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ABSTRACT Objectives: to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer. Methods: a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0. Results: participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned. Final Considerations: spirituality and religiosity are dimensions that guide oncology nurse residents’ attitudes.

Purpose: Data indicates that clinicians might be under-prescribing opioids for patients with chronic cancer pain, and this could impact adequate pain management. Few studies have sought to understand healthcare provider (HCP) perceptions and practices regarding the prescription of opioids for chronic cancer pain. We assessed HCP perceptions and practices regarding opioid prescription for patients with chronic cancer pain since the onset of the COVID-19 pandemic. Methods: An anonymous cross-sectional survey was conducted among 186 HCPs who attended an opioid educational event in April 2021 and 2022. Results: Sixty-one out of 143 (44%) opioid prescribers reported reluctance to prescribe opioids for chronic cancer pain. In a multivariate logistic model, younger participants (log OR − 0.04, 95% CI − 0.085, − 0.004; p = 0.033) and pain medicine clinicians (log OR − 1.89, CI − 3.931, − 0.286; p = 0.034) were less reluctant, whereas providers who worry about non-medical opioid use were more reluctant to prescribe opioids (log OR 1.58 95% CI 0.77–2.43; p < 0.001). Fifty-three out of 143 (37%) prescribers had experienced increased challenges regarding opioid dispensing at pharmacies, and 84/179 (47%) of all respondents reported similar experience by their patients. Fifty-four out of 178(30%) were aware of opioid-related harmful incidents to patients or their families, including incidents attributed to opioid misuse by a household or family member. Conclusion: A considerable number of opioid prescribers were reluctant to prescribe opioids for patients with chronic cancer pain. Many reported challenges regarding dispensing of opioids at the pharmacies. These may be unintended consequences of policies to address the opioid crisis. Future measures should focus on addressing regulatory barriers without undermining the gains already made to combat the opioid crisis. [ABSTRACT FROM AUTHOR]

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Copyright of Saberes Plurais is the property of Saberes Plurais 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.)

Copyright of Saberes Plurais is the property of Saberes Plurais 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.)

Copyright of Saberes Plurais is the property of Saberes Plurais 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.)

Background and purpose: Vocal nodules are the main cause of voice disorders in children, which can be caused by several behaviors such as excessive speaking and yelling, and can significantly impact their overall communication development. Different nonmedical treatments exist for vocal nodules, but there is no consensus on the most effective methods. The aim of the present systematic review was to study the nonmedical interventions for vocal nodules in children. Materials and methods: The systematic search was performed in electronic databases, including PubMed, Scopus, Science Direct, ISI (Web of Science), Cochrane Database of Systematic Reviews, and Google Scholar. The search involved articles published between 2000 and 2022. The following terms were used as keywords: vocal nodule, vocal fold nodules, therapy, treatment, intervention, voice disorder, pediatric, and telepractice. Studies were selected if they 1) had examined 0-18-year-old subjects with vocal fold nodules; 2) had obviously stated the kind, process, and evaluation tools and also 3) the kind and the process of the interventions and the intervention groups; 4) had provided nonmedical interventions; 5) had been published in English and after 2000; and 6) presented the outcome data. The methodological quality of the papers was evaluated using the Physiotherapy Evidence Database scale. Results: We identified 729 articles, of which 11 met the inclusion criteria. These studies were different in the study design, participant characteristics, types of assessments, types of interventions, and follow-up periods. According to findings, nonmedical treatments of vocal nodules were successful in elimination of/decreasing the vocal nodules sizes (four studies), improving the quality of life (two studies), and improving acoustic parameters of voice (nine studies). Conclusion: The present systematic review showed the effectiveness of nonmedical treatment of vocal nodules in children, despite being challenging. Further researches are required to have higher levels of evidence, more accurate methodological quality, and long-term follow-up evaluations to draw more accurate conclusions.

Background and Objectives: Ethical sensitivity prevents moral dilemmas; moral self-concept develops via adaptation to others’ expectations. Nursing education provides an opportunity to internalize ethical sensitivity and improve moral self-concept because nurses are often faced with serious situations that require higher ethical knowledge. Therefore, we assessed sensitivity and moral self-concept in nursing students and related factors. Methods: This quasi-experimental study was designed for one group to investigate the degree of students’ moral self-concept and ethical sensitivity in an internship program (12 months) and their related factors. Thirty-nine undergraduate nursing students were selected by census sampling method. The inclusion criteria included senior bachelor’s degree students and their desire to participate in the study. Lutzen’s ethical sensitivity questionnaire (25 items) and Lutzen’s moral self-concept questionnaire (18 items) were used. Data were analyzed by SPSS software, version 22 using described by number, percentage, Mean±SD and assessed by the paired t-test. Results: The majority of the participants (74.4%) were women (76.9%) and single, (48.7%) aged 23 years, and (76.9%) reported participation in the ethics workshops. The mean score of students’ ethical sensitivity before the internship was at a medium level (109.64±9.51), which improved to a higher level (115.56±8.88) after the internship. There was a significant difference between the mean score of ethical sensitivity before and after the internship (P

