American Survey Research Articles

Multidimensional assessment and analysis of the mental health of teachers and police officers

Abstract Background The years-long COVID-19 pandemic, the proximity of the Russian-Ukrainian war, high inflation, and the economic recession are significant stressors for the Hungarian people. Numerous domestic and international surveys are prepared every year, in which the most stressful professions are ranked. In recent years, based on Hungarian, American and European surveys, teachers and police officers have always been included in the 10 most stressful jobs. They also rank the most valued jobs and highest paid jobs every year. In this relation, police and teaching jobs never made it into the top 10, despite the fact that both professions are very important on a social level. Methods 20 male and 20 female teachers and police officers completed a complex quality of life and psychological assessment using international tests with ethics approval. We measured pain syndromes, such as headache, neck and back pain, joint pain, assessed depression, anxiety, sleep quality, and gastrointestinal symptoms. Results For police officers and teachers, gender differences were not verified with regard to any parameter. None of the parameters differed significantly for male police officers and teachers. Many significant differences were confirmed between female police officers and female teachers, in all of them the results of the teachers were worse: depression (9,4±10,3 vs 2,9±4,3; p = 0.02) anxiety(43,3±12,2 vs 33±4,6; p = 0.01), sleep disorders(32,7±8,2 vs 24,3±7,8; p = 0.01), gastrointestinal complaints(24,7±9,4 vs 17,6±2,3; p = 0.01). Conclusions The sleep quality, depression and anxiety levels of female teachers are worse than those of female police officers who live at least as stressful a life. There is no difference between the mental and psychological state of male teachers and police officers. It is important to pay attention to the mental support of female teachers. Key messages • We consider the assessment of the mental state of police officers and teachers and the creation of primary prevention programs and a mental support network to be an important public health task. • In particular, the mental state of female teachers should be monitored and supported.

Do immigrant women spend more time on unpaid labor? Generational differences by race, ethnicity, and household composition in household work within the United States

ABSTRACT Despite relative progress, it is an overt fact that women still take on the heavier burden of unpaid work in the household compared to men in the United States. Our study expands the horizons of previous studies by looking at women specifically and analyzes how women’s performance of unpaid labor differentiates based on various contexts such as generational status, household composition, race, and ethnicity. Using the pooled cross-sectional data from the 2011-2021 American Time Use Survey (ATUS), we test hypotheses derived from an absolute resources perspective and a structural perspective to examine migrant generational differences among married, cohabiting, and single women as well as investigate the intra-group differences of racial and ethnic groups. From our descriptive analysis and ordinary least squares (OLS) regression analyses, we find support for the structural perspective for housework, as the generational differences remain even after controlling for socioeconomic factors, but only for first-generation married women. However, socioeconomic factors account for the differences between cohabiting or single first-generation women, which is supported by the absolute resources perspective. Our intra-group analysis by racial and ethnic groups yielded similar findings but found that Hispanic and Asian first-generation women take on a larger proportion of housework, relative to later-generation women.

A Novel Time Use Approach on Daily Active Engagement with Life: The Intersectionality of Race and Gender.

Active engagement with life (AE) is an integral aspect of successful aging. Using time diary data, this study explored how U.S. older adults structure their daily lives involving social participation and productive engagement, and the extent to which these patterns differ by race and gender. We used American Time Use Survey (ATUS) data (n = 17,990) and sequence and cluster analyses to identify distinctive daily AE patterns. Multivariable linear regression models were used to evaluate associations between AE patterns and self-rated health, and the moderating roles of race and gender. Five AE clusters were identified: Low Degree of AE (26%), Moderate Unpaid Work & Light Social Participation (39%), Persistent Unpaid Work (20%), Persistent Paid Work (10%), and Persistent Social Participation (4%). White women were the most likely and Black men the least likely to have any AE. Compared to "Low Degree of AE", all other AE clusters were associated with better self-rated health, with these associations varying by gender and race. The strongest positive association was observed for "Persistent Paid Work", especially among women. Racial differences in the association between AE and health were more prominent among women than men. Differences by AE were less pronounced among Black women in comparison to White women. We found that the association between AE and self-rated health varies by race and gender. Persistent structural barriers may prevent older adults from historically minoritized backgrounds, particularly Black women, from benefiting from AE.

