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Background: Both autologous and cadaveric grafts are often used during rhinoplasty to create volume and provide support. Despite discussion in the literature comparing the efficacy, cost-effectiveness, and complication rates between grafting options, it remains unclear which is the superior choice when considering availability, donor site morbidity, and cost. There is a little description of the current use of these materials amongst facial plastic surgeons. Methods: A 12 question survey was created, and IRB approval was obtained. The survey was distributed to practicing members of the AAFPRS via their membership listserv. Results: 178 respondents completed the survey for an overall response rate of 17.5%. The most common rhinoplasty graft types used by respondents were autologous septal cartilage (96.6%), autologous auricular grafts (93.8%), autologous rib graft (ARG) (75.8%), and cadaveric rib graft (CRG) (56.7%). Patient comorbidities and performing more than 50 rhinoplasties per year were positively correlated with use of CRG grafts and concerns about complications and cost were negatively correlated. Conclusions: While autologous septal and auricular cartilage remain the most common graft choices amongst surveyed facial plastic surgeons, a majority utilize cadaveric rib grafts in their practice. Patient comorbidities, surgery volume, concerns about graft complications, and cost were the chief factors associated with use of cadaveric grafts amongst survey respondents. Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Paramedics commonly experience both poor sleep and mental health symptoms. Clarifying whether sleep or mental health symptoms are a challenge prior to commencement of employment is important, as early prevention and intervention initiatives during training could support these workers. Paramedicine students (n=53) were included, with sleep disorder screening (obstructive sleep apnea, insomnia and restless legs syndrome), and mental health outcomes (depressive symptoms: Patient Health Questionnaire-9, and anxiety symptoms: General Anxiety Disorder-7). Data were analysed using robust regression models, adjusted for age, sex, and shift work status. Meeting criteria for a sleep disorder (n=21) was associated with higher scores for anxiety (8.2 [95% CI: 5.9-10.5] v 4.6, [3.4-5.8]) and depressive symptoms (11.1 [8.6-13.6] v 4.4 [3.1-5.7)] compared to those who did not meet the criteria for a sleep disorder (n=32). Depressive symptoms were lower in those with perceived control over sleep (5.2 [3.2-7.2] v 9.8 [7.7-11.8]). There was no interaction between sleep disorder risk and perceived control over sleep on mental health symptoms. Investigation and management of factors contributing to low perceived control over sleep, together with early screening and management of sleep disorders, are likely to be important priorities to support paramedic student wellbeing prior to commencing shift work.

Competing Interests: Conflicts of interest None disclosed.

Flow is an aspect of player experience that has been often targeted in game studies. Still, similar to presence it can be ambiguous and difficult to quantify. In this study, we approach the concept of flow in cooperative gaming and frame the target of this study as ""collaborative flow"". Team-play and Flow relevant aspects of player experience, Flow, Co-presence, Sensory Immersion, Imaginative Immersion, Behavioral involvement, social presence, and Engagement, were mapped in an online survey with 75 participants. We noticed small significant differences between semi-professional gamers and hobbyists in some flow related aspects of player experience. In addition, weekly gaming time influenced the results. In this study we used existing validated questionnaires and can only state that better metrics and definitions for this aspect of player experience are needed for future research.

Mobile phones are a popular platform for gaming in addition to being perhaps the most ubiquitous one. Monetization of free to play games with embedded and interstitial advertisements is one of the main sources of income for mobile game creators. We used a constructive approach in this study. A mobile game developed during the study, Between Beats, was used to survey the influence of interstitial advertisement on selected aspects of player experience. The study was conducted by deploying the game to Google Play and guiding the players, after gameplay, to an online survey. The survey was answered by 51 participants who were divided randomly into four groups based on how much they were subjected to interstitial or rewarded advertisements while playing. Our results show that embedding rewarded advertisements to a situation where there already is interstitial advertisements, resulted in reduction of perceived advertisement intrusiveness and increase in advertisements viewed. Player engagement remained constant in all groups. Our findings complement earlier findings on the use of rewarded advertisements in mobile games.

Objective In Sweden, an abdominal aortic aneurysm (AAA) screening programme was gradually implemented from 2009 to reduce the incidence of rupture and thereby mortality. AAA screening introduces a variety of unintended, but generally unavoidable, harms, e.g. stress and worry. Such psychosocial consequences have previously only been investigated with generic measures. Therefore, the aim of this study was to describe and compare the psychosocial consequences in men with a screening detected AAA to men with a normal screening result after they participated in the Swedish national AAA-screening programme using a validated psychometric instrument. Material and methods This study was a cross-sectional survey. Data were originally collected to validate the COS-AAA and has previously been published in details. The Consequences of Screening in Abdominal Aortic Aneurysm (COS-AAA) questionnaire was sent to 250 men with a screening detected AAA and 500 with a normal screening result who were randomly selected from a Swedish population-based screening register. Results In total, 158 (63%) men with a screening detected AAA and 275 (55%) men with a normal screening result completed the COS-AAA. We found that men with a screening detected AAA reported negative psychosocial consequences to a greater extent in 10 of 13 COS-AAA Part 1 scales, all statistically significant except three (behaviour, sleep and negative experiences from examination). For COS-AAA Part 2, there was a statistically significant difference between groups in four of five scales. Conclusions Men diagnosed with a screening detected AAA, reported more negative psychosocial consequences compared to men with a normal result. Screening for abdominal aorta aneurism (AAA) introduces intended benefits and unintended harms. Adequate measures are necessary to determine the balance between them.Key points: This study applied a condition-specific questionnaire with high content validity and adequate psychometric properties to measure psychosocial consequences in men participating in AAA screening. We found that men with a screening detected AAA reported more negative psychosocial consequences than men with a normal aorta size. The risk of negative psychosocial consequences is important to include in the decision making on whether to participate in screening or not.