Simple Summary: A urine drug test (UDT) is often used in the treatment of cancer pain to monitor compliance with opioid treatment. Two types of UDT are commonly for this purpose: the immunoassay test, and the mass spectrometry method. Only a few studies have examined the use of immunoassay UDT for cancer patients in palliative care clinics. In this study, we examined the frequency of immunoassay UDT abnormalities, and the factors associated with aberrant findings at a safety-net hospital palliative medicine clinic. Electronic medical records of 913 patients were reviewed. We found that 27% had aberrant UDT results; 35% of these were positive for cocaine. Non-Hispanic White race, history of illicit drug use, and history of marijuana use were associated with an aberrant finding. Despite limitations of immunoassay UDT, it could detect aberrant drug-taking behaviors in a significant number of patients. These findings support the utility of immunoassay UDT in clinical settings with less resources. Background: Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics. Objectives: We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic. Methods: A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results. Results: Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03–4.38; p = 0.04), history of illicit drug use (OR = 3.57; CI: 1.78–7.13; p < 0.001), and history of marijuana use (OR = 7.05; CI: 3.85–12.91; p < 0.001) were independent predictors of an aberrant UDT finding. Conclusion: Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings. [ABSTRACT FROM AUTHOR]

Background and purpose: Vocal nodules are the main cause of voice disorders in children, which can be caused by several behaviors such as excessive speaking and yelling, and can significantly impact their overall communication development. Different nonmedical treatments exist for vocal nodules, but there is no consensus on the most effective methods. The aim of the present systematic review was to study the nonmedical interventions for vocal nodules in children. Materials and methods: The systematic search was performed in electronic databases, including PubMed, Scopus, Science Direct, ISI (Web of Science), Cochrane Database of Systematic Reviews, and Google Scholar. The search involved articles published between 2000 and 2022. The following terms were used as keywords: vocal nodule, vocal fold nodules, therapy, treatment, intervention, voice disorder, pediatric, and telepractice. Studies were selected if they 1) had examined 0-18-year-old subjects with vocal fold nodules; 2) had obviously stated the kind, process, and evaluation tools and also 3) the kind and the process of the interventions and the intervention groups; 4) had provided nonmedical interventions; 5) had been published in English and after 2000; and 6) presented the outcome data. The methodological quality of the papers was evaluated using the Physiotherapy Evidence Database scale. Results: We identified 729 articles, of which 11 met the inclusion criteria. These studies were different in the study design, participant characteristics, types of assessments, types of interventions, and follow-up periods. According to findings, nonmedical treatments of vocal nodules were successful in elimination of/decreasing the vocal nodules sizes (four studies), improving the quality of life (two studies), and improving acoustic parameters of voice (nine studies). Conclusion: The present systematic review showed the effectiveness of nonmedical treatment of vocal nodules in children, despite being challenging. Further researches are required to have higher levels of evidence, more accurate methodological quality, and long-term follow-up evaluations to draw more accurate conclusions. [ABSTRACT FROM AUTHOR]

Owing to their small size, microrobots have many potential applications. In addition, four-dimensional (4D) printing facilitates reversible shape transformation over time or upon the application of stimuli. By combining the concept of microrobots and 4D printing, it may be possible to realize more sophisticated next-generation microrobot designs that can be actuated by applying various stimuli, and also demonstrates profound implications for various applications, including drug delivery, cells delivery, soft robotics, object release and others. Herein, recent advances in 4D-printed microrobots are reviewed, including strategies for facilitating shape transformations, diverse types of external stimuli, and medical and nonmedical applications of microrobots. Finally, to conclude the paper, the challenges and the prospects of 4D-printed microrobots are highlighted. [ABSTRACT FROM AUTHOR]

Copyright of Revista Família, Ciclos de Vida e Saúde no Contexto Social (REFACS) is the property of Universidade Federal do Triangulo Mineiro, Instituto de Ciencias da Saude 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.)

Context: Suicide and attempted suicide are some of the alarming issues in recent times. It was the second leading cause of death among 15–29 years old in 2015. The suicide death toll is rising alarmingly in India, which needs prevention strategies and a suicide prevention policy nationally. Attitude toward suicide varies depending on social, cultural, and individual perceptions and beliefs. The studying of attitudes of the people in society towards suicide helps in devising better suicide prevention strategies and planning early intervention measures. Aims: This study explores attitude toward suicide between the medical and nonmedical groups and their relationship with other sociodemographic variables. Settings and Design: A cross-sectional comparative study was done at a tertiary care hospital in South India. Materials and Methods: One hundred participants belong to nonmedical and 100 belong to medical groups were assessed using Eskin's Attitude towards Suicide Scale. Statistical Analysis Used: Descriptive statistical tests and independent t-tests were applied to find the significant difference in the means between the two groups using SPSS version 23. Results: Nonmedical group scored high in "hiding the suicidal behavior" and low in "communicating psychological problems" and vice versa in the medical group. Females scored higher on "acceptability of suicide" and "punishment after death" among the medical group. Conclusion: Imparting psychoeducation and promoting awareness about suicide can help change individuals' attitudes toward suicide at the microlevel and society's macrolevel. [ABSTRACT FROM AUTHOR]

Context: Suicide and attempted suicide are some of the alarming issues in recent times. It was the second leading cause of death among 15–29 years old in 2015. The suicide death toll is rising alarmingly in India, which needs prevention strategies and a suicide prevention policy nationally. Attitude toward suicide varies depending on social, cultural, and individual perceptions and beliefs. The studying of attitudes of the people in society towards suicide helps in devising better suicide prevention strategies and planning early intervention measures. Aims: This study explores attitude toward suicide between the medical and nonmedical groups and their relationship with other sociodemographic variables. Settings and Design: A cross-sectional comparative study was done at a tertiary care hospital in South India. Materials and Methods: One hundred participants belong to nonmedical and 100 belong to medical groups were assessed using Eskin's Attitude towards Suicide Scale. Statistical Analysis Used: Descriptive statistical tests and independent t-tests were applied to find the significant difference in the means between the two groups using SPSS version 23. Results: Nonmedical group scored high in “hiding the suicidal behavior” and low in “communicating psychological problems” and vice versa in the medical group. Females scored higher on “acceptability of suicide” and “punishment after death” among the medical group. Conclusion: Imparting psychoeducation and promoting awareness about suicide can help change individuals' attitudes toward suicide at the microlevel and society's macrolevel.

