Email Group Research Articles

INTEROCEPTION: ASSESSMENT OF BODY PERCEPTION IN CHILDREN WITH AUTISM AND SENSORY ISSUE

Background and Aims: Children with autism and sensory processing disorder may suffer from issues in interoception or its awareness. However, limited studies have been conducted till date this study is aimed to assess the interoceptive awareness among children with autism and sensory processing disorder. Methodology: A cross-sectional survey was conducted on autistic children to observe interoception through a self-administered questionnaire based on emotional awareness, self-regulation and body awareness formulated on Google Docs and distributed via email or Whatsapp group. Results: A total number of 63 children consisted of 42 (67%) males and 21 (33%) females showed that (30.3%) children were always able to recognize their anger, (47.6%) feels pain in their body, (58.7%),feel and inform their parents while only (19%) children knows and feel about their mouth being dry or about their thirst. During eating, the (76.2%) children never have difficulty coordinating swallowing, chewing or sucking with breathing. In toileting routines, (41%) and (28.6%) always communicated regarding urination and defecation. Conclusion: It was concluded that less notable interoceptive differences were found in the children with autism; however, future trials may use standardized approaches to rule out such components in autistic children for effective care and management of the disability.

OBSCENE BEHAVIOR: A REAL CHALLENGE FOR THERAPEUTIC RELATIONSHIP

Background and Aims: Number of studies in healthcare context has described the rehabilitators as harassment perpetrator and patient as the victim, in particular therapists. Therefore, these issues must examine the dynamics of patient-therapists’ relationships to understand the factors related to the inappropriate sexual behavior. Methodology: A cross-sectional survey was conducted on physical and occupational therapists, recruited via convenience sampling technique. The data was collected through Inappropriate Patient Sexual Behavior questionnaire, sent to participants via email or WhatsApp groups. Results: A total number of 106 participants including 12.3% males and 87.7% females with 71.7% physical and 28.3% occupational therapist. The finding revealed that 82.1% therapists never had training in the context of understanding the inappropriate patient sexual behavior. Whereas 28.3% revealed that a patient has stared the body that made them uncomfortable, 9.5% reported to have sexual flattering remarks, 4.7% had purposeful touched in a sexual manner. Unfortunately, only 37.7%has expressed their disgust and raised voice to report the issues. Conclusion: It was concluded that relatively very low percentage of IPSB is present and reported cases are usually recorded as disgust feeling or raised voice. Thus for healthy therapeutic relationship, training for handling obscene behavior must be conducted and the curriculum should promote knowledge of this aspect.

Factors Affecting the Psychological Well-Being of Health Care Workers During the COVID-19 Crisis.

BackgroundHealth care workers (HCWs) are a group that especially suffered during the COVID-19 pandemic. In addition to facing the stress of dealing with patients and social isolation, they had to worry about being infected themselves and transmitting the infection to their families. This study evaluated the fear, anxiety, and depression experienced by HCWs during the COVID-19 crisis.Subjects and MethodsThe sample size was 541 HCWs. Data collection was done using an online validated questionnaire through Google Docs, sent to HCWs by email and WhatsApp groups. We assessed depression and anxiety with the 4-item Patient Health Questionnaire-4 (PHQ-4), while evaluating fear with the Fear of COVID-19 Scale (FCV-19S).ResultsA statistically significant difference was found in the perception of fear between married and unmarried people, and between those with colleagues who had died from COVID-19 infection and those without. There was a significant relation between HCWs’ anxiety and a history of death from COVID-19 infection, either of friends or of close relatives. The prevalence of depression was 18.48% in the tested sample of HCWs. Participants who had close relatives or friends infected with COVID-19 showed a significantly higher degree of depression. The age group <30 and those working 20 to 30 hours weekly showed higher degrees of anxiety and depression.ConclusionSociodemographic variables such as age, marital status, and working area had a significant impact on the mental and psychological health of HCWs during the COVID-19 crisis. HCWs who lost patients due to COVID-19 had a significantly higher prevalence of fear, depression, and anxiety.

