Paper Copies Research Articles

Do male and female heads of households have different beliefs about gender equity among young people in Nigeria?

Gender-transformative approaches (GTAs) have been successfully carried out to address harmful gender norms and power imbalances to promote more gender equitability. However, to improve the health and wellbeing of young people, it is necessary to involve household heads by positively transforming their beliefs on gender equity and norms. This study was cross-sectional quantitative research undertaken in six local government areas in Ebonyi State, Nigeria. The study population consisted of household heads in households with young people aged 15-24 years. Data were collected for 15 days using paper and electronic copies of the questionnaire. Descriptive, bivariate, and logistic regression analyses were performed using Stata. The results showed that 46.32% of male and 62.81% of female heads of households disagreed with the statement "a good woman never questions her husband's opinions, even if she is not sure she agrees with them." Female heads of households aged 50 years and below with an odds ratio of 0.47 (p-value = 0.02) suggest they were 0.47 times more likely to have a positive attitude toward the rights and privileges of young girls. Male heads of households aged 50 years and below with an odds ratio of 1.05 (p-value = 0.84) suggest that they were 1.05 times more likely to have a positive attitude toward the rights and privileges of young girls. This paper provides new knowledge on the gender norm attitude of male and female heads of households on the rights, privileges, and equity promotion of young boys and young girls, as well as its associated factors.

Reprocessing and interpretation of legacy seismic data using machine learning from the Granada Basin, Spain

The Granada Basin (Spain) is a Neogene sedimentary depression with irregular geomorphology and deep depocenters. It is located in the most seismically hazardous part of the Iberian Peninsula with an historically experienced extremely destructive earthquakes, followed by periods of low to moderate seismicity. In 1980s the Chevron Oil Company collected a set of 30 deep seismic reflection sections in this Basin of which only the results on paper are kept. Due to the fact that many of these seismic profiles are currently located in urban areas and the economic cost of carrying out a similar exploration, it was decided to recover these old data and apply a post-stack treatment to improve their quality. The purpose of this study is to show the applied reprocessing flow and, with the new sections, to present a spatial model of the basin. The first stage of recovery and enhacement of seismic sections has consisted in three phases: first, high-resolution scanning of paper copies to TIFF images followed by the transformation of TIFF images to SEG-Y format; second, poststack processing workflow to increasing resolution and lateral coherence of these seismic lines; and third, it has been used a machine learning algorithm, among others, increasing the spatial resolution, signal-to-noise ratio, and coherence of the seismic signals. In addition, basement horizons, as well as three sedimentary sequences, were identified in all seismic sections and interpolated to create a three-dimensional basement model composed by normal faults, horst and grabens related to the seismotectonic behavior of the basin. As an overall assessment, this work is an example of the usefulness of ‘recycling’ legacy seismic data, which nowadays are usually in archived boxes, but at the time required a great economic and acquisition effort.

O-225 A study investigating whether egg share donors treatment outcome impacted on their overall psychological well-being and treatment experience