Objective: to analyze the perception of resident nurses in Child Health regarding the process of infant death and dying in Pediatrics. Method: qualitative study, developed with four resident nurses from a University Hospital in Recife, Pernambuco, Brazil. The sample was selected by non-probabilistic sampling of the intentional type. The interviews were processed in IRAMUTEQ software and analyzed using the Descending Hierarchical Classification. Results: the following categories were observed: 1) coping with infant death; 2) process of pediatric death and dying; 3) expression of feelings before infant death; 4) formation and resilience of the multidisciplinary team before the end of life; 5) residency experiences. Final considerations: despite being part of the vital cycle of living beings, death is seen as a tragic event, especially in childhood, awakening different feelings, mostly negative.

Background and Objectives: Ethical sensitivity prevents moral dilemmas; moral self-concept develops via adaptation to others’ expectations. Nursing education provides an opportunity to internalize ethical sensitivity and improve moral self-concept because nurses are often faced with serious situations that require higher ethical knowledge. Therefore, we assessed sensitivity and moral self-concept in nursing students and related factors. Methods: This quasi-experimental study was designed for one group to investigate the degree of students’ moral self-concept and ethical sensitivity in an internship program (12 months) and their related factors. Thirty-nine undergraduate nursing students were selected by census sampling method. The inclusion criteria included senior bachelor’s degree students and their desire to participate in the study. Lutzen’s ethical sensitivity questionnaire (25 items) and Lutzen’s moral self-concept questionnaire (18 items) were used. Data were analyzed by SPSS software, version 22 using described by number, percentage, Mean±SD and assessed by the paired t-test. Results: The majority of the participants (74.4%) were women (76.9%) and single, (48.7%) aged 23 years, and (76.9%) reported participation in the ethics workshops. The mean score of students’ ethical sensitivity before the internship was at a medium level (109.64±9.51), which improved to a higher level (115.56±8.88) after the internship. There was a significant difference between the mean score of ethical sensitivity before and after the internship (P<0.001). This difference was not significant for the mean score of moral self-concept. The correlation of study variables with gender, marital status, and age was not significant, while there was a significant difference regarding participation in the workshop (P<0.02). Conclusion: Ethical sensitivity was influenced by participating in ethics workshops; thus, continuous training can be effective to improve it. It can enhance ethical sensitivity and reduce the risk of unethical behavior among nurses in the future. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Atencao Primaria a Saude is the property of Revista de Atencao Primaria a Saude 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.)

Background: Few studies have assessed interventions aimed at managing nonmedical opioid use (NMOU) behavior among patients with cancer. The authors developed the Compassionate High-Alert Team (CHAT) intervention to manage patients receiving opioids for cancer pain who demonstrate NMOU behavior. The objective of this study was to determine the change in frequency of NMOU behaviors, pain intensity, and opioid requirements among those who received the intervention.Methods: A total of 130 patients receiving opioids for cancer pain that had documented evidence of NMOU and received the CHAT intervention were reviewed. Demographic and clinical information such as NMOU behaviors, pain scores, and morphine equivalent daily dose at baseline, 3, and 6 months post-intervention was obtained.Results: NMOU behaviors significantly decreased from a median (interquartile range) of 2 (1-3) at baseline to 0 (0-1) at both 3 and 6 months post-intervention (p < .001). A total of 45 of 75 (60%) and 31 of 50 (62%) of CHAT recipients achieved complete response to the intervention at 3 and 6 months, respectively. Higher baseline number of NMOU behaviors was independently associated with patient response to the intervention (odds ratio [OR], 1.97; 95% confidence interval [CI],1.09-4.28, p = .049 at 3 months; OR, 2.5; 95% CI, 1.20-6.47, p = .03 at 6 months). The median pain score decreased from 7 at baseline to 6 at both 3 and 6 months (p = .01). Morphine equivalent daily dose did not significantly change during that same period (143 mg/day vs. 139 mg/day, p = .13).Conclusions: Most patients who received the CHAT intervention improved in their NMOU behaviors and pain intensity scores 3 and 6 months post-intervention. These preliminary findings support the efficacy of CHAT in managing patients receiving opioids for cancer pain who demonstrate NMOU behavior. [ABSTRACT FROM AUTHOR]

Owing to their small size, microrobots have many potential applications. In addition, four-dimensional (4D) printing facilitates reversible shape transformation over time or upon the application of stimuli. By combining the concept of microrobots and 4D printing, it may be possible to realize more sophisticated next-generation microrobot designs that can be actuated by applying various stimuli, and also demonstrates profound implications for various applications, including drug delivery, cells delivery, soft robotics, object release and others. Herein, recent advances in 4D-printed microrobots are reviewed, including strategies for facilitating shape transformations, diverse types of external stimuli, and medical and nonmedical applications of microrobots. Finally, to conclude the paper, the challenges and the prospects of 4D-printed microrobots are highlighted.

Copyright of Revista Enfermagem Digital Cuidado e Promoção da Saúde is the property of Revista Enfermagem Digital Cuidado e Promocao da Saude 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.)

