Center Staff Research Articles

A Survey on Variables Influencing a Patient's Preferences in Choosing Their Chiropractor in Klang Valley, Malaysia

ObjectiveThe aim of this study was to examine the variables influencing patients’ preferences in choosing their chiropractor in Klang Valley, Malaysia. MethodsThis cross-sectional study included patients from 5 different chiropractic centers in Klang Valley, Malaysia. Demographic information and variables influencing patients’ decisions were obtained through an online questionnaire via quick-response code. Descriptive statistics were used to describe patients’ demographics and factors influencing patients’ preferences in choosing their chiropractors. ResultsData were available for 198 chiropractic patients with a mean age of 31.5 years. Approximately 90% of the participants agreed that a chiropractor with good technical and interpersonal skills and excellent service by chiropractic center staff strongly influenced their preference in choosing their chiropractor, while only 13.6% agreed that referral by other health care professionals influenced their preference in choosing their chiropractor. ConclusionThis study emphasizes the influence of a chiropractor's technical and interpersonal skills, as well as friendly staff, on a patient's preferences when choosing their chiropractor. Our findings may provide chiropractic centers and health care providers with a better understanding of the variables that influence a patient's decisions and assist them in improving their services.

Investigating the feasibility of implementing the SafeCare parenting program in birthing centers in Haiti.

Child maltreatment is a global issue in need of intervention. This study investigated whether SafeCare, an evidence-based behavioral parenting program to prevent child neglect and physical violence, is desired and feasible to implement in Haiti birthing centers. A total of four focus groups were conducted with 29 birthing center staff and mothers in two birthing centers in Haiti. Staff participants also completed the World Health Organization Readiness Assessment for the Prevention of Child Maltreatment written survey. Focus group findings suggest that SafeCare is a desired program by both caregivers attending the birth center and birth center staff. Findings also showed that the SafeCare curriculum needs cultural adaptations before delivery in Haitian birth centers. We also found that despite contextual challenges that pregnant mothers and birth center staff face in Haiti, birth centers continue to be a place for women to receive pre- and post-natal medical care and weekly education sessions. Findings support that although there are contextual challenges to a SafeCare implementation in Haiti, birthing centers are ideal and feasible locations in which to deliver SafeCare. Birth center networks may be potential settings in which to disseminate and scale evidence-based programs for improved health outcomes for mothers and children.

Predicting Performance of Call Center Staff: The Role of Cognitive Ability and Emotional Intelligence

This study examined the relationship between cognitive ability (IQ) and emotional intelligence (EQ) in predicting a range of different performance metrics from a call centre environment. In all, 303 call centre staff completed multi-dimensional measures of both EQ and IQ. We also had recorded nine performance data measures for each individual over a 12-month period. There were a few significant correlations with IQ (4/35) and a few more with EQ (4/28), though all EQ measures were related to “Errors Made over the year”. The performance metric that had most correlates was Average Handling Time (AHT) relating to speed of working. The number of errors an employee made was significantly positively correlated with all four EQ factors. Correlational and Structural Equation Model (SEM) analysis highlighted the importance of analysing performance metrics as distinct variables, finding contradictory evidence in the sense that some individual difference factors correlated positively with some and negatively with other outcome measures. The results are discussed in relation to the theoretical implications for researchers interested in analysing call centre performance, and also practical implications for organisations with call centres.

Analysis of the health conditions of migrants and asylum seekers in reception centers: From scene investigation to the evaluation of signs of torture

