have knowledge about the association between DM and PD. More than 90% know that DM has an effect on PD; however, 70% know about the effect of untreated PD in DM patients. Most of physicians think that DM screening in dental clinics is important (79.1%) and are ready to accept referred cases for definite DM diagnosis from a dentist (84.1%). The concerned issues among the participants were the accuracy of the test results in DM screening (73%) and ability of a dentist to perform the screening (71.5%). CONCLUSIONS The majority of participating physicians have adequate knowledge about the bidirectional relationship between DM and PD. They have a positive attitude towards DM screening in dental setting. The collaboration between physicians and dental professionals should be established to reduce the number of undiagnosed DM patients and enhance the medical care of DM patients.
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Affiliation(s)
- Manatsara Panakhup
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Intouch Lertpanomwan
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Chayaphat Pajonklaew
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Tawepong Arayapisit
- Department of Anatomy, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Suraphong Yuma
- Department of Physics, Faculty of Science, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Patr Pujarern
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Tharee Champirat
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Naiyana Buranachad
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Pornpoj Fuangtharnthip
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Chanita Tantipoj
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
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McCade D, Frewen A, Fassnacht DB. Burnout and depression in Australian psychologists: The moderating role of self-compassion. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1890979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Donna McCade
- School of Psychology, Charles Sturt University, Bathurst, Australia
| | - Amie Frewen
- School of Psychology, Charles Sturt University, Bathurst, Australia
| | - Daniel B. Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
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Molia S, Saillard J, Dellagi K, Cliquet F, Bart JM, Rotureau B, Giraudoux P, Jannin J, Debré P, Solano P. Practices in research, surveillance and control of neglected tropical diseases by One Health approaches: A survey targeting scientists from French-speaking countries. PLoS Negl Trop Dis 2021; 15:e0009246. [PMID: 33661894 PMCID: PMC7963066 DOI: 10.1371/journal.pntd.0009246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/16/2021] [Accepted: 02/16/2021] [Indexed: 12/24/2022] Open
Abstract
One health (OH) approaches have increasingly been used in the last decade in the fight against zoonotic neglected tropical diseases (NTDs). However, descriptions of such collaborations between the human, animal and environmental health sectors are still limited for French-speaking tropical countries. The objective of the current survey was to explore the diversity of OH experiences applied to research, surveillance and control of NTDs by scientists from French-speaking countries, and discuss their constraints and benefits. Six zoonotic NTDs were targeted: echinococcoses, trypanosomiases, leishmaniases, rabies, Taenia solium cysticercosis and leptospiroses. Invitations to fill in an online questionnaire were sent to members of francophone networks on NTDs and other tropical diseases. Results from the questionnaire were discussed during an international workshop in October 2019. The vast majority (98%) of the 171 respondents considered OH approaches relevant although only 64% had implemented them. Among respondents with OH experience, 58% had encountered difficulties mainly related to a lack of knowledge, interest and support for OH approaches by funding agencies, policy-makers, communities and researchers. Silos between disciplines and health sectors were still strong at both scientific and operational levels. Benefits were reported by 94% of respondents with OH experience, including increased intellectual stimulation, stronger collaborations, higher impact and cost-efficiency of interventions. Recommendations for OH uptake included advocacy, capacity-building, dedicated funding, and higher communities' involvement. Improved research coordination by NTD networks, production of combined human-animal health NTD impact indicators, and transversal research projects on diagnostic and reservoirs were also considered essential.
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Affiliation(s)
- Sophie Molia
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | | | - Koussai Dellagi
- Institut Pasteur International Network, Institut Pasteur, Paris, France
| | - Florence Cliquet
- ANSES, Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | | | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Department of Parasites and Insect Vectors and INSERM U1201, Institut Pasteur, Paris, France
| | - Patrick Giraudoux
- Chrono-environnement Université de Bourgogne Franche-Comté/CNRS, Besançon, France
| | - Jean Jannin
- Société de Pathologie Exotique, Paris, France
| | | | - Philippe Solano
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
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Nischwitz SP, Luze H, Popp D, Winter R, Draschl A, Schellnegger M, Kargl L, Rappl T, Giretzlehner M, Kamolz LP. Global burn care and the ideal burn dressing reloaded - A survey of global experts. Burns 2021; 47:1665-1674. [PMID: 33838957 DOI: 10.1016/j.burns.2021.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/15/2021] [Accepted: 02/03/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE Burn care is a highly relevant medical specialty in every part of the world. Different infrastructure, healthcare systems and access to medical supplies lead to different needs, treatment strategies and outcomes. A fundamental tool in a burn care provider's armamentarium is the use of different dressings. Several studies have investigated the question of the ideal burn dressing, but none could achieve a proper global perspective. With advanced dressings being on the rise, we conducted this study to get a global understanding of the actual use and idea of the ideal burn dressing. OBJECTIVE The objective of this study was to investigate the understanding of an 'ideal burn dressing' on a global scale. MATERIALS AND METHODS A questionnaire about burn care and the ideal burn dressing has been created and translated to five of the most spoken languages world-wide (English, Spanish, French, Chinese, Indonesian). It has been uploaded to an online survey platform and sent out to burn experts worldwide. The voluntary participation was possible for a period of four weeks. RESULTS In total, 196 respondents from 49 countries participated in the study, yielding a response rate of 24.5%. The most important burn dressing characteristics in a cumulative ranking were (1) lack of adhesion (80.54%), (2) pain-free dressing change (79.87%), (3) requirement of fewer dressing changes, while in a linear ranking they were (1) anti-infective (35.14% 1st), pain-reduction (24.14% 2nd), and high absorbency (23.49% 3rd). Silver-based dressings are the most used dressings for superficial (45.21%) and deep (52.78%). 94.81% believe that the choice of burn dressing affects the outcome. CONCLUSION This investigation has delivered valuable insights into the global perspective of the ideal burn dressing. Yet, the question of the ideal burn dressing is still inconclusive. Wound dressing research is of fundamental interest for patients, healthcare providers and healthcare systems.
