Email Blasts Research Articles

62 Transitioning the Alabama Bermudagrass Hay Summit to a Virtual Workshop

Abstract The Bermudagrass Hay Summit is an in-state Extension workshop that began in 2017. The objective of this workshop has been to provide recent updates and advanced information to bermudagrass hay producers in Northern Alabama. Topics have included insect pests, weed control, soil nutrients, and hay storage techniques. In 2021, organizers of the meeting were left with the conundrum of canceling the event or converting the event into a virtual-only platform as current Alabama Cooperative Extension guidelines would not allow an in-person meeting. As a result of deciding to convert the meeting to a virtual format, the organizers broaden the promotion of the event. The meeting was a 6-hour workshop with multiple speakers. The videoconferencing software Zoom (Zoom Video Communications, Inc., San Jose, CA) was used to register and deliver the workshop. The workshop was advertised on social media, through an Extension communications press release, email blasts, and word of mouth. All presentations were delivered remotely from different locations across Alabama. To ensure technology problems could be resolved quickly, an Extension information technology specialist participated in the videoconference, as well as a graduate student to communicate any chat questions/discussions from participants and assist individual participants as necessary. There were 129 people registered for the meeting, a 1,075% increase over the average from the four previous years (12 participants). Of those registered, 26% were out of state and 1 participant was out of the US. Even though the platform was virtual, the overall satisfaction of the meeting did not change in 2021 (4.7 on a 5-point scale) compared with 2020 (4.8 on a 5-point scale). While it is important to continue in-person and one-on-one interactions in Extension, the ability to provide virtual or hybrid events will allow Extension agents to be relevant to a broader audience, as well as inform potential clients of Extension’s mission.

The Empirical Change of Playing Habits among Children

To maximize the growth and manage psychological distress as well as the formation of good character, children need to develop a variety of skills such as cognitive, language, self-regulation, and social-emotional skills which often appended in different outdoor traditional games. Thus, the degree of playing traditional games by the children nowadays compared with the previous generation is discussed in this study. 38 parents regardless of their status and gender were surveyed on their active participation in the traditional games as children, as well as their children’s play involvement today who are 1-12 years old. Data were collected through the created Google form link and sent via Messenger and email blasts to parents. Findings reveal that (1) significant number of children nowadays tend to play video games instead of playing traditional games; (2) safety is the utmost concern of the parents which hinder children to play some of the traditional outdoor games; and (3) the availability of mobile phones with uploaded game apps has contributed to the ignorance of traditional game playing culture.

How Candidates Influence Each Other in Electoral Politics: Intercandidate Agenda-Building in Florida’s 2018 Midterm Election

This study investigates how the electoral campaigns in Florida’s 2018 gubernatorial and Senate races used information subsidies to influence each other’s integrated marketing communications. Informed by agenda-building theory, the study probes which campaign and which party had the strongest transfer of issue and stakeholder salience (first-level) and sentiment (second-level) in campaign communications across the two races. Data include issue statements, press releases, tweets, and email blasts. Results of a lexicon-based automated content analysis show evidence for both unidirectional and bi-directional agenda-building influence of stakeholder salience. Further, data suggest the gubernatorial campaigns (DeSantis and Gillum) engaged in subtly more positive, self-promotion-based marketing than their counterparts in the Senate race (Scott and Nelson). Findings contribute theoretical and practical applications to political communication in election campaigning.

Physical Therapists and Physical Therapist Assistants' Knowledge and Use of the STEADI for Falls Risk Screening of Older Adults in Physical Therapy Practice in the United States.

Fall-risk screening and prevention is within the scope of physical-therapy practice. Prior research indicates United States-based physical therapists (PTs) and physical-therapist assistants (PTAs) use the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) toolkit for community-based fall-risk screenings of older adults. However, clinically based fall-risk screenings and knowledge and use of the STEADI by PTs and PTAs is unknown. We conducted a cross-sectional survey distributed to a convenience sample of PTs and PTAs in the United States through email blasts and social media. PTs and PTAs (N = 425) who responded to the survey and worked in clinical settings with older adults were included. Eighty-nine percent of respondents reported conducting clinical fall-risk screening. Approximately 51% were ‘familiar’ to ‘very familiar’ with the STEADI, and 21.7% of the overall sample were not familiar at all. Only 26.1% utilize the STEADI for clinical fall-risk screening. Of the respondents who were ‘very familiar’ with the STEADI (n = 132, 31.1%), 84.1% (n = 111) reported using the STEADI in clinical practice. Seventy-six percent of respondents who use the STEADI implemented it by choice even though the majority (52.1%, n = 63) did not have it embedded in their documentation/workflow. Some PTs/PTAs can and do manage falls using the STEADI, but there is a gap in knowledge and use of the STEADI for falls management among PTs and PTAs in the United States. Further research is needed to identify the tools PTs use for multifactorial-fall screening and management and the impact of PTs’ use of the STEADI on patient outcomes.