Abstract Study question Does unsuccessful egg sharing treatment impact on the egg share donor’s psychological well-being or make her regret her decision to participate? Summary answer Egg share (ES) donors whose treatment was unsuccessful did not regret egg sharing, and were unanimously happy for their recipient if her treatment was successful. What is known already ES programmes are a unique form of egg donation for two main reasons. First, both the donor and her anonymously matched recipient are engaged in the simultaneous pursuit of having a baby. Second, egg sharing schemes offer a benefit for the donor other than altruism. However, a major concern is for the psychological well-being of ES donors whose own treatment is not successful. This concern raised was based on opinion, rather than empirical research. It is therefore vital that the psychological well-being of ES donors through egg sharing is better studied. Study design, size, duration Data for this study were gathered using a questionnaire. Selection criteria for the study were those who had participated in egg donation treatment between 2014-2022 at Lister Fertility Clinic (LFC), Chelsea, London. Only patients who had agreed to participate in research during the consenting process of their treatment were sent an email invitation asking them to participate in the study. 394 ES donors were sent an email invite. Participants/materials, setting, methods After receiving the email link, respondents filled out the questionnaire online using the Qualtrics survey tool. The paper copies received were manually inputted by the research team onto Qualtrics. The questionnaire took on average 15-20 minutes for participants to complete. 197 egg share donors were included in analysis Statistical analysis was conducted using the χ², analysis of variance (ANOVA), Mann Whitney U test, and Fisher’s exact test. Main results and the role of chance This is the largest study to investigate the psychological issue surrounding ES donation. Overall, ES donors rated their treatment ‘very positively’ (85.7%). The vast majority of egg sharers (91.8%) were glad they took part in the programme. Significantly, patients were stratified into whether IVF treatment was successful or not, with successful treatment being defined as a resulting live birth. For egg sharers, there was no difference between positive or negative treatment outcome, and their responses to whether they: would participate in egg sharing again in the future; would recommend egg sharing to a friend or family member who needs fertility treatment; felt well informed of egg sharing; and felt they had sufficient support from the fertility clinic during and after treatment. The only answer that was statistically significant based on treatment outcome was when asked if they were ‘glad they took part’, with 99.4% of successful egg sharers answering yes, compared to 72.7% of unsuccessful egg sharers (Fishers exact, p < 0.05). Of the unsuccessful ES donors who found out their recipient’s treatment was successful, 100% reported they were ‘happy for their recipients’, with the vast majority of this category stating they were glad they took part (85.7%). Limitations, reasons for caution As with all questionnaire generated data, there is a potential for sampling bias. Second, this is a single centre study. LFC is one of the largest ES centres in the UK and has success rates above the national average. Therefore, this data may not represent the ES programme nationally. Wider implications of the findings As with all questionnaire generated data, there is a potential for sampling bias. Second, this is a single centre study. LFC is one of the largest ES centres in the UK and has success rates above the national average. Therefore, this data may not represent the ES programme nationally. Trial registration number n/a

Designing and Validating a Comprehensive Patient-Reported Outcomes Measure for Ambulatory Cancer Settings: The Revised Edmonton Symptom Assessment System for Cancer.

Patient-reported outcomes (PROs) information has been routinely collected in Cancer Care Alberta (CCA) for years using the revised Edmonton Symptom Assessment System (ESAS-r) and Canadian Problem Checklist (CPC). There was interest in combining these into a more comprehensive single measure tailored to ambulatory cancer settings. The purpose of this study was to validate an expanded and redesigned ESAS-r called the ESAS-r Cancer. Stakeholder engagement, a review of the literature, and 2 years of CPC data collected in the cancer program informed the addition of six symptoms to the ESAS-r. To assess and validate the measure, 1,600 randomly sampled patients were mailed paper copies of the ESAS-r Cancer, ESAS-r, and a validated, comprehensive PRO measure called the Memorial System Assessment Scale-Short Form (MSAS-SF), which is often used with patients with cancer. Canonical Correlation Analysis and exploratory factor analyses were performed to assess concurrent and construct validity of the ESAS-r Cancer against ESAS-r, using MSAS-SF as the reference measure for comparison. Cronbach α was calculated to assess reliability. Four hundred and sixty-one patients (29% response rate) completed all three questionnaires. ESAS-r Cancer showed higher numerical correlation than ESAS-r and accounted for more information included on MSAS-SF, explaining slightly more variance than ESAS-r (75.2% v 73.5%). The three-dimensional factor structure of ESAS-r Cancer outperformed the two-dimensional factor structure of ESAS-r. The reliability of ESAS-r Cancer was verified and found to be slightly higher than ESAS-r (Cronbach α = .903 v .884). ESAS-r Cancer is now in use with patients throughout CCA. This valid and reliable PRO measure can be used by other cancer or specialized health care programs who wish to routinely assess common symptoms.