Multicenter survey clarifying phrases in emergency radiology reports.

Interactions between radiologists and emergency physicians are often diminished as imaging volume increases and more radiologists read off site. We explore how several commonly used phrasings are perceived by radiologists and emergency physicians to decrease ambiguity in reporting. An anonymous survey was distributed to attendings and residents at seven academic radiology and emergency departments across the USA via a digital platform as well as to an email group consisting of radiologists across the country with an interest in quality assurance. Physicians were asked to assign a percent score to probabilistic phrases such as, "suspicious of," or "concerned for." Additional questions including, "how often the report findings are reviewed," "what makes a good radiology report," and "when is it useful to use the phrase 'clinical correlation are recommended.'" Median scores and confidence intervals were compared using an independent Student's T-test. Generally, there was agreement between radiologists and emergency room physicians in how they interpret probabilistic phrases except for the phrases, "compatible with," and "subcentimeter liver lesions too small to characterize." Radiologists consider a useful report to answer the clinical question, be concise, and well organized. Emergency physicians consider a useful report to be concise, definitive or include a differential diagnosis, answer the clinical question, and recommend a next step. Radiologists and emergency physicians did not agree on the usefulness of the phrase, "clinical correlation recommended," in which radiologists found the phrase more helpful under particular circumstances. The survey demonstrated a wide range of answers for probabilistic phrases for both radiologists and emergency physicians. While the medians and means of the two groups were often different by statistical significance, the actual percent difference was minor. These wide range of answers suggest that use of probabilistic phrases may sometimes lead to misinterpretation between radiologist and emergency room physician and should be avoided or defined if possible.

Educational, psychosocial, and clinical impact of SARS-CoV-2 (COVID-19) pandemic on medical students in the United States.

BACKGROUNDThe coronavirus disease 2019 (COVID-19) pandemic altered education, exams, and residency applications for United States medical students.AIMTo determine the specific impact of the pandemic on US medical students and its correlation to their anxiety levels.METHODSAn 81-question survey was distributed via email, Facebook and social media groups using REDCapTM. To investigate risk factors associated with elevated anxiety level, we dichotomized the 1-10 anxiety score into low (≤ 5) and high (≥ 6). This cut point represents the 25th percentile. There were 90 (29%) shown as low anxiety and 219 (71%) as high anxiety. For descriptive analyses, we used contingency tables by anxiety categories for categorical measurements with chi square test, or mean ± STD for continuous measurements followed by t-test or Wilcoxson rank sum test depending on data normality. Least Absolute Shrinkage and Selection Operator was used to select important predictors for the final multivariate model. Hierarchical Poisson regression model was used to fit the final multivariate model by considering the nested data structure of students clustered within State. RESULTS397 medical students from 29 states were analyzed. Approximately half of respondents reported feeling depressed since the pandemic onset. 62% of participants rated 7 or higher out of 10 when asked about anxiety levels. Stressors correlated with higher anxiety scores included “concern about being unable to complete exams or rotations if contracting COVID-19” (RR 1.34; 95%CI: 1.05-1.72, P = 0.02) and the use of mental health services such as a “psychiatrist” (RR 1.18; 95%CI: 1.01-1.3, P = 0.04). However, those students living in cities that limited restaurant operations to exclusively takeout or delivery as the only measure of implementing social distancing (RR 0.64; 95%CI: 0.49-0.82, P < 0.01) and those who selected “does not apply” for financial assistance available if needed (RR 0.83; 95%CI: 0.66-0.98, P = 0.03) were less likely to have a high anxiety.CONCLUSIONCOVID-19 significantly impacted medical students in numerous ways. Medical student education and clinical readiness were reduced, and anxiety levels increased. It is vital that medical students receive support as they become physicians. Further research should be conducted on training medical students in telemedicine to better prepare students in the future for pandemic planning and virtual healthcare.