Bridging the Patient Engagement Gap in Research and Quality Improvement Utilizing the Henry Ford Flexible Engagement Model.

This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings. Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants consistently engaged included monthly email blasts, an annual patient advisor retreat, and inviting patient advisors to attend/present at local and national conferences. As of January 2020, the program had 419 patient advisors. Almost 50% self-reported as Caucasian and 31% as African American; 73% were women, and most were 45-74 years of age. Recruitment methods proved effective, as 85% of advisors were initially engaged through print and digital marketing. Mean advisor orientation workshop evaluation scores regarding content, facilitators, and logistics were high, with all 4.5 or higher on a Likert scale of 1 (strongly negative) to 5 (strongly positive). Given the FEM's flexible nature and adaptability, PERC has been successful in effectively leveraging the patient voice and experiences in research and health care delivery. Further research could investigate the model's generalizability, return on investment, and how to formally embed its methodology institutionally.

387. Predictors of Seropositivity to SARS-CoV-2 Among Workforce Members at a Large Urban Medical Center

BackgroundPrior to SARS-CoV-2 vaccination availability, medical centers workers were at significant COVID-19 (COVID) infection risk. As part of a program offering free SARS-CoV-2 serology tests to medical center employees, we examined risk factors for prior COVID infection.MethodsFrom Sept. to Dec. 2020, we advertised free IgG antibody testing to all Los Angeles County-Univ. of Southern California Medical Center (LAC+USC) workforce members (clinical and non-clinical) via repeated email blasts. Antibody was determined using the Abbott SARS-Cov-2 IgG test against SARS-CoV-2 nucleocapsid protein. Program participants were asked to fill out a detailed epidemiologic questionnaire about work and non-work COVID risks on their cell phone or on paper at the time of phlebotomy. All testing was done prior to COVID vaccine availability.ResultsAmong approximately 10,500 workforce members, 1327 had serologies done. Among those 1273 (96%) completed the questionnaire and were included in the analysis. SARS-CoV-2 IgG antibodies were found in 60 (4.7%). In bivariate analysis, we found associations between SARS-CoV-2 seropositivity and persons who previously tested positive for COVID (OR 175.8 [95% CI 77.6 – 398.6]), persons who thought they had prior COVID but tested negative (OR 3.9 [95% CI 1.3 – 11.4]), and persons who thought they had prior COVID but did not get a COVID test (OR 4.2 [95% CI 1.4 – 12.5]). In a multivariate model of SARS-CoV-2 seropositivity examining work- and non-work-related COVID exposures (Table), seropositivity was associated with work-related COVID exposure without adequate personal protective equipment (PPE) (OR 5.1 [95% CI 2.1 – 12.2]), work-related COVID exposure with adequate PPE (OR 3.5 [95% CI 1.5 – 8.0]), never wearing a mask outside of work (OR 7.1 [95% CI 1.3 – 38.4]), and Native Hawaiian/Pacific Islander race (OR 6.6 [95% CI 1.7 – 23.4]). Seropositivity was inversely associated with living at home with multiple age groups (OR 0.4 [95% CI 0.2 – 0.8]). Multivariate Model of Exposures Associated with Positive COVID Serology Among LAC+USC Workforce Members ConclusionAmong workers in a large urban medical center prior to COVID vaccine availability, SARS-CoV-2 seropositivity was associated with work-related COVID exposures and low mask use outside of work, suggesting that COVID transmission in workforce members occurs both via occupational and non-occupational routes.Disclosures Loren G. Miller, MD, MPH, Medline (Grant/Research Support, Other Financial or Material Support, Contributed product)Stryker (Other Financial or Material Support, Contributed product)Xttrium (Other Financial or Material Support, Contributed product)

Adoption of an Evidence-Based Intervention for Mammography Screening Adherence in Safety Net Clinics.

