Detailed Questions Research Articles

Abstract 004: Summary of MT2020+ Research Internship Progress from 2021 to 2023

Introduction Mission Thrombectomy, established in 2016 by the Society of Vascular and Interventional Neurology, aims to enhance global accessibility to mechanical thrombectomy surgery for strokes caused by large vessel occlusion in the brain. High school students interested in exposure to global health have limited access to get exposure in this rapidly expanding area of public health. The MT2020+ student internship was designed in collaboration with MT2020+ to provide such an experience to US High School students. Students designed and carried out projects to raise stroke awareness among other high school students and communities while studying the barriers to stroke treatment. We report on this novel internship program's methodology, results, and outcomes. Methods The MT2020+ internship program followed a comprehensive framework. Three phases were implemented: Phase A involved secondary research, stakeholder identification, and the formation of a detailed survey and interview questions. Stakeholders included neurologists, neuro‐interventionalists, neuro‐radiologists, and members of stroke societies. Countries in the region of interest were categorized into three groups based on stroke and COVID‐19 data. A survey template was created in Phase B, and stakeholders were contacted for data collection. Interviews were conducted to delve deeper into survey responses. Phase C focused on analyzing the collected data, articulating the key barriers, and generating a written report. Interns also developed interventions to address key barriers identified during the research. Results The first cohort (2020) comprised 8 interns who investigated barriers to stroke treatment across different regions. The interns received survey responses and conducted interviews with stakeholders. Their research covered the U.S. & North America, Latin America, Europe, Africa, Asia, and Australia. The outcomes varied, with different levels of engagement. One student developed an app in Peru to address transportation, educational, and rehabilitation barriers. The second cohort (2021) had 2 interns who focused on Latin America and Asia, working on rehabilitation apps. The third cohort (2022) included 4 interns studying Asia, Australia/New Zealand, North America/US, and Latin America. Their interventions ranged from creating stroke awareness clubs to organizing virtual conferences. Conclusion The MT2020+ student internship provided a novel opportunity for high school students to get exposure to global health implementation. The student research in this internship has contributed valuable insights into stroke treatment barriers and raised awareness among high school students worldwide.

Capturing the patient’s voice to inform advanced clinical decision support for guideline-based cancer symptom management.

510 Background: Electronic patient reported outcomes (ePROs) have become routine in cancer care; however, ePROs alone do not provide sufficient information to enable informed symptom management. Informed symptom management requires an awareness of patient context to reduce inappropriate or erroneous advice. In this project we asked: how can information be collected directly from patients to provide clinicians with detailed, contextually-informed, patient-specific, evidence-based recommendations to manage distressing symptoms, especially among patients with complex comorbidities. Methods: The literature states that text messages are the most effective way to engage patients in clinical data collection. We texted patients a link that led them to a Web-based questionnaire that asked them about their common cancer symptoms. Prototypes were tested with 9 cancer patients through structured interviews and think aloud sessions from which themes were identified. Feedback from these interviews was used to develop a patient data collection questionnaire that we iteratively refined through think aloud sessions with 9 cancer patients to achieve universal patient acceptance. We also engaged 28 oncology clinicians in semi-structured interviews to assess the clinical impact of the additional contextual information on the symptom recommendations they received. Results: Formative evaluation identified four themes: 1) make instructions brief, 2) use intuitive navigation buttons with labels, 3) focus on multiple-choice style questions, and 4) extract data from the medical record for patient verification instead of free text entry by patients (e.g., medications). Developers incorporated “more detailed” questions into the patient data collection questionnaire; additional questions were presented if the patient indicated moderate or greater severity of a given symptom. These detailed questions focused on characteristics of the symptoms (e.g. neuropathic or somatic pain), remedies a patient had already initiated for self treatment (e.g., laxatives for constipation), and comorbid conditions that could impact the safety of recommendations (e.g., fall risk). Clinicians indicated that the additional data collected from patients increased the value of the tailored recommendations for enhanced symptom management. Conclusions: Additional data collection from patients using standard text messaging enables clinical decision support algorithms to provide more individually tailored cancer symptom management recommendations. This study is limited in that the design enhancements have been tested with a small number of end-users in a laboratory setting. Acknowledgements: This project was 100% funded using Cancer Moonshot funding through Phase I and II SBIR contracts from the National Cancer Institute, Contract #75N91018C00022 and #75N91020C00019, respectively.