Abstract 20: Recruitment Strategies To Increase Diversity And Enrollment In Behavioral Clinical Trials

Background: Increasing rates of obesity are a major contributor to CV disease among women of reproductive age, especially Black women. Enrollment of racially diverse populations in behavioral weight loss trials is suboptimal and may be impacted by recruitment approaches. Our objectives are to evaluate the effectiveness of recruitment strategies informed by principles of behavioral economics on the enrollment of women into a weight loss trial and to understand the impact of race and insurance. Methods: We tested 4 strategies to enroll postpartum women with CV risk factors into a behavioral weight loss trial. 1,047 individuals who met inclusion criteria in the electronic health record were randomized to receive one of two personalized emails. Email 1 stated that “we reserved a spot” in the study for the patient. Email 2 asked the patient to “commit to health.” Patients who did not respond or have an email address were then randomized to receive a mailer or mailer plus baby bib (gift). All groups were asked to sign up for a virtual information session. We compared response rates between the 2 email and 2 mail strategies. We identified participant characteristics associated with signing up using multivariate logistic regression. Results: Mean age was 31.3 years, 65% were Black and 52% had Medicaid. 1000 patients were randomized to email 1 (n=497) and email 2 (n=503). Response rates were similar in the email groups (17.7% vs. 20.3%, p=0.299). 849 patients were randomized to the mailer (n=424) or mailer plus gift (n=425). Response rates were low but did not differ by strategy (2.6% vs. 3.8%, p=0.331), and largely did not vary by race or insurance (Table). In multivariable analysis, Medicaid insurance was associated with lower odds of signing up for an info session, but race was not. Conclusion: A tailored email is a low-cost and time effective strategy to recruit racially diverse women in a behavioral weight loss trial, though women with Medicaid insurance may require additional outreach.

Global variations in preoperative practices concerning patients seeking primary bariatric and metabolic surgery (PACT Study): A survey of 634 bariatric healthcare professionals.

Bariatric and Metabolic Surgery (BMS) is a popular weight loss intervention worldwide, yet few scientific studies have examined variations in preoperative practices globally. This study aimed to capture global variations in preoperative practices concerning patients planned for BMS. A 41-item questionnaire-based survey was designed and the survey link was freely distributed on social and scientific media platforms, email groups and circulated through personal connections of authors. The survey included eight parts: basic information; criteria for BMS; preoperative nutritional screening; preoperative weight loss; preoperative diets for liver size reduction; preoperative glycemic control; other laboratory investigations and preparations; decision making, education, and consents. Descriptive statistics were used to analyse data and graphs were used for representation where applicable. Six hundred thirty-four bariatric healthcare professionals from 76 countries/regions completed the survey. Of these, n = 310 (48.9%) were from public hospitals, n = 466 (73.5%) were surgeons, and the rest were multidisciplinary professionals. More than half of respondents reported using local society/association guidelines in their practice (n = 310, 61.6%). The great majority of respondents routinely recommend nutritional screening preoperatively (n = 385, 77.5%), mandatory preoperative diets for liver size reduction (n = 220, 53.1%), routine screening for T2DM (n = 371, 90.7%), and mandate a glycemic control target before BMS in patients with T2DM (n = 203, 55.6%). However, less than half (n = 183, 43.9%) recommend mandatory preoperative weight loss to all patients. Most respondents (n = 296, 77.1%) recommend psychological intervention before surgery for patients diagnosed with psychological conditions. Variations were also identified in laboratory investigations and optimisation; and in the aspects of decision making, education and consent. This survey identified significant global variations in preoperative practices concerning patients seeking primary BMS. Our findings could facilitate future research for the determination of best practice in these areas of variations, and consensus-building to guide clinical practice while we wait for that evidence to emerge.

System design and production practices of aquaponic stakeholders.

