Answered Survey Questions Research Articles

Holding a position: Public opinion as cognition in a disorganized field

I develop a theoretical model of the relationship between the macro-structure of political communications and the micro-structure of individuals’ political attitudes. This model conceives of public opinion as a field of competition, where positions correspond to stances on issues, and are occupied both by individuals and by major political actors who compete over their support via political communications. Individuals attend to these communications to better develop their political attitudes. Since a large volume of interdisciplinary work suggests that reliably answering survey questions is an acquired cultural competency that requires substantial training to achieve, I use survey response reliability as a key measure of this enculturation. This points me to a concrete question: do patterns of survey response reliability suggest that competing ideological camps focus on the same issues? To answer this, I develop a formal latent class model of position reliability and estimate it with the 2008-2010-2012 General Social Survey panel. I find that more popular positions are generally reported more reliably than less popular ones, as would be expected if ideological camps predominantly focused on issues where they had an advantage.

Development and Validation of a Health-Related Quality-of-Life Measure in Older Children and Adolescents with Early-Onset Scoliosis

The 24-question Early-Onset Scoliosis Questionnaire (EOSQ-24) is a proxy measure assessing health-related quality of life (HRQoL) among patients with early-onset scoliosis (EOS). There exists an increasing need to assess HRQoL through a child's own perspective, particularly for older children and adolescents with EOS. The purpose of this study was to develop and validate a self-reported questionnaire, the Early-Onset Scoliosis Self-Report Questionnaire (EOSQ-SELF), to assess HRQoL in older children and adolescents with EOS. A literature review, an expert focus group, and patient interviews were used to generate a preliminary survey of appropriate domains and question items. This survey was provided to English-speaking patients with EOS who were 8 to 18 years of age and capable of answering survey questions. Content validity was assessed for clarity and relevance of questions. Confirmatory factors analysis was performed to reduce the number of items and determine domains that fit items. Reliability was evaluated by measuring the internal consistency of items and test-retest reliability. Construct validity was evaluated by convergent, discriminant, and known-group validity. The literature review, expert focus group, and patient interviews identified 59 questions in 14 domains. Psychometric analysis reduced these to 30 questions across 12 domains: General Health, Pain/Discomfort, Pulmonary Function, Transfer, Physical Function/Daily Living, Participation, Fatigue/Energy Level, Sleep, Appearance, Relationships, Emotion, and Satisfaction. The final questionnaire was found to have good content and construct validity and adequate reliability. The EOSQ-SELF is a valid and reliable instrument for measuring self-reported HRQoL among older children and adolescents with EOS (ages 8 to 18 years). This will serve as an important research outcome measure and enhance clinical care by providing a better understanding of HRQoL for these patients. Diagnostic Level II . See Instructions for Authors for a complete description of levels of evidence.

Associations between healthcare utilization and access and diabetic retinopathy complications using All of Us nationwide survey data.

PurposeInadequacies in healthcare access and utilization substantially impact outcomes for diabetic patients. The All of Us database offers extensive survey data pertaining to social determinants that is not routinely available in electronic health records. This study assesses whether social determinants were associated with an increased risk of developing proliferative diabetic retinopathy or related complications (e.g. related diagnoses or procedures).MethodsWe identified 729 adult participants in the National Institutes of Health All of Us Research Program data repository with diabetic retinopathy (DR) who answered survey questions pertaining to healthcare access and utilization. Electronic health record data regarding co-morbidities, laboratory values, and procedures were extracted. Multivariable logistic regression with bi-directional stepwise variable selection was performed from a wide range of predictors. Statistical significance was defined as p<0.05.ResultsThe mean (standard deviation) age of our cohort was 64.9 (11.4) years. 15.2% identified as Hispanic or Latino, 20.4% identified as Black, 60.6% identified as White, 2.74% identified as Asian, and 16.6% identified as Other. 10–20% of patients endorsed several reasons for avoiding or delaying care, including financial concerns and lack of access to transportation. Additional significant social determinants included race and religion discordance between healthcare provider and patient (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.02–1.41, p = 0.03) and caregiver responsibilities toward others (OR 3.14, 95% CI 1.01–9.50, p = 0.04).ConclusionsNationwide data demonstrate substantial barriers to healthcare access among DR patients. In addition to financial and social determinants, race and religion discordance between providers and patients may increase the likelihood of PDR and related complications.