Exploring the impact of a digital health tool on patients’ interaction with community pharmacists: A pilot randomized controlled study

BackgroundThe use of digital Patient- Reported Outcomes (PRO) tools has been shown to enhance the exchange of information and shared decision-making in medical encounters. However, their influence on patient-pharmacist interactions has not yet been explored. ObjectivesThis study aimed to examine the impact of RxTalk™, a digital PRO tool, in supporting the communication between patients and pharmacists compared to usual care. MethodsIntervention: RxTalk™ was developed to collect information about medication adherence and beliefs, using a tablet computer. Study designA pilot randomized controlled study was conducted at a community pharmacy in Wisconsin, USA. Sixty patients were randomized to either the intervention group who used RxTalk™ during medication pick-up or the control group who did not use the tool. Patients who used RxTalk™ received paper copies of their responses which were also shared with pharmacists. The consultation was audio-recorded for both groups and coded using the Active Patient Participation Coding scale. Follow-up phone interviews were conducted with both groups within one week of enrollment. ResultsPatient tapes were analyzed. In the unadjusted model, patients in the intervention group had a higher active participation rate (p = 0.004) and raised significantly more concerns during consultations (p < 0.001) compared to the control group. Pharmacists asked twice as many questions while counseling patients in the intervention group compared to the control group (p < 0.001). After controlling for patients' demographics and pharmacists’ questions, there was a statistical difference between the two patient groups in their odds of expressing at least one concern utterance. ConclusionThis pilot study suggests that collecting PRO from patients with chronic illnesses and providing results to pharmacists and patients can help patients express their health and medication concerns. RxTalk™ would be useful for pharmacists who wish to improve the recognition and management of medication-related problems.

QOL-51. FEASIBILITY AND EASE OF USE OF A REMOTE ONLINE COGNITIVE BATTERY AMONG PEDIATRIC BRAIN TUMOR SURVIVORS

Abstract BACKGROUND Pediatric brain tumor survivors are at risk for cognitive deficits, including inattention, poor memory, and slow processing speed. Due to technology advances, computerized neuropsychological batteries were developed that can be completed via internet in the home. The primary aim of this study was to evaluate the rate of successful completion and ease of use of the Penn Computerized Neuropsychological Battery (CNB) among pediatric brain tumor survivors. METHODS Forty-eight pediatric brain tumor survivors completed the online remote administration version of the Penn CNB (10 subtests) assessing complex cognition, memory, executive control, processing speed, and motor speed. Participants were provided with an electronic link to the online cognitive battery as well as paper and electronic copies of an instruction guide and post-completion surveys to return via mail/email. RESULTS Patients (56.3% female) were diagnosed and treated for a brain tumor (54.2% received radiotherapy). All participants were at least 8 years of age (M=13.71, SD=3.82) and at least one-year post-diagnosis (M=4.76, SD=2.58 years). Eighty-eight percent of participants beginning the CNB completed all subtests. Sixty percent of participants completed and returned the post-assessment survey. Participants who returned post-assessment surveys were similar to those who did not on demographic and medical factors (all p-values &amp;gt;.05). Mean ratings suggest that survivors were “very interested” in the tasks and they were “somewhat easy” to complete. Younger children were more likely to have trouble understanding task instructions (r=.56, p &amp;lt;.01) and ask for help answering specific questions (r=.46, p &amp;lt;.05). CONCLUSIONS Remote administration of computerized batteries are feasible among pediatric brain tumor survivors and may assist with advancing both research and patient care. From a research standpoint, remote batteries may allow for participation and engagement in research with minimal survivor burden. Clinically, such batteries may offer alternatives for screening patients who will benefit from comprehensive services.

COST-EFFECTIVE AND EFFICIENT BLOCKCHAIN FRAMEWORK FOR VERIFYING CERTIFICATE IN YEMENI UNIVERSITIES

Recognizing the necessity to preserve the integrity and good name of degrees awarded by Yemeni universities. It should provide an efficient way of verifying certificates. The effectiveness of the conventional method of confirming the validity of certificates in reducing fraud has not been very strong. Therefore, it is necessary to stop this kind of fraud by using blockchain technology, which has several benefits, such as encryption, sharing of data, and the capacity to store information as permanent data that cannot be altered. Low latency and low cost will be available for the issuance, sharing, and verification of these certifications in universities if the suggested system is implemented. The paper presents the proposed framework, which uses smart contracts in the Ethereum blockchain and a distributed peer-to-peer network (filebase) for certification verification by a certificate’s hash immediately without waiting for the facility’s response. It also contains an estimate of the average cost of publishing a certificate. It also frees students from having to constantly carry paper copies of their documents by enabling them to access them via a certificate's hash. Furthermore, there is no extra cost for the verification process, and it does not require an Ethereum network account.