Aquaponics is an agricultural practice incorporating aquaculture and hydroponic principles. This study assesses the current system design and production practices of the aquaponic industry, compares these metrics by stakeholder group, identifies trends, and provides recommendations for future development. An electronic survey of aquaponic stakeholders was conducted from December 2019 to June 2020 targeting hobbyists, producers, and educators from various aquaponic-focused professional associations, email and social media groups. Of 378 total responses, 84% came from the United States and were clustered in plant hardiness zones five to nine. Aquaponic systems were commonly homemade/do-it-yourself (DIY), many of which incorporated commercially available (turn-key) technology. Most growers used coupled systems that integrated recirculating aquaculture systems and either deep-water culture (DWC) or media bed hydroponic units. Common plant lighting sources were sunlight and light emitting diode (LED). Water sources were typically municipal or wells. Personal labor input was typically less than 20 hrs/wk. Funding sources were primarily personal funds, followed by government grants, and private investor funds. System sizes varied greatly, but the median area was 50 to 500 ft2 for hobbyists and educators and 500 to 3,000 ft2 for producers. Respondents commonly sold vegetable produce, training and education, food fish, and microgreens. Tilapia and ornamental fish were commonly grown, with 16 other species reported. Common crops were lettuce, leafy greens, basil, tomatoes, peppers, and herbs with many additional lesser-grown crops reported, including cannabis. Overall, the industry still growing, with a large portion of stakeholders having less than two years of experience. However, veteran growers have remained in operation, particularly in the producer and educator groups. The survey results suggest a shift away from outdoor systems, media beds, tomatoes, ornamental fish, and perch production, and a shift toward decoupled systems, DWC, drip irrigation, and wicking beds, larger system area, leafy greens, and trout/salmon production compared to previous industry surveys. The reduced diversity of plant species grown suggest some level of crop standardization. Commercial producers tended to sell more types of products than other stakeholders, suggesting that diversification of offerings may be key to profitability. The combined production area specified by respondents indicates the industry has grown substantially in recent years. Finally, the presence of bank loan-funded operations suggests increased knowledge and comfort with aquaponics among lenders.

COVID-19 exposure and health status of orthopedic residents: A survey study

Considering the increased patient burden and disruptions in the healthcare system, orthopedic residents are affected both psychologically and physically while working both in the management of trauma patients and caring for COVID-19 patients. Our objective was to investigate the virus exposure and health status of orthopedic residents during the pandemic and to review the measures that can be taken. A survey consisting of 15 questions was organized and circulated through e-mail groups and social media platforms in order to evaluate the health status of residents. Demographic data, co-morbidities, whether they had a COVID-19 infection, time they work in orthopedics-related and COVID-related units, whether there was infection among their colleagues or family members and the infected patient care were questioned. A total of 136 residents completed the survey, of which 41 (30.1%) were infected. A significant difference was found between COVID-infected and COVID-free residents in terms of comorbidities (p=0.026). Residents with infection among their colleagues had lower infection rates (p&lt;0.001). No significant difference was found between groups in terms of the working periods in orthopedics-related or COVID-related units (p&gt;0.05 for each). With this study, the infection rate among orthopedic residents were reported for the first time in the literature, considering the fact that a third of all the participants in our study were infected. The infection rate among the orthopaedics residents were reported for the first time in the literature with this study. The fact that residents with infected colleagues have lower infection rates, demonstrates the importance of self-awareness and protective behaviors. During the pandemic, all healthcare professionals should pay maximum attention for simple measures, like practicing protective behaviors and use of personal protective equipment.

Comparing Reminders Sent via SMS Text Messaging and Email for Improving Adherence to an Electronic Health Program: Randomized Controlled Trial.