Oral cancer - knowledge and perception of the population in the screening program during world oral, head and neck cancer awareness week

Aim: Oral cancer (OC) is characterized by a high mortality rate because most cases are diagnosed at an advanced stage. The purpose of this study was to assess population knowledge at screening for OC, risk factors, prevention, and early detection, and to determine whether factors such as level of education and gender affect knowledge of the respondents. Material and Methods: The study was conducted at the School of Dental Medicine University of Zagreb and the Faculty of Dental Medicine University of Rijeka using the attached questionnaire. Participants were patients who arrived for free screening examinations during World Oral, Head and Neck Cancer Awareness Week from 22–28 April 2017, and answered survey questions on their knowledge of OC. Results: One hundred and eighty-five participants attended the screening event. Some participants did not answer certain questions, so the statistics with each question were made only for those respondents who answered that question. Screening event has included 99 (57.9%) females and 72 (42.1%) males (14 participants did not answer). The median age of participants was 67 years. The majority of participants (115; 80.4%) had heard about OC, but had not heard about nor previously attended OC screening examination (71 or 51.1% of females and 123 or 86.6% of males). No significant difference between genders and between participants with different levels of education was observed. The majority of participants (111;79.3%) knew that smoking was a risk factor for OC, and believed that their risk of getting OC was similar to other people in their age group and gender. Conclusions: Our results show that most participants have heard about OC, but have not heard about nor previously attend OC screenings. Future programs should be directed more to the high-risk population in order to achieve early detection and treatment of OC.

Impact of a Spiral Learning Strategy on the Integration of Pharmacology Content in a Pre‐clerkship Osteopathic Medical

BackgroundIn 2020, during the restrictions imposed by the COVID‐19 pandemic, the Academic and Career Advising Office from the COM at Michigan State University USA implemented a platform named On‐Target to support pre‐clerkship students navigating academic life. Based on spiral learning principles, we created didactic material (ppt) and offered it to the students through On‐Target to support the transition from Basic Principles of Medical Pharmacology in the Fall semester of 2020 to courses in the next semester (Spring‐2021). We hypothesized that this pilot educational intervention, delivered through an online platform, would be valuable to shape future integrative approaches for medical academic success. This cross‐sectional retrospective observational study aimed to evaluate the impact of pharmacology learning practiced through On‐Target from the students' perspective.MethodsAn anonymous online survey was distributed via email invitation to 1st‐year medical students in the Summer of 2021 (IRB approval: MSU‐ ID6229). The survey was organized through Qualtrics into questions related to 1) student demographics and learning styles and 2) experiences and perceptions of the didactic material integrating pharmacology with systems courses in the following semester: Neuromusculoskeletal, Endocrine, and Genitourinary (timeline, fig 1). Statistical analyses were done by Chi‐square test and Pearson correlation coefficient (CI95).ResultsThirty‐seven students participated (54.05% female; average age: 24.5). A higher proportion was self‐reported as visual learners (83.8%, P&lt;0.05). Auditory (18.9%) and social (10.8%) represented a significantly low proportion of learners. Regarding knowledge of On‐Target, 62.2% had never heard of it; none of those who knew about the platform were aware that it contained pharmacology content. A greater number of participants (73%, P&lt;0.05) answered the 2nd set, Likert scale questions. Of these, 48.2% were familiar with the resources provided; 88.5% were infrequent users; and 40.7% understood the meaning of the transition material (pharmacology). Over 44% reported applying the pharmacology material in the transition to upcoming courses, while 29.6% were neutral. When asked about how the material could be improved, 40.7% stated that the transitional content in pharmacology could be better utilized if it had been presented through voice‐overs. For those who did not continue the survey, 38.5% reported being comfortable with other resources; however, 30.8% found answering survey questions too time‐consuming.ConclusionThere is a positive correlation between the students who understood the meaning of the transitional material in pharmacology and applied the content to courses in upcoming semesters. There is a negative correlation between students self‐reporting as visual learners vs the suggestion to enhance the utility of the educational material through recording materials. A small number of students participating in this survey limits further conclusions. This limitation may have been partly caused by the online overload that students experienced during COVID‐19 restrictions.