IPUMS Multigenerational Longitudinal Panel

Over the past five years, the IPUMS Multigenerational Longitudinal Panel (MLP) has constructed a massive longitudinal population panel by linking together American censuses, surveys, administrative sources, and vital records spanning the period from 1850 to the present. MLP is designed as a general-purpose resource for studying longitudinal processes and long-run social and economic change. By linking individuals across generations from birth through death using data from multiple sources, MLP enables reproducible research on shifting patterns of life course patterns and intergenerational processes. The large scale of the MLP database allows researchers both to study particular communities and small dispersed populations and to conduct big studies spanning many places and periods. Data that allow investigators to examine simultaneously the broad sweep of time and fine spatial detail will yield new insights into ongoing transformations of demographic behavior. The presentation will describe the creation of the IPUMS MLP database and the current MLP linking strategy. We then detail our plans for expansion and improvement of MLP over the next five years, including the incorporation of additional data sources, the development of a “linkage hub” to connect MLP with other major record linkage efforts, and the refinement of our technology and dissemination efforts. We will conclude by describing a few early examples of MLP-based research.

Telepsychiatry Current Practice and Implications for Future Trends: A 2023 American Psychiatric Association Member Survey.

Introduction: Although telehealth was a viable means of delivering psychiatric care even before the COVID-19 public health emergency, flexibilities at the federal and state levels during the pandemic prompted mass adoption in a short timeframe. Little is known about how psychiatrists plan to offer care going forward and to what degree services will be offered virtually, in-person, or in a hybrid format. Methods: We conducted a survey of American Psychiatric Association (APA) members regarding telepsychiatry practice and potential barriers. Results: The survey was completed by 1,660 APA members. Most survey respondents (94%) conduct at least some telepsychiatry. Most respondents indicate operating in a hybrid environment in which they maintain a physical practice location, while 16% indicate that they do not have a physical practice and only see patients remotely. Across all setting types, 82% of respondents deliver telehealth via all or mostly video; 11% report conducting telehealth visits via mostly audio-only modalities; and 7% report equal usage of both modalities. Barriers to telepsychiatry noted by respondents include limited reimbursement, state medical licensure, federal and state regulations regarding controlled substance prescribing via telehealth, and technical challenges. Conclusion: Results of this survey of APA members show that the majority conduct at least some telepsychiatry; operate in a hybrid environment; and deliver telehealth via all or mostly video. Reported barriers to telepsychiatry practice include legal, regulatory, reimbursement, and technical issues. The future of telepsychiatry may largely be determined by which legal, regulatory, and reimbursement flexibilities are ended, extended temporarily, or made permanent.

Per- and polyfluoroalkyl substances (PFAS) in paired tap water and house dust from United States homes

Most people in the United States have been exposed to per- and polyfluoroalkyl substances (PFAS) which have been linked to a wide array of adverse health conditions in adults and children. The consumption of contaminated drinking water is an important human exposure pathway to PFAS. Residential sources also contribute to PFAS exposure through dermal contact and ingestion of house dust, which acts as an aggregate of chemicals from sources like furnishing materials and consumer products. The U.S. Department of Housing and Urban Development (HUD) conducted the first nationwide survey of residential hazards called the American Healthy Homes Survey (AHHS) in 2005, followed by a second survey (AHHS II) in 2017. The U.S. Environmental Protection Agency (EPA) collaborated with HUD on both efforts and subsequently analyzed PFAS in household tap water and house dust collected from the same homes during the AHHS II study. This study leverages these paired samples to investigate potentially important exposure sources and pathways in the residential environment. Here we report results for paired household tap water and house dust samples from 241 homes for 13 and 16 PFAS chemicals, respectively. All 13 targeted chemicals were detected in the household tap water samples with detections ranging from 100 % for PFBS to 1 % for PFNS, and all 16 targeted chemicals were detected in the house dust samples with detections ranging from 97 % for PFOA to 9 % for PFNS. Four chemicals (PFOA, PFOS, PFHxS, and PFHpA) were measured above the limit of detection in at least 50 % of the samples in both media. All households had at least one of the targeted PFAS detected in both their tap water and house dust. Results provided evidence that geographical factors, such as proximity to ambient contamination sources, were main drivers of PFAS contamination in tap water, while PFAS contamination in house dust was driven mainly by within-home sources. Exposure estimates calculated from the measured PFAS concentrations highlight the importance of addressing potential sources of exposure to PFAS within homes in addition to ambient sources affecting communities’ drinking water, particularly to reduce children’s exposure to these chemicals.