PurposeThe goal of t his study was to describe the characteristics of primary care teams, activities, and ro les of physician assistant (PA) students as they encounter various primary care sites.MethodsAn electronic survey was distributed to second year PA students in 12 programs who had completed at least 4 weeks in a primary care rotation.ResultsOf the 179 students who responded (response rate 41 %), 88% had completed their primary care rotations in urban settings, mostly in private practices (53%). Physician assistant students reported encountering many types of health care providers on their teams, and the 2 most favored features of the rotations were the interactions with their supervising clinicians and clinical responsibilities. About 68% interacted with other health profession students during their rotation(interprofessional experiential learning). Almost all students completed histories, physical examinations, and treatment plans, but less than 30% reported involvement in billing or care coordination and less than 10% participated in quality improvement projects. More than 60% were satisfied with team-based and interprofessional practices encountered during their primary care rotations, and 39% were more than likely to pursue primary care careers.ConclusionsTeam-based prima ry ca re had a positive impact on students, but more exposure to underserved clinical settings, care coordination, quality improvement, and billing is needed to prepare PA students for the practice of the future. This study is t he first of its kind to explore the relationship between primary care sites and PA training in the era of health care reform.

Background: Globally, there are 45 million blind people with an annual increase of 1–2 million. Corneal blindness is the 4th leading cause of blindness. The demand for donor’s eyes is much higher than the number of donor’s eyes collected, and the number of corneal transplants done is insufficient. One of the reasons for reduced eye donation is the lack of awareness of the process of eye donation and corneal transplantation. Materials and Methods: A comparative, questionnaire-based cross-sectional study was conducted to assess the awareness on eye donation among medical and nonmedical students of Puducherry. The participants were given a predesigned and structured questionnaire which included 25 questions after informed consent was obtained from them. The results were derived through the statistical analysis. Results: The primary source of awareness for both groups was mass media. About 90.3% of medical and 41.9% of the nonmedical students knew that consent for eye donation is given by the donor while alive (P < 0.000), also that the first-degree relatives have the right to give consent for the dead was 88.2% and 49.5% among medical and nonmedical students, respectively (P < 0.000). Three-fourths of medical and half the nonmedical students knew that corneal donation could not cure all types of blindness. Around 87.1% of medical and 36.6% of nonmedical students were aware that eyes with corneal diseases could not be donated. Conclusion: The present study showed that participants from both groups were aware of eye donation, but the awareness among nonmedical students was not adequate. This study also shows that mass media was the most common source of awareness among the students, which could be used to create further awareness among the students. [ABSTRACT FROM AUTHOR]

In recent times, the Nigerian public space has been awash with various incidences of "fainting" during investigations seeking to unravel issues surrounding alleged financial mismanagement in public institutions. A critical question is, to what extent do these apparent fainting behaviors represent a true illness-related event? Feigning of medical symptoms for external gains is well-described phenomenon with enormous cost to both forensic and nonforensic settings. Separating the sheep from the goats in these situations is a task many clinicians are not familiar with. This article aims to articulate the current models of malingering and to highlight the various ways of detecting deception in clinical settings. The authors opine that an integrative strategy, which involves the combination of various approaches with emphasis on the verbal and nonverbal signals during clinical interviews coupled with psychological testing and perhaps neuroimaging techniques, may improve the detection of deception in the clinical setting. We recommend that clinicians should not shy away from employing any of these "malingering diagnostic" approaches when there is a reasonable suspicion to the veracity of patients' symptoms such as fainting during a panel inquiry. [ABSTRACT FROM AUTHOR]

Sultan M Alshahrani,1 Sirajudeen Shaik Alavudeen,1 Khaled M Alakhali,1,2 Yaser Mohammed Al-Worafi,3 Ahmed K Bahamdan,1 Easwaran Vigneshwaran1 1Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Clinical Pharmacy Department, College of Pharmacy, USCI University, Kuala Lumpur, Malaysia; 3Clinical Pharmacy Department, College Of Pharmacy, University of Science and Technology of Fujairah, Fujairah, UAECorrespondence: Yaser Mohammed Al-WorafiCollege of Pharmacy, University of Science And Technology of Fujairah, Fujairah, UAETel +971543041178Email yworafi@yahoo.comPurpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia.Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia.Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study.Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended.Keywords: self-medication, students, medical, nonmedical, King Khalid University, Saudi Arabia

Objective: to describe the perspective of nurses graduated from a residency program of Psychiatry and Mental Health Nursing in Alagoas on training and the labor field. Method: exploratory, qualitative study conducted with ten nurses graduated from a nursing residency program in Psychiatry and Mental Health in northeastern Brazil. Semistructured interviews were conducted with audio recording. The data were submitted to thematic content analysis and discussed in the light of the theoretical references of psychiatric reform and mental health nursing. Result: the thematic categories identified were "Training Process: expectations versus reality" and "Labor Field: opportunities and professional satisfaction". Final thoughts: in relation to education, the graduated nurses were satisfied with the knowledge provided by the residency; in relation to the labor field, they expressed frustration at not being valued, despite being specialized professionals able to contribute to the qualification of the service. [ABSTRACT FROM AUTHOR]

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem 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.)

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem 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.)