The phenomenon of migration is an international issue that mainly concerns Europe. In Italy, because of its close proximity to Africa, there are many migrant landings, especially on the islands of Lampedusa and Sicily. Migrants and asylum seekers suffer torture on their journey to their destination country, however, most of the time the signs are not always recognizable. In the present study, a scene investigation was carried out in a reception center for level II immigrants in Sicily, in order to evaluate the hygiene conditions of the migrants and asylum seekers inside this center. Subsequently 26 migrants and asylum seekers, all minors and males, were examined in a clinic of the Department of Forensic Medicine of the University of Catania, with the help of a native speaker interpreter and applying the Istanbul Protocol. The scene investigation demonstrated the poor clinical conditions of the reception center and the failure to comply with emergency regulations. The physical examination of the migrants and asylum seekers demonstrated that all the torture reported had taken place in Libya. However, only 4 migrants and asylum seekers showed signs of violence consistent with torture, compatible with the Istanbul Protocol. Nine migrants and asylum seekers (34.6 %) reported having pathologies and asked to undergo a medical examination in a hospital but were not listened to by the reception center staff. Two migrants and asylum seekers reported having worn the same clothes for several weeks to the reception center staff. In particular, all the migrants and asylum seekers reported having suffered torture using blunt instruments, especially beatings with truncheons. One migrant and asylum seeker reported being detained for days without food, instead 1 migrants and asylum seekers reported being kidnapped-blindfolded-stripped naked for days, and 1 migrants and asylum seekers reported having contracted infections, including scabies, with electrical and thermal trauma. Despite the international commitment to the phenomenon of migration, migrants and asylum seekers continue to receive abuse and torture. Furthermore, most migrants and asylum seekers studies primarily involve surveys, and few have applied the Istanbul Protocol to a sizable sample. An original aim of the study is the use of forensic tools to assess the sanitary and hygienic conditions of a migrant reception center, with the secondary aim of assessing alleged cases of torture.

The Discretionary Power of Street‐Level Bureaucrats From the Perspective of Illusio

ABSTRACTInterrogating the tension between care and control in the work of social services staff in Belgian immigration detention centres, this article sheds light on the uses of discretion from the perspective of Bourdieu's concept of illusio. I argue that social services staff's use of discretionary power must be understood at the crossroads of their belief in their professional ethos and the power relations within these centres, which enabled them to frame the element of control as something they had to deal with professionally, rather than something to which they contributed. This sheds light on both the uses of discretion as well as on the articulation of care and control in border humanitarianism.

Transition of Care of Stable Kidney Transplant Patients to Referring Nephrologists: A Survey of U.S. Transplant Program Staff.

We conducted a national survey to assess the opinions and experiences of transplant center staff related to processes of care graduation. Following IRB approval, medical staff at U.S. adult kidney transplant programs were surveyed using the Qualtrics survey platform (4/5/2022-10/05/2022). Respondents were invited via email and listservs of professional societies. If > 1 survey was submitted for a program, a selection hierarchy was utilized (e.g., prioritizing nephrologists' responses). Respondents provided data from 46.7% of active programs (N = 92), representing 67% of the national kidney transplant volume. Most respondents (70%) were nephrologists. Full graduation to referring nephrologists was reported by 39% of transplant programs, with an additional 48% reporting partial graduation with ongoing co-management. Rationales for graduation were multifactorial, most commonly including patient travel distance (64%), maintenance of referral base (58%), continuity of care (58%), and center and/or patient burden (54%). Common reasons cited by programs for postgraduation return of care to the transplant center included worsening renal function (82%), malignancy (66%), opportunistic infection (63%), limited local nephrologist availability (60%), and pregnancy planning (57%). Additional coordinators and clinic staff were cited as needed to make transplant center perpetual care feasible by 78% of programs, with 71% stating that more clinicians are needed, while half thought more physical space or telemedicine are required. Graduation of kidney transplant patients is common, with half of programs using a joint-care approach and another third reporting full return of care to the referring nephrologist. Expanded opportunities related to transplant care for the broad nephrology community are essential.