Through an academic-community partnership, an evidence-based intervention to reduce mammography appointment no-show rates in underserved women was expanded to safety net clinics. The partnership implemented four strategies to improve the adoption and scale-up of evidence-based interventions with Federally Qualified Health Centers and charity care clinics: (1) an outreach email blast targeting the community partner member clinics to increase program awareness, (2) an adoption video encouraging enrollment in the program, (3) an outreach webinar educating the community partner member clinics about the program, encouraging enrollment and outlining adoption steps, and (4) an adoption survey adapted from Consolidated Framework for Implementation Research constructs from the Cancer Prevention and Control Research Network for cancer control interventions with Federally Qualified Health Centers. The development of academic-community partnerships can lead to successful adoption of evidence-based interventions particularly in safety net clinics.

116 How to create a regional simulation course for teaching vaginal hysterectomy and mid urethral sling

The objective is to create a guide for faculty on how to create a regional hands-on simulation workshop for vaginal hysterectomy and mid urethral slings, with target audience of residents and early-stage practitioners. Guide: 8 months ahead: Choose date, location, and simulation model. Information on both low and high-fidelity trainers will be presented. Elicit your institution's CME office to solicit industry support. Request educational grants, exhibitors, and donation of slings and suture. Apply for CME credits from AMA, ACOG, and ABOG. Six months ahead: Reach out to program directors in your region explaining the course and inviting their residents and faculty to participate, and choose speakers for didactics. Four months ahead: Send out brochures or email blasts to licensed practitioners in your region, recruit medical students interested in OBG to help with the course. Day before course: Set up, and host a faculty dinner to allow faculty to meet. In 2015, we started a one-day simulation course at our institution for teaching residents and early-stage practitioners’ vaginal hysterectomy (VH) and mid urethral slings (MUS). The first year we invited residents within our state by emails to program directors describing the course, and the CME office sent email brochures to practitioners in the state. We had approximately 25 attendees, mainly residents and five practitioners. The course was successful, and has continued yearly. Over the next few years, we reached out to program directors in neighboring states within driving distance and recruited faculty from these programs to serve as proctors. The course consists of a half day for VH and a half day for MUS: TVT and TOT. Each half day has 1.5 hours didactic and 2 hours of simulation, with a 1-hour lunch break for attendees to visit the exhibitors. We use the Miya Model, a high-fidelity pelvic trainer, for attendees to perform the procedure on, with 1 faculty per 2 learners. The past three years we have also added a cadaver to the didactic portion: A video is shown for each step of the procedure and then a faculty member performs that step on the cadaver, projected onto a screen with the Vitom device. We now have residents and faculty from three neighboring states who have attended the course. Our CME office assists with obtaining industry support, which is of three types: educational grants (largest amount), exhibitor, and supply donation. We have a small exhibit hall for industry vendors to step up a table and have 6 to 8 vendors exhibit each year. Due to industry sponsorship, we are able to keep tuition very low, at $100/resident and $350/practitioner. The course is approved for 7 AMA PRA Category 1 hours, 7.0 ACOG Cognate credits, and ABOG Improvement in Medical Practice (Part IV) MOC requirement. Setting up a simulation course for VH and MUS is feasible, rewarding, and can be accomplished with the support of colleagues, industry, and your institutional CME office.

The Annual American Men's Internet Survey of Behaviors of Men Who Have Sex With Men in the United States: Key Indicators Report 2018.