"An app is just available at all times"-the process and outcomes of converting the Georgia Tuberculosis Reference Guide into a mobile application.

The physical, paper-based Georgia TB Reference Guide has served as the clinical reference handbook on tuberculosis (TB) diagnostic and treatment guidelines for the state of Georgia in the United States. Supported by the Georgia Department of Public Health, the production of the 112-page palm-sized booklet was previously led by a team of Georgia-based TB experts at Emory University and printed every three-five years with updates to clinical management guidelines and TB consult contact information. However, the costs associated with editorial printing combined with delays in updating a static printed booklet with revised guidance hampered the utility of the tool. Considering the barriers with paper-based production and based on the beneficial use of apps to support the dissemination of clinical management guidance in other settings, the booklet was converted into a mobile application. This paper describes the process of developing a mobile app version of the Georgia TB Reference Guide in an easy-to-update and readily available format. We employed a user-centered design approach to develop the app, including a series of qualitative interviews and quantitative surveys. Participants included a mix of state officials and local TB experts. First, initial foundational interviews were conducted to conceptualize current utilization practices of both the paper and PDF versions of the tool. Second, the findings from the initial interviews were organized thematically and informed the design of the app, which was then beta tested by a round of previously unsampled TB experts as well as a re-sample from the initial interviews. Third, the designs were coded into developmental phases and beta tested among users of the current Georgia TB Reference Guide. Fourth, the app was published and downloaded by a pre-selected group of local users who provided answers to a follow-up survey after using the app for one month. Fifth, user growth, self-reported demographics, and app usage between February and July 2022 were recorded through automatic data metrics built into the app. The paper copy Georgia TB Reference Guide usage themes included commonly referenced content, navigation paths, and desired features and content. The themes were converted into features and designs such as prioritizing commonly reviewed topics and guide customization with bookmarks and notes. Iterations of the designs were driven by feedback from TB experts and included home page featured content, improving content readability, and improving the search feature. The follow-up survey revealed a 90% preference for the app over the paper version of the guide. In the six months following the app's release, the app was downloaded by 281 individuals in the United States. The majority of downloads were in Georgia and the app also expanded organically to 19 other states. The experience of converting the Georgia TB Reference Guide offers specific and effective steps to converting a medical reference guide into a mobile application tool that is readily available, easy to use, and easy to update. The organic dissemination of the app beyond the state of Georgia's borders within the first six months of app launch underscores desire among TB healthcare professionals for high-quality digital reference content outside the state. This experience offers clear outlines for replication in other contexts and demonstrates the utility of similar mobile medical reference tools.

Kult Matki Bożej Nieustającej Pomocy w koś­ciele Redemptorystów w Krakowie-Podgórzu

The picture of Our Lady of Perpetual Help in Podgórze was painted in 1903 in Rome, blessed by pope Leon XIII on 18 April and brought in the same year to Krakow by Father Bernard Łubieński, who was greatly involved in popularising the worship of Virgin Mary related to the painting. The Redemptorists linked their apostolic work with Mary Our Lady of Perpetual Help from the beginning. The painting had already been known to the inhabitants of Podgórze, since its paper copy was hung in the parish church. A turning point in the growth of the worship of Our Lady of Perpetual Help was the introduction of the service known as constant novena, which involves group prayers before her icon on the selected day of every week­ to request some special grace.