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Affiliation(s)
- Sebastian P Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria.
| | - Hanna Luze
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Daniel Popp
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Raimund Winter
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | | | - Marlies Schellnegger
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Lukas Kargl
- Department of Plastic-, Hand- and Reconstructive Microsurgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
| | - Thomas Rappl
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Michael Giretzlehner
- Research Unit for Medical-Informatics, RISC Software GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
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Beyond guidelines: analysis of current practice patterns of AANS/CNS tumor neurosurgeons. J Neurooncol 2021; 151:361-366. [PMID: 33611703 DOI: 10.1007/s11060-020-03389-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/02/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Evidence-based medicine guidelines are increasingly published and sanctioned by organized neurosurgery. However, implementation, interpretation, and use of clinical guidelines may vary substantially on a regional, national and international basis. Survey research can help bridge the gap by providing a snapshot of neurosurgeon attitudes, knowledge, and practices. The American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Section on Tumors formed a Survey Committee to formalize the process by which surveys are submitted and reviewed before distribution to our membership. The goal of this committee is to provide peer-review so that collected information will be scientifically robust and useful to the neurosurgical community. METHODS Surveys submitted to the AANS/CNS tumor section between 2015 and 2019 were reviewed and metrics such as response rate and publication status assessed. RESULTS Six surveys were submitted to the Survey Committee of the AANS/CNS section on tumors between 2015 and 2019. Four have been circulated to section members, of which three have been published. Response rate has averaged 19% (range 16-23%), a majority of respondents (mean 70%) practice in academic settings. CONCLUSIONS The AANS/CNS Section on Tumors Survey Committee has and continues to help promote and improve the practice of surveying our community to answer important questions that can advance future training, research, and practice. There remains significant room for improvement in response rates, but ongoing tumor section efforts to increase member engagement will likely improve these numbers.
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Delnevo CD, Singh B. The effect of a web-push survey on physician survey responses rates: a randomized experiment. ACTA ACUST UNITED AC 2021; 14. [PMID: 33604202 DOI: 10.29115/sp-2021-0001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Achieving a high response rate for physicians has been challenging, and with response rates declining in recent years, innovative methods are needed to increase rates. An emerging concept in survey methodology has been web-push survey delivery. With this delivery method, contact is made by mail to request a response by web. This study explored the feasibility of a web-push survey on a national sample of physicians. Methods A total of 1,000 physicians across six specialties were randomly assigned to a mail-only or web-push survey delivery. Each mode consisted of four contacts including an initial mailing, reminder postcard, and two additional follow-ups. Response rates were calculated using the American Association for Public Opinion Research's response rate 3 calculation. Data collection occurred between Febuary and April 2018; data were analyzed March 2019. Results Overall reponse rates for the mail-only versus web-push survey delivery were comparable (51.2% vs. 52.8%). Higher response rates across all demographics were seen in the web-push delivery, with the exception of pulmonary/critical care and physicians over the age of 65. The web-push survey yielded a greater response after the first mailing, requiring fewer follow-up contacts resulting in a more cost-effective delivery. Conclusions A web-push mail survey is effective in achieving a comparable response rate to traditional mail-only delivery for physicians. The web-push survey was more efficient in terms of cost and in receiving responses in a more timely manner. Future research should explore the efficiency of a web-push survey delivery across various health care provider populations.