Working Hours, Shift, and Remote Work by Industry and Occupation in U.S. Full-time Workers.

This study examines working hours, shift work, and remote work patterns by occupation and industry among U.S. full-time workers, along with the association between working and sleeping hours. Utilizing data from 2011 to 2020 American Time Use Survey, this national household survey examines how individuals aged 15 years or older in the United States spend their time within a 24-hour period. In 2011 to 2019, U.S. full-time workers averaged 8.1 hours of work and 7.8 hours spent sleep on workdays, increasing to 9.6 hours on non-workdays. Among all occupations, Emergency medical technicians and paramedics had the longest average working hours (10.4 hours). Protective services occupations had the highest percentage (41.7%) of workers reporting often working shifts other than daytime. Among all industries, truck transportation industry had the longest average working hours (9.2). Food services and drinking places industries had the highest percentage (28.6%) of workers reporting often working shifts other than daytime. Working hours showed a negative association with sleeping hours. In 2020, 34.0% of full-time workers reported remote work due to COVID-19, with the largest percentage (72.3%) occurring in business and financial operations. The study findings offer essential benchmarks for comparing working hours and schedules across diverse occupations and industries. These insights empower occupational health practitioners to advocate for prevention measures, addressing health concerns arising from prolonged working hours and shift work.

Brief report: participation frequency across climbing disciplines from North American surveys

ABSTRACT A lack of relevant data impedes our understanding of how people engage in different types of climbing. This study sheds light on participation frequency across disciplines in contemporary climbing with findings from two convenience sample surveys targeting overlapping North American climbing populations: identified indoor climbers and outdoor climbing advocates. The findings indicate that the overall participation frequency is highest for top-rope climbing and sport climbing, followed by bouldering and traditional climbing. The relative popularity of these disciplines varies somewhat based on the climbing population in question. In contrast, ice climbing, free soloing, and aid climbing exhibit low participation rates among survey respondents overall, and relatively infrequent engagement among participants. The findings contribute to our understanding of how people participate in climbing, with insights into the sport’s evolution through processes such as indoorization, sportivization, and specialization.

Youth Caregivers of Adults in the United States: Prevalence and the Association Between Caregiving and Education

A growing proportion of individuals adopt family caregiving roles. Family caregivers are the primary providers of long-term care in the United States yet limited federal policy supports exist, despite the known negative impacts of caregiving. There is also limited information about the prevalence of youth/young adult caregivers and the impacts of caregiving at formative ages in the United States. Our objective is to estimate the prevalence of youth caregivers and examine the association of caregiving with educational investments. We use the American Time Use Survey (2013–2019) to identify and describe youth caregivers (aged 15–18) and young adult caregivers (aged 19–22) and compare them with non-caregiving peers. We estimate that there are approximately 1,623,000 youth caregivers and 1,986,000 young adult caregivers, corresponding to 9.2% and 12.7% of these age groups, respectively. However, there is a wide range in the estimated prevalence per year, from approximately 364,000 to 2.8 million youth caregivers and from 353,000 to 2.2 million young adult caregivers, depending on caregiver definition. Unlike adult caregivers, we find that young men and women were nearly equally likely to provide care. We also find that non-White individuals are disproportionately represented as youth caregivers. Compared with non-caregiving peers, both youth and young adult caregivers are less likely to be enrolled in school and, among those enrolled in school, spend significantly less time on educational activities. Considering the association of caregiving among youth/young adults and education, policies supporting youth and young adult caregivers are critical.

Intention of filing tax claims for religious donations: Results from a Muslim American survey

AbstractThis study examined the intention to claim exemption for zakat and other monetary donations on the annual tax return among US Muslims. We used a survey of 575 Muslims living in the United States to test several exploratory hypotheses. Our statistical results suggest that after controlling for other demographic differences, (1) respondents who identified as non‐Sunni (as opposed to Sunni) Muslims, had medium or high (as opposed to low) income, and those who believed that Covid‐19 is a Zakat‐eligible cause had higher odds of claiming an exemption for their Zakat donations; and (2) permanent residents (as opposed to US citizens), high (as opposed to low) income earners, non‐faith‐based donors, and those who believed that Covid‐19 is a Zakat‐eligible cause had higher odds of claiming exemption for their non‐Zakat monetary donations. Implications are discussed.