CALC 1

CALC is the section of PIMR which focuses on career preparation, advice, and facilitating the development of a diverse and inclusive mathematics community by highlighting the work of a wide variety of luminaries, especially those not typically represented, in the mathematical sciences. Each edition will feature short articles condensing information regarding careers in mathematics. In addition, there will be a short profile of a mathematical professional describing their path to mathematics and individual experience. There will be quite a bit of resource aggregation which will hopefully allow interested parties to more easily learn about careers in interdisciplinary mathematics, and the larger mathematical community (many links are embedded so if you are reading a paper copy you can visit ``pimr.pitt.edu." to access these). Most importantly this section is dedicated to you the reader, and the mathematics community as a whole, so if you have any questions you would like us to look into, or if you would like to share your own perspective don't hesitate to email.

Patient Satisfaction in Neurosurgery Clinic.

National commercial surveys are used to assess patient satisfaction. However, the information obtained does not always correspond tothe clinical situation and therefore may be inadequate to help improve a specific patient experience when through no fault of its design, results in low response rates and inadequate specifics. The objective is to investigate patient satisfaction using real-time in-person patient experience survey responses at the end of a neurosurgical clinic visit and review the results from these survey responses and those from national commercial survey responses provided by the hospital for the ability to affect change. This is a prospective study from October 2023 to December 2023 during which a paper copy of 10 questionnaires derived from a national commercial outpatient clinical survey was given to every unique patient who was neurologically capable of filling it out at the end of his or her neurosurgery clinic visit. The electronic medical record was used to collect patient demographics and details of the clinic visit. National commercial survey responses from July 2022 to November 2023 provided by the hospital were reviewed. A total of 149 patients were seen in the neurosurgery clinic from October 2023 to December 2023, 121 patients were given the in-person patient satisfaction survey, and the response rate was 100%. The mean age was 46.5 years with females constituted 45.5% of the patient sample. The visit type included 46 (38.0%) new patients, 53 (43.8%) returning patients, and 22 (18.2%) post-op patients, of which 45.5% presented with cranial pathologies. Comparing the patient satisfaction level between those seen by one provider and those seen by two providers, such as resident, or mid-level with attending, patients seen by two providers were less satisfied with "feeling respected by the providers" (4.92 vs. 4.64, p=0.0088), "feeling listened to by the providers" (4.84 vs. 4.50, p=0.0180), and "feeling appreciated that the providers discussed illness prevention" (4.72 vs. 4.29, p=0.0232). Due to a lack of necessary information from our national commercial outpatient clinic survey responses provided by the hospital, a direct comparison between the in-person survey and our national commercial outpatient clinic survey was not made. Patient satisfaction surveys when not given in real-time in-person run the risk of low response rate and lack of specifics to help guide providers in quality improvement. Our data supports the use of real-time in-person patient satisfaction surveys that not only increase response rate but also provide useful information to help improve patient experience.

1907 Completing the ‘This is me’ document within the first 48 hours reduces length of stay and improves patient experience

Abstract Introduction By 2025 over 1 million people will be diagnosed with dementia in the UK. Person-centred care is the best practice for looking after patients with dementia, but this is often not managed well within acute hospital settings. This can result in poor hospital experience and longer than necessary stay. A snapshot of data was taken retrospectively from May 2023 within the ED &amp; AMU at an acute hospital. This showed an average length of stay (LOS) of 5.25 days. A study in 2013, which implemented This Is Me (TIM) documents in hospital saw a reduction in inpatient falls, improved patient experience and in turn LOS reduced. Aim To reduce LOS and improve the patient experience for people with dementia presenting to the hospital following a fall. Method A two-week pilot was implemented in ED &amp; AMU 7 days a week, 8-6pm. Patients were identified through the ED therapy screening process. Paper copies of the TIM were filled in for patients meeting the criteria. Inclusion criteria were admission with a fall and had a dementia diagnosis. LOS data was collected and follow-up data was collected. Results Twenty-five patients met the inclusion criteria. Every patient had a TIM document completed within 48 hours. The average LOS was 1.87 days. All patients/relatives reported the TIM was important, and that it improved information transfer. There were several limiting factors including the time involved to complete the TIM, reduced weekend staffing and limited awareness from the multidisciplinary team of the TIM document. Conclusion To conclude, using the TIM Document facilitates a reduction in LOS and an improvement in patient experience. Further recommendations such as launching this project for a longer time frame, using an electronic version of TIM and MDT teaching.