The aim of this online-survey study is the development and evaluation of a mobile health application specifically designed to meet the needs of individuals who have previously undergone intensive-care treatment. User acceptance and perception play a crucial role in refining and optimizing the app's features and functionalities. By actively incorporating suggestions and insights from users, the goal is to enhance the overall usability and better cater to the diverse needs of individuals in post-intensive care recovery. This iterative approach ensures that the application remains responsive to the evolving requirements of its target audience. Overall, the emphasis is on creating a user-centric and adaptive tool for former intensive care patients, to develop a user-friendly mobile app. [ABSTRACT FROM AUTHOR]

Despite much research in the context of aging and technology, the role of Views on aging (VoA) for differences in technology use and attitudes among older adults has rarely been studied so far. This study focuses on the associations between a multidimensional measure of VoA and technology use, technology skills, and attitudes toward technology in a sample of older adults (n = 369, age range: 65–93 years, 48.2% male). We apply the concept of Awareness of age-related change (AARC) to examine the role of positive (AARC-Gains) and negative (AARC-Losses) self-perceptions of aging. Bivariate and multivariate regression analyses were conducted. The results showed positive associations of AARC-Gains with technology skills and technology attitudes. For AARC Losses, we identified negative associations with technology skills, technology attitudes as well as general technology use. In contrast, associations between subjective age (SA) and all technology-related measures were non-significant. The results stress the importance to consider multidimensional measures of VoA to gain a better understanding of the associations between an individuals’ experiencing of own aging processes and technology adoption. More research is needed to determine the stability of these findings in other samples and for other kinds of technology use and attitudes. [ABSTRACT FROM AUTHOR]

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Background: Obesity is a chronic disease with increasing prevalence. We aimed to explore primary care physicians' knowledge and attitudes about obesity and how knowledge and attitudes are associated with confidence and adherence to obesity guidelines and barriers to obesity treatment. Methods: A questionnaire survey was sent by e-mail to 1642 primary care physicians in four regions in Sweden. The survey focused on the physicians' knowledge, attitudes towards obesity, confidence in obesity management, adherence to obesity guidelines and barriers to optimal care. We created different statistical indices for knowledge, attitudes and adherence. To analyse the correlation between these indices, we used linear regression analyses. Results: Replies from 235 primary care physicians yielded a response rate of 14.3%. Most physicians answered correctly that obesity is a disease (91%), that obesity regulation sits in the hypothalamus (70%) and that obesity is due to disorders of appetite regulation (69%). However, 44% of the physicians thought that the most effective weight reduction method for severe obesity was lifestyle changes; 47% believed that obesity is due to lack of self-control, 14% mentioned lack of motivation and 22% stated laziness. Although 97% believed that physicians can help individuals with obesity and 56% suggested that obesity treatment should be prioritised, 87% of the physicians expressed that losing weight is the patients' responsibility. There was a positive association between higher knowledge and better adherence to obesity guidelines (B = 0.07, CI 0.02–0.12, p-value = 0.005) and feeling confident to suggest medication (p < 0.001) or bariatric surgery (p = 0.002). While 99% of the physicians felt confident to discuss lifestyle changes, 67% and 81% were confident to suggest medication or bariatric surgery, respectively. Respondents perceived that the greatest barrier in obesity management was lack of time (69%) and resources (49%). Conclusion: There was a positive association between Swedish primary care physicians' knowledge and adherence to obesity guidelines and being more confident to suggest obesity treatment. Yet, many physicians had an ambivalent attitude towards obesity management. [ABSTRACT FROM AUTHOR]

Background: While various quantitative studies based on the Unified Theory of Acceptance and Use of Technology (UTAUT) and Technology Acceptance Models (TAM) exist in the general medical sectors, just a few have been conducted in the behavioral sector; they have all been qualitative interview-based studies.Objective: The purpose of this study is to assess the adoption dimensions of a behavioral electronic health record (EHR) system for behavioral clinical professionals using a modified clinical adoption (CA) research model that incorporates a variety of micro, meso, and macro level factors.Methods: A questionnaire survey with quantitative analysis approach was used via purposive sampling method. We modified the existing CA framework to be suitable for evaluating the adoption of an EHR system by behavioral clinical professionals. We designed and verified questionnaires that fit into the dimensions of the CA framework. The survey was performed in five US behavioral hospitals, and the adoption factors were analyzed using a structural equation analysis.Results: We derived a total of seven dimensions, omitting those determined to be unsuitable for behavioral clinical specialists to respond to. We polled 409 behavioral clinical experts from five hospitals. As a result, the ease of use and organizational support had a substantial impact on the use of the behavioral EHR system. Although the findings were not statistically significant, information and service quality did appear to have an effect on the system's ease of use. The primary reported benefit of behavioral EHR system adoption was the capacity to swiftly locate information, work efficiently, and access patient information via a mobile app, which resulted in more time for better care. The primary downside, on the other hand, was an unhealthy reliance on the EHR system.Conclusions: We demonstrated in this study that the CA framework can be a useful tool for evaluating organizational and social elements in addition to the EHR system's system features. Not only the EHR system's simplicity of use, but also organizational support, should be considered for the effective implementation of the behavioral EHR system.Trial Registration: The study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB No.: B-1904-534-301). [ABSTRACT FROM AUTHOR]