Evaluating some ways of semantisation of the vocabulary in teaching English in high schools

The study presents evaluation and analyses of some ways for semantisation in foreign vocabulary mastery in teaching English in high schools. The study aims to identify effective ways of semantisation in vocabulary teaching and word mastery. The relevance of the present study can be explained by the fact that identifying effective ways of semantisation in vocabulary teaching may aid higher English language proficiency of the 10th-grade students in meeting the curriculum requirements and standards. This also relates to the fact that teaching vocabulary remains to be one of the central issues in foreign language acquisition, as it is the basis for both productive and perceptive skills. It is hard to imagine a learner speaking a foreign language well without sufficient vocabulary. Thus, one of the main tasks in the EFL class is to expand the vocabulary of learners. The study provides general background on the peculiarities of teaching and learning foreign vocabulary, types of vocabulary, and reviews some ways of semantisation. The authors have reviewed and classified vocabulary semantisation into several groups: semantisation through translation, demonstration, description, numeration, synonyms, antonyms, semantic fields. A survey was applied to identify the effectiveness of the ways of semantisation in teaching vocabulary. Thirty-eight 10th-grade students answered survey questions and shared their perceptions and views on the ways of teaching vocabulary in EFL classrooms. According to survey results, semantisation of vocabulary based on lexical-semantic fields and description were evaluated as the most effective ways. It was found that each semantisation method may work effectively if it is applied with the appropriate word, phrase, or concept.

Key factors associated with malaria infection among patients seeking care through the public sector in endemic townships of Ayeyarwady Region, Myanmar

BackgroundAyeyarwady Region in Myanmar has made significant progress towards malaria elimination, with cases decreasing from 12,312 in 2015 to 122 in 2019. As transmission declines, malaria becomes increasingly focalized both in geographic hotspots and among population groups sharing certain risk factors. Developing a thorough profile of high-risk activities associated with malaria infections is critical to ensure intervention approaches are evidence-based.MethodsA test-negative study was conducted from September 2017 to May 2018 in Ngaputaw, Pathein and Thabaung townships in Ayeyarwady Region. Patients that presented to selected public facilities or community health volunteers with fever answered survey questions on demographic and behavioural risk factors, including exposure to malaria interventions, and were assigned to case and control groups based on the result of a malaria rapid diagnostic test. A random-effects logistic regression model adjusted for clustering at the facility level, as well as any variables along the causal pathway described by a directed acyclic graph, was used to determine odds ratios and association with malaria infections.ResultsA total of 119 cases and 1744 controls were recruited from 41 public facilities, with a mean age of 31.3 and 63.7% male. Higher risk groups were identified as males (aOR 1.8, 95% CI 1.2–2.9) and those with a worksite located within the forest (aOR 2.8, 95% CI 1.4–5.3), specifically working in the logging (aOR 2.7, 95% CI 1.5–4.6) and rubber plantation (aOR 3.0, 95% CI 1.4–6.8) industries. Additionally, links between forest travel and malaria were observed, with risk factors identified to be sleeping in the forest within the past month (aOR 2.6, 95% CI 1.1–6.3), and extended forest travel with durations from 3 to 14 days (aOR 8.6, 95% CI 3.5–21.4) or longer periods (aOR 8.4, 95% CI 3.2–21.6).ConclusionMalaria transmission is highly focalized in Ayeyarwady, and results illustrate the need to target interventions to the most at-risk populations of working males and forest goers. It will become increasingly necessary to ensure full intervention coverage of at-risk populations active in forested areas as Myanmar moves closer to malaria elimination goals.