Development of Multiple Discrete-Continuous Extreme Value Model with Non-Monotonic Utilities: Formulation and Application to Outdoor Non-Mandatory Time-Use Decisions

This paper further explores multiple discrete-continuous extreme value (MDCEV) models. MDCEV models are widely used for time-use analysis because they can accommodate the diminishing marginal utility with respect to time consumption and benefit from simple closed-form likelihood expressions for estimation, while considering the overall constraints of time resource. However, all of the existing models adopt a monotonically increasing form of utility function, which does not accommodate possible non-monotonic utilities with respect to time-use. This paper further develops the MDCEV model by firstly introducing utility functions with a form of parabola to capture non-monotonic preferences in time allocation behaviors. A corresponding simple and computationally efficient forecasting algorithm to predict the time-use of individuals is also developed. The proposed MDCEV model with parabolic utilities is applied to analyze time-use decisions among a variety of outdoor non-mandatory activities on weekends using data from the 2019 American Time Use Survey. The proposed model is compared with traditional MDCEV models to show its ability to describe non-monotonic preferences in time-use in association with various explanatory variables. This paper makes an initial attempt to specify non-monotonic utilities for time-use analysis, but further studies are required to develop more sophisticated non-monotonic utility formulation to improve the goodness-of-fit of the model.

The ethics perspective of physics department chairs

Although a new American Physical Society ethics survey shares some conclusions with a previous one, disparities between the two highlight the need for improved procedures and open communication channels in physics departments.

Management of ulnar collateral ligament injury in baseball athletes: An online survey in Japanese surgeons

BackgroundThe management of ulnar collateral ligament (UCL) injuries widely varies among surgeons. Although various treatment options have been proposed including surgical and conservative treatments, no golden standard treatment strategy has been established of yet. The American survey reported an overall experienced and well-trained cohort of surgeons often reached consensus opinions on how to approach UCL injury. However, the consensus among Japanese surgeons on the treatment of UCL injuries remains unclear. The purpose of this study was to survey current trends among Japanese orthopaedic surgeons in the treatment of UCL injuries in baseball players. MethodsAn online survey was distributed to the active members of the Japanese doctor's network for baseball injury prevention, which was formed by partial members of the medical committee in the Japan Baseball Council. The survey was composed of three sections: demographics of the surveyees, preferred operative and nonoperative management of UCL injuries, and five fictional clinical case scenarios of baseball players with a UCL injury. ResultsThe 131 e-mailed invitations to society members yielded 78 completed online surveys with a participation rate of 60%. Sixty-four respondents (82%) reported >15 years of clinical experience. Sixty-five respondents (83%) performed ≤5 UCL reconstructions per year. As nonsurgical management of UCL injuries, seventy-four surgeons (95%) preferred physiotherapy followed by intraarticular injection (46%). For surgical management, seventy-three surgeons (93%) preferred UCL reconstruction. Of the five case scenarios, a consensus was reached in three cases: to perform surgery on the patient with full-thickness UCL tear. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction. ConclusionJapanese doctors involved in the treatment of baseball injuries reached a consensus to indicate high-level athletes with a full-thickness UCL tear for surgery. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction. These results may contribute to the decision-making for managing UCL injuries.

Organ-sparing techniques and dose-volume constrains used in breast cancer radiation therapy – Results from European and Latin American surveys