Manifestations of emotional burnout in rehabilitation centers staff

Introduction. High emotional intensity of professional activities of rehabilitation centers staff, the need to constantly respond to unexpected non-standard pedagogical situations, the requirements for empathy and reflection in conditions of uncertainty, etc. determine the development of emotional burnout. Consequently, an employee suffering from emotional burnout cannot fulfill professional duties efficiently and solve tasks set by the organization. In this regard, it is necessary to understand the emotional sphere manifestations in employees of rehabilitation centers and organize appropriate preventive work. The purpose of this article is to summarize the data on studying the emotional peculiarities, to identify the manifestations of emotional burnout in rehabilitation centers employees. Materials and Methods. The methodological basis of the research includes studying the content of the phenomenon of emotional burnout with the focus on personal and professional self-fulfillment. In order to solve the research tasks the authors used analysis and generalization as theoretical methods and empirical methods, including testing, conversation, and methods of quantitative and qualitative data analysis. The sample consisted of 124 employees of rehabilitation centers in the Krasnodar Territory. Results. The article presents a theoretical overview and summarizes the results of studying the emotional sphere of rehabilitation centers employees. The study reveals the manifestations of emotional burnout, clarifies essential aspects of emotional disorders prevention. Conclusions. Emotional exhaustion, stress resistance disorders, tension, etc. are revealed as basic manifestations of emotional burnout in the research sample. The article concludes that prevention should be comprehensive and take into account the identified characteristics of emotional disorders.

Analysis of the mean electrical axis of the heart from standard electrographic leads in normal adult males

Background: Electrocardiogram has been widely applied as a diagnostic tool for cardiovascular disease. The concept of the cardiac vector is crucial for the clinical application in ECG interpretation. Methods: A prospective cross-sectional study was conducted among 116 male subjects, aged 18-25 years, comprising students and staff of Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal, over the period from June to September 2023. Electrocardiograms (ECGs) were recorded using a standard ECG machine with conventional limb leads. The mean electrical axis of the heart for each individual was determined by plotting the net voltage of the QRS complex in Lead-I and Lead-III. The study aimed to analyze the correlation between the cardiac vector and physical measurements, such as height, weight, Body Surface Area (BSA), and Body Mass Index (BMI). Data analysis was performed using SPSS version 27.0. Results: The normal mean electrical axis of the healthy male subjects was observed as 57.88±24.55°. There was significant positive correlation of cardiac vector with height (p< 0.05), whereas negative correlation was observed with weight and BMI (p< 0.01). However, there was no significant correlation with BSA. In our study we observed the maximum left axis cardiac vector as -10° and right axis as 90° among 116 male subjects. Conclusion: We established a cardiac vector with values differing from those reported in other studies, using standard bipolar limb leads in normal, healthy male subjects. It is also examined that greater BMI has shifted the electrical activity of the ventricles to the left.

Keeping Community During a Pandemic

The purpose of this qualitative exploratory study was to better understand how LGBTQ+ senior centers created virtual communities and implemented organizational adaptation in the earliest stages of the pandemic. Three focus groups (n=22) were conducted with program facilitators and senior center employees to better understand how these key stakeholders contributed to the transition from in person senior center to virtual senior center programming in March of 2020. The experiences of LGBTQ+ program facilitators and senior center staff varied based on the nature of their assigned roles. Latent pattern content analysis of the focus groups unveiled both shared and divergent categories and themes from the two cohorts. Themes identified for program facilitators included: adaptation, interconnectedness, some not served, and virtual preference. Themes identified for senior center staff included: communication, the blurring of the personal/professional, urgent needs, and future planning.

Investigating the Relationship between Emotion Regulation Strategies and Anxiety Caused by COVID-19 in Employees of Rehabilitation Centers