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Affiliation(s)
| | - Binu Singh
- Center for Tobacco Studies, Rutgers University New Brunswick
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Karobari MI, Marya A, Ali S, Basheer SN, Adil AH, Horn R, Marya CM, Venugopal A, Messina P, Scardina GA. A Multicultural Demographic Study to Evaluate the Impact of the SARS-CoV-2 Pandemic on the Job Satisfaction across the Dental Industry. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Anand Marya
- University of Puthisastra, Cambodia; Saveetha University, India
| | - Saqib Ali
- Imam Abdulrahman Bin Faisal University, Saudi Arabia
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Bachtiger P, Adamson A, Quint JK, Peters NS. Belief of having had unconfirmed Covid-19 infection reduces willingness to participate in app-based contact tracing. NPJ Digit Med 2020; 3:146. [PMID: 33299071 PMCID: PMC7648058 DOI: 10.1038/s41746-020-00357-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/09/2020] [Indexed: 11/26/2022] Open
Abstract
Contact tracing and lockdown are health policies being used worldwide to combat the coronavirus (COVID-19). The UK National Health Service (NHS) Track and Trace Service has plans for a nationwide app that notifies the need for self-isolation to those in contact with a person testing positive for COVID-19. To be successful, such an app will require high uptake, the determinants and willingness for which are unclear but essential to understand for effective public health benefit. The objective of this study was to measure the determinants of willingness to participate in an NHS app-based contact-tracing programme using a questionnaire within the Care Information Exchange (CIE)—the largest patient-facing electronic health record in the NHS. Among 47,708 registered NHS users of the CIE, 27% completed a questionnaire asking about willingness to participate in app-based contact tracing, understanding of government advice, mental and physical wellbeing and their healthcare utilisation—related or not to COVID-19. Descriptive statistics are reported alongside univariate and multivariable logistic regression models, with positive or negative responses to a question on app-based contact tracing as the dependent variable. 26.1% of all CIE participants were included in the analysis (N = 12,434, 43.0% male, mean age 55.2). 60.3% of respondents were willing to participate in app-based contact tracing. Out of those who responded ‘no’, 67.2% stated that this was due to privacy concerns. In univariate analysis, worsening mood, fear and anxiety in relation to changes in government rules around lockdown were associated with lower willingness to participate. Multivariable analysis showed that difficulty understanding government rules was associated with a decreased inclination to download the app, with those scoring 1–2 and 3–4 in their understanding of the new government rules being 45% and 27% less inclined to download the contact-tracing app, respectively; when compared to those who rated their understanding as 5–6/10 (OR for 1–2/10 = 0.57 [CI 0.48–0.67]; OR for 3–4/10 = 0.744 [CI 0.64–0.87]), whereas scores of 7–8 and 9–10 showed a 43% and 31% respective increase. Those reporting an unconfirmed belief of having previously had and recovered from COVID-19 were 27% less likely to be willing to download the app; belief of previous recovery from COVID-19 infection OR 0.727 [0.585–0.908]). In this large UK-wide questionnaire of wellbeing in lockdown, a willingness for app-based contact tracing over an appropriate age range is 60%—close to the estimated 56% population uptake, and substantially less than the smartphone-user uptake considered necessary for an app-based contact tracing to be an effective intervention to help suppress an epidemic. Difficulty comprehending government advice and uncertainty of diagnosis, based on a public health policy of not testing to confirm self-reported COVID-19 infection during lockdown, therefore reduce willingness to adopt a government contact-tracing app to a level below the threshold for effectiveness as a tool to suppress an epidemic.
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Affiliation(s)
- Patrik Bachtiger
- National Heart and Lung Institute, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Alexander Adamson
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Nicholas S Peters
- National Heart and Lung Institute, Imperial College London, London, UK. .,Imperial College Healthcare NHS Trust, London, UK.
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Little RJA, West BT, Boonstra PS, Hu J. Measures of the Degree of Departure from Ignorable Sample Selection. JOURNAL OF SURVEY STATISTICS AND METHODOLOGY 2020; 8:932-964. [PMID: 33381610 PMCID: PMC7750890 DOI: 10.1093/jssam/smz023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With the current focus of survey researchers on "big data" that are not selected by probability sampling, measures of the degree of potential sampling bias arising from this nonrandom selection are sorely needed. Existing indices of this degree of departure from probability sampling, like the R-indicator, are based on functions of the propensity of inclusion in the sample, estimated by modeling the inclusion probability as a function of auxiliary variables. These methods are agnostic about the relationship between the inclusion probability and survey outcomes, which is a crucial feature of the problem. We propose a simple index of degree of departure from ignorable sample selection that corrects this deficiency, which we call the standardized measure of unadjusted bias (SMUB). The index is based on normal pattern-mixture models for nonresponse applied to this sample selection problem and is grounded in the model-based framework of nonignorable selection first proposed in the context of nonresponse by Don Rubin in 1976. The index depends on an inestimable parameter that measures the deviation from selection at random, which ranges between the values zero and one. We propose the use of a central value of this parameter, 0.5, for computing a point index, and computing the values of SMUB at zero and one to provide a range of the index in a sensitivity analysis. We also provide a fully Bayesian approach for computing credible intervals for the SMUB, reflecting uncertainty in the values of all of the input parameters. The proposed methods have been implemented in R and are illustrated using real data from the National Survey of Family Growth.