Osama Y Alshogran,1 Karem H Alzoubi,1 Omar F Khabour,2 Shatha Farah2 1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan Background and objective: Self-medication practice involves consumption of medicines by one’s own initiative or on the consultation of others without the guidance of a physician. Self-medication and use of over-the-counter drugs are prevalent worldwide public health concerns. University students of medical and nonmedical disciplines may have different levels of health education. This study evaluated the prevalence and patterns of self-medication and the attitudes toward this practice among medical and nonmedical university students in Jordan. Methods: A descriptive cross-sectional study was conducted in 504 students (medical: 248 and nonmedical: 256). The students were invited to complete a questionnaire that included questions primarily related to patterns of physician visits, self-medication practice, symptoms provoking self-medication, and sources of advice. Results: Self-medication was highly prevalent and comparable between medical and nonmedical students (~96%). Headache (81.9%), cold (58.3%), and flu (53%) were the frequent symptoms provoking self-medication among students. Self-medication for headache (86.7% vs 77.3%) and tooth pain (53.1% vs 27%) was significantly higher among medical vs nonmedical students, respectively. Self-treatment with painkillers (82.3% vs 73%) or antiallergy (11.3% vs 5.9%) drugs was significantly higher among medical students, while the use of anti-flu decongestants (47.6% vs 60.2%) was lower compared to nonmedical students, respectively. Nonmedical vs medical students were significantly more dependent on friends (14.8% vs 7.7%) and own experience (7.4% vs 2.4%) as a source of self-medication advice. Conclusion: Self-medication is common among Jordanian university students of medical and nonmedical disciplines. This practice, if used irrationally, may constitute a health problem that needs awareness and interventions by health care regulators in Jordan. Future studies are warranted to examine the impact of self-medication on students’ health. Keywords: self-medication, students, medical, nonmedical, survey, Jordan

Background: Many medical students, junior doctors, and other health-care professionals have been affected by the negative experience of bullying. Research is scarce on bullying experienced by medical and nonmedical students in Saudi Arabia unlike what is found in Western countries. It is unclear whether being a nonmedical student modifies the risk of being bullied. Materials and Methods: A cross-sectional study included 400 university students using convenient sampling. The sample comprised 295 students who responded and were stratified into medical (n = 176) and nonmedical (n = 119) groups. Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyze our data. Normality was measured using the Kolmogorov–Smirnov test. Statistical significance was tested using chi-square test for categorical variables, and t-test for continuous variables. Results: Almost half of the respondents were found to have experienced some bullying, victimization, or other harassment during their medical education. The most common forms of bullying were verbal abuse and undue pressure to produce work (43.8%; n = 77). Nonmedical students experienced more bullying than medical students and were more likely to be female, single, and younger in age. The number of medical students subjected to sexual harassment (1.7%; n = 3) was higher than nonmedical students (0.8%; n = 1). Physical violence was more towards nonmedical (4.2%; n = 5) than medical students (1.1%, n = 2). The rates of bullying continue to be associated with anxiety and depression. Conclusions: Our data suggest similar bullying rates in the developed world but higher than previously reported in a Saudi study. Bullying or harassment affects both medical and nonmedical students and is associated with high levels of anxiety and depression.

Coronavirus disease 2019, otherwise referred to as COVID-19, started in China and quickly became a worldwide pandemic. Beginning in March 2020, nonessential businesses in the United States were closed, and many communities were under shelter-in-place orders. As of May 2020, some business sectors started reopening, even amidst concerns of worker health as the pandemic continued. In addition to physical distancing, cleaning and disinfection routines, and using face coverings, building ventilation can also be an important risk mitigation measure for controlling exposure to SARS-CoV-2 indoors. A number of studies to date, however, have focused on ventilation in medical facilities (e.g. hospitals) as the risk of transmission of SARS-CoV-2 is higher there (because of the close proximity of workers to patients who have the disease and their treatment procedures). Few studies have focused on ventilation use in nonmedical settings (e.g. office buildings and school classrooms), despite the large population of workers and community members in these facilities. In this article, we review the role that building ventilation can play in minimizing the risk of SARS-CoV-2 transmission in nonmedical environments and some recommended protocols to follow for its proper use, including cleaning and maintaining mechanical ventilation systems for businesses, schools, and homes. [ABSTRACT FROM AUTHOR]

Background: Entrustable Professional Activities (EPAs) are a list of professional tasks that pharmacy educational organizations support, and accreditation organizations encourage, for assessment by colleges and schools of pharmacy. Objective: This manuscript evaluates the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota. Methods: This survey evaluated the self-reported EPA activities of registered pharmacists living and practicing in North Dakota. For EPAs and supporting tasks in the 6 domains (including the PHP domain), respondents were asked to self-report the number of times during the last 30 days that they perform the task, using a 6 point response scale (0, 1, 2, 3, 4, 5 or more times). There were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded. Results: Within the PHP domain, pharmacists reported performing "Minimize adverse drug events and medication errors" most frequently (mean=3.4, SD=2.0), followed by "Ensure that patients have been immunized against vaccine-preventable diseases" (mean=2.3, SD 2.3), "Maximize the appropriate use of medications in a population" (mean=2.2, SD 2.3), and "Identify patients at risk for prevalent diseases in a population" (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists. Conclusions: Pharmacists in North Dakota currently perform some population health promoter activities, but not at a consistent and high level. Most of the health prevention activities were medication-related and oriented towards individual patients (micro-level), rather than at a community (population-based) macro-level. [ABSTRACT FROM AUTHOR]