The American Men’s Internet Survey (AMIS) is an annual web-based behavioral survey conducted in the United States of men who have sex with men (MSM). This rapid surveillance report describes the sixth cycle of data collection (September-December 2018; AMIS 2018). The key indicators were the same as those previously reported for past AMIS cycles. The AMIS methodology has not substantively changed since AMIS 2017. MSM were recruited from a variety of websites using banner advertisements and email blasts. In addition, participants from AMIS 2017 who agreed to be recontacted for future research were emailed a link to AMIS 2018. Men were eligible to participate if they were aged ≥15 years, resided in the United States, provided a valid US ZIP code, and reported ever having sex with a man or identified as gay or bisexual. The analysis was limited to those who reported having oral or anal sex with a male partner in the past 12 months. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants’ self-reported HIV status. The AMIS 2018 round of data collection resulted in 10,129 completed surveys from MSM representing every US state, Puerto Rico, and Guam. Most participants were non-Hispanic White, aged between 15 and 24 years, living in urban areas in the southern United States, and recruited from general social networking websites. The plurality (4230/10,129, 41.76%) of participants was in the youngest age group, 15-24 years, followed by the 40 years and older age group (3088/10,129, 30.49%). The self-reported HIV prevalence was 6.08% (616/10,129). Compared with HIV-negative or unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past 12 months (adjusted odds ratio [aOR] 2.02, 95% CI 1.63-2.50) and more likely to have had anal sex without a condom with a serodiscordant or an unknown status partner (aOR 3.90, 95% CI 3.27-4.66). The reported use of marijuana in the past 12 months was higher among HIV-positive participants than among HIV-negative or unknown status participants (aOR 1.39, 95% CI 1.15-1.68). The reported use of methamphetamines and other illicit substances in the past 12 months was higher among HIV-positive participants than among HIV-negative or unknown status participants (aOR 3.42, 95% CI 2.41-4.87 and aOR 1.90, 95% CI 1.56-2.32, respectively). Most HIV-negative or unknown status participants (6838/9513, 71.88%) reported ever taking an HIV test previously, and 52.51% (4995/9513) of the participants reported undergoing HIV testing in the past 12 months. HIV-positive participants were more likely to report testing and diagnosis of sexually transmitted infections than HIV-negative or unknown status participants (aOR 3.50, 95% CI 2.89-4.24 and aOR 2.61, 95% CI 2.10-3.25, respectively).

Genetic counselors' experiences with transgender individuals in prenatal and preconception settings.

Many transgender individuals want to have children and are pursuing reproductive care. Limited research has described the experiences of transgender individuals during pregnancy, and no known studies have examined reproductive genetic counseling sessions with this patient population. To understand what topics and considerations are explored within this sector of reproductive care, prenatal and preconception genetic counselors that have seen a transgender patient and/or transgender partner of a patient were recruited through an email blast to members of the National Society of Genetic Counselors. Nine genetic counselors completed phone interviews. Content analysis was used to identify, quantify, and examine the concepts within the transcripts. Six major themes emerged: (1) Trans individuals were referred for common genetic counseling indications, (2) genetic counselors were driven to think of more inclusive language, (3) genetic counselors considered ways to make written materials more inclusive, (4) trans individuals expressed discomforts in the prenatal/preconception setting, (5) genetic counselors observed challenges with the care team, and (6) genetic counselors felt underprepared. This study identifies areas within reproductive spaces of genetic counseling that could be more inclusive, particularly relating to commonly used gendered language and written materials, and provides training recommendations for genetic counselors. Additionally, we outline the reported areas of discrimination for these patients and partners, and discuss ways that genetic counselors can be advocates for respectful and equitable care within their clinics.

Abstract PO-011: Mays Cancer Center, South Texas cancer survey: Preliminary results