Sustainable international business model innovations for a globalizing circular economy: a review and synthesis, integrative framework, and opportunities for future research

AbstractThe global imperative has increased in recent years for international firms to respond to major threats such as unintended environmental, social, and economic problems arising from ecological destruction, population growth, and economic activity. To respond to this confluence that has created an emerging existential crisis, we identify that a globalizing circular economy (CE) is required and subsequently define a new construct: sustainable international business model innovations. In doing so, we introduce circular inputs, sharing platforms, product as a service, product use extension, and resource recovery as business models that contain the potential to reply to these grand challenges. Based on CE principles, the innovations and designs introduced are contrasted with the traditional linear economic model and are presented as actionable standardization/adaptation alternatives for companies responding to differing informal and formal international institutions. Based on the theoretical underpinnings of the resource-based, dynamic capabilities, and international business model innovation perspectives, we introduce an integrative framework that is accompanied by a series of detailed research questions to provide future research opportunities for the domain. This conceptual approach holds that international resource design influences marketing capabilities adaptation which, in turn, impacts international performance and offers a foundation from which to build the literature.

Akut Üst Gastrointestinal Kanama İle Başvuran Hastaların Endoskopi Yapılma Zamanının Hastaların Mortalitesine Etkileri

Background: Endoscopy is recommended in acute upper gastrointestinal bleeding (AUGIB) to detect the bleeding source and stop the bleeding. The optimal timing of endoscopy in AUGIB is controversial. We aimed to investigate the time of endoscopy and the factors affecting it.
 Materials and methods: Retrospective, single-center study. The patients were divided into four groups: endoscopy after discharge, 0-12 hours endoscopy, 12-24 hours endoscopy and 24 hours later. Age, sex, vital signs, laboratory findings were recorded. Glasgow-Blatchford Score (GBS) and Charlson comorbidity index (CCI) were calculated. The obtained data were compared between these four groups. All-cause mortality for 30 days was recorded.
 Results: A total of 318 patients were included. In the comparison of endoscopy times, the parameters found to be statistically significant between the four groups are Hb, BUN, and INR levels, GBS and CCI. As a result of CHAID analysis, the most crucial variable affecting the timing of endoscopy was found to be the Hb value of the patients (χ2=66.528; adjusted p=0.000). Mortality occurred in 10.69% of the patients. The timing of endoscopy did not affect mortality. In binary logistic regression analysis, low systolic BP (0.967 times increase), high CCI (86,402 times increase) were found to affect mortality.
 Conclusion: The factors affecting the timing of endoscopy are the signs of bleeding. A thorough follow-up of vital signs in patients presenting to the emergency department with acute gastrointestinal bleeding, particularly an evaluation of systolic blood pressure and detailed questioning of additional comorbid conditions, is critical to reduce mortality.

Feasibility and acceptability of a timeline follow-back method to assess opioid use, non-fatal overdose, and substance use disorder treatment