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Affiliation(s)
- Roderick J A Little
- Professor of Biostatistics at the School of Public Health and Research Professor in the Survey Methodology Program (SMP), Survey Research Center (SRC), Institute for Social Research (ISR), University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Brady T West
- Research Associate Professor in the Survey Methodology Program (SMP), Survey Research Center (SRC), Institute for Social Research (ISR), University of Michigan, 426 Thompson Street, Ann Arbor, MI 48106-1248, USA
| | - Philip S Boonstra
- Research Assistant Professor of Biostatistics in the School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Jingwei Hu
- Survey Research Director at SurveyPlus Ltd., 1079 Nanhai Street, Shuma Building 201A, Shenzhen, Guangdong 518023, China
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Ansa BE, Zechariah S, Gates AM, Johnson SW, Heboyan V, De Leo G. Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center. Healthcare (Basel) 2020; 8:healthcare8030323. [PMID: 32899937 PMCID: PMC7551229 DOI: 10.3390/healthcare8030323] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022] Open
Abstract
The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.
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Affiliation(s)
- Benjamin E. Ansa
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA
- Correspondence: (B.E.A.); (G.D.)
| | - Sunitha Zechariah
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Morrison Healthcare, Sandy Springs, GA 30350, USA
| | - Amy M. Gates
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Neonatal Intensive Care Unit, Augusta University Health, Augusta, GA 30912, USA
| | - Stephanie W. Johnson
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Occupational Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
| | - Vahé Heboyan
- Health Economics and Modeling Division, Population Health Sciences Department, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Gianluca De Leo
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30921, USA
- Correspondence: (B.E.A.); (G.D.)
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Nakkash R, Ali A, Alaouie H, Asmar K, Hirschhorn N, Mugharbil S, Nuwayhid I, London L, Saban A, Rashid SF, Ahmed MK, Knai C, Bigland C, Afifi RA. Attitudes and practices of public health academics towards research funding from for-profit organizations: cross-sectional survey. Int J Public Health 2020; 65:1133-1145. [PMID: 32840634 PMCID: PMC7497330 DOI: 10.1007/s00038-020-01416-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives The growing trend of for-profit organization (FPO)-funded university research is concerning because resultant potential conflicts of interest might lead to biases in methods, results, and interpretation. For public health academic programmes, receiving funds from FPOs whose products have negative health implications may be particularly problematic. Methods A cross-sectional survey assessed attitudes and practices of public health academics towards accepting funding from FPOs. The sampling frame included universities in five world regions offering a graduate degree in public health; 166 academics responded. Descriptive, bivariate, and logistic regression analyses were conducted. Results Over half of respondents were in favour of accepting funding from FPOs; attitudes differed by world region and gender but not by rank, contract status, % salary offset required, primary identity, or exposure to an ethics course. In the last 5 years, almost 20% of respondents had received funding from a FPO. Sixty per cent of respondents agreed that there was potential for bias in seven aspects of the research process, when funds were from FPOs. Conclusions Globally, public health academics should increase dialogue around the potential harms of research and practice funded by FPOs. Electronic supplementary material The online version of this article (10.1007/s00038-020-01416-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ahmed Ali
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hala Alaouie
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil Asmar
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Sanaa Mugharbil
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Iman Nuwayhid
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Amina Saban
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sabina Faiz Rashid
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Md Koushik Ahmed
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Cecile Knai
- London School of Hygiene and Tropical Medicine, London, UK
| | - Charlotte Bigland
- UK Specialty Registrar, Severn Postgraduate Medical Education School of Public Health, Health Education England, London, UK
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA, USA.
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Olusanya OA, Barry AE. Dissemination of Prenatal Drinking Guidelines: A Preliminary Study Examining Personal Alcohol Use Among Midwives in a Southwestern US State. J Midwifery Womens Health 2020; 65:634-642. [PMID: 32844544 DOI: 10.1111/jmwh.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 05/30/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The constellation of birth defects seen in fetuses exposed to alcohol in utero have been described as fetal alcohol spectrum disorders. Evidence suggests that health care providers' communication practices regarding prenatal alcohol use could have beneficial outcomes. There is a paucity of investigations, however, that have examined the health professionals' personal alcohol use and prenatal alcohol recommendations they provide. METHODS This study sought to examine and compare midwives' personal alcohol use and communication practices regarding prenatal alcohol consumption. Certified nurse-midwives (CNMs) and certified professional midwives (CPMs) in a southwestern US state participated. Inclusion criteria included training in prenatal care, labor, birth, and membership in a midwife professional organization. Personal drinking behaviors were assessed with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). RESULTS All midwives (N = 61; 100%) reported they typically screened a patient for alcohol use during an initial prenatal visit. However, 5 (8.2%) respondents opted for recommendations that advised patients to drink once in a while. Similarly, 4 (6.6%) midwives counseled no more than one drink per day. In the cohort of participants (n = 40) with AUDIT-C scores, 25 (62.5%) engaged in nonrisky drinking (AUDIT-C scores <3). Most respondents (n = 39 of 40; 97.5%) typically consumed 1 to 2 standard drinks on the day they drank. There was no statistically significant difference in mean overall AUDIT-C scores between CNMs and CPMs (P = .42). When examining midwives' (1) responses on the AUDIT-C questionnaire, (2) nonrisky or risky drinking behaviors, and 3) communication practices regarding prenatal alcohol use, Fisher's exact test showed no statistically significant differences between CNMs and CPMs. DISCUSSION Results of this study highlight the importance of advocating healthy lifestyles among health care professionals while also promoting communication practices that align with national alcohol guidelines. Future investigations that examine associations between health care professionals' personal alcohol use and type or effectiveness of services offered to patients may be beneficial.