A psychometric modeling approach to fuzzy rating data

Modeling fuzziness and imprecision in human rating data is a crucial problem in many research areas, including applied statistics, behavioral, social, and health sciences. Because of the interplay between cognitive, affective, and contextual factors, the process of answering survey questions is a complex task, which can barely be captured by standard (crisp) rating responses. Fuzzy rating scales have progressively been adopted to overcome some of the limitations of standard rating scales, including their inability to disentangle decision uncertainty from individual responses. The aim of this article is to provide a novel fuzzy scaling procedure which uses Item Response Theory trees (IRTrees) as a psychometric model for the stage-wise latent response process. In so doing, fuzziness of rating data is modeled using the overall rater's pattern of responses instead of being computed using a single-item based approach. This offers a consistent system for interpreting fuzziness in terms of individual-based decision uncertainty. A simulation study and two empirical applications are adopted to assess the characteristics of the proposed model and provide converging results about its effectiveness in modeling fuzziness and imprecision in rating data.

Health-related debt and Health Savings Accounts over time

ABSTRACT This study examines Health Savings Account (HSA) effects on health-related debt outcomes. Applying the health lifestyles theory, a subset of 12,686 respondents from three years (2010, 2012, and 2014) of secondary quantitative data from the National Longitudinal Surveys of Youth (NLSY) was drawn. The sample included respondents who answered survey questions about owning an HSA, chronic disease status, health behavior, and health-related debt. Descriptive, bivariate, and generalized estimating equation (GEE) analyses were conducted. Results indicate HSA ownership status (p = .76) is not significantly associated with reporting health-related debt. Implications for social work practice are discussed.

Integrated Comprehensive Care for Transcare and Gender Diverse Clinic Patients: An Assessment of Physical, Mental, and Social Needs.

IntroductionThere is a large body of research reporting the healthcare needs of groups identifying as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ); however, a gap exists in the research literature because many epidemiological studies focus on sexual orientation rather than gender identify/incongruence. To address the lack of specific data from transgender and gender diverse (TGD) individuals, our organization designed and deployed a survey to assess the gender-affirming physical, mental, and social care needs of current patients.MethodsA group of subspecialty physicians currently working with TGD patients created a list of questions and requested feedback from medical professionals familiar with the healthcare needs of this population. In addition, patients reviewed the survey for content and clarity. The final 68-item survey was distributed in April 2020 to patients or patients' representatives with an email address on file at the Nebraska Medicine Transgender Care Clinic (NMTCC). Participants were asked to respond to questions regarding their gender identity, their transition-related medical decisions, and their interest in services.ResultsInvitations were sent to 690 patients and 168 surveys were completed (response rate: 24.3%). Over 90% (n = 153) of the participants were patients and 9% (n = 15) answered survey questions on the patient’s behalf. A majority (77.2%) had started the medical transition (hormones or puberty blockers) in the past four years. Nearly half (46.4%) identified as trans women, 43.4% identified as trans men, and 10.2% indicated they were nonbinary or gender expansive. Participants' sex assigned at birth was 50.9% female and 46.1% male. Most patients (n = 149; 92%) reported currently receiving hormone treatment within the Nebraska Medicine healthcare system. Results indicated the highest level of clinical services interest was primary care (38.4%), gender-affirming surgery (73.5%), voice therapy (49.0%), and hair removal (37.5%). In addition, participants were very likely to participate in support groups with "people of similar gender identity" (32.9%), with "others around my age" (28.6%), and "including a mix of ages and identities" (26.9%).DiscussionThis study suggests that our TGD patients would utilize integrated services to access a variety of clinical and non-clinical services. Ongoing community engagement and direct feedback from patients are critical to the success and growth of our gender-affirming care clinic. The results of this study will inform the planning and further evolution of a program designed to build trust and address health inequities for TGD individuals throughout the region.