The aim of this study was to assess variations in midwives' practices of cord clamping (early versus delayed) and to identify factors potentially associated with delayed clamping. This was a descriptive cross-sectional survey by self-administered online questionnaire among French midwives working in delivery rooms from March to July 2018. We obtained complete responses from 350 midwives. Only 120 (34.3%) reported always or sometimes performing delayed cord clamping at one minute or more after birth. Delayed cord clamping was significantly associated with midwives' experience (adjusted OR 3.99; 95% confidence interval [CI] 2.10, 7.83 for experience >10 years), maternity unit written protocol (adjusted OR (aOR) 5.17; 95% CI 1.88, 16.00), knowledge of guidelines (aOR 3.33; 95% CI 1.98, 5.71) and neonatal care level 1 (aOR 2.95; 95% CI 1.53, 5.78).Impact StatementWhat is already know on this subject? Despite benefits and the safety of delayed cord clamping, many newborns likely had their umbilical cords clamped immediately after delivery as part of routine care or because providers were not convinced of the benefits of delayed clamping.What do the results of this study add? Most of the midwives surveyed did not systematically delay cord clamping. Individual and organisational factors were associated with adherence to guidelines regarding delayed cord clamping.What are the implications of these findings for clinical and/or further research? A protocol should be implemented in every maternity unit with information about the benefits and risks of delayed cord clamping to reduce variations in practice and improve the safety of care. [ABSTRACT FROM AUTHOR]

After 2008 and 2012 USPSTF recommendations against PSA screening, studies revealed a decline in screening rates and trend towards more advanced disease at presentation. After revision of this recommendation in 2017, PSA screening guidelines remain inconsistent and controversy still exists about its clinical utility. We seek to better understand the knowledge of medical trainees regarding this fundamental controversy and gain better insight into what they are being taught regarding this topic. Participants were medical students (n = 66) and residents (n = 60) from a single institution. REDCap software was used for informed consent, survey distribution, and data collection. Variables measured included PSA clinical knowledge, awareness of the PSA guideline changes, and attitudes, confidence, and viewpoints on use of PSA screening in clinical practice. More than 60% of medical trainees reported little or no knowledge of PSA screening guidelines. Although residents reported more knowledge than medical students, actual assessed knowledge of PSA screening did not differ between groups. Trainees reported receiving education primarily from other healthcare professionals and didactics, with some self-learning online. Though confidence was low overall, residents were more confident than medical students in discussing PSA screening with patients. The majority of respondents wanted more information about PSA testing, with medical students particularly interested in diagnosis/detection, treatment, and survival. Overall, opinions towards PSA testing as an aid were generally positive. Better education about the current PSA screening guidelines for medical trainees is imperative, particularly given that shared decision-making is of great importance when counseling patients on cancer screening. [ABSTRACT FROM AUTHOR]

Millions of users write and read freely accessible texts every day on online literary platforms (OLPs). Intra-platform surveys aside, only very few studies have considered the demographics of digital readers and authors. Our exploratory study of avid OLP users helps to close this research gap. We requested an international sample of OLP users (13 years and above) to complete an online questionnaire. Our survey gathered demographic data and information about participants' OLP usage, motivation, (communicative) relationship with other users, and perceptions of the positive effects of OLP usage (Nmax = 315). Among others, our results not only reinforce the theoretical concept of wreading but also indicate that OLPs are likely to enhance the pleasure derived from writing and reading. Our data show that OLP usage is not limited to adolescent users. Reportedly, for participants from Generation Y as well as from Generation Z, the experience of creative freedom and the possibility to get direct reader feedback are major motivational factors to write on OLPs. Also, our data indicate that our surveyed writers on OLPs prefer short stories. We call for more longitudinal investigations and for a common theoretical framework, in order to strengthen future research on digital literature practices and to be able to implement the didactic potential of OLPs in the classroom. [ABSTRACT FROM AUTHOR]

Over the last decade, digitisation and individualisation have fostered the development of on-demand services in many industries. In the insurance sector, technological progress brings new possibilities on how risks can be insured. This paper studies on-demand insurance and thereby takes three perspectives. First, we define on-demand insurance and study the current market landscape of offerings, leading to a characterisation of the phenomenon. Second, we analyse the on-demand insurance business model, discuss how value is created, and develop a taxonomy of the dimensions among business model components. Third, we describe the awareness and interest of potential customers in Switzerland using novel data recorded from a recent consumer survey. Using the results from the market study, business model analysis, and customer survey, we discuss the (future) role of on-demand insurance, shedding light on the ongoing business model transformation in the insurance industry. We conclude that insurtech companies address emerging customer needs and that traditional incumbent insurers must innovate to keep their prominent role at the customer interface. While novelty and complementarity of on-demand insurance solutions bring value today, we expect that efficiency and customer retention will add more value in the future, especially once technology has matured and business model components are well-aligned. [ABSTRACT FROM AUTHOR]