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Affiliation(s)
| | - Adam E Barry
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
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Lewis JA, Chen H, Weaver KE, Spalluto LB, Sandler KL, Horn L, Dittus RS, Massion PP, Roumie CL, Tindle HA. Low Provider Knowledge Is Associated With Less Evidence-Based Lung Cancer Screening. J Natl Compr Canc Netw 2020; 17:339-346. [PMID: 30959463 DOI: 10.6004/jnccn.2018.7101] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/22/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite widespread recommendation and supportive policies, screening with low-dose CT (LDCT) is incompletely implemented in the US healthcare system. Low provider knowledge of the lung cancer screening (LCS) guidelines represents a potential barrier to implementation. Therefore, we tested the hypothesis that low provider knowledge of guidelines is associated with less provider-reported screening with LDCT. PATIENTS AND METHODS A cross-sectional survey was performed in a large academic medical center and affiliated Veterans Health Administration in the Mid-South United States that comprises hospital and community-based practices. Participants included general medicine providers and specialists who treat patients aged >50 years. The primary exposure was LCS guideline knowledge (US Preventive Services Task Force/Centers for Medicare & Medicaid Services). High knowledge was defined as identifying 3 major screening eligibility criteria (55 years as initial age of screening eligibility, smoking status as current or former smoker, and smoking history of ≥30 pack-years), and low knowledge was defined as not identifying these 3 criteria. The primary outcome was self-reported LDCT order/referral within the past year, and the secondary outcome was screening chest radiograph. Multivariable logistic regression evaluated the adjusted odds ratio (aOR) of screening by knowledge. RESULTS Of 625 providers recruited, 407 (65%) responded, and 378 (60.5%) were analyzed. Overall, 233 providers (62%) demonstrated low LCS knowledge, and 224 (59%) reported ordering/referring for LDCT. The aOR of ordering/referring LDCT was less among providers with low knowledge (0.41; 95% CI, 0.24-0.71) than among those with high knowledge. More providers with low knowledge reported ordering screening chest radiographs (aOR, 2.7; 95% CI, 1.4-5.0) within the past year. CONCLUSIONS Referring provider knowledge of LCS guidelines is low and directly proportional to the ordering rate for LDCT in an at-risk US population. Strategies to advance evidence-based LCS should incorporate provider education and system-level interventions to address gaps in provider knowledge.
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Affiliation(s)
- Jennifer A Lewis
- aGeriatric Research, Education and Clinical Center, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee.,bDivision of Hematology/Oncology, Department of Medicine, and
| | - Heidi Chen
- cDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kathryn E Weaver
- dDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lucy B Spalluto
- aGeriatric Research, Education and Clinical Center, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee.,eDepartment of Radiology
| | | | - Leora Horn
- bDivision of Hematology/Oncology, Department of Medicine, and
| | - Robert S Dittus
- aGeriatric Research, Education and Clinical Center, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee.,fDivision of General Internal Medicine and Public Health, Department of Medicine, and
| | - Pierre P Massion
- gDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and.,hDepartment of Medicine, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Christianne L Roumie
- aGeriatric Research, Education and Clinical Center, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee.,fDivision of General Internal Medicine and Public Health, Department of Medicine, and
| | - Hilary A Tindle
- aGeriatric Research, Education and Clinical Center, Veterans Health Administration - Tennessee Valley Healthcare System, Nashville, Tennessee.,fDivision of General Internal Medicine and Public Health, Department of Medicine, and
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Bettaieb J, Cherif I, Kharroubi G, Mrabet A. Attitudes towards plagiarism among academics of the faculty of Medicine of Tunis. Account Res 2020; 27:521-537. [PMID: 32508135 DOI: 10.1080/08989621.2020.1780426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Assessing the extent of plagiarism within academics remains the first step in the fight against this behavior. The current study aimed to explore the attitudes of the Faculty of Medicine of Tunis (FMT)'s academics toward plagiarism. A cross-sectional study was conducted within the FMT during the 2018-2019 academic year. Data were collected using a questionnaire including the English version of the attitudes toward plagiarism questionnaire (ATPQ) which is composed of 29 statements divided into three attitudinal factors: positive, negative attitudes and subjective norms toward plagiarism. A total of 340 faculty members responded to the survey. The mean scores for both positive attitudes (28.8 ± 6.9) and subjective norms (24.6 ± 4.9) were between low to moderate and that of negative attitudes was moderate (22.4 ± 2.6). In multivariate analysis, participants with higher academic rank, those who had a good level of English or who attended English courses and those who attended workshops in scientific writing were less tolerant toward plagiarism. The implementation of courses on research practices as well as the introduction of medical English courses in the FMT's post graduate program could constitute relevant approaches to limit the extent of plagiarism.