Lost to follow-up: does it matter after arthroscopic rotator cuff repair (a matched cohort analysis of functional outcomes).

BackgroundLoss to follow-up after surgery is problematic in that it is thought to lead to poorer outcomes. There is little research on the long-term outcomes of people who have been lost to follow-up vs. patients who attended all follow-up appointments. Rotator cuff repair is unique in that the postoperative course is lengthy, and the rehabilitation program is typically tightly supervised. Therefore, the aim of this investigation is to determine whether there is any long-term difference in functional outcomes after arthroscopic rotator cuff repair between patients who are noncompliant with follow-up appointments vs. those who are compliant with all follow-up.MethodsA database query was carried out which identified 782 patients who underwent arthroscopic rotator cuff repair at our institution during 2016. Patients were separated into 2 cohorts based on whether they were compliant with all follow-up appointments. Demographic variables such as age and sex were compiled along with objective details from surgery such as size of tear, number of anchors, and other pathologies treated. Patients who were lost to follow-up were contacted by phone to answer survey questions. A matching control group of patients who attended all follow-up appointments was identified based on demographics and surgery details using propensity score matching. The control group was then contacted by phone to answer survey questions. Statistical results were reported as P values. Minimum follow-up was set at 2 years.ResultsThe nonsatisfactory follow-up cohort consisted of 44 people (average follow-up: 30 months), with the satisfactory follow-up cohort consisting of 57 people (average follow-up: 42 months). There was no statistical difference between groups in sex, age, American Shoulder and Elbow Surgeons scores, Single Assessment of Numeric Evaluation scores, number of anchors, number of tears, additional surgical procedures, and patient satisfaction with the surgery and the surgeon. Of the reasons patients gave for why they did not attend follow-up appointments, 25.0% felt fine or returned to work, 22.7% did not know why, 15.9% reported travel distance, 13.6% of patients gave other explanations, 11.4% reported unrelated medical issues, and 11.4% were unaware they missed any appointments.ConclusionThis study demonstrated that there is no difference in the outcomes of patients who attended all follow-up appointments vs. patients who prematurely discontinued follow-up after arthroscopic rotator cuff repair. Better communication with patients in the postoperative period may help to improve follow-up after arthroscopic rotator cuff repair.

Exploring Perceptions of Age Friendliness Across Different Campus Constituent Groups

College campuses are typically considered as environments for adults ages 18-24, even though campuses are comprised of faculty, staff, students, and lifelong learners of all ages. Each group may experience the campus environment differently due to their differing roles. Faculty, staff and students from 21 participating designated Age Friendly Universities across the country answered survey questions on age friendliness, AFU awareness, and on campus practice items. Crosstab analyses show that constituent groups are equally aware of their university as an AFU (6% of each group). Students perceived their university as more age friendly (M=3.47, SD=0.73) compared to faculty and staff, the latter having the lowest perceived friendliness (M=3.27, SD=0.63). Specific age friendly practices show that staff members had markedly different perceptions of the institution’s age friendly practices. AFUs need to consider higher education environments as workplaces as well as learning centers to make policies age friendly for all groups.

Assessment of a gluten‐free laboratory exercise in an undergraduate food processing course