BackgroundNon-fatal overdoses are underreported and there is no accepted and feasible self-report research measure of non-fatal opioid overdose. Timeline follow-back (TLFB) calendar-based questionnaires assess self-reported risk behaviors. We assessed feasibility and acceptability of a new TLFB research measure for opioid use, non-fatal opioid overdose, and substance use disorder treatment among opioid overdose survivors. MethodsFor the Repeated-dose Behavioral Intervention to Reduce Opioid Overdose Trial (REBOOT) study among opioid overdose survivors, we developed a TLFB questionnaire to assess daily non-prescribed opioid use, opioid overdose, facility stays, medications/behavioral treatment for opioid use disorder, and COVID-19 history during the previous 120 days. Staff assessors administered TLFB at four-monthly visits over the 16-month study participation period. To measure feasibility, we estimated TLFB completion time using an electronic timestamp tool. To measure acceptability, we administered a satisfaction survey to 103 participants who completed REBOOT. ResultsAmong 525 TLFB assessments conducted in 174 participants from January 2021-January 2023, opioid use was reported in 510 assessments, medication for opioid use disorder (MOUD) in 331 assessments, and ≥ 1 overdose in 107 assessments. Median TLFB completion time was 11 (IQR: 6–17) minutes for sections administered to all participants; detailed overdose questions administered to those reporting overdose took an additional 3 (IQR: 2–6) minutes. Report of ≥ 1 overdose and MOUD use were significantly associated with increased TLFB completion time. 88 % of participants reported that TLFB was very/somewhat acceptable. ConclusionsAmong opioid overdose survivors, REBOOT TLFB was a feasible and acceptable research measure, with similar completion time as other TLFB assessments of substance use.

Assessing Circularity in the Wood Industry—Methodology, Tool and Results

The article presents a complete approach for the wood industry for assessing the state of circular economy adoption by companies. A methodology for achieving this purpose is proposed and then implemented with the help of a specific questionnaire. The study is based on a literature survey with two components, one relating to reports on the concept of circularity and one relating to the methodological aspects of determining and measuring the progress of companies. Starting from these aspects and factoring in the sectoral evolution in Romania, the assessment directions and detailed questions for each are established essentially through a mind-mapping process. For validation, the questionnaire with seven evaluation viewpoints covered in 28 items is applied within the Romanian wood industry to 60 companies. The analysis of results is carried out using descriptive and inferential statical methods, such as ANOVA, showing good progress of the industry at company level, through individual efforts as well as the need to continue the transformation of the sector from the point of view of regulatory oversight and market acceptance. A set of recommendations for companies to advance their situation is proposed to help the maturation of the current circular approaches.

Performing a vibrotactile discrimination task modulates finger representations in primary somatosensory cortex.

It is well established that vibrotactile stimuli are represented in somatotopic maps. However, less is known about whether these somatotopic representations are modulated by task demands and maybe even in the absence of tactile input. Here, we used a vibrotactile discrimination task as a tool to investigate these questions in further detail. Participants were required to actively perceive and process tactile stimuli in comparison to a no-task control condition where identical stimuli were passively perceived (no-memory condition). Importantly, both vibrotactile stimuli were either applied to the right index or little finger, allowing us to investigate whether cognitive task demands shape finger representations in primary somatosensory cortex (S1). Using multivoxel pattern analysis and representational similarity analysis, we found that S1 finger representations were more distinct during the memory than the no-memory condition. Interestingly, this effect was not only observed while tactile stimuli were presented but also during the delay period (i.e., in the absence of tactile stimulation). Our findings imply that when individuals are required to focus on tactile stimuli, retain them in their memory, and engage in active processing of distinctive stimulus features, this exerts a modulatory effect on the finger representations present in S1.NEW & NOTEWORTHY Using multivoxel pattern analysis, we found that discrimination task demands shape finger representations in the contralateral primary somatosensory cortex (S1), and that somatotopic representations are modulated by task demands not only during tactile stimulation but also to a certain extent in the absence of tactile input.

The Development, Validity, and Responsiveness of a Patient-Centred Outcome Measurement Tool for Evaluating Integrative Medicine Interventions.

The paper sets out the development, validity, and responsiveness of the Integrative Medicine Treatment Evaluation Form (IMTEF), which has been designed to measure the effects of complementary and integrative therapy (CIT) interventions in cancer and palliative care (PC) patients in a National Health Service (NHS) hospital setting. Treatment evaluation is essential for ensuring safety and quality of services, for meeting NHS governance requirements. It also helps to add to the evidence base for complementary and integrative therapies through collecting data about treatments. A number of different Patient Reported Outcome Measures (PROMs) tools were reviewed in order to design the IMTEF, which details questions that captures both quantitative and qualitative data. The IMTEF was reviewed by patients and a range of health care practitioners. IMTEF's validity is supported by feedback from health care practitioners and patients, by its ability to detect different degrees of change in relation to change scores, and by its correlations with Visual Analog Scale (VAS) scores. The IMTEF can be used to assess the effects of therapeutic bodywork and CITs when many of the patients do not have the capacity or the time to answer many questions, and when therapists do not know in advance the number of treatments that patients will be able to receive. Because of the way it is structured, it can also assess the effects after a number of sessions.