Understanding end-of-life doula care provision: reporting on the design of a bereavement survey to evaluate doula support.

Delivery of consistent patient-centred care at end-of-life care continues to challenge healthcare providers and research continues to suggest that peoples' needs are not being reliably met. Consequently, healthcare services are looking to innovate how support is provided, such as commissioning doulas to support dying people and those close to them. Within the United Kingdom, there is little existing research about peoples' experience of receiving end-of-life doula support. This paper outlines the design of a survey for the family or friends of a person who received end-of-life doula support. To evaluate the role of an end-of-life doula in supporting the dying person and those who care for them, we designed a post-bereavement survey as part of a wider evaluation strategy of doula services. Following multiple literature reviews and an iterative process of consulting with the professional organisation and previous service users, a questionnaire was developed to collect this data. This survey is hosted online, with paper copies available to widen accessibility. End-of-life doula support is a relatively new area of provision for dying people and those important to them, such as family and friends. It is even more innovative to have doula support commissioned as part of a locality's healthcare service. There is a dire need for empirical research to understand the impact of this further. The process of researching the area and designing the evaluation survey for this service revealed the complexity of the role and the difficulty of capturing what was found to be helpful for the dying person and those around them.

Notice of Violation of IEEE Publication Principles: Integrated Control of Braking and Steering Subsystems for Autonomous Vehicle based on an Efficient Yaw Moment Distribution

Notice of Violation of IEEE Publication Principles Control of Braking and Subsystems for Autonomous Vehicle based on an Efficient Yaw Moment by Shaobo Lu, Sheng Cen, Xiaosong Hu, Cheewah Lim and Jinlong Zhang, in the IEEE Transactions on Industrial Electronics, Early Access, May 2017 After careful and considered review of the content and authorship of this paper by a duly constituted expert committee, this paper has been found to be in violation of IEEE’s Publication Principles. This paper copies equations from the paper(s) cited below. The content was copied without attribution (including appropriate references to the original author(s) and/or paper title) and without permission. The lead and the second author of the paper were responsible for the violation. A correction letter for this misconduct was submitted and published at http://ieeexplore.ieee.org/document/8017449 Coordinated Control with Electronic Stability Control and Active Front Using the Optimum Yaw Moment Distribution Under a Lateral Force Constraint on the Active Front Steering by Seongjin Yim, Seungjun Kim and Heesung Yun, in the Proceedings of Institution of Mechanical Engineers, Part D: Journal of Automobile Engineering, 2016, Vol. 230(5) pp. 581-592 This paper presents an Integrated Chassis Control (ICC) strategy for Electronic Stability Control (ESC) and Active Four Wheel (AFWS) based on an efficient optimal yaw moment distribution. To further enhance the handling and lateral stability of vehicle equipped with ESC, a new Weighted Pseudo- inverse Control Allocation (WPCA) based ICC is proposed. The cornering forces of both front and rear wheels are used to cooperate with the ESC braking forces, so as to further extend the operational envelope of the vehicle. A bi-level hierarchical control structure is employed. In the upper level, the sliding mode control with a combined sliding surface is used to generate the desired virtual control. In the lower level, a revised optimal function is defined to tune the control authority of actuators, and an algebraic operation based WPCA method is adopted. To avoid tire forces saturation and enforce a certain stability margin, a boundary layer constraint is further considered in the proposed optimization problem. A severe lane change maneuver is used to investigate the performance via closed-loop driver-vehicle- controller simulations using CarSim and MATLAB/Simulink. Simulation results demonstrate that the proposed algorithm outperforms current control practice without violating the actuators physical limitation.