AbstractThere is a growing body of research that suggests better course outcomes for instructors that incorporate active learning into their curriculum. Laboratory exercises can be used to promote active learning. The objective of this study was to develop and assess the efficacy of a gluten‐free bread laboratory exercise for an undergraduate course (Fundamentals of Food Processing). Students enrolled in the course worked in groups to prepare four treatments: 100% white whole grain sorghum as control (C), 15% burgundy waxy sorghum (15W), 25% burgundy waxy sorghum (25W), and 35% burgundy waxy sorghum (35W) in a gluten‐free bread formulation. Students evaluated physical properties (yield, loaf height, color, water activity) using analytical measurements, and organoleptic properties (appearance, color, texture, flavor, and overall acceptability) via sensory analysis on a hedonic scale. Students wrote a scientific report to communicate the results. At the completion of the lab, students answered survey questions (n = 53 or 85% of the class) to self‐evaluate their understanding of gluten‐free bread properties, research and writing skills, and food processing knowledge. Sixty percent or more of the students said that the exercise improved their understanding of the physical and sensory properties of gluten‐free bread. Over 68% of students agreed or strongly agreed that the exercise reinforced their research and writing skills. Over 75% of respondents felt the exercise improved their food processing knowledge. Overall, the results of the survey indicated that the active lab exercise was effective in teaching the desired learning outcomes.

Phone or Email Survey: How do Demographics of People Aging with Long-term Physical Disability Associate with Survey Format Choice?

<h3>Research Objectives</h3> To examine the association between characteristics of people aging with long-term physical disability (PAwLTPD) and their preference for phone or email survey format. Also, to understand the use of technology in this population <h3>Design</h3> A cross-sectional survey study. <h3>Setting</h3> This study used data collected from a cohort study conducted in the community. <h3>Participants</h3> Convenience sampling was used. PAwLTPD who participated in Year 2 of a longitudinal cohort survey were included in this study. The inclusion criteria of the cohort survey were: age 45-65 years, English speaking, and self-reported onset of a physical disability at least 5 years before study recruitment. The exclusion criterion was the presence of a cognitive impairment that precludes answering survey questions reliably. Among all cohort participants, 2 were excluded from our analyses due to completion of surveys using both email and phone formats. In total, 387 participants were included in the analyses. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Survey formats were phone or email. Demographics included age, sex, race/ethnicity, marital status, living arrangement, and socioeconomic status. Self-rated physical health was measured on a 5-point scale (excellent to poor). Technology use was a multiple response question asking what forms of technology participants use to communicate with others or to find information. <h3>Results</h3> Approximately 91%, 74%, and 78% of participants reported using a mobile/smartphone, the internet, and email, respectively. Only 3% reported not using any technology. An age difference was found between survey groups (U=13137, P < .001). Participants' survey format preferences were associated with socioeconomic status (ie, income [X2=53.90, df=1, P < .001], education [X2=48.32, df = 2, P < .001], and employment [X2=17.95, df=3, P < .001]), marital status (X2=42.20, df=1, P < .001), living arrangement (X2=36.26, df=1, P < .001), and physical health (X2=9.13, df=3, P < .001). <h3>Conclusions</h3> Participants with different characteristics tend to choose different survey formats. Researchers should provide both formats to prevent biased sampling. Future studies using a larger, more representative sample and considering statistics that allow for control of covariates are suggested. <h3>Author(s) Disclosures</h3> All authors do not have anything to disclose.

The Dynamics of Interpersonal Relationships: Understanding Power and Control Tactics Among College Students.

Intimate partner violence (IPV) is a significant public health problem among college students and many students have difficulty identifying unhealthy and abusive behaviors. The aims of this mixed methods study are to: (a) create an inclusive tool that illustrates the power and control experiences of a diverse group of young adult college students, (b) ensure a broad scope of tactics are illustrated (related to technology and different types of relationships), and (c) measure the experience of these tactics, including how IPV knowledge, attitudes, and self-efficacy are influenced by a more inclusive tool. In Phase I, semi-structured interviews were conducted with students (n = 33) and staff (n = 10) at campus sexual assault centers at the three University of Michigan (UM) campuses to explore power and control tactics utilized by perpetrators on college campuses. Content analysis revealed 13 categories of tactics in college relationships. A draft tool was created and assessed for accuracy using cognitive interviews with students (n = 20) from all three campuses in Phase II. Cognitive interviews resulted in the following changes to the final tool: (a) new presentation of the Socioecological Model, (b) identification of substance use as a facilitator for multiple forms of violence, and (c) edits to tactic descriptions. In Phase III, 250 students at UM-Ann Arbor participated in a quasi-experimental evaluation in which 133 interacted with the tool and 117 received access to usual care (campus sexual misconduct policy). Both groups answered survey questions about IPV knowledge, attitudes, self-efficacy, and experiences at baseline, and after one month and five months. Among all college participants in Phase III, 33.5% had experienced lifetime IPV and 25.2% had experienced IPV in the past year. There were no significant differences among IPV knowledge, attitudes, or self-efficacy by group. The Dynamics of Interpersonal Coercion Among College Students tool was created by incorporating current tactics utilized among a diverse college population.