A Case of Long COVID-19 Myocarditis with Asymptomatic Manifestation in a Young Male

Background. Myocarditis is one of the most dangerous complications of both the acute phase of COVID-19 and long COVID-19, with a rather heterogeneous clinical presentation that ranges from asymptomatic to life-threatening. The diverse clinical presentation with a high risk of further complications, on the one hand, and a good prognosis in case of appropriate treatment, on the other hand, demand great attention from doctors.
 Case Report. We report a case of a 27-year-old male presented to a cardiologist with complaints of dyspnea, chest pain, palpitation occurred eight months after a mild COVID-19 episode. The diagnostic search commenced with a detailed questioning and physical examination with further laboratory testing and instrumental procedures, including resting electrocardiography, resting two-dimensional speckle-tracking echocardiography, and stress echocardiography. Gadolinium-enhanced cardiac magnetic resonance was the final step in diagnosis establishment. Half-a-year follow-up period of the patient with asymptomatic manifestation of COVID-19 myocarditis demonstrated the normalization of the condition after prescribed pathogenetic treatment.
 Conclusions. This case report raises awareness of the need for prolonged follow-up of patients after an episode of COVID-19 and proposes a comprehensive approach to a possible differential diagnostic search for precise diagnosis and treatment in a young male with rationale based on the relevant literature.

Long-term memory for movie details: selective decay for verbal information at one week

ABSTRACT Mnemonic representations of complex events are multidimensional, incorporating information about objects and characters, their interactions and their spatial–temporal context. The present study investigated the degree to which detailed verbal information (i.e., dialogues), as well as semantic and spatiotemporal (i.e., “what”, “where”, and “when”) elements of episodic memories for movies, are forgotten over the course of a week. Moreover, we tested whether the amount of dimension-specific forgetting differed as a function of the participant's age. In a mixed design, younger and middle-aged participants were asked to watch a ∼90 min movie and provide yes/no answers to detailed questions about different dimensions of the presented material after 1, 3 days, and 1 week. The results indicate that memory decay mainly affects the verbal dimension, both in terms of response accuracy and confidence. Instead, detailed information about objects/characters’ features and spatiotemporal context seems to be relatively preserved, despite a general decrease in response confidence. Furthermore, younger adults were in general more accurate and confident than middle-aged participants, although, again, the verbal dimension exhibited a significant age-related difference. We propose that this selective forgetting depends on the progressive advantage of visual compared to auditory/verbal information in memory for complex events.

Global indicators framework for socially responsible research and innovation (RRI): Aligning standards to monitor public and researcher perspectives with the UNESCO Recommendation on Science and Scientific Researchers.

As calls for more socially responsible research and innovation (RRI) policies and practices grow more insistent, the need for high-quality indicators that can be used to evaluate progress is becoming increasingly important. Given the global nature of science, such indicators need to be relevant to countries across all world regions. Moreover, the methodological quality of indicators is critical to provide a strong foundation for long-term comparative measurement of the impacts of different kinds of policy intervention. There is a practical challenge here, given the uneven mechanisms for data collection and analysis available in different countries. There is also a geopolitical challenge in gaining buy-in from countries with very different, and sometimes competing, agendas. Here, the 2017 UNESCO-led Recommendation on Science and Scientific Researchers is highlighted as an existing vehicle that can enable cooperation on globally comparative measurement of socially responsible research and innovation. In particular, the quadrennial monitoring of the implementation of this wide-ranging global policy instrument that has been ratified by 195 countries affords a unique opportunity to add value for these countries by linking RRI to the 2017 Recommendation while establishing benchmark indicators for RRI more generally. As a practical and methodological contribution to the global community of science and innovation policymakers, researchers and research and innovation stakeholders committed to socially responsible research, this report contains detailed survey questions and response options focusing on public opinion and individual researchers' level of measurement. It provides details of sources of benchmark survey data that have readily available open data that can be used to benchmark the development of socially responsible research and innovation over time from the vantage points of the public and researchers around the world. The aim of this kind of science ecosystem-level indicators framework is to enable evidence-based practice in socially responsible research and innovation.