Abstract Background People living in the Mays Cancer Center (MCC) catchment area face greater cancer-related disparities and face a greater risk of developing liver and cervical cancer. Other priority cancers include colorectal, prostate, and breast cancer. All five major metropolitan cities in the catchment area have lower use of preventive screening services compared to the rest of Texas and nation. In response the MCC conducted a community survey to examine South Texas residents’ 1) exposure to cancer information; 2) knowledge about cancer risk reduction; and 3) intentions and behaviors to reduce cancer risk. Methods A postal address file (PAF) was purchased of 58,960 households throughout the catchment area. The survey was distributed via mail on postcards in two waves. Wave one was launched in May 2020 and was distributed to 30,892 households. Each wave included two mail-outs two weeks apart. To bolster response rate, one week from the last mail out, two follow-up email blasts were sent one week apart to a list of 8,825 addresses from the same mailing list. Post-survey weighting will be applied to the full dataset upon project closeout to provide corrected standard errors and confidence intervals not available at this time. Results Preliminary results (n=432) show the survey has reached 35 of the 38 counties in the MCC catchment area, 36% are from urban counties and 51% rural. Majority of respondents were Hispanic (51%) followed by non-Hispanic white (NHW) (28%) and non-Hispanic black (NHB) (3%). Liver cancer risk: Overall 38% of respondents had been tested for Hepatitis C (n=302). Men had a higher rate of being tested (40%) when compared to women (37%). 51% of respondents were Hispanic followed by 35% NHW and 7% NHB. Colorectal cancer risk: Overall 25% of respondents had received a blood stool test (n=365). Higher than the state (10.9%) and the US (8.9%). Men had a higher rate of being tested (34%) when compared to women (22%). 45% of respondents were Hispanic followed by 43% NHW and 5% NHB. Breast cancer risk: Overall 60% of women had received a mammogram (n=249). Lower than the state (74.9%) and the US (78.3%). 56% (n=83) were Hispanic followed by 38% (n=57) NHW and 3% (n=5) NHB. Cervical cancer risk: Overall 86% (n=212) of women respondents had received a Papanicolaou test (n=246). Higher than the state (77.1%) and the US (80.1%). 58% (n=124) were Hispanic followed by 34% (n=72) NHW and 5% (n=10) NHB. Prostate cancer risk: Overall 49% (n=48) of men had received a PSA test (n=107). Higher than the state (27.1%) and the US (33.2%). 52% (n=25) were NHW followed by 42% (n=20) Hispanic and 2% (n=1) NHB. Conclusions Controlling for gender specific cancers women indicated a higher rate of screening behaviors when compared to men. The highest screening rates among women were found in Hispanics. Alternatively, screening rates were highest among NHW men. Men were more likely to have been screened for liver and colorectal cancer. Screening rates in the catchment area were higher than both state and US rates for pap, PSA, and blood stool tests. Citation Format: Rebecca Jones, Patricia Chalela, Harriet Van Loggerenberg, Edgar Munoz, Ruben Mesa, Amelie G. Ramirez. Mays Cancer Center, South Texas cancer survey: Preliminary results [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-011.

Survey of cancer care providers' attitude toward care for older adults with cancer during the COVID-19 pandemic

Objectives: Care for older adults with cancer became more challenging during the COVID-19 pandemic. We sought to examine cancer care providers' attitudes toward the barriers and facilitators related to the care for these patients during the pandemic.Materials and Methods: Members of the Advocacy Committee of the Cancer and Aging Research Group, along with the Association of Community Cancer Centers, developed the survey distributed to multidisciplinary healthcare providers responsible for the direct care of patients with cancer. Participants were recruited by email sent through four professional organizations' listservs, email blasts, and messages through social media.Results: Complete data was available from 274 respondents. Only 15.4% had access to written guidelines that specifically address the management of older adults with cancer during the COVID-19 pandemic. Age was ranked fifth as the reason for postponing treatment following comorbid conditions, cancer stage, frailty, and performance status. Barriers to the transition to telehealth were found at the patient-, healthcare worker-, and institutional-levels. Providers reported increased barriers in accessing basic needs among older adults with cancer. Most respondents agreed (86.3%) that decision making about Do Not Resuscitate orders should be the result of discussion with the patient and the healthcare proxy in all situations. The top five concerns reported were related to patient safety, treatment delays, healthcare worker mental health and burnout, and personal safety for family and self.Conclusion: These findings demand resources and support allocation for older adults with cancer and healthcare providers during the COVID-19 pandemic.

S1278 COVID-19 Effects on the Gastroenterology Fellowship Application Process: A Survey of Program Directors