Background and Objectives: In the current situation, it is essential to determine the level of anxiety in medical and non-medical employees due to the pandemic. Therefore, this research aims to assess the relationship between corona anxiety, emotion regulation strategies, and stress tolerance among the staff of rehabilitation centers in Tehran Province, Iran. Methods: This study was descriptive, cross-sectional, and correlational. The statistical population of the present study included the entire staff of rehabilitation centers served by the Welfare Organization of Tehran Province in 2022. Using simple random sampling, 10 rehabilitation centers were selected as study centers. Subsequently, 200 employees of these centers were selected and tested using Morgan’s sampling table (the male age of the participants was 31.5 years). The data collection instruments included the corona disease anxiety scale, the emotional distress tolerance questionnaire (2005), and the March emotional self-regulation strategies scale (2007). Data were analyzed by SPSS software, version 26. Results: The results showed that the mean of corona anxiety was 18.94 out of a maximum of 54 and the proportion of psychological symptoms of corona anxiety was higher than physical symptoms. The highest score from the participant’s point of view from dimensions of distress tolerance was assigned to the subjective assessment of distress. The mean score for distress tolerance was 52.68 out of a maximum of 75 points and the mean score for employees’ emotion regulation strategies was 134.37 points, which shows that the use of emotional self-regulation strategies is strong. The results of the current research showed that corona anxiety decreases significantly by increasing distress tolerance, absorption of negative emotions, regulation of efforts to relieve distress and distress tolerance, and corona anxiety also decreases significantly. Also, with the increase in the level of emotion regulation strategies, the anxiety of corona decreases significantly. Distress tolerance showed a negative correlation with corona anxiety, and with the improvement of distress tolerance, corona anxiety decreased (P=0.014). Conclusion: Based on the results, increasing and improving distress tolerance and emotional regulation strategies significantly reduced corona anxiety. Also, the experiences and work of experts with more work experience alongside the younger and less experienced forces and their cooperation prepared the ground to reduce the effects of corona anxiety, as well as to improve the level of stress tolerance and emotion regulation strategies of employees.

Meaning-making of mental health among reception center clients in Finland

Abstract Introduction Asylum seekers and refugees face significant challenges, including high rates of mental health issues, as they navigate unfamiliar societal systems and norms. However, little is known about their subjective experiences of mental health and the mental health support in everyday social encounters. This study aims to explore the meaning-making of mental health and the experiences of receiving mental health support among clients of Finnish reception centers (FRCs). Methods Semi-structured individual in-person interviews were conducted with 11 reception center clients from various locations in Finland, with an interpreter present in four interviews. Interviews lasted approximately 60-90 minutes. Thematic analysis was employed to identify recurring themes and subthemes. Results Preliminary findings indicate a diversity in the meaning-making of mental health among participants. While some discussed mental health in terms of stress, others approached the topic analytically, while some avoided it altogether. Participants highlighted the importance of access to external resources, such as schools, language courses, and employment, for enhancing overall well-being. Trust in FRC staff emerged as a crucial factor in seeking and receiving assistance for mental health concerns. Additionally, participants exhibited resilience, suggesting benefits of empowering them during this challenging period. Conclusions Adopting a holistic approach to mental health care within FRCs is imperative. Understanding how clients construct meaning around mental health is particularly relevant for training FRC staff, who serve as primary points of contact for asylum seekers and refugees in Finland. Moreover, amplifying the voices of reception center clients can contribute to improving services and enhancing the health and well-being of this population in Finland. Key messages • It is necessary to adopt a holistic approach to mental health care within reception centers, one that addresses broader social determinants of mental health. • Trust in the staff of Finnish reception centers is a critical factor in facilitating the seeking and receiving of assistance for mental health concerns among asylum seekers and refugees.

An Overview of Knowledge and Attitude About Premenstrual Syndrome on 9th Grade Students at Junior High School Number 1 West Selemadeg

Adolescent health efforts are activities that aim to help adolscents become healthy adults. The change towards adolescence is marked by puberty, such as the occurrence of menstruation in teenage girls. Before expriencing the menstrual phase, woman will experience symptoms such as stomach ache, difficulty concentrating and sharp emotional changes called premenstrual syndrome. The aim of this research is to determine the description of knowledge and attitudes about premenstrual syndrome in class IX students at SMP Negeri 1 Selemadeg Barat. This research wa conducted from March to April 2024 at SMP Negeri 1 Selemadeg Barat. This type of research is descriptive research with design cross sectional. The number of respondents used was 64 female students. Data collection includes filling out knowledge and attitudequestionnaires. The results of the study showed that the majority of respondents ages 15 years, began to experience menarche at the age of 12, has no sisters and the majority obtains information from the surrounding environment. The assessment regarding female students’ knowledge obtained results, only a few got good marks, namely 10 female students (15,6%) and the majority of female students showed a positive attitude, namely 36 female students (56,25%). Female students are advised to learn more about premenstrual syndrome and local health center staff are advised to provide edication to female students to from an attitude of students who are ready to face the problem menarche and premenstrual syndrome.