Identifying Roles for Public Administrators to Foster Anticipatory Altruism for Severe Weather Preparedness

Will people choose behaviors that benefit all persons in the community before a severe weather event? Or, will they choose behaviors that benefit themselves only? Knowing the answer to these questions can inform public administrators about the level of anticipatory altruism in their community. With this knowledge, they can design strategic plans that leverage a willingness to coproduce community preparedness. Over four hundred people in six severe weather and tornado prone states answered survey questions inviting them to choose between severe weather preparation options that benefit the community or the individual. Overall, our findings suggest a modest level of support for community preparation options, anticipatory altruism demonstrated by a willingness to pay, and intergenerational equity in their choices. These findings are salient in a time when governments may need to cut funding and rely more and more on foundations, nonprofits, and private efforts to provide a wide range of services. Government planners and emergency managers can use our results to strategically nudge residents into making severe weather preparations as well as to estimate support for co-production efforts with citizens to prepare the community for disasters.

Matching Perspectives of Refugees and Voluntary Sports Clubs in Germany

In recent years thousands of refugees from the Middle East and Africa have moved to Europe. Many of them have experienced extremely stressful events and suffer, amongst other things, from lack of social relationships. Policy makers do often convey the impression that voluntary sports clubs (VSCs) can easily help to deal with these issues, as they provide broad offers matching every person’s individual needs. With only few exceptions, research has focused on the view of VSCs and their officials, but mostly left out the perspectives of refugees themselves, especially those outside organized sports. Thus, the focus of the present contribution is on the mutual fit between refugees’ expectations and the offers that sports organizations have. Following a socio-ecological perspective, data from a research project will be used to illustrate both perspectives. Refugees were asked about hindering conditions for participating in sports. In addition, functionaries of sports organizations were asked to answer survey questions regarding the efforts that sports organizations make to include refugees. The results reveal that the majority of the refugees had already actively participated in sports offers in their countries of origin. After arriving in Germany, the sporting habits changed, mostly due to organizational and financial reasons. With respect to functionaries we found that the idea that sport is integrative per se is widely believed in the field.

Undernutrition, food insecurity, and leprosy in North Gondar Zone, Ethiopia: A case-control study to identify infection risk factors associated with poverty.

Ethiopia has over 3,200 new cases of leprosy diagnosed every year. Prevention remains a challenge as transmission pathways are poorly understood. Susceptibility and disease manifestations are highly dependent on individual host-immune response. Nutritional deficiencies, such as protein-energy malnutrition, have been linked to reduced cell-mediated immunity, which in the case of leprosy, could lead to a higher chance of active leprosy and thus an increased reservoir of transmissible infection. Between June and August 2018, recently diagnosed patients with leprosy and individuals without known contact with cases were enrolled as controls in North Gondar regional health centers. Participants answered survey questions on biometric data, demographics, socioeconomic situation, and dietary habits. Descriptive statistics, univariate, and multivariate logisitic regression examined associations between undernutrition, specifically body mass index (BMI), middle upper arm circumference (MUAC), and leprosy. Eighty-one participants (40 cases of leprosy, 41 controls) were enrolled (75% male) with an average age of 38.6 years (SD 18.3). The majority of cases were multibacillary (MB) (90%). There was a high prevalence of undernutrition with 24 (29.6%) participants underweight (BMI <18.5) and 17 (21%) having a low MUAC. On multivariate analysis, underweight was significantly associated with leprosy (aOR = 9.25, 95% CI 2.77, 30.81). Also found to be associated with leprosy was cutting the size of meals/skipping meals (OR = 2.9, 95% CI 1.0, 8.32) or not having enough money for food (OR = 10, 95% CI 3.44 29.06). The results suggest a strong association between leprosy and undernutrition, while also supporting the framework that food insecurity may lead to undernutrition that then could increase susceptibility to leprosy. In conclusion, this study highlights the need to study the interplay of undernutrition, food insecurity, and the manifestations of leprosy.