By 2019, over 70,000 undergraduates had been awarded bachelor's degrees in music education under the Free Education for Students in Teacher Education Programme in China. Although this helped to relieve a severe shortage of music teacher supply, recent studies reported serious concerns regarding the career readiness of this population. The purposes of this study were to (a) provide a role-identity profile of 4th-year undergraduate music education majors in China, (b) identify key elements in their professional identity development (PID), and (c) explore whether these elements were different from those identified in research findings in other education systems. Survey data were collected from 1,321 music education students in three Chinese universities for content analysis. The results suggest that occupation-oriented external factors are the most influential source in career decision-making. Most participants are struggling with multiple professional identity shifts that combine music trainee, teacher trainee, and preservice teacher roles across degree programs. These present the complexity of identity development in policy-reinforced professionalism in the Chinese education system. [ABSTRACT FROM AUTHOR]

Abstract Background The outbreak of the COVID-19 pandemic caused great uncertainty about causes, treatment and mortality of the new virus. Constant updates of recommendations and restrictions from national authorities may have caused great concern for pregnant women. Reports suggested an increased number of pregnant women choosing to give birth at home, some even unassisted (‘freebirth’) due to concerns of transmission in hospital or reduction in birthplace options. During April and May 2020, we aimed to investigate i) the level of concern about coronavirus transmission in Danish pregnant women, ii) the level of concern related to changes in maternity services due to the pandemic, and iii) implications for choice of place of birth. Methods We conducted a nationwide cross-sectional online survey study, inviting all registered pregnant women in Denmark (n = 30,009) in April and May 2020. Results The response rate was 60% (n = 17,995). Concerns of transmission during pregnancy and birth were considerable; 63% worried about getting severely ill whilst pregnant, and 55% worried that virus would be transmitted to their child. Thirtyeight percent worried about contracting the virus at the hospital. The most predominant concern related to changes in maternity services during the pandemic was restrictions on partners’ attendance at birth (81%). Especially nulliparous women were concerned about whether cancelled antenatal classes or fewer physical midwifery consultations would affect their ability to give birth or care for their child postpartum.. The proportion of women who considered a home birth was equivalent to pre-pandemic home birth rates in Denmark (3%). During the temporary discontinue of public home birth services, 18% of this group considered a home birth assisted by a private midwife (n = 125), and 6% considered a home birth with no midwifery assistance at all (n = 41). Conclusion Danish pregnant womens’ concerns about virus transmission to the unborn child and worries about contracting the virus during hospital appointments were considerable during the early pandemic. Home birth rates may not be affected by the pandemic, but restrictions in home birth services may impose decisions to freebirth for a small proportion of the population.

Abstract BACKGROUND: Due to “stay at home” restrictions during the coronavirus disease 2019 (COVID-19) pandemic, people spent more time at home leading to an increase in home accidents, including burns. OBJECTIVE: To investigate the epidemiology of burns that occurred within homes during the COVID-19 pandemic in Brazil. DESIGN AND SETTINGS: This was a quantitative, descriptive, and cross-sectional study with a non-probabilistic sample. METHODS: Data were collected through the distribution of survey links on social networking sites and websites, and through email between December 2020 and February 2021. Participants were over 18 years of age, living in Brazil. Data analysis was performed using descriptive and dispersion statistics. RESULTS: A total of 939 adults (aged > 18 years) participated in this study. The mean age was 37.2 years (standard deviation [SD] = 12.5), 75.6% were female, 70.0% self-reported white skin color, 74% had completed higher education, and 28.1% had an income of 3 to 6 times the monthly minimum wage. A total of 21.6% suffered burns during the pandemic, 44.3% from a hot object. Approximately 49.3% never had access to a burn prevention campaign. CONCLUSION: It is necessary to develop burn prevention strategies that reach a wider population and to strengthen public policies to reduce the prevalence of domestic burns, especially during the pandemic.

The practice of science outreach is more necessary than ever. However, a disconnect exists between the stated goals for science outreach and its actual impact. In order to examine one potential source of this disconnect, we undertook a survey-based study to explore whether barriers to participation (either intrinsic or extrinsic) in science outreach exist within the academic community. We received responses to our survey from 530 individuals, the vast majority of whom engage in some type of science outreach activity on an annual basis. Those who engage in outreach report doing so for both personal and altruistic reasons, and having high (yet varied) levels of comfort with performing outreach activities. Respondents also report the existence of several significant yet surmountable barriers to participation, including lack of time and funding. Our findings demonstrate that both levels of participation in, and attitudes toward, science outreach within the academic community are generally favorable, suggesting that the general ineffectiveness of science outreach is due to other causes. We place our findings within the context of the broader science outreach, science communication and public engagement literature. We make recommendations on how existing approaches and infrastructure can, and must, be changed in order to improve the practice.