Objective: Mixed findings exist regarding extent and efficacy of nonmedical use of prescription stimulants (NMUPS) for study enhancement (SE). This national study of US high school seniors examined NMUPS for SE and addressed risk/benefit questions: To what extent are students reporting NMUPS specifically for SE, and do these individuals demonstrate fewer problem behaviors and superior academic performance? Method: Total of 15 098 US students surveyed (2009-2015) and divided into 4 subgroups: (1) no past-year NMUPS (nonusers), (2) past-year NMUPS to help study (NMUPS-SE only), (3) past-year NMUPS for study/nonstudy motives (NMUPS-SE+ other), and (4) past-year NMUPS for nonstudy motives (NMUPS-nonSE only). Student characteristics (eg, grade point average [GPA]) and substance-related problems (eg, binge drinking) compared between subgroups. Results: Among students who reported past-year NMUPS (n = 781), 7.4% reported NMUPS-SE only, 40.9% NMUPS-SE+ other, and 51.7% NMUPS-nonSE only. Odds of binge drinking, cigarette smoking, marijuana, and opioid nonmedical use significantly higher among all NMUPS subgroups. GPAs significantly lower among subgroups reporting NMUPS nonstudy motives; did not differ between NMUPS-SE only and nonusers. Conclusions: 7% of US high school seniors engaged in NMUPS for SE only (0.4% total population). Findings indicate greater substance-related problems without superior academic performance among NMUPS-SE subgroups. [ABSTRACT FROM AUTHOR]

Objective: to know the contributions of a residency program in psychiatry and mental health in the training of registered nurses. Methods: it is a qualitative, exploratory research carried out with 10 registered nurses. The data production was through semi-structured interview and audio recording, analyzed in light of the Content Analysis technique, in the category Categorical Analysis modality, proposed by Bardin. Results: the following categories emerged from the participants' speeches: contributions in mental health training; contributions as a nursing professional; and contributions in personal life. Conclusion: The contributions were both in the development of skills for mental health care as in the profession of nurses, to act at all levels of health. There were also contributions in the personal life, promoting the maturity to face the difficulties and most diverse situations in work and life. [ABSTRACT FROM AUTHOR]

A 25-year-old man seeking increased prominence of the cheeks self-injected a topical skin preparation containing hyaluronic acid into his malar soft tissues. Labeling and marketing of the product, which highlighted the hyaluronic acid as one of the ingredients, might have contributed to his misunderstanding of the intended use for the product. Additionally, a popular medical-based talk show and numerous videos online contributed to the errant belief that self-administration was a viable option. Complications from the injection of nonpharmaceutical substances of this type and implications for treatment in clinical practice are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many medical students, junior doctors, and other health-care professionals have been affected by the negative experience of bullying. Research is scarce on bullying experienced by medical and nonmedical students in Saudi Arabia unlike what is found in Western countries. It is unclear whether being a nonmedical student modifies the risk of being bullied. MATERIALS AND METHODS: A cross-sectional study included 400 university students using convenient sampling. The sample comprised 295 students who responded and were stratified into medical (n = 176) and nonmedical (n = 119) groups. Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyze our data. Normality was measured using the Kolmogorov-Smirnov test. Statistical significance was tested using chi-square test for categorical variables, and t-test for continuous variables. RESULTS: Almost half of the respondents were found to have experienced some bullying, victimization, or other harassment during their medical education. The most common forms of bullying were verbal abuse and undue pressure to produce work (43.8%; n = 77). Nonmedical students experienced more bullying than medical students and were more likely to be female, single, and younger in age. The number of medical students subjected to sexual harassment (1.7%; n = 3) was higher than nonmedical students (0.8%; n = 1). Physical violence was more towards nonmedical (4.2%; n = 5) than medical students (1.1%, n = 2). The rates of bullying continue to be associated with anxiety and depression. CONCLUSIONS: Our data suggest similar bullying rates in the developed world but higher than previously reported in a Saudi study. Bullying or harassment affects both medical and nonmedical students and is associated with high levels of anxiety and depression. [ABSTRACT FROM AUTHOR]

Summary Objectives The aim of the present systematic review was to investigate the nonmedical treatments of vocal fold nodules (VFNs). Study Design The present study is a systematic review. Methods The following electronic databases were searched from inception until August 2016: PubMed, Scopus, ScienceDirect, Ovid, ISI (Web of Sciences), Cochrane, PsychINFO, The Cochrane Central Register of Controlled Trials, and Google Scholar. Reference lists of included articles were evaluated for additional data. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to carry out and report the review. The methodological quality of the articles included was evaluated using the Physiotherapy Evidence Database scale. Due to the heterogeneity of the studies, a narrative synthesis of the evidence was performed to summarize the evidence. Results Out of 2,099 records identified, 21 articles met the inclusion criteria and thus were included in the review. The studies investigated in the present review were different in terms of study design, participant characteristics, types of assessments and treatments, and treatment delivery. However, nonmedical treatments of VFNs were found to be successful in improving vocal quality, decreasing VFN sizes, and resolving these nodules. Conclusions The results of the present review could provide primary evidence related to the effectiveness of nonmedical treatment of VFNs. Yet further studies with a high level of evidence, a rigorous methodological quality, and long-term follow-up evaluations are required to make stronger claims. [ABSTRACT FROM AUTHOR]

There are inconsistent findings regarding the rates of nonmedical prescription drug use (NMPDU) among Black Americans. The majority of previous studies used pharmaceutical names of drugs and relied on national data that excludes incarcerated populations, in which Black men are overrepresented. Therefore, the current study aimed to describe pre-incarceration rates of NMPDU among Black men in prison using culturally relevant alternative drug names. We recruited 208 incarcerated (adult age 18 or older) Black men nearing community reentry to urban counties from four state prisons in Kentucky. Results indicated the majority of participants engaged in lifetime NMPDU. The most commonly endorsed class of prescription drug was, "Other Sedatives, Hypnotics, and Tranquilizers" and the most commonly endorsed specific prescription drugs were "Syrup," Lortab/Hydrocodone, and Xanax. There were significant age differences in the number of days that drugs were used in the year prior to incarceration. The current study contributes to the dearth of literature on NMPDU among Black Americans. These findings have implications for disease transmission, overdose risk, and culturally relevant data collection methods and interventions aimed at reducing NMPDU among Black men. [ABSTRACT FROM AUTHOR]