BackgroundeHealth interventions can help people change behavior (eg, quit smoking). Reminders sent via SMS text messaging or email may improve the adherence to web-based programs and increase the probability of successful behavior change; however, it is unclear whether their efficiency is affected by the modality of the communication channel.ObjectiveA 2-armed randomized control trial was conducted to compare the effect of providing reminders via SMS text messaging versus email on the adherence to an eHealth program for smoking cessation and on the probability to initiate a quit attempt.MethodsSmokers were recruited via an internet-based advertisement. A total of 591 participants who diverted from intended use of the program (ie, failed to log on to a session) were automatically randomized to the experimental (SMS text messaging reminder, n=304) or the active comparator (email reminder, n=287) group.ResultsUnexpectedly, we found that the mode of reminder delivery did not significantly affect either the adherence, namely the number of completed program sessions, with the SMS text messaging reminder group showing a mean of 4.30 (SD 3.24) and the email reminder group showing a mean of 4.36 (SD 3.27) (t586=0.197, P=.84, and Cohen d=0.016), or the outcome, namely the quit smoking attempt rate (34.2% in the SMS text messaging group vs 31.7% in the email group; χ21=0.4, P=.52). Secondary analyses showed that age, gender, and education had significant effects on program adherence and education on the outcome. Moreover, we found a significant interaction effect between the mode of reminder delivery and gender on program adherence, suggesting that the effectiveness of SMS text message reminders might be different for females and males. However, this particular finding should be treated with care as it was based on post hoc subgroup analysis.ConclusionsThis study indicates that the modality of user reminders to log on increased neither the program adherence nor the probability of quitting smoking. This suggests that program developers may save costs using emails instead of SMS text messaging reminders.Trial RegistrationClinicalTrials.gov NCT03276767; https://clinicaltrials.gov/ct2/show/ NCT03276767

Psychological impact during COVID-19 pandemic: A web-based cross-sectional study among students studying at College of Science and Technology (CST), Phuentsholing, Bhutan.

The unprecedented experience of national lockdowns and uncertainty of academic career due to the COVID-19 pandemic has multifaceted impacts on mental health among university students worldwide. This study determined its impact on depression and anxiety level, and associated risk factors among engineering students studying at College of Science and Technology (CST), Phuentsholing, Bhutan during the first lockdown in the country. Self-reported depression and anxiety levels were assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) respectively. Data was collected using an e-questionnaire link generated in Google form and the link was shared with students via the student’s official email group. A total of 278 students (response rate, 26.9%) completed the questionnaire. The majority of respondents were male (69.8%) and were aged from 18 to 30 (Mean: 21.7 ±SD 2.07) years. The prevalence of self-reported moderate to severe depression and anxiety were 44.2% (95% CI, 38.5–49.6) and 27.3% (95% CI, 22.3–32.4) respectively. Participants having their family members as frontline workers reported a significantly higher level of anxiety (χ2 = 4.85, p = 0.028). In multivariable logistic regression analysis, students who were academically lagging showed a higher risk of depression (AOR = 5.36, 95% CI = 2.86–10.04) and anxiety (AOR = 3.83, 95%CI = 1.86–7.88) as compared to students who were not academically behind. A high percentage of depression and anxiety was reported by students of CST during the COVID-19 pandemic. Findings from the study highlight the importance of adopting appropriate online-based teaching and learning methods to ensure timely academic and professional achievements. Moreover, the relevant stakeholders should put health system strategies in place to provide psychological support to university students during the COVID-19 pandemic.