INTRODUCTION: The COVID-19 pandemic has significantly affected GI fellowship training programs including the consideration of virtual interviews for applicants during the 2020-2021 academic year. Prior studies have shown success with virtual interviews within GI, but this has not been implemented on a larger scale. This study aimed to clarify the potential impact of COVID-19 on GI fellowship recruitment, particularly in areas hardest hit by COVID-19. METHODS: In May, a questionnaire was distributed to the GI Program Directors’ Listserv requesting participation via Survey Monkey. Data regarding demographics of programs and program director (PD) perception of the impact of COVID-19 on the upcoming recruitment season were collected. An email blast was sent to the entire listserv, with follow up individual emails to PDs. Results were analyzed using SPSS v25. RESULTS: 57 PDs started the questionnaire with a 95% completion rate. There was representation from all geographic regions, size, institution affiliation, and pandemic stage [Table 1]. 23 programs (40.4%) were from institutions identifying as pandemic Stage 3 by the ACGME (extraordinary circumstances). PDs from Stage 3 institutions did not expect differences in application strength or letters of recommendation from prior years but did expect a decrease in research productivity from applicants compared to other programs (78.3% vs 41.9%, P = 0.03). Programs at Stage 3 institutions were more likely to expect decreases in number of applications (43.5% vs 16.1%, P = 0.03) but did not anticipate increasing the number of interviews conducted. If virtual interviews are utilized, PDs had a varied response to predict the success level of the interview season (Scale 0-100; mean 57.2 ± 27.2). There was no difference in predicted success based on pandemic stage (P = 0.76) but PDs from community and academic-affiliated programs were far less optimistic about having a successful interview season compared to those from tertiary care centers (mean 36.4 vs 55.9, P = 0.04). See Table 2 for additional results. CONCLUSION: GI fellowship PDs have differing views on how the COVID-19 pandemic will affect the upcoming fellowship recruitment season. Programs in areas with high COVID-19 prevalence are more concerned about decreased applications, and programs from community and academic affiliated institutions have more doubts about an overall successful recruitment. Programs should work together to share experiences and best practice standards to increase success for all programs.Table 1.: Program DemographicsTable 2.: Select question results

Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

ObjectivesCare for older adults with cancer became more challenging during the COVID-19 pandemic. We sought to examine healthcare providers' clinical barriers, patient questions, and overall experiences related to care delivery for these patients during the pandemic. Materials and methodsMembers of the Advocacy Committee of the Cancer and Aging Research Group along with the Association of Community Cancer Centers developed a 20-question survey for healthcare providers of older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. This manuscript reports the qualitative data from the survey's three open-ended questions. Free text, open-ended survey items were analyzed by two independent coders for identification of common themes using NVivo software. Theme agreement was reached through consensus and count comparisons of participant responses were made. ResultsHealthcare system organizational challenges and meeting basic needs and support were commonly reported themes among respondents (n = 274). Barriers to care delivery included organizational challenges, patients' access to resources and support, concerns for patients' mental and physical health, and telehealth challenges. Respondents reported older adults were asking about their health and cancer care as well as access to basic needs and supports. Providers described worrying about patients' mental health, fear of personal safety, frustration in multi-level institutions, as well as experiencing positive leadership and communication. ConclusionProviders are faced with balancing their concerns for personal and patient safety. These findings demand resources and support allocation for older adults with cancer and healthcare providers during the COVID-19 pandemic.

Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes

BackgroundLittle is known about how cannabis knowledge and attitudes impact cannabis use behavior.ObjectiveTo test the knowledge-attitudes-behavior paradigm in active adult athletes.DesignThe Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data.ParticipantsSelf-defined active adult athletes (n = 1161).Main measuresKnowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use.Key resultsA three-cluster solution was the best fit to the data. The clusters were named Conservative (n = 374, 32.2%), Unsure (n = 533, 45.9%), and Liberal (n = 254, 21.9). There was a significant difference among the clusters for all 11 attitudes items (all p < 0.001). Attitude cluster membership was significantly different by age (p < 0.001), primary sport (p < 0.05), and knowledge about cannabis (p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user (p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. (p < 0.001).ConclusionsCannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.

The Annual American Men's Internet Survey of Behaviors of Men Who Have Sex With Men in the United States: 2017 Key Indicators Report.