Existential psychological therapies: An overview of empirical research

BackgroundExistential therapies are a range of psychotherapies inspired by existential and phenomenological philosophers. Although relatively little empirical research was conducted on their therapeutic model and outcomes in the early days, a substantial body of research has evolved. AimThis article aims to give an overview of the empirical literature on existential therapies. This article will be divided into four parts: empirical research on existential practices, key concepts, critical therapeutic competences, and outcomes of existential therapies. MethodThis article will review findings from previous systematic literature reviews and meta-analyses. FindingsThe etiological model in many existential therapies seems to focus on how individuals may limit the totality of their subjective experiences. Ignoring or denying a part of the totality of their experiences limits their opportunities to live a meaningful, fulfilling and mentally healthy life and cope in beneficial ways with life's inevitable limitations and challenges. Their clinical concerns may include existential moods, detailed questions, or crises about life, meaning, identity or spirituality. Existential therapists may help via several evidence-based competencies: phenomenological and experiential skills, relational skills, explicating existential themes and processes, school-specific and meta-competences. Meta-analyses show that some existential therapies (particularly meaning-centred therapies) have large positive effects on psychological and physical well-being and overall quality-of-life. DiscussionA large body of empirical literature supports the key therapeutic existential concepts, competences, and outcomes. The discussion compares this literature with other therapies, showing that existential therapies have similarly strong empirical support. These findings indicate that existential therapies are bona fide therapies that may be considered for funding by health insurance and health services. Therapists and training institutes should focus on these evidence-based existential components.

The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

The impact of the Covid‐19 pandemic on the environmental sustainability strategies of listed firms in Sweden

AbstractHow macroeconomic crises affect firms' environmental sustainability strategies is an open question. We study the impact of the Covid‐19 pandemic on the environmental sustainability strategies of firms listed on the OMXNasdaq stock exchange in Sweden. The analysis is based on a survey distributed twice, once during the summer of 2020 and once during the summer of 2021 with detailed questions related to the firms' environmental strategies. We find that most firms view the pandemic as an opportunity to strengthen their environmental strategies. However, we also find that the economic downturn caused most firms to redirect scarce resources away from environmental sustainability. We also find that firms which had adopted the Taskforce on Climate‐Related Financial Disclosures were less likely to divert resources. These short‐term results indicate that the pandemic will not enhance firms' environmental sustainability practices in the future.

Transformer-Based Multi-Hop Question Generation (Student Abstract)

Question generation is the parallel task of question answering, where given an input context and, optionally, an answer, the goal is to generate a relevant and fluent natural language question. Although recent works on question generation have experienced success by utilizing sequence-to-sequence models, there is a need for question generation models to handle increasingly complex input contexts to produce increasingly detailed questions. Multi-hop question generation is a more challenging task that aims to generate questions by connecting multiple facts from multiple input contexts. In this work, we apply a transformer model to the task of multi-hop question generation without utilizing any sentence-level supporting fact information. We utilize concepts that have proven effective in single-hop question generation, including a copy mechanism and placeholder tokens. We evaluate our model’s performance on the HotpotQA dataset using automated evaluation metrics, including BLEU, ROUGE and METEOR and show an improvement over the previous work.