Background: Despite the epidemic of nonmedical analgesic use (NMAU) in North America, there is a scarcity of research quantifying the effect of pain on NMAU. Aims: This study sought to investigate the relationship between NMAU and functional pain interference, defined as the perceived level of interference in performing activities of daily living due to pain, in a population-based sample of the general Canadian population. Methods: Data from the 2012 Canadian Community Health Survey (CCHS)–Mental Health, a nationally representative cross-sectional survey, were used to conduct bivariable and multivariable logistic regression analyses. Results: The weighted prevalences of pain and NMAU were 20.6% and 6.6%, respectively. After adjusting for age, sex, education, culture/race, and chronic mental health diagnosis, a dose–response relationship was observed between higher functional pain interference and increased odds of NMAU, ranging from 1.61 (95% confidence interval [CI], 1.22–2.12) to 2.98 (95% CI, 2.21–4.01) from the lowest to the highest levels of functional pain interference. Elevated odds of NMAU were also observed among younger respondents aged 20–29 years and 15–19 years, respondents with a chronic mental illness diagnosis, and males. Secondary analyses revealed that the dose–response relationship between greater function pain interference and increased odds of NMAU persisted within subgroups with and without mental illness, as well as within subgroups aged 40 to 69. Conclusions: These findings highlight the potential role of pain on increasing NMAU and the need for targeted strategies to reduce harms of NMAU among high-risk subgroups such as young adults. [ABSTRACT FROM AUTHOR]

Background: The Specialization Program in Medical-Surgical Nursing is a postgraduate program that confers the title of specialist, which is recognized by the Portuguese Order of Nurses. Objective: To analyze specialist nurses' professional expectations after completing the Specialization Program in Medical-Surgical Nursing in Portugal. Methodology: A qualitative study was conducted using semi-structured interviews. The nonprobability convenience sample consisted of 10 specialist nurses. The interviews were transcribed and analyzed according to Laurence Bardin's content analysis technique. Results: No changes were found in the professional career after the program. The program improved nurses' knowledge and practice and, consequently, their professional competence. Conclusion: Despite the lack of change in their careers, nurses considered that the program improved their competence in delivering care in their area of specialization. [ABSTRACT FROM AUTHOR]

Aim: to report the implementation of the National Residency Program in Obstetrical Nursing from the perspective of the obstetrical nurses who graduated in the first class of the southern region of Brazil. Method: report of experience. The training scenarios of obstetrical nurses are represented by a public maternity unit, a Basic Health Unit and two Family Health Strategies. Results: many advances have been achieved through joint discussions and exchanges of knowledge among all actors involved in the program implementation process. Currently, teamwork, discussion of behaviors and prescriptions, and trust in the work of the residents are possible. Final considerations: the Residency Program in Obstetric Nursing is in the process of being implemented and, therefore, new challenges arise, and, in some cases, limitations and difficulties also arise, which contribute to its improvement and reorients the qualification actions of nurses Obstetricians. [ABSTRACT FROM AUTHOR]

Objective: To explore influences of co-investigators on the successful publication of a pharmacy residency project. Methods: We analyzed published and non-published research presented at a regional pharmacy conference. Abstracts were matched 1:1 based on state and abstract year. We assessed university affiliation, number, degree, and H-Index of co-investigators on the abstract. Descriptive and inferential analyses were used to identify variables associated with resident publication. Results: University-affiliated programs (p=0.015), highest H-Index of a non-physician co-investigator (p=0.002), and positive H-Index (≥1) of a non-physician co-investigator (p=0.017) were significant predictors of resident publication on univariate analyses. There were no differences in the number of co-investigators (p=0.051), projects with physician co-investigators (p=1.000), or projects with Doctor of Philosophy (PhD) or Master of Science (MS) co-investigators (p=0.536) between published and non-published projects. Multivariate analysis found that the highest H-index of non-physician co-investigator remained significant as a predictor to resident publication (odds ratio (OR) 1.09, 95% Confidence Interval (CI) 1.01-1.17). Conclusions: The quality of co-investigators, as measured by an increasing H-Index, is associated with the successful publication of residency projects. More emphasis may need to be placed on resident research co-investigator selection and training to prepare pharmacy residents for research and scholarly activity. [ABSTRACT FROM AUTHOR]

Purpose Little is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. Methods We assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10–18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008–2011). Results NMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. Conclusions We contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls. [ABSTRACT FROM AUTHOR]