A CROSS-SECTIONAL SURVEY ON KNOWLEDGE, ATTITUDE AND PRACTICE IN PARENTS WITH DOWN SYNDROME CHILDREN

BACKGROUND AND AIMS Parents with Down syndrome children may be unfamiliar with coping strategies because of limited knowledge, negative attitude and inappropriate practice. To the best of author’s knowledge, no study has been conducted in Pakistan till date to explore the issue. METHODOLOGY A cross-sectional survey was conducted among parents of children with Down syndrome, enrolled in the study via convenience sampling technique. Data was collected on self-administered questionnaire based on parental knowledge, attitude and practice on Down syndrome distributed via email or WhatsApp group. RESULTS A total number of 24 parents with Down syndrome included in this study involving majority of mothers (52.2%) showed that (79.2%) parents understand that Down syndrome is a genetic disorder, (91.7%) agreed that children are born through it. Moreover, (83.3%) think that the syndrome can be detected during pregnancy through prenatal tests whereas (100%) showed that physiotherapy, occupational and speech therapy plays a pivotal role in the management of disorder. Besides, (83.3%) parents have recommended the special health services. Therefore, (87.5%) parents will prefer to seek the genetic counselling when planning for next child. CONCLUSION It was concluded that majority of parents have demonstrated the sound knowledge, positive attitude and proactive practice among parents with Down syndrome children. Thus, multicenter large scale studies should be conducted to investigate the factors associated to parent-child relationship and promote education for better health outcomes. KEYWORDS Down syndrome, disability, intellectual, ADLs, Knowledge, Management.

THE EFFECT OF VIRTUAL LEARNING THROUGH ONLINE LEARNING SYSTEM (SPADA) ON STUDENTS' LEARNING OUTCOMES IN ALGEBRAIC STRUCTURE COURSE IN DEPARTMENT OF MATHEMATICS EDUCATION, MUHAMMADIYAH UNIVERSITY OF MAKASSAR

This study aims to determine the effect of treatment on student learning outcomes in the algebraic structure course at the Department of Mathematics Education of the University of Muhammadiyah Makassar in virtual learning through the online learning system (SPADA). This study is a quasi-experimental design with a post-test-only control group whose results were analyzed using descriptive analysis and inferential analysis (mann whitney test). The population is the class of 2019 who is programming an algebraic structure course consisting of 3 classes, then a sample consisting of 2 classes was selected, namely, one experimental class taught through SPADA, and one control class taught in addition to using SPADA, namely, zoom meeting, google meet, email, and whatsApp groups. The instrument used is a test of student learning outcomes. The results obtained are that the average learning outcomes of students who are taught through SPADA are higher than the average learning outcomes of students who are taught other than through SPADA, but the results of the Mann Whitney test show that there is no significant difference from the learning outcomes of students who have been taught through SPADA or other than SPADA. Researchers suggest that providing virtual learning not only relies on one learning media but also on the synergy between one media and another, which will further optimize virtual learning.

EXAMINATION OF COVID-19 FEAR IN TERMS OF ITS DEFINING CHARACTERISTICS

Aim: The aim of the study is to determine the fear of coronavirus and affecting factors. Method: It was conducted as a descriptive study. Data on participants were collected using an online questionnaire spread throughout the social media, e-mail and whatsapp groups. Socio-demographic questionnaire form, COVID-19 Fear Scale and Visual Analogue Scale (VAS) were used to collect data. Number, percentage, mean, t test, one way anova and pearson correlation analysis were used to evaluate the research data. The research was completed with 727 people. Result: A statistically significant relation was found between the COVID-19 fear with age, gender, marital status, having children, having a chronic disease, working status and being health personnel, watching coronavirus news and always talk about coronavirus at home settings. Conclusıon Accordingly, it is recommended to determine the fear of coronavirus in the society, to identify high-risk individuals by performing community screenings and to provide psychological support. It is very important to diversify and implement protective intervention programs in order to reduce some of the psychological consequences of fear and fear.

Financial well-being of Vietnamese students

This study aims to analyze financial well-being as well as the factors affecting the financial well-being of Vietnamese students. The study surveyed 658 students in Vietnam via email and Facebook groups with suitable survey subjects in the period from May to June, 2021. The study also collected demographic information and the status of independence or financial dependence of students participating in the survey in Vietnam. The study analyzes the direct and indirect effects of six groups of independent factors on the financial well-being of Vietnamese students through the PLS-SEM model. Empirical study results show that three factors, such as Financial Attitude, Financial Behavior, and Financial Self-Efficacy, have a direct impact, while two other factors, Financial Knowledge and Financial Skills, have an indirect impact on financial well-being of students in Vietnam. Although there are some limitations in the representative level of students participating in the survey, sampling methods and the number of respondents in the survey, the study achieved its research objectives. This study provides more empirical evidence and insights to the Ministry of Education and Training and economics universities in designing training programs that equip students with knowledge and skills to achieve financial well-being. AcknowledgmentThe author wishes to acknowledge support from the Banking University of Ho Chi Minh City. The author would like to thank all the lecturers and students for their support in sharing the survey, and the students who completed the survey. This study was made possible thanks to all valuable support from relevant stakeholders.