P-461 Patients need fertility specialists to improve communication depth, quality and frequency in order to promote transparency, understanding and empathy with the patient

Abstract Study question What are the key pain-points that patients experience during fertility treatments? Based on patient perception, how can fertility clinics improve their standard of care? Summary answer Most patients would like to receive regular updates and more detailed explanation from their doctor, yet this happened in only half of the cases. What is known already IVF treatments have an emotional, psychological and economical toll on patients. On previous studies, half the women reported that infertility is the most upsetting experience of their lives, approximately 20% of the males and females had dysfunctional emotional distress or personal difficulties. Patient’s needs, pain points, expectations and education, therefore, require further research. Study design, size, duration An electronic survey was dispensed via the Embie mobile application or e-mail to women registered to Embie who have given their consent for communication. 98 women completed the survey from December 26th 2022 to January 15th 2023. The respondent profile was: White, Well-educated, from USA, 70% aged 31-40, 44% aged 31-35, heterosexual, tech oriented (100% Embie users), no kids, middle and upper middle class. Participants/materials, setting, methods The survey contained questions on demographics, IVF history, understanding of how patients choose their fertility clinic, how they educate themselves on their treatment options, how they communicate with their healthcare providers, awareness of AI, how they fund their treatment, their expectations for the clinic's equipment, usage of new advanced technologies and level of involvement in their fertility care. Main results and the role of chance Pricing is a pain-point for IVF patients, yet it does not affect their clinic choice, which is primarily linked to clinic location and doctor reputation. Most patients are willing to pay for modern technology. 58% of respondents state that the doctor discusses with them their chances of having a successful pregnancy, yet only 16% of women confidently know their chances of taking home a healthy baby. &amp;gt;90% of patients state that they would like to receive regular updates and detailed explanation from their doctor, yet this happened in only half of the cases. “Transparency of the process and decision making” is the most important tool for patients to empower themselves, followed by “answering my questions in detail”. While 60% feel comfortable approaching the doctor with questions, 40% state they search for an answer prior to asking the doctor. Almost all patients expand their knowledge before and after discussions with the doctors by Internet and by approaching experienced peers. Patients expect high-tech in clinics and are ready to pay for that. 92% of patients describe at least 1 pain point with their clinic: primarily communication: inconsistent communication (39%), lack of transparency (17%), lack of understanding (12%) and lack of empathy (4%). Limitations, reasons for caution The respondents mostly came from the USA and represented a non-diverse group. These findings may not generalize to other geographies or socio-economic groups. Wider implications of the findings The more the healthcare provider shares and involves the patient, the better the education they receive, and the less likely they will seek alternative information elsewhere which may be less medically accurate. Healthcare providers must educate themselves on the latest innovative technologies to meet patient expectations. Trial registration number n/a

Perceived risk of HIV transmission by blood transfusion among gay, bisexual, and other men who have sex with men (gbMSM) in Australia.

In Australia, men who have sex with men (MSM) are deferred from blood donation for 3 months from last sexual contact. Internationally, deferral policies for MSM are evolving in the direction of expanded inclusivity in response to community expectations. To inform future policy options, we assessed perceptions of the risk of HIV transmission from blood transfusion among Australian MSM. Flux is an online prospective cohort of Australian gay and bisexual men (cis or trans, regardless of their sexual history) and other men who have had sex with men (gbMSM). We included questions on blood donation rules, window period (WP) duration, infectivity of blood from people with HIV on treatment and attitudes to more detailed questioning of sexual practices in the regular survey of Flux participants and conducted a descriptive analysis of responses. Of 716 Flux participants in 2019, 703 responded to the blood donation questions. The mean age was 43.7 years (SD 13.6 years). Overall, 74% were willing to confidentially respond to specific sexual behavior questions, such as the last time they had sex and the type of sex they had, in order to be considered eligible to donate blood. The majority (92%) of participants correctly assessed the duration of the WP as less than 1 month. When asked whether transfusion of blood from a donor with HIV and an undetectable viral load could transmit HIV, just under half (48%) correctly said yes. Our study suggests Australian gbMSM are generally comfortable with answering more detailed questions regarding sexual activity during the assessment to donate, indicating they would do so honestly. gbMSM are knowledgeable about the WP duration, important for their ability to correctly self-assess their HIV risk. However, half of participants incorrectly assessed the transmissibility by blood transfusion from an HIV positive person with an undetectable viral load, suggesting the need for a targeted education campaign.