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Affiliation(s)
- Jihène Bettaieb
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar , Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - Ines Cherif
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar , Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - Ghassen Kharroubi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar , Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - Ali Mrabet
- Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
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Bedin F, Moré AOO, de Oliveira JC, Tesser CD, Min LS. Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system. Acupunct Med 2020; 38:319-326. [PMID: 32538101 DOI: 10.1177/0964528420912250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. OBJECTIVE To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. METHOD A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. RESULTS Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. CONCLUSION Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.
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Affiliation(s)
- Fernanda Bedin
- Family Medicine Residency Program, Florianópolis Municipal Health Care Office, Florianópolis, Brazil
| | - Ari Ojeda Ocampo Moré
- Family Medicine Residency Program, Florianópolis Municipal Health Care Office, Florianópolis, Brazil.,Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Jardel Corrêa de Oliveira
- Family Medicine Residency Program, Florianópolis Municipal Health Care Office, Florianópolis, Brazil
| | - Charles Dalcanale Tesser
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.,Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Li Shih Min
- Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil.,Department of Internal Medicine, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Mallows A, Jackson J, Littlewood C, Debenham J. The association of working alliance, outcome expectation, adherence and self-efficacy with clinical outcomes for Achilles tendinopathy: A feasibility cohort study (the MAP study). Musculoskeletal Care 2020; 18:169-176. [PMID: 31997555 DOI: 10.1002/msc.1451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION This study evaluated the feasibility of a large longitudinal cohort study utilizing an online platform to investigate the association and predictive relationship of working alliance, outcome expectations, adherence and self-efficacy with outcome in Achilles tendinopathy. The objectives were: (1) to determine the recruitment and retention rate and (2) to carry out preliminary data analysis of the selected variables and clinical outcomes. METHODS A multi-centred, longitudinal feasibility cohort study was used. Eligible participants were directed to a bespoke online platform hosting study information and the outcome measures in the form of an online questionnaire. Responses from the online questionnaire were collected on three occasions: at baseline, at 6 and at 12 weeks following completion of the first questionnaire. Feasibility outcomes (recruitment and retention rates) were described using descriptive statistics. RESULTS The website recorded a total 55 views. These 55 views resulted in 24 participants consenting to join the study. The questionnaire at baseline was started 63 times and completed on 60 separate occasions resulting in a 95% conversion rate. Retainment for completion of the questionnaire for a second time was 83.3% and for the third time was 66.6%. All questionnaires were completed fully yielding a missing data indicator of 0%. CONCLUSIONS Feasibility studies ask the question 'can this be done'? Based on the data from recruitment and rates and exploratory correlation analysis a future study can be done; this previously untested online platform appears feasible, but changes could be useful before proceeding to a much larger study.
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Affiliation(s)
- Adrian Mallows
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, CO4 3SQ, UK
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, CO4 3SQ, UK
| | - Chris Littlewood
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - James Debenham
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
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Peltz-Rauchman CD, Divine G, McLaren D, Rubinfeld IS, Conway WA, Allard D, Johnson CC. Response to survey directed to patient portal members differs by age, race, and healthcare utilization. JAMIA Open 2020; 2:429-433. [PMID: 31984374 PMCID: PMC6970447 DOI: 10.1093/jamiaopen/ooz061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/24/2019] [Accepted: 10/24/2019] [Indexed: 11/16/2022] Open
Abstract
Health care systems are increasingly utilizing electronic medical record—associated patient portals to facilitate communication with patients and between providers and their patients. These patient portals are growing in recognition as potentially valuable research tools. While there is much information about the response rates and demographics of internet-based surveys as well as the demographics of patients who are portal members, not much is known about the response rate of internet-based surveys directed to a group of patient portal members or the demographics of which portal members respond to internet-based surveys issued within that specific population. The objective of these analyses was to determine the demographics of patient portal users who respond to an internet-based survey request. We hypothesized that respondents would more likely be: (1) older (65+), (2) European American, (3) married, (4) female, (5) college educated, (6) have higher medical care utilization, (7) have more comorbidities, and (8) have a private practice primary care physician (as opposed to a salaried group practice primary care physician). We found that our respondents tended to be older, of European geographic ancestry, and more frequent users of healthcare. While patient portal members are an easily identifiable and contactable group that are potentially valuable participants for research, it is important to understand that respondents to surveys solicited from this sampling frame may not be entirely representative. It will be important to develop strategies to more fully engage populations that represent the target population in order to increase overall and subgroup response rates.