The American Men’s Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) who live in the United States. This Rapid Surveillance Report describes the fifth cycle of data collection (July 2017 to November 2017: AMIS 2017). The key indicators are the same as those previously reported for past AMIS cycles (December 2013 to May 2014: AMIS 2013; November 2014 to April 2015: AMIS 2014; September 2015 to April 2016: AMIS 2015; and September 2016 to February 2017: AMIS 2016). The AMIS methodology has not substantively changed since AMIS 2016. The MSM were recruited from a variety of websites using banner advertisements and email blasts. Additionally, participants from AMIS 2016 who agreed to be recontacted for future research were emailed a link to AMIS 2017. Men were eligible to participate if they were aged ≥15 years, resided in the United States, provided a valid US zone improvement plan code, and reported ever having sex with a man or identified as gay or bisexual. The analysis was limited to those who reported having oral or anal sex with a male partner in the past 12 months. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants’ self-reported HIV status. The AMIS 2017 round of data collection resulted in 10,049 completed surveys from MSM representing every US state, Puerto Rico, and Guam. Participants were mainly non-Hispanic white, over the age of 40 years, living in the Southern United States and urban areas, and recruited from geospatial social networking websites. The plurality (4485/10,049, 44.6%) of participants was in the 40 years and older age group, followed by the youngest age group, 15 to 24 years (2726/10,049, 27.1%). Self-reported HIV prevalence was 9.6% (964/10,049). Compared with HIV-negative or unknown-status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past 12 months (adjusted odds ratio [aOR] 2.21, 95% CI 1.86-2.63) and more likely to have had anal sex without a condom with a serodiscordant or an unknown-status partner (aOR 3.13, 95% CI 2.71-3.62). The reported use of marijuana in the past 12 months was higher among HIV-positive participants than HIV-negative or unknown status participants (aOR 1.29, 95% CI 1.09-1.51). The reported use of methamphetamines and other illicit substances in the past 12 months was higher among HIV-positive participants than HIV-negative or unknown status participants (aOR 5.57, 95% CI 4.38-7.09 and aOR 1.93, 95% CI 1.65-2.27, respectively). Most HIV-negative or unknown status participants (7330/9085, 80.7%) reported ever taking an HIV test previously, and 60.6% (5504/9085) reported undergoing HIV testing in the past 12 months. HIV-positive participants were more likely to report testing and diagnosis of sexually transmitted infections than HIV-negative or unknown status participants (aOR 2.85, 95% CI 2.46-3.31 and aOR 2.73, 95% CI 2.29-3.26, respectively).

The Critical Nature of Addressing Burnout Prevention: Results From the Critical Care Societies Collaborative's National Summit and Survey on Prevention and Management of Burnout in the ICU.

To summarize the results of expert discussions and recommendations from a National Summit and survey on the promoting wellness and preventing and managing burnout in the ICU. Literature review; Critical Care Societies Collaborative (CCSC) Statement on Burnout Syndrome in Critical Care Healthcare Professionals: A Call for Action; CCSC's National Summit on Prevention and Management of Burnout in the ICU; and a descriptive survey on strategies for addressing burnout using Research Electronic Data Capture (REDCap) (project-redcap.org). Building on the CCSC call for action to address burnout among critical care professionals, the CCSC sponsored the National Summit on Prevention and Management of Burnout in the ICU with 55 invited experts in various fields including psychology, sociology, integrative medicine, psychiatry, suicide prevention, bereavement support, ethics, palliative care, meditation, mindfulness-based stress reduction, among others. Attendees joined breakout groups, to identify factors influencing burnout in ICU professionals and the value of organizational and individual interventions. As a follow-up to the Summit, a descriptive survey assessing strategies for addressing burnout was sent via email or newsletter blast with responses received from 680 CCSC members, including physicians, nurses, pharmacists, therapists, and others. The Summit attendees identified the importance of raising awareness among critical care clinicians and key stakeholders, advocating for workplace changes to promote healthy work environments, and promoting research to further explore practical strategies to address, mitigate, and prevent burnout. Critical care clinicians reported that a number of initiatives are being implemented both at their hospitals and at the unit level to build resilience and address burnout prevention. However, other respondents reported that no measures were being used within their organizations, and that colleagues were experiencing burnout. Dissemination and application of resiliency building measures and strategies to address burnout in critical care clinicians are needed.