Functional outcomes and post-discharge care sought by patients with COVID-19 compared to matched controls after completing inpatient acute rehabilitation.

IntroductionA subset of patients with coronavirus disease 19 (COVID‐19) can develop severe illness, resulting in significant functional and cognitive deficits that require acute inpatient rehabilitation. Guidelines following discharge from acute inpatient rehabilitation have not yet been established. This study seeks to establish outcomes of rehabilitation patients with COVID‐19 and characterize their need for long‐term care.ObjectiveTo determine the functional outcomes and utilization of follow‐up medical care for patients with COVID‐19 90 days following discharge from acute inpatient rehabilitation, as compared to rehabilitation impairment and age‐matched controls.DesignProspective, single‐center cohort study.SettingInpatient rehabilitation facility (IRF).PatientsSixty‐four patients recovering from COVID‐19 and 64 age and impairment group category controls were identified to answer survey questions following discharge from inpatient rehabilitation. A total of 36 patients participated in the study (18 patients with COVID‐19 and 18 controls).InterventionsNot applicable.Main Outcome Measure(s)Functional outcomes at discharge (GG Self‐Care and Mobility Activities items of the IRF‐PAI Version 3.0), hospital readmissions, and follow‐up care sought by patients.ResultsThe COVID‐19 patient group had similar improvements in functional outcomes as compared to controls. Patients with COVID‐19 required fewer 0–90 day readmissions than their matched controls (22.2% vs 61.1%, P < .05), but there were no differences in 0–90 day urgent care/emergency department visits, clinic visits and use of outpatient therapies.ConclusionsPatients with functional deficits as a result of COVID‐19 who require multiple therapy disciplines should be considered for acute inpatient rehabilitation as this study demonstrates their ability to participate in and benefit from IRF level care.

The Value of Blood Urea Nitrogen in the Prediction of Risks of Cardiovascular Disease in an Older Population.

Background: High blood urea nitrogen (BUN) is associated with adverse outcomes in patients with cardiac disease risks. However, no study has explored whether BUN can predict the risk of cardiovascular disease (CVD) in the healthy older population. This study aims to explore the incidence and risk factors of CVD among a healthy older population community in China.Design and Methods: This study was designed as a cohort study with a 4-year follow-up. We recruited 5,000 older people among 137,625 residents of the Gaohang community. In the baseline, subjects were asked to participate in medical screening and biological tests, and answered survey questions. During the follow-up period (2014–2017), the researchers regularly tested the subjects' indicators and assessment scales. We monitored the occurrence of CVD and explored the relationship between BUN and CVD via a Cox regression analysis.Results: During the follow-up, subjects were newly diagnosed with CVD including heart failure (HF), heart disease events, atrial fibrillation, diabetes, hypertension, metabolic syndrome, and kidney disease. The Cox regression analysis found an association between baseline BUN and incident CVD in female subjects, with higher BUN associated with increased risk of AF in females and kidney disease in both male and females. No association was found between BUN and CVD in male subjects.Conclusions: Current results indicate that BUN is a valuable predictive biomarker of CVD. A higher BUN level (>13.51 mg/dL) is associated with an increased occurrence of HF but a decreased occurrence of diabetes and metabolic symptoms in normal older females.