Abstract Background Obesity prevalence is increasing globally. Bariatric surgery is an effective treatment for severe and complex obesity resulting in significant and sustained weight loss. In Sweden, most bariatric surgery patients are referred by primary care physicians. We aimed to explore barriers for physicians to refer patients with severe and complex obesity for bariatric surgery. Methods A questionnaire survey was in 2019 emailed to 1100 primary care physicians in the Skåne and Kronoberg regions in south Sweden. The survey focused on referral patterns, knowledge and attitudes towards bariatric surgery and concerns about postoperative complications. We created different statistical indices for referral patterns, knowledge, attitudes and concerns about bariatric surgery. To analyze the correlation between these indices, we did Spearman’s correlations and regression analyses. Results Of 1100 email respondents, we received 157 (14%) completed surveys. Among 157 physician respondents, 73% answered that they had good knowledge about the referral criteria for bariatric surgery, whereas 55 and 60% answered correctly to two items on criteria for bariatric surgery. A majority of respondents (84%) stated that their patients initiated referral to bariatric surgery. Half of the respondents had concerns about postoperative medical and surgical complications, but another half had a positive attitude to bariatric surgery as a treatment for obesity comorbidities. Almost half of the respondents (44%) answered that they needed to learn more about bariatric surgery. We found significant positive correlations between high knowledge and referral patterns (r = 0.292, p

(1) Introduction: Chronic insomnia (CI) reduces quality of life and may trigger depression and cardiovascular diseases. The European Sleep Research Society recommends cognitive behavioural therapy (CBT-I) as the first-line treatment. Because a recent study in Switzerland demonstrated that this recommendation was inconsistently followed by primary care physicians, we hypothesised that pharmacists also deviate from these guidelines. The aim of this study is to describe current treatment practices for CI recommended by pharmacists in Switzerland, compare them to guidelines and examine their attitudes towards CBT-I. (2) Methods: A structured survey was sent to all the members of the Swiss Pharmacists Association, containing three clinical vignettes describing typical CI pharmacy clients. Treatments had to be prioritised. The prevalence of CI, and the pharmacists’ knowledge and interest in CBT-I were assessed. (3) Results: Of 1523 pharmacies, 123 pharmacists (8%) completed the survey. Despite large variations, valerian (96%), relaxation therapy (94%) and other phytotherapies (85%) were most recommended. Although most pharmacists did not know about CBT-I (72%) and only 10% had recommended it, most were very interested (64%) in education. Missing financial compensation hampers the recommendation of CBT-I. (4) Conclusions: Contrary to existing European guidelines, community pharmacists in Switzerland mostly recommended valerian, relaxation therapy and other phytotherapies for treating CI. This might be connected to the client’s expectation of pharmacy services, e.g., medication dispensing. While pharmacists recommend sleep hygiene regularly, most did not know of CBT-I as an overarching concept but were willing to learn. Future studies should test the effects of dedicated training about CI and changes in the financial compensation for counselling for CI in pharmacies.

To compare the prevalence of multiple physical symptoms, coping scores, and associations between multiple physical symptoms and coping in two population-based surveys within a 10-year interval. A nationwide study on symptoms and healthcare-seeking, the Danish Symptom Cohort, was carried out in 2012 and repeated in 2022. For each survey, 100,000 randomly selected individuals were invited, and individuals aged 20–64 years were eligible for inclusion. Multiple physical symptoms were identified using the 25-item Bodily Distress Syndrome checklist, and coping was assessed with the Brief Approach/Avoidance Coping Questionnaire. Statistical analyses included multinomial and logistic regressions. A total of 35,877 were included in 2012 and 18,330 in 2022. Overall, 35.1% reported multiple physical symptoms in 2022 compared with 23.8% in 2012. The mean sum score for approach was lower in 2022 than in 2012 with a statistically significant mean difference of −1.27 (Cohen's d = −0.34), while diversion and resignation scores were significantly higher in 2022 with mean differences of 0.34 (Cohen's d = 0.11) and 0.52 (Cohen's d = 0.17), respectively. Regression analyses showed that lower approach scores and higher diversion and resignation scores were associated with an increased probability of having multiple physical symptoms in 2022, thereby confirming the results from 2012. Over the decade, symptom reporting may have increased while coping strategies may have changed towards a slightly higher use of avoidance and lower use of approach. It seems relevant to identify modifiable contributing factors in society to prevent an acceleration of symptom reporting and avoidant behavior. • The frequency of multiple physical symptoms was higher in 2022 compared to 2012. • Coping scores in 2022 were slightly different from coping scores in 2012. • Approach scores were lower, while diversion and resignation scores were higher. • High avoidance and low approach were associated with having multiple symptoms. • It may be beneficial to expand focus from coping with symptoms to general coping. [ABSTRACT FROM AUTHOR]