Explanation of Tong Shaowen's Local Examination Zhu-juan Today

Based on a specific analysis of a person's Zhu-juan (red-ink copy of test papers used in imperial examinations) in the late Qing Dynasty, it includes personal resume, teacher-student relationship, the content and answers of the exam questions, and the examiner's comments. It should be said that the study of Zhujuan has important historical value for studying historical figures and regional historical culture. Tong Shaowen’s Zhu-juan written in Provincial examination originates from The Collection of Zhu-juan in the Qing Dynasty, which was compiled by Gu Tinglong and published by Taipei Chengwen Publishing House in 1992. Tong Shaowen (1816-1860) , also known as Ziyin and Jianqin, was born in Lanxi, Zhejiang Province today. He was the Zengguang scholar at prefectural school in JinHua, the civilian in registered residence in Lanxi County. This Zhu-juan is Zhejiang provincial examination paper written in 1846. Tong ranked 54th in the list of successful candidates. In the third year of Xianfeng (1853) , Tong Obtained first class in the Datiao examination selecing excellent candidates to become officials and served as the Supervisor of the County in Henan Province for trial use. He died while serving as an official. Tong was born on the eleventh day of the first month in the third year of the Jiaqing reign (1816) at Maoshi, and died on the twelfth day of the third month in the Gengshen year of the Xianfeng reign (1860) at Youshi. In combination with the Huanggang Tong's Genealogy (1949) from Hongnishan Village, Nubu Street, Lanxi City, Zhejiang Province, this paper annotates Tong’s Zhu-juan, including the personal resume, the teacher-student relationship, and the political ideas. The purpose is to highlight its historical and cultural value and historical data value, so as to provide an important reference for the study of imperial examination history, local history and family history.

An overlooked 2nd-century BC decree by the polis of the Orthieians, Thessaly

The National Archive of Monuments in Athens contains a dossier with documents regarding complications relating to road construction works in 1905 at the then-unknown archaeological site of Kedros in Western Thessaly. Among the documents is a paper copy of a fragmentary inscription of the 2nd century BC, reportedly found at the site. The preserved text of the inscription indicates that it was an honorific decree set up by the polis of the Orthieians to a benefactor from the nearby city of Gomphoi.

Evaluating the patient reported reasons, challenges and outcomes of oncology second opinion.

361 Background: Due to the disease complexity and life-threatening nature, many patients with cancer seek a second opinion (SO) pursuing the best help to navigate through their disease journey. In this study, we evaluated the reasons for seeking SO, challenges, and outcome. Methods: This is a cross section study using a 62-item questionnaire inquiring about patients’ demographics, reasons, challenges, comparison between primary specialists (PS) and SO specialists, and SO outcome. Patients with cancer diagnosis served at the collaborating institutions between January and November 2022 completed the survey either on paper copy or online via provided link to a SurveyMonkey form. Results: 425 surveys were sent, and 205 (48%) patients responded. Median age at diagnosis was 67 years (19-90), 80% were males, 93% were white and 36% had private insurance. A total of 137 (67%) sought a SO. The most frequent reason to seek SO was lack of confidence in treatment plan (52%). Recommendations of SO were different from PS recommendations in 48% of the cases. Predictors of seeking SO on a multivariate analysis (MVA) were diagnosis after 2015, having metastatic disease, and having private insurance. 54% of the those sought SO transferred care to other physicians, 43% to the ones who provided SO. The MVA of factors related to patient characteristics revealed that having genitourinary malignancies, metastatic disease, and private insurance were predictors of changing PS. Factors related to PS performance are depicted in Table 1. Conclusions: A high percentage of patients received SO changed their PS to the physicians who provided the SO. Empathy and confidence are essential to maintain the relation with physician. Social determinants of health such as insurance has significant impact on seeking SO and changing PS.[Table: see text]

Barriers to and facilitators of human papillomavirus vaccination in an ethnically diverse group of migrant parents: A qualitative mixed methods study