What do we mean by “agency”? A framework and tools for supporting visitors' agency in museums and science centers

AbstractAgency is a central value within museums and science centers, but it has not been defined and operationalized in ways that can guide museum practice or support inclusion for new audiences. In this project, an interdepartmental group of science center staff co‐created a conceptual framework for noticing and supporting visitors' agency. The framework includes four interconnected aspects of agency: physical environment, social engagement, choice and autonomy, and relevance and empowerment. Conceptualizing agency as multifaceted led to more expansive approaches for supporting it, allowing staff to move beyond open‐endedness to consider a wider range of supports and structures that can make museum experiences more inviting and inclusive. The framework informed the development of practical tools for use by exhibit/program developers and facilitators. Tools are freely available and guide museum staff in questioning current practices and integrating the four facets of agency into planning, prototyping, and observation of interactive experiences.

Implementing Dynamic Systems Development Method for a Web-Based System to Evaluate Child Health and Growth

The Simpang Gambir UPTD Community Health Center has developed an innovative digital system to monitor the growth of toddlers. Previously, the recording of toddler growth data was done manually, often leading to data loss or damage. This new system is designed to address these issues and provide a more efficient and accurate solution. The system not only facilitates health center staff and posyandu cadres in monitoring toddler development but also assists them in creating digital growth reports. With this system, toddler growth data can be accessed quickly and easily, facilitating decision-making regarding child health management. One of the key features of this system is its ability to track toddler growth based on weight-for-age charts. This feature allows health workers to easily identify toddlers with nutritional problems and promptly provide necessary interventions. Additionally, the system is equipped with a fast data search feature, enabling staff to easily find specific toddler growth data. The development of this system utilizes the Dynamic System Development Method (DSDM), allowing for a structured and efficient development process. With this method, the system can be developed rapidly and in accordance with user needs.

Women's self-reported symptoms of reproductive tract infection, medical consultations, and factors influencing them in less developed regions: perimenopausal and older women in need of urgent attention.

Reproductive tract infections (RTIs) represent a critical public health concern impacting women's health, particularly pronounced in developing countries. We aim to investigates the prevalence of self-reported RTI symptoms in women aged 18 to 65 and the factors influencing gynecological examination behavior and associated risks are explored. From May 6, 2022, to September 20, 2022, a comprehensive survey engaged 20,864 women aged 18 to 65 in 19 townships in Lueyang, Shaanxi. Each survey team, comprising a gynecologist, two female health center staff, and a master's student, conducted face-to-face questionnaire surveys in villages and households. The questionnaire featured three sections: prevalence of self-reported RTI symptoms, gynecological examination history, and factors influencing examination behavior. The high response rate of 98.69% yielded 20,590 valid questionnaires. Among surveyed women, 42.04% reported RTI symptoms, with a higher prevalence in those aged 30 and above, peaking at 44.88% in the 50-59 age group. Vulvar itching (24.73%), abnormal vaginal discharge (17.41%), and urinary tract irritation signs (11.73%) were most common. Older adult women (≥60) reported higher frequency and longer duration of symptoms. Only 9.88% of symptomatic women underwent gynecological examinations in 2022. Examination likelihood decreased with age, presenting a critical gap in healthcare utilization among older women. Reasons for checkups included routine checkups (47.02%), symptom concerns (41.29%), and the availability of free medical checkup programs (9.82%). Barriers included perceived lack of serious symptoms (23.7%), lack of necessity (4.41%) and lack of time (3.98%). Among those examined, 40.58% had a diagnosis of gynecological disorders, including pelvic inflammatory disease, human papilloma virus infection and cervical cancer. Widespread RTI symptoms, particularly in perimenopausal and older women, underscore the need for enhanced healthcare. Barriers to gynecological examinations include awareness, education, and accessibility issues. Strategies must prioritize health education, routine examinations, and improved healthcare infrastructure in underdeveloped regions.