The present study of college students investigated (a) the prevalence of nonmedical use of three classes of prescription drugs (stimulants, anxiolytics/sedatives, analgesics), (b) the prevalence of negative sexual events (NSE) associated with any nonmedical use of prescription drugs (NMUPD), and (c) a set of correlates of NSE. The specific NSE were sexual aggression victimization and perpetration, and regretted sex. The correlates of the NSE were sex, race/ethnicity, year in school, psychological symptoms, alcohol use, illegal drug use, and NMUPD. Participants were 509 (254 females, 255 males) randomly-selected college students who reported any NMUPD. The majority (76.2%) of the sample reported ever using stimulants, 38.9% reported ever using anxiolytics/sedatives, and 40.9% reported using analgesics. During NMUPD, 14.3% of the students reported regretted sex, 7.1% of female students reported sexual victimization, and 6.3% of male students reported perpetrating sexual aggression. Multiple logistic regression analyses indicated that anxiolytic/sedative use (Adj. OR=1.99; 95% CI=1.51-2.62) was positively associated with regretted sex, whereas anxiolytic/sedative use (Adj. OR=1.79; 95% CI=1.01-3.16) and psychological symptoms (Adj. OR=1.06; 95% CI=1.02-1.10) were positively associated with sexual victimization. Illegal drug use was positively associated with perpetrating sexual aggression (Adj. OR=4.10; 95% CI=1.21-13.86). These findings suggest that among these college students, NMUPD-associated NSE were not uncommon, and primarily associated with anxiolytic/sedative use. Given the academic, physical, and psychological implications associated with NSE, research needs to further explore the causal nature of these relations. [ABSTRACT FROM AUTHOR]

Objective: To analyze the link between the rank at the national pharmacy residency examination and the choice of pharmacy specialty for hospital residency-admitted French pharmacy students. Methods: Examination ranks as well as the pharmacy residency specialty to which residency candidates are finally admitted were collected for all students (n=1948) having successfully passed the national French pharmacy residency examination over the period 2013-2016. Students were categorized by their pharmacy specialty for residency, i.e., “Medical Biology” (n=591), “Hospital Pharmacy” (n=1175) and “Pharmaceutical Innovation and Research” (n=182), and medians of examination ranks as well as limit ranks (the rank of the last admitted postulant) by specialty were compared. Results: Examination ranks for pharmacy residency-admitted students were found to significantly differ according to the nature of the specialty in which students were finally admitted. “Medical Biology” has the lowest examination ranks (and appears thus as the most selective specialty), followed by “Hospital Pharmacy” and ended by “Pharmaceutical Innovation and Research”, that has the highest examination ranks (and appears thus as the least selective specialty). Limit examination ranks were additionally shown to discriminate university hospitals in which residents were assigned. Conclusion: Specialty choice for hospital residency-admitted French pharmacy candidates is closely associated with their rank at the national pharmacy residency examination, which can be assumed as reflecting their academic level. By this way, an implicit hierarchy of French pharmacy residency specialties according to the academic level of postulants can likely be drawn. [ABSTRACT FROM AUTHOR]

Introduction: The study focuses on healthcare delivery standards in Pakistan's tertiary care hospitals. Poor accountability and a lack of financial and human resources are the main contributing factors to a hospital's substandard performance and low patient satisfaction rates. Feedback surveillance forms are the Achilles tendon in the quality improvement of a facility, and this practice is, unfortunately, not widely practiced in the hospitals of Pakistan. Through this paper and experience, the authors hope to shed light on the need for regular feedback surveys and implementing their results to improve healthcare quality., Settings and Design: A prospective, observational study of seven tertiary care hospitals in Pakistan., Materials and Methods: The data was collected using a survey form. Each survey form was filled out by a team comprising three public health professionals who observed the hospital and its functioning without interfering with its workings. The questionnaire was developed with the help of Tools for Assessing the Operationality of District Health Systems: Health Facility Questionnaire designated in the respective facilities. The analysis was then draughted as a qualitative narrative review. Finally, the review was broken down into an assessment of the hospital's outpatient clinic setting, inpatient department, emergency department and other departments., Results: The survey was conducted at seven public sector hospitals in three major cities of Pakistan. The survey focused on administrative and nonmedical parameters of healthcare facilities. Overall, the hospitals of Lahore and Islamabad lacked mass casualty apparatus and cleanliness, and staff behaviour can be improved. The hospitals in Rawalpindi have mass casualty apparatuses in place. However, they need improvement in accessibility services and hygiene and staff attitude., Conclusions: The survey showed that all the hospitals had good access and accessibility, and the directions were clearly marked for the visitors. The hospital staff is knowledgeable about the hospital, but their behaviour needs to be improved. Also, the quality of the cleanliness and waiting areas is fair but needs improvements. Finally, regular cheques via regular feedback and quality assessments can improve healthcare delivery., Competing Interests: No conflicts of interest declared by the authors.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: The Cut down, Annoyed, Guilty, and Eye opener- Adapted to Include Drugs (CAGE-AID) questionnaire (CA) is a validated screening tool used to assess risk for nonmedical opioid use (NMOU) in patients receiving opioids for cancer pain. Data on consistencies and variations in responses to the CA between different clinical settings are lacking. We evaluated the frequency and consistency in scoring of the CA among patients seen between the first inpatient consult (T1) and the first outpatient follow-up (T2) visits., Methods: A retrospective chart review of 333 consecutive patients seen at both T1 and T2 within 3 months between August 2016 and March 2017 was reviewed., Results: Median age was 58 years (range, 18-87 years); 53% were female. CA was completed for 88% of patients at T1 and 94% at T2. Of these, 10% and 13% were CAGE-AID positive, respectively. CA score changed from negative to positive in 4% and from positive to negative in 1% of patients between T1 and T2. Kappa coefficient for agreement of CA between T1 and T2 was 0.74 (95% CI: 0.62-0.86, p  = 0.02)., Significant of Results: Completion rate and consistency of patient responses to the CA were high irrespective of clinical setting. Of these patients, 10% and 13% were CA positive which is suggestive of high risk for NMOU. Further studies are needed to evaluate ways to ensure more consistency in the completion of the CA and enhance its utilization in routine clinical practice.