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Affiliation(s)
| | - George Divine
- Department of Public Health Sciences, Henry Ford Health System, Michigan, USA
| | - Daniel McLaren
- Department of Public Health Sciences, Henry Ford Health System, Michigan, USA
| | - Ilan S Rubinfeld
- Department of Acute Care Surgery, Henry Ford Health System, Michigan, USA
| | - William A Conway
- Department of Internal Medicine, Henry Ford Health System, Michigan, USA
| | - David Allard
- Department of Family Medicine, Henry Ford Health System, Michigan, USA
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O'Neill M, Henderson M, Duffy OM, Kernohan WG. The emerging contribution of speech and language therapists in awake craniotomy: a national survey of their roles, practices and perceptions. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:149-162. [PMID: 31778003 DOI: 10.1111/1460-6984.12510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/22/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Awake craniotomy with electrical stimulation has become the gold standard for tumour resection in eloquent areas of the brain. Patients' speech during the procedure can inform the intervention and evidence for language experts to support the procedure is building. Within the UK a burgeoning speech and language therapist awake craniotomy network has emerged to support this practice. Further evidence is needed to underpin the specific contribution of speech and language therapists working within the awake craniotomy service. AIMS To investigate and analyse the current practices of speech and language therapists: their role, pre-, intra- and postoperative assessment, and management practice patterns and skill set within awake craniotomy. METHODS & PROCEDURES Speech and language therapists in the UK, who work in awake craniotomy, were invited to complete an online questionnaire. Participants were recruited via several networks supported by a social media campaign. Data were analysed using a mixed methodology approach including descriptive statistics, summative and conventional content analysis. OUTCOMES & RESULTS A total of 24 speech and language therapists completed the survey, an unknown proportion of the available population. All four UK countries were represented. The majority were highly specialist clinicians 58% (n = 14) with the remainder clinical leads 25% (n = 6) or specialist clinicians 17% (n = 14). Only 29% (n = 7) had funding for awake craniotomy or had awake craniotomy in their job description. Median experience with awake craniotomy was 3 years. Median estimated contact time per case was 10.3 h. Current intraoperative practice is characterized by a sustained period of real-time, dynamic, informal assessment of speech, language, oromotor and cognitive functions. Respondents described a range of intraoperative clinical deficits that, once detected, are immediately communicated to surgeons. There was evidence of variable and diverse language mapping practices and barriers to the translation of information at multidisciplinary team level. Barriers to participation in awake craniotomy included lack of: standardized validated language mapping methods, funding, standardized training methods and guidance to direct practice. CONCLUSIONS & IMPLICATIONS The evidence suggests areas of consistent practice patterns in preoperative preparation and intraoperative assessment. However, considerable variability exists within language testing and mapping that would benefit from validation. These speech and language therapists support improved outcomes of awake craniotomy by real-time intraoperative speech, language, oromotor and cognitive assessment, rapid detection of clinical deterioration and immediate communication to surgeons. Further research exploring intraoperative language testing, consistent use of language mapping terminology, and selection of test methods is recommended.
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Affiliation(s)
- Michelle O'Neill
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, UK
| | | | - Orla M Duffy
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, UK
| | - W George Kernohan
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, UK
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Rosenberg LJ, Butler JM, Caprio AJ, Rhodes RL, Braun UK, Vitale CA, Telonidis J, Periyakoil VS, Farrell TW. Results From a Survey of American Geriatrics Society Members' Views on Physician‐Assisted Suicide. J Am Geriatr Soc 2019; 68:23-30. [DOI: 10.1111/jgs.16245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/06/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Lisa J. Rosenberg
- Southwest Medical Hospice and Palliative Care Las Vegas Nevada
- Roseman University of Health Sciences Henderson Nevada
| | - Jorie M. Butler
- Division of Geriatrics, Department of Internal MedicineUniversity of Utah Salt Lake City Utah
- Geriatrics Research Education and Clinical Center, IDEAS HSR&D COINVeterans Affairs Medical Center Salt Lake City Utah
| | - Anthony J. Caprio
- Department of Family MedicineAtrium Health Charlotte North Carolina
- Department of Family MedicineUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Ramona L. Rhodes
- Division of Geriatric Medicine, Department of Internal MedicineUT Southwestern Medical Center Dallas Texas
| | - Ursula K. Braun
- Section of Geriatrics, Department of MedicineBaylor College of Medicine Houston Texas
- Center for Innovations in Quality, Effectiveness and SafetyMichael E. DeBakey VA Medical Center Houston Texas
| | - Caroline A. Vitale
- Division of Geriatric and Palliative Medicine, Department of Internal MedicineUniversity of Michigan Ann Arbor Michigan
- Geriatrics Research Education and Clinical CenterVA Ann Arbor Healthcare System Ann Arbor Michigan
| | - Jacqueline Telonidis
- Division of Geriatrics, Department of Internal MedicineUniversity of Utah Salt Lake City Utah
| | - Vyjeyanthi S. Periyakoil
- Stanford University School of Medicine Stanford California
- VA Palo Alto Health Care System Palo Alto California
| | - Timothy W. Farrell
- Division of Geriatrics, Department of Internal MedicineUniversity of Utah Salt Lake City Utah
- VA Salt Lake City Geriatric Research, Education, and Clinical Center Salt Lake City Utah
- University of Utah Health Interprofessional Education Program Salt Lake City Utah
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Abstract
BACKGROUND AND PURPOSE Clinician research competencies influence research use for evidence-based practice (EBP). We aimed to develop, refine, and psychometrically assess the Research Competencies Assessment Instrument for Nurses (RCAIN) to measure registered nurse research competencies (i.e., knowledge, skills, attitudes) focused on EBP-related domains: research process, knowledge synthesis, and knowledge translation activities. METHODS The preliminary psychometrics (face, content, construct/criterion validity) were evaluated based on 63 completed surveys. RESULTS The Cronbach's α coefficients were .871, .813, and .946 for each domain, respectively; interitem correlations ranged from .472 to .833 (explained variance: 68.5%). Three components/factors revealed: comprehension of and skills required in research process and application of knowledge and skills. The revised RCAIN consists of 19 five-point Likert-type questions. CONCLUSIONS The RCAIN assesses modifiable characteristics and explains variance in practice, health system, and patient outcomes. Further assessments are underway.