HEART FAILURE PATIENT AND MEDICAL WORKERS, INTERACTION POST DISCHARGE: SINGLE CENTER STUDY

Objective: It is well known that the period after discharge from the hospital is very important for a patient with heart failure. For to achieve the desired result, improve the quality of life, reduce the number of repeated hospitalizations, increase life expectancy, it is necessary to coordinate all parts of the healthcare system. The purpose of the study: to find out the level of involvement of medical workers of various parts of the health care system in the treatment of patients with heart failure. Design and method: 91 patient, 61male, 30 women,mean age 59, years, 31-84, mean hospitalization rate mean 4 times, 1-10+, represented, 33,7%, sample of 271 patients with heart failure hospitalized at Research Institute of Cardiology, Baku, Azerbaijan in 11 june-18 august 2022 represented study population. Patient-hospital-ambulatory interaction related questionnaire,15questions, table 1, and Voils patient adherence to medications questionnaire, 3main+18 detailed question, were used. Results: 74,7% noticed that after discharge they being in touch with hospital cardiologist,73,4% being in touch no later than 1 time in a 3 month,mainly once a month, 54% of patients recognized hospital cardiologist as –my doctor,44% offered to the hospital cardiologist during post-discharge period this percentage increase to 52%patients when their condition worsens. Only 23% of patients offered to polyclinic in the period after discharge, drive by patients with heart failure and Type 2 Diabetes. 12% of patients noticed that they offer to the hospital cardiologist and polyclinic doctor.73% noticed that have no contacts with polyclinic medical workers, neither cardiologist or general practice. 79% of patients noticed high adherence to medication. Cardiologists weak adherence related to the list and dosages of medications recommended in modern guidelines has been observed. table 2. Conclusions: It is necessary to organize optimal medical care for the heart failure patients and to work measures for effective interaction of all chains of medical system.

‘We need to use the entire toolbox’ storytelling in the unarmed Norwegian police

ABSTRACT Norway is one of the few European countries in which the police, in the course of their normal duties, are unarmed. Based on a risk assessment, Norwegian police were permanently armed from 25th November 2014 and 3rd February 2016. This was the longest period during which the police in Norway had been routinely armed, and an evaluation of their experience was required, the aim being to collect police officers’ own experiences from this period. The police interviewees (n = 30) answered specific and detailed questions. Surprisingly, they answered more than the questions asked of them, they told stories before, during and after the interviews which highlighted uncertainty in the service indicating the need to be armed. The evaluation found that these stories were repeated in every police district used in the data collection. They described observable phenomena; they meant something central to those who were interviewed. The question was: What were the stories about? Which challenges did these stories point to? What forms of justification for the arming of the police do we find in them? In the article we see storytelling through a (cultural) sociological approach as attempts at justification and legitimation

Blood and Body Fluid Exposure Among Healthcare Workers and Personal Protective Equipment Usage in the United States.

The International Safety Center disseminates the Exposure Prevention Information Network (EPINet) surveillance system to standardize a system for healthcare facilities to track mucocutaneous blood and body fluid exposures. Occupational exposure incidents to blood and body fluids were recorded within the participant health systems and hospitals (N = 41), using the EPINet Blood and Body Fluid Exposure Report Form. Forms include detailed questions about the circumstances surrounding the exposure, including the type of exposure, body part(s) involved, and if the employee reporting the incident was wearing personal protective equipment (PPE). There were statistically significant differences between participants who wore PPE at time of exposure versus those who did not. Differences were noted by job category (χ2 =32.91, p-value = <.001); where the exposure occurred (χ2 = 32.31, p-value = <.001); what the exposure was a result of (χ2 = 50.19, p-value = <.001); and day versus night shift (χ2 = 11.47, p-value = .001). The study found that occupational exposure to blood and body fluids in 2021 remain high risk given the frequency with which they happen, the exposure site (face) and lack of PPE use. The pandemic seemed to matter little in changing frequencies despite high awareness and growing PPE availability and supply. The findings provide robust information about how exposures occur, why they remain high risk, and how important it is to improve reporting and surveillance to prevent occupational exposures and disease in healthcare in future.