Surgical coaching has been proposed as a mechanism to fill gaps in proficiency and encourage continued growth following formal surgical training. Coaching benefits have been demonstrated in other surgical fields; however, have not been evaluated within pediatric urology. The aims of this study were to survey members of The Societies for Pediatric Urology (SPU) to assess the current understanding and utilization of surgical coaching while gauging interest, potential barriers and personal goals for participation in a coaching program. Following IRB approval, members of the SPU were invited to electronically complete an anonymous survey which assessed 4 domains: 1) understanding of surgical coaching principles, 2) current utilization, 3) interest and potential barriers to participation, and 4) personal surgical goals. To evaluate understanding, questions with predefined correct answers on the key principles of coaching were posed either in multiple choice or True/False format to the SPU membership. Of the 674 pediatric urologists invited, 146 completed the survey (22%). Of those, 46% correctly responded the definition of surgical coaching. Coaching utilization was reported in 27% of respondents currently or having previously participated in a surgical coaching program. Despite current participation rates, only 6 surgeons (4%) have completed training in surgical coaching, despite 79% expressing interest to participate in a surgical coaching program. The most influential barrier to participating in a coaching program was time commitment. Respondents largely prioritized technical and cognitive skill improvement as their primary goals for coaching (see figure below). While interest in surgical coaching is high among pediatric urologists, the principles of surgical coaching were not universally understood. Furthermore, formal coach training is markedly deficient, representing a gap in our profession and an opportunity for significant avenues for improvement, especially for technical and cognitive skills. Development of a coaching model based on these results would best suit the needs of pediatric urologists providing that the time commitment barrier for these endeavors can be mitigated and/or reconciled. [Display omitted] [ABSTRACT FROM AUTHOR]

Simple Summary: Headshaking syndrome is a frustrating health problem in horses whose aetiopathogenesis is poorly understood. This study was dedicated to investigating signalment and therapeutic interventions in headshakers in France and Switzerland. To do this, an online survey was developed and distributed via the Internet. This showed that mainly middle-aged geldings were affected. The breeding distribution matched the breeding distribution of the relevant country. Furthermore, alternative healing methods were used by the horse owners, which have not yet been scientifically examined. Overall, it was possible to formulate conclusions regarding signalment and therapies used in practice. Equine headshaking syndrome (EHS) is characterised as non-physical and involuntary movement of the horse's head and neck. Although EHS is clinically simple to diagnose, its aetiopathogenesis often remains unclear. The aim of this study was to gain an overview of signalment and therapy possibilities used in France and Switzerland. To do this, an online survey was developed and distributed via newsletters. A total of 933 complete, answered surveys from France (n = 804) and Switzerland (n = 129) were evaluated. The median age in France was 12.4 years (CH = 14.3). Mostly geldings were affected (58.5%FRA, 57.4%CH). There was an association with Warmbloods in Switzerland (55.8%CH), but in France, in addition to Warmbloods (34.4%FRA), Thoroughbreds (27.2%FRA) were also affected. Moreover, horses affected by EHS often show stereotypical behaviour (15.7%FRA, 14.7%CH). A total of 38.4%FRA and 67.4%CH of horse owners utilised therapy measures, with nose covers being most commonly used (19.9%FRA, 30.2%CH). Horse owners resorted to alternative treatments that had not previously been studied in context with EHS (15%FRA, 20.9%CH). Conservative treatments, such as medication, were used by 5.4%CH and 1.9%FRA. This study provides an overview of the status of horses affected by EHS in France and Switzerland and thus offers a fundamental step to understanding the consequences of welfare issues associated with EHS. [ABSTRACT FROM AUTHOR]

Background: As part of a decades-long process of restructuring primary care, independent (also known as community) healthcare workers are being encouraged to work in groups to facilitate their coordination and continuity of care in France. French independent midwives perform about half of the early prenatal interviews that identify mothers' needs during pregnancy and then refer them to the appropriate resources. The French government, however, structured the COVID-19 pandemic response around public health institutions and did not directly mobilise these community healthcare workers during the lockdown phase. These responses have raised questions about their role within the healthcare system in crises. This survey's main objectives were to estimate the proportion of independent midwives who experienced new difficulties in referring women to healthcare facilities or other caregivers and in collaborating with hospitals during the first stage of this pandemic. The secondary objective was to estimate the proportion, according to their mode of practice, of independent midwives who considered that all the women under their care had risked harm due to failed or delayed referral to care.Methods: We conducted an online national survey addressed to independent midwives in France from 29 April to 15 May 2020, around the end of the first lockdown (17 March-11 May, 2020).Results: Of the 5264 registered independent midwives in France, 1491 (28.3%) responded; 64.7% reported new or greater problems during the pandemic in referring women to health facilities or care-providers, social workers in particular, and 71.0% reported new difficulties collaborating with hospitals. Nearly half (46.2%) the respondents considered that all the women in their care had experienced, to varying degrees, a lack of or delay in care that could have affected their health. This proportion did not differ according to the midwives' form of practice: solo practice, group practice with other midwives only, or group practice with at least two types of healthcare professionals.Conclusions: The pandemic has degraded the quality of pregnant women's care in France and challenged the French model of care, which is highly compartmentalised between an almost exclusively independent primary care (community) sector and a predominantly salaried secondary care (hospital) sector. [ABSTRACT FROM AUTHOR]