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Andridge RR, West BT, Little RJA, Boonstra PS, Alvarado-Leiton F. Indices of non-ignorable selection bias for proportions estimated from non-probability samples. J R Stat Soc Ser C Appl Stat 2019; 68:1465-1483. [PMID: 33304001 PMCID: PMC7724611 DOI: 10.1111/rssc.12371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Rising costs of survey data collection and declining response rates have caused researchers to turn to non-probability samples to make descriptive statements about populations. However, unlike probability samples, non-probability samples may produce severely biased descriptive estimates due to selection bias. The paper develops and evaluates a simple model-based index of the potential selection bias in estimates of population proportions due to non-ignorable selection mechanisms. The index depends on an inestimable parameter ranging from 0 to 1 that captures the amount of deviation from selection at random and is thus well suited to a sensitivity analysis. We describe modified maximum likelihood and Bayesian estimation approaches and provide new and easy-to-use R functions for their implementation. We use simulation studies to evaluate the ability of the proposed index to reflect selection bias in non-probability samples and show how the index outperforms a previously proposed index that relies on an underlying normality assumption. We demonstrate the use of the index in practice with real data from the National Survey of Family Growth.
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Singh S, Prasad S, Bhatnagar S, Lal R, Choudhary N, Sahi MS. A Cross-Sectional Web-Based Survey of Medical Practitioners in India to Assess their Knowledge, Attitude, Prescription Practices, and Barriers toward Opioid Analgesic Prescriptions. Indian J Palliat Care 2019; 25:567-574. [PMID: 31673214 PMCID: PMC6812418 DOI: 10.4103/ijpc.ijpc_83_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Inadequate training of medical practitioners is a key factor responsible for inappropriate use of opioid analgesics. AIMS We assessed the current knowledge, attitude, prescribing practices, and barriers perceived by the Indian medical practitioners in three tertiary care hospitals toward the use of opioid analgesics. SUBJECTS AND METHODS Web-based survey of registered medical practitioner employed at three chosen tertiary health care institutions in New Delhi. STATISTICAL ANALYSIS USED Descriptive analysis of survey responses was carried out. Comparative analysis was done using Chi-square test, independent samples t-test, and Pearson correlation coefficient. RESULTS The response rate was 10.4% (n = 308). Two-thirds of the participants (61.7%) had never received formal pain management training, and 86.7% participants would like further training. Most participants (71.1%) agreed that opioids should be prescribed in cancer pain, while 26.3% agreed that opioids should be prescribed in noncancer pain. Half of the participants agreed that SOS (if necessary) dosing schedule (48.4%), low dosage (61.7%), and short duration of use (51.4%) could decrease the harmful effect of opioids. Lack of information about opioid-related policies and addiction potential were identified as the most common barriers to prescribing opioids. Those seeing more patients with chronic noncancer pain come across opioid misuse and diversion more often (P = 0.02). Those who understood addiction were more likely to agree that patients of chronic cancer pain with substance use disorders should be prescribed opioid analgesics (P < 0.01). CONCLUSIONS Indian medical practitioners felt the need for formal pain management training. There is a lack of consensus on how to manage the pain using opioid analgesics. Tough regulations on medical and scientific use of opioids are the most commonly reported barrier to prescribing them.
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Affiliation(s)
- Shalini Singh
- Department of Psychiatry, Institute of Liver and Biliary Sciences, Dr. B.R.A IRCH, AIIMS, New Delhi, India
| | - Shiv Prasad
- Department of Psychiatry, Lady Hardinge Medical College, Dr. B.R.A IRCH, AIIMS, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A IRCH, AIIMS, New Delhi, India
| | - Rakesh Lal
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Nandan Choudhary
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A IRCH, AIIMS, New Delhi, India
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