Proses Rebranding MGo Shuttle Menjadi Lintas Shuttle

MGo Shuttle management decided to rebrand, they changed the overall MGo brand identity. One of them is by changing the name, namely Lintas Shuttle. The company's decision to conduct a rebranding began with the bankruptcy of the parent company, namely PT. Citra Maharlika Nusantara Corpora. finally the son of this holding company, PT. Citra Maharlika Lintas Wahana (CMLW) "Lintas Shuttle" decided to leave and from its parent company. The purpose of this study was to find out why companies rebranded, the process of developing new brands, the new brand management process, the process of evaluating rebranding activities. The method used in this study is descriptive qualitative. Based on the results of the study it can be concluded that the reason for the company rebranding because of the crisis that occurred in the parent company of PT. Citra Maharlika Lintas Wahana and finally decided to break away. The reason for rebranding was also due to misunderstandings regarding the perceptions of employees, and PT. Citra Maharlika Lintas Wahana requires legality after leaving the parent company. Furthermore, the process of developing a new brand is done by changing the company's identity, changes are made to be able to be thought and felt by the customer that the brand that was different from the current one. In the process of managing a new brand PT. Citra Maharlika Lintas Wahana performs management stages by planning (planning) before the activity, in addition to the strategy of delivering messages and promotions in the form of outdoor media, online, sms blast, email blast, and employees. Furthermore, the process of evaluating rebranding activities is carried out by monitoring and controlling activities, this is intended so that when the process takes place, it turns out that there is something that is not appropriate or that there is an addition from the supervisor, it can be directly conveyed.

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

BackgroundThere is a paucity of information regarding cannabis use behaviors in adult community-based athletes as most research in athletes has focused on misuse of cannabis in elite, adolescent, university-based athletes. We aimed to determine whether age related differences exist in patterns of cannabis use and subjective effects to cannabis in adult athletes.MethodsThe Athlete PEACE Survey used mainly social media and email blasts to recruit and SurveyGizmo to collect data. Cannabis patterns of use (duration of use, frequency of use, routes of administration, cannabinoid used, concurrent use with exercise), benefits, and adverse effects were reported. Age was reported by decade from 21 to ≥60. Age trends in cannabis use patterns and subjective effects were assessed using linear trend analysis.ResultsOf the 1161 participants, 301 (26%) athletes currently used cannabis. Younger athletes compared to older athletes reported significantly more positive and adverse subjective effects to cannabis, used cannabis longer, and used both tetrahydrocannabinol and cannabidiol for medical and recreational purposes. Younger athletes used cannabis concurrently with exercise more often than older athletes and consumed edibles, vaporized, and smoked more than older athletes.ConclusionsWe found age-related cannabis patterns of use and subjective effects to cannabis. Concerns about cannabis mis-use and abuse in athletes maybe overstated with the potential benefits (improved sleep, decreased anxiety, less pain) outweighing the adverse effects (increased anxiety, increased appetite, difficulty concentrating).

Cannabis use in active athletes: Behaviors related to subjective effects.

Cannabis use has not been well characterized in athletes. Studies primarily examine problematic use or its categorization by anti-doping bodies as a banned substance. Patterns of use, reasons for use, and responses to cannabis consumption have not been studied in a community-based sample of adult athletes. The Athlete PEACE Survey examined cannabis use patterns and subjective effects to cannabis in a community-based cohort of adult athletes. We used mainly social media and email blasts to recruit and SurveyGizmo to collect data. 1,161 (91.1%) of the 1,274 athletes taking the survey completed it. Current cannabis use was evaluated by asking “In the past two weeks, have you used marijuana (including THC and/or CBD)?” and cannabis type used was assessed by asking “What do you primarily use THC, CBD, or both?”. Cannabis benefits and adverse effects (i.e. subjective effects) and patterns of use were reported. 302 athletes (26%) currently use cannabis of whom 301 had complete data for cluster analysis. Cluster analysis was used to determine cannabis user phenotypes and exploratory factor analysis (EFA) was used to create subjective effects factors. Associations between cannabis user phenotype clusters and the subjective effects factors were explored using multivariate analysis. Cluster analysis identified three statistically distinct cannabis user phenotypes: (1) older athletes who primarily use medical CBD, (2) mixed age athletes who use cannabis mainly recreationally with both THC and CBD use, and (3) mixed age athletes who used cannabis the longest with primary THC and CBD use. EFA showed three subjective effects factors: (1) Well-being, (2) Calm, and (3) Adverse. Mean positive subjective were higher than mean adverse subjective effects (p<0.001). The cluster using THC and CBD showed the highest mean scores for all three subjective effects factors (p<0.001). Athletes who use a combination of THC and CBD exhibited the most benefit to well-being and calm with minimal adverse effects. Our methodology can be used to develop real-world evidence to inform future use of medical cannabis products.