This article investigates vocational teachers’ competence for differentiated teaching in the broad introductory courses that exist in vocational education and training (VET) in Norway. In these courses students can specialise in a chosen vocation according to their interest. The study compares perceptions of vocational teachers educated in two different vocational teacher education programmes at two different universities. The programmes included are a 3-year bachelor programme (180 ECTS) and a 1-year postgraduate programme in education (60 ECTS). Cross-sectional survey data were collected among vocational teacher graduates (n = 279). Tests of mean differences indicated that the bachelor sample reported being significantly better prepared than the postgraduate sample for differentiated teaching according to students’ vocational interests. However, the same difference could not be found in teachers’ report of how often they used differentiated learning activities in school. The discussion points to how differences and similarities between content and practice areas in teacher education can explain teachers’ perceptions and whether both teacher programmes develop the competence needed to teach in the broad structure of Norwegian VET. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the scale of clinical implementation of automated treatment planning techniques in the United States. In this work, we examine the barriers and facilitators to adoption of commercially available automated planning tools into the clinical workflow using a survey of medical dosimetrists. Methods/materials: Survey questions were developed based on a literature review of automation research and cognitive interviews of medical dosimetrists at our institution. Treatment planning automation was defined to include auto‐contouring and automated treatment planning. Survey questions probed frequency of use, positive and negative perceptions, potential implementation changes, and demographic and institutional descriptive statistics. The survey sample was identified using both a LinkedIn search and referral requests sent to physics directors and senior physicists at 34 radiotherapy clinics in our state. The survey was active from August 2020 to April 2021. Results: Thirty‐four responses were collected out of 59 surveys sent. Three categories of barriers to use of automation were identified. The first related to perceptions of limited accuracy and usability of the algorithms. Eighty‐eight percent of respondents reported that auto‐contouring inaccuracy limited its use, and 62% thought it was difficult to modify an automated plan, thus limiting its usefulness. The second barrier relates to the perception that automation increases the probability of an error reaching the patient. Third, respondents were concerned that automation will make their jobs less satisfying and less secure. Large majorities reported that they enjoyed plan optimization, would not want to lose that part of their job, and expressed explicit job security fears. Conclusion: To our knowledge this is the first systematic investigation into the views of automation by medical dosimetrists. Potential barriers and facilitators to use were explicitly identified. This investigation highlights several concrete approaches that could potentially increase the translation of automation into the clinic, along with areas of needed research. [ABSTRACT FROM AUTHOR]

The term "superfood" is linked to food that is beneficial to health. However, there is no legal or clear scientific definition, and little is known about individual perceptions of this food group. Therefore, an online survey was conducted (n = 1006 respondents) to assess the public's understanding of superfoods in Germany, including (a) the conceptual understanding of the term "superfood", (b) corresponding consumption behavior, and (c) the risk–benefit appraisal. In total, 70% of respondents were aware of the term "superfood", and 33% reported consuming superfoods at least once a week. The term was mainly associated with positive food properties, such as "healthy" and "contains vitamins". Health benefits were rated to be much higher than potential health risks. In addition, imported foods were more likely to be labelled as superfoods, compared to domestic equivalents. In further analyses, we found women, younger people, and organic buyers to have an even more positive impression. That is, specific parts of the population may be particularly attracted to superfood products. Therefore, target-group specific information campaigns can be a useful tool to increase the population's awareness of the potential health risks of superfood consumption and to highlight the presence of equivalent "domestic superfoods" in Germany. [ABSTRACT FROM AUTHOR]

Abstract Background Essential to the professional development of mentors is making explicit and critically challenging the knowledge and beliefs underpinning their mentoring practice. This paper reports on the development of a survey instrument called MERIT, MEntor Reflection InstrumenT, which was designed to support mentors’ systematic reflection on the how, what and why of their practice. Methods In 2019, a twenty-item survey instrument was developed and piloted. Initial validation data (N = 228) were collected by distributing the survey through the authors’ network. An exploratory factor analysis (EFA) was conducted and internal consistency reliability coefficients were calculated. Results The Principal Axis EFA with Direct Oblimin rotation (Delta = 0) resulted in four factors: 1) supporting personal development, 2) modelling professional development, 3) fostering autonomy, and 4) monitoring performance. The four factors explained 43% of the total variance of item scores. The Cronbach’s alphas for the subscale scores were between .42 and .75. Conclusions The MERIT can help mentors reflect on their beliefs and professional knowhow. These reflections can serve as input for the faculty development initiatives mentors undertake, which may ultimately improve their knowledge and skills as a mentor.

The character of current students who are technology-savvy and the fast development of educational technology raises challenges for teachers to take advantage of these conditions to make learning effective. Technological, Pedagogical, Vocational Knowledge (TPVK) come as a framework for the effective use of technology in teaching and learning in vocational fields. This research aimed to capture the Indonesian secondary vocational non-Information and communications technology (ICT) teachers’ perspective toward TPVK for 21st Century Learning (CL). Research with a mixed-method approach was conducted during the second semester in the 2019/2020 academic year. Sixty-five secondary vocational building engineering teachers from nine schools located in Central Java, Indonesia were recruited as survey respondents. The instrument used was a self-assessment questionnaire, lesson plan rubric, and observational protocol enriched with interview protocol. Results from this study show that the in-service vocational teacher shows readiness for TPVK 21st CL at the intermediate level. The TPVK component with the highest mean point is Pedagogical knowledge, while the lowest point is on the Vocational knowledge component. The lesson plan prepared by teachers and learning practiced performed by teachers showed less fitness of technology integration in learning with the strategies and objectives of the curriculum.