ABSTRACT A disparity in the uptake of the Human papillomavirus vaccine (HPVV) among immigrants and refugees leads to a social gradient in health. Recognizing that immigrants and refugees may encounter unique barriers to accessing prevention and care, this study seeks to determine barriers to and facilitators of HPVV among these subgroups to uncover high-resolution quality improvement targets of investment for under-immunized pockets of the population. The study undertook a qualitative inquiry into understanding immigrant and refugee parents’ perspectives on HPV infection and HPVV experience through school-based programs. We collected data first through short online surveys (N = 15) followed by one-on-one interviews (N = 15) and then through detailed online surveys (N = 16) followed by focus group discussions (N = 3) with 4–6 participants per group discussion from different groups: Black, South Asian and West Asian. Analysis of surveys and interviews identified that: information, awareness, and education about HPV infection and HPVV were among the most cited barriers that impede the uptake of HPVV. Moreover, vaccine-related logistics were equally important, including not having immunization information packages in different languages and relying solely on the child to bring home packages in paper copies from school-based vaccine programs. A multi-component intervention remains instrumental in enhancing HPV immunization rates, given the inconsistent uptake of HPVV by these subgroups who voice unique barriers and facilitators. An educational campaign that involves educating parents who consent for their child(ren) for HPVV, the children receiving the vaccination, and training staff providing HPVV through school-based immunization programs would be paramount.

Engaging Ambulatory Cancer Patients to Develop and Validate a Comprehensive New Patient-Reported Outcomes Measure

The ambulatory cancer program in Alberta, Canada routinely collects Patient-Reported Outcomes (PROs) using a common symptom rating measure, the Edmonton Symptom Assessment System-Revised (ESAS-r). The purpose of this study was to redesign, test, and validate a modified ESAS-r (the ESAS-r Cancer) for use in the province's new clinical information system and online patient portal. Patient advisors participated in regular meetings to redesign the measure, creating expanded definitions for the original symptoms and new symptoms, added based on trends identified in our historical PRO data. To test the modified measure, patient advisors first completed the measure online to test the feasibility of remote electronic completion. Next, the advisors participated in cognitive interviews to discuss and finalize the wording of each symptom definition for clarity. To test the validity and reliability of the finalized measure, 1600 randomly sampled patients were mailed paper copies of the ESAS-r Cancer, ESAS-r, and a validated PRO measure called the Memorial System Assessment Scale-Short Form (MSAS-SF), which is often used with cancer patients. Canonical Correlation Analysis and exploratory factor analyses were performed to assess concurrent and construct validity of the ESAS-r Cancer against ESAS-r, using MSAS-SF as the gold standard. Cronbach's α was calculated to assess reliability. The nine original ESAS-r symptoms were retained and six new symptoms were added to create the ESAS-r Cancer. All but one of the 26 patient advisors (96.2%) who completed the online measure did so without assistance. After two rounds of cognitive interviews all symptom definitions were finalized and deemed clear by almost all advisors. 461 patients (29% response rate) completed all three questionnaires. Using MSAS-SF as the gold standard, ESAS-r Cancer showed stronger canonical correlation than ESAS-r, indicating higher concurrent validity and fitting degree. ESAS-r Cancer also accounted for more information included on MSAS-SF than did ESAS-r, explaining more variance (75.2% vs. 73.5%). As revealed by factor analysis, the three-dimensional factor structure of ESAS-r Cancer outperformed the two-dimensional factor structure of ESAS-r, by allowing for new constructs within measurement. The reliability of ESAS-r Cancer was verified (Cronbach's α = .903, > threshold of 0.8) and slightly higher than ESAS-r (Cronbach's α = .884). ESAS-r Cancer is now in use with patients throughout Alberta's cancer program. The redesign, testing, and validation process involved patient engagement throughout. Patient testing and perspectives were critical as ESAS-r Cancer is intended for use with ambulatory cancer patients. ESAS-r Cancer can help ensure patients are included in care decisions and that their perspectives are involved in guiding care.

Editorial

Since 1991, preprints have increasingly been distributed over the Internet, as opposed to paper copies. Preprints date back to at least the early 1960s, when the National Institutes of Health (NIH) in the United States began circulating preprints in the biological sciences. After six years, journals stopped accepting submissions shared via these channels. Then, in 2017, the Medical Research Council and the Wellcome Trust began accepting citations of preprints in grant and fellowship applications [1], [2].