The effect of acceptance and commitment therapy on work-related rumination and job fatigue of medical emergency and accident management center staff: an experimental study

BackgroundWorking in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran.MethodsThis study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis.ResultsThe findings showed that the average job fatigue reached 16.78\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\pm\\:$$\\end{document} 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue.ConclusionTreatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel’s mental health and the quality of services provided to patients.Clinical trial numberNot applicable.

Pengaruh Beban Kerja dan Pembinaan Disiplin terhadap Kinerja Staf Bagian Kesatuan Pengamanan Rutan dan Subseksi Rutan Perempuan Kelas IIA Bandung

The decline in staff performance reviewed from the aspect of assessing the performance of the Bandung Class IIA Women's Prison staff still needs to be improved. The purpose of this study is to see the influence of workload and discipline coaching on performance partially and simultaneously. The study uses quantitative methods and questionnaires with interval scales as data collection. The research population is 32 staff of the Bandung Class IIA Women's Detention Center. Samples were taken using a saturated sampling technique. Data processing was analyzed using multiple regression analysis and hypothesis tests using partial (t-test) and simultaneous (F-test). This study proves that workload has a negative and significant effect on staff performance partially. Discipline coaching has a positive and significant effect on staff performance. Meanwhile, simultaneously workload and discipline coaching have a significant effect on staff performance.

Exploring the Relationship between HRM Practices and Organizational Performance: Insights from the Sports Centre Staff at the National University of Malaysia (UKM)

Exploring the Relationship between HRM Practices and Organizational Performance: Insights from the Sports Centre Staff at the National University of Malaysia (UKM)

Assessment of the Risks of Zoonotic Infection at the Primatology Centre of the Interdisciplinary Medical Research Centre of Franceville in Gabon.

Non-human primate (NHPs) conservation sites could be sites of exchange of pathogens involved in infectious diseases. It is important to assess the potential risks associated with this type of structure. The objective of this study was to carry out a risk assessment of the Primatology Centre housed in the Interdisciplinary Centre for Medical Research of Franceville (CIRMF). A questionnaire was administered to the centre's staff to assess the risk associated with each workstation, followed by a review of the various pathogens identified in NHPs. The data were analysed using two diagrams: the Kiviat diagram and the Pareto diagram. Based on our results, a variety of pathogens such as viruses, bacteria and parasites, potentially transmissible to humans, were described in the NHPs at the Primatology Centre of CIRMF. The position most exposed to zoonotic risks was that of animal handlers. The Primatology Centre of CIRMF is a potential transfer site for the transfer of zoonotic agents. To avoid the risk of parasite exchange between staff and animals, the implementation of biosecurity measures is essential.

Binary and Nonbinary Transgender Patient Experiences Accessing Gender-affirming Top Surgery.

Transgender and gender diverse (TGD) individuals face barriers when seeking top surgery, or bilateral mastectomies, as part of surgical transition, leading to delayed care and adverse health outcomes. Understanding differential experiences between nonbinary and binary patients is crucial for improving TGD patient care, but this distinction is seldom made in the current literature. This single-center cross-sectional mixed-methods survey study conducted between 2022 and 2023 enrolled all consecutive TGD patients undergoing top surgery. Significant differences between datasets were determined by two-sample unpaired t tests. Summative content analysis and descriptive analysis were performed for free-text responses. Thirty-seven binary and 71 nonbinary patients completed the survey. Lack of funding, long wait times within the healthcare system, and long wait times to access surgery were the three most impactful barriers for both cohorts. Nonbinary patients were more impacted by a lack of TGD-friendly surgeons and community physicians, prejudice from surgical center staff and community doctors, and employment concerns. More binary patients desired a "masculine chest" and to stop using a binder. The nonbinary group more frequently desired a "smaller chest" and had greater variability of surgical goals. Binary and nonbinary TGD patients both experience barriers to top surgery; however nonbinary patients may experience distinct barriers and have differential surgical goals. It is important to discuss specific surgery goals and offer top surgery options beyond bilateral mastectomy with nipple grafting, especially with nonbinary patients.