BackgroundAdvances in local and systemic therapies have improved the outcomes of patients with breast cancer (BC), leading to a possible increased risk for postoperative radiation therapy (RT) late adverse events. The most adequate technologies and dose constraints for organs at risk (OAR) in BC RT have yet to be defined. MethodsAn online survey was distributed to radiation oncologists (ROs) practicing in Europe and Latin America including the Caribbean (LAC) through personal contacts, RO and BC professional groups’ networks. Demographic data and clinical practice information were collected. ResultsThe study included 585 responses from ROs practicing in 57 different countries. The most frequently contoured OAR by European and LAC participants were the whole heart (96.6 % and 97.7 %), the ipsilateral (84.3 % and 90.8 %), and contralateral lung (71.3 % and 77.4 %), whole lung (69.8 % and 72.9 %), and the contralateral breast (66.4 % and. 83.2 %). ESTRO guidelines were preferred in Europe (33.3 %)and the RTOG contouring guideline was the most popular in LAC (62.2 %), while some participants used both recommendations (13.2 %and 19.2 %). IMRT (68.6 % and 59.1 %) and VMAT (65.6 % and 60.2 %) were the preferred modalities used in heart sparing strategies, followed by deep inspiration breath-hold (DIBH)(54.8 % and 37.4 %) and partial breast irradiation (PBI)(41.6 % and 24.6 %). Only a small percentage of all ROs reported the dose-volume constraints for OAR used in routine clinical practice. A mean heart dose (Heart-Dmean) between 4 and 5 Gy was the most frequently reported parameter (17.2 % and 39.3 %). ConclusionThe delineation approaches and sparing techniques for OAR in BC RT vary between ROs worldwide. The low response rate to the dose constraints subset of queries reflects the uncertainty surrounding this topic and supports the need for detailed consensus recommendations in the clinical practice.

Surgical Specialty Consultation for Pediatric Facial Laceration Repair: An American and Canadian Survey.

We sought to describe patterns of and indications for surgical specialty consultation for facial laceration repair in pediatric emergency departments (PEDs). We performed a multicenter survey of PED leadership throughout the United States and Canada evaluating the practice patterns of surgical specialty consultation for patients presenting for facial lacerations requiring repair. We measured demographics of PEDs, factors influencing the decision to obtain a surgical specialty consultation, and the presence and components of consultation guidelines. Factors related to consultation were ranked on a Likert scale from 1 to 5 (1 = Not at all important, 5 = Extremely important). We evaluated relationships between reported rates of surgical specialty consultation and PED region, annual PED volume, and reported factors associated with PED consultation. Survey responses were received from 67/124 (54%) queried PEDs. The median self-reported rate of surgical specialty consultation for facial lacerations was 10% and ranged from 1% to 70%, with resident physicians performing the repair 71% of the time a subspecialist was consulted. There was regional variability in specialty consultation, with the highest and lowest rate in the Midwest and Canada, respectively ( P = 0.03). The top 4 influential factors prompting consultation with the highest percentage of responses of "Extremely Important" or "Very Important" were: discretion of the physician caring for the patient (95%), parental preference (39%), limited PED resources (32%), and patient requires sedation (32%). Surgical specialty consult guidelines were used in only 6% of PEDs with consensus that depth necessitating more than 2-layer repair or involvement of critical structures should prompt consultation. Surgical specialty usage in the management of patients who present with facial lacerations to PEDs has significant variation related to patient, provider, and department-level factors that influence the decision to consult. Lack of consult guidelines represent a potential opportunity to standardize care delivery to this common presentation.

Abstract TP228: Association of Dependent Cannabis Use in Patients With Chronic Liver Disease With Stroke Hospitalizations and Subsequent Mortality: A Nationwide Analysis

Introduction: Chronic liver disease (CLD) predisposes to systemic manifestations like thrombocytopenia and coagulopathy that can trigger stroke onset. Cannabis, due to its anti-inflammatory effects, could have a potential benefit for CLD patients. We aimed to study the impact of cannabis use disorder (CUD) or dependent use on stroke risk in CLD, considering recent American and Canadian surveys reporting 85% overlap between medicinal and recreational use. Methods: The National Inpatient Sample, 2019, was queried to identify adult stroke hospitalizations in patients with CLD. Two cohorts were created based on the presence of CUD. The primary outcomes were the rates and odds of stroke or acute ischemic stroke (AIS), with subsequent mortality in CUD vs. non-CUD cohorts. Secondary outcomes were resource utilization. Multivariable regression was controlled for patient-hospital-level factors and relevant comorbidities. Results: The CUD+ cohort had a lower rate of both overall stroke hospitalization (1.2% vs. 2.0%) and AIS hospitalization (0.8% vs. 1.2%) as compared to the CUD- cohort (p<0.001). The median age of admissions for stroke and CLD with CUD was 58 years, whereas it was 64 years in the non-CUD cohort. Traditional CVD risk burden was lower, but uncomplicated hypertension, PVD, prior MI, and drug abuse were more prevalent in the CUD+ cohort. Patients with CLD and CUD showed lower odds of any stroke (OR: 0.61, 95% CI: 0.51-0.73; p <0.001) and AIS (OR: 0.68, 95% CI: 0.55-0.85; p = 0.001) vs. the CUD- cohort. When adjusted for confounders, the odds of overall stroke risk were still lower (OR: 0.81; 95% CI: 0.66-0.98; p = 0.029) among the CUD+ cohort. However, adjusted odds for AIS showed no statistical significance (OR: 0.94; 95% CI: 0.74-1.19; p = 0.594). The all-cause mortality in the CUD+ cohort was lower compared to the CUD- cohort: 11.0% vs. 14.4%, p= 0.017, with shorter hospital stays and frequent routine discharges. Conclusion: This nationwide study revealed significantly reduced odds [20%] of stroke hospitalization in adults with CLD using cannabis on a regular, habitual basis. However, more prospective controlled studies are required to evaluate its impact on cardio-cerebrovascular risk with clarity on dose, duration, and mode of CUD in the long term.

Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010-2019.

The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives.

Pregnancy planning may impact maternal and neonatal outcomes in people with myasthenia gravis.

Myasthenia Gravis (MG) is an acquired autoimmune condition commonly diagnosed in young people of reproductive age resulting in neuromuscular junction dysfunction. The course of MG during pregnancy and its impact on maternal and neonatal outcomes is vary in the literature. Pregnancy planning is a known strategy and modifiable risk factor in obstetric practice to decrease maternal and neonatal morbidity. We aim to assess if planning a pregnancy impacts maternal and neonatal outcomes, MG exacerbation, and pregnancy-related complications. This study utilized data from an online, North American survey entitled "A Patient Centered study on Pregnancy in People with Myasthenia Gravis", distributed with the assistance of MG advocacy groups in the United States and Canada. It included individuals with MG who had at least one pregnancy in the last 10-years. Key maternal and neonatal outcomes were compared between planned and unplanned pregnancies. Out of 156 survey participants, 58 had a pregnancy following MG diagnosis, totaling 90 reported pregnancies. Of these, 56 (62.2%) were planned and 34 (37.8%) were unplanned pregnancies. The unplanned pregnancies were associated with more MG exacerbations, hospitalizations, and intensive care unit admission (37.7% vs. 13.7%, 26.5% vs. 11%, and 17.6% vs. 8.9%, respectively, p ≤ .05). The neonatal outcomes did not significantly differ between the groups. Planned pregnancies in people with MG may be associated with a reduced gestational and post-partum risk of MG exacerbation, hospitalizations, and ICU admissions. Larger studies are required to confirm this association and account for potential contributing variables.

Variations in Practice Among Cirrhotic Patients With Portal Vein Thrombosis and Esophageal Varices: A North American Survey Study.

There exists variation regarding the approach to anticoagulation and variceal hemorrhage (VH) prophylaxis among patients with cirrhosis and portal vein thrombosis (PVT). A survey was distributed to gastroenterology and hepatology providers to assess the approach to anticoagulation and VH prophylaxis among patients with PVT in cirrhotic patients. Providers were more likely to start anticoagulation if the patient was listed for liver transplantation, was symptomatic, or had superior mesenteric vein thrombosis. For prevention of first VH, many providers opt for combination therapy with both nonselective beta blockers and variceal ligation. Although providers agree on the clinical scenarios that merit initiation of anticoagulation, practice variation was identified in the means of preventing first VH.

Does Maslow’s Hierarchy of Needs Explain Volunteer Time Allocations? An Exploration of Motivational Time Allowances Using the American Time Use Survey

This study examines whether there is an optimal set point along Maslow’s (1943) hierarchy of needs associated with disaggregated forms of volunteerism. Taniguchi’s (2012) study examined major life domains (e.g., work, education, and religion) for associations with formal and informal volunteerism. An alternative approach is to include life domains with variables measuring motivational concerns to better identify time allocation patterns for disaggregated volunteerism. This study analyzed the results of 9,435 time diaries recorded on the 2019 American Time Use Survey (ATUS). The time allocated to formal and informal volunteerism associates with intermediate belongingness concerns. There is no association between time spent on self-esteem and self-actualization concerns and informal volunteering. Tertiary education as a baseline measure for self-actualization shares a weaker association than belonging with formal volunteering. The data suggest that research into maximizing formal volunteerism may be searching at the wrong point at self-actualization. Implications are discussed for motivating volunteerism.