Abstract Background Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI). Methods We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results Surveys were distributed to 591 PCPs (n = 538 family physicians; n = 53 nurse practitioners) identified as practicing in the Southeastern Ontario and 92 (15.6%) participated. PCPs serving a rural population estimated that 14.2 ± 10.9% of patients would qualify for MSWLI compared to 9.9 ± 8.5% of patients of PCPs serving an urban population (p = .049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past 5 years. Conclusion The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

In Norway there exist two different educational pathways for vocational teachers, a bachelor programme and a postgraduate programme in education. This article reports on a comparison of teacher preparation in these two programmes that qualify vocational teachers for work in schools. The purpose is to explore the competence vocational teachers develop during teacher education that is particularly relevant for the broad introductory courses in vocational education and training (VET). Previous research has found that teachers should choose authentic learning activities relevant for working life, as well as developing students’ interests in a vocation. Cross-sectional survey data were collected among vocational teacher graduates (n = 279). Tests of mean differences indicated that the bachelor sample reported being significantly better prepared for teaching in broad courses than the postgraduate sample. However, the same difference could not be found in teachers’ report of different learning activities in school. The discussion points to how differences and similarities between content and practice arenas in teacher education can explain teachers' experiences and whether both teacher programmes develop the competence needed to teach in the broad structure of Norwegian VET.

There are little published data on the transition of care in EB. We conducted a survey study recruiting EB patients from the Dystrophic EB Research Association (debra) website and centers caring for high numbers of EB patients in the United States and internationally from Sept 17, 2019 to Nov 3, 2021. The majority of participants had not discussed the transition of care with their healthcare providers, nor the healthcare needs to be required as an adult. Ongoing pediatric subspecialty care was reported by 12% of adults, most commonly in pediatric dermatology. Identified barriers to transition included the perceived lack of adult providers' knowledge about EB patient healthcare needs. The results suggest the need for transition guidelines, early discussions with families about transition, and practical information for the adult providers accepting care. [ABSTRACT FROM AUTHOR]

Introduction: Socioeconomic status (SES) is a known risk factor for gastric cancer (GC). This study seeks to examine education, income, and occupation variables separately to identify the single variable that can be best used to assess SES risk for GC. Methods: Data from a case-control survey study were used. Logistic regression models were created for education, income, and occupation adjusted for age, sex, and race. Models were compared using AIC, c-statistics, and pseudo-R square to determine the model that had the highest risk predictive ability. Results: GC cases had lower education levels and more commonly held jobs in unskilled labor. Annual household income was lower in cases compared to controls. Age, gender, race, education, and occupation were associated with increased risk of GC. The education model adjusted for age, gender, and race found < high school (HS) education to have an OR of 3.18 (95% CI 1.09–9.25) for GC compared to > HS education. The occupation model demonstrated that employment in unskilled labor had OR of 4.32 (95% CI 1.05–17.76) for GC compared to professional occupation. Model fit was best for the education model (AIC: 113.583, lower AIC is better) compared to income (117.562) or occupation (117.032). Education contributed the most to model variability (% delta pseudo-R square (4.7%)) compared to occupation (4.0%) or income (3.8%). Conclusion: Education level was the single most reliable measure of GC risk among 3 SES variables and can be employed as an ideal single indicator of SES-related GC risk when multiple SES factors cannot be obtained. [ABSTRACT FROM AUTHOR]

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Copyright of Finance & Business Economies Review is the property of Finance & Business Economies Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We sought to understand the attitudes of individuals with abnormal breast imaging findings prompting a diagnostic breast biopsy toward donation of blood, excised tissue, or percutaneous biospecimens for research, and to understand medical oncologists' attitudes toward research biospecimen collection in this population. Methods: We included individuals who presented to a single academic medical center for a clinically indicated, image-guided, percutaneous breast biopsy. We administered a survey prior to knowledge of biopsy results to assess willingness to consider, entirely for research purposes, donating blood or excess excised breast tissue, or having additional biospecimens (AB) obtained during a clinically indicated percutaneous biopsy. We also surveyed breast medical oncologists from National Cancer Institute-designated cancer centers to assess attitudes toward approaching patients for biospecimen research. Results: Overall, 53/63 patients responded to the survey; 70% would consider donating blood, 85% would consider donating excess excised breast tissue, and 32% would consider having AB obtained during a clinically indicated biopsy. Main motivating factors for considering AB included contributing to scientific knowledge and return of study or biopsy results, whereas anxiety and the potential discomfort were the main dissuading factors. Among 191 medical oncologists, most were very comfortable (59.2%), or somewhat comfortable (32.5%) asking patients to have AB obtained during a clinically indicated breast biopsy. Medical oncologists reported hesitancy to refer a patient for AB due to potential pain/discomfort, and other procedure risks. Conclusions: Only one-third of individuals with breast imaging findings would consider consenting to AB during a diagnostic biopsy, whereas most were open to donating blood or excess excised breast tissue. Most medical oncologists would be comfortable asking patients to have AB obtained during the biopsy. Understanding patients' and oncologists' baseline attitudes may inform the design and approach to breast biospecimen-based research. [ABSTRACT FROM AUTHOR]