Durability of Endoscopes Used During Routine Lumbar Endoscopy: An Analysis of Use Patterns, Common Failure Modes, Impact on Patient Care, and Contingency Plans.

Successful implementation of endoscopic spinal surgery programs hinges on reliable performance and case cost similar to traditional decompression surgeries of the lumbar spine. To improve the statistical power of studying the durability of endoscopes with routine lumbar endoscopy, the authors performed a retrospective survey study among endoscopic spine surgeons by email and chat groups on social media networks WhatsApp and WeChat. Descriptive and correlative statistics were done on the surgeon's responses recorded in multiple-choice questions. Surgeons were asked about their clinical experience with spinal endoscopy, training background, the types of lumbar endoscopic decompression they perform by approach, their preferred decompression instruments, and their experience with endoscopic equipment failure. A total of 485 surgeons responded, of whom 85 submitted a valid survey recording, rendering a completion rate of 27.1%. These 85 respondents reported a case volume of 12,650 lumbar endoscopies within the past year and, to date, had performed a total of 120,150 spinal endoscopies over their collective career years. The majority of respondents performed endoscopic surgery for herniated disc (65.9%) vs spinal stenosis (34.1%) in a hospital setting, preferentially employing the transforaminal (76.5%), interlaminar (51.8%), and unilateral biportal endoscopic (UBE; 15.3%) approach technique. The most commonly used endoscopic spine systems were Wolf/Riwo Spine (38.8%), Joimax (36.5%), Storz (24.7%), unspecified Chinese brand (22.4%), Maxmore (15.3%), Spinendos (12.9%), Elliquence (10.6%), unspecified Korean brand (7.1%), and asap Endosystems GmbH (2.4%). The most frequent failure mode of the endoscope reported by survey respondents was a blurry image (71.8%), followed by the loss of focus (21.2%), the loss of illumination of the surgical site (18.8%), and the failure of the irrigation/suction system integrated into the endoscope (4.7%). Most respondents thought they had problems with the lens (67.1%), the fiberglass light conductor (23.5%), the prism (16.5%), or the rod system (4.7%). Motorized high-speed power burrs and hand reamers and trephines were the reported favorite decompression tools that were presumably associated with the endoscope's failure. The majority of respondents (49.5%) performed up to 50 endoscopies before the endoscope had to be either exchanged or repaired. Another 15.3% of respondents reported their endoscope lasted between 101 and 200 cases and only 12.9% reported more than 300 cases. Besides abuse during surgery (25.9%), bad handling by staff was the most common suspected reason (45.9%), followed by the wrong sterilization technique (21.2%). Some 23.5% of respondents noted that the endoscope failed during their surgery. In that case, 66.3% asked for a replacement endoscope, and 36.1% completed the surgery with the broken endoscope. However, 10.8% stopped and another 6% of respondents woke the patient up and rescheduled the surgery to complete the decompression at another time. Spinal endoscopes used during routine lumbar decompression surgeries for herniated disc and spinal stenosis have an estimated life cycle between 50 and 100 surgeries. Abusive use by surgeons, mishandling by staff, and deviation for prescribed cleaning and sterilization protocols may substantially shorten the life cycle. Contingency protocols should be in place to readily replace a broken spinal endoscope during surgery. More comprehensive implementation of endoscopic spine surgery techniques will hinge on technology advancements to make these hightech surgical instruments more resistant to the stress of daily use and abuse of expanded clinical indications' for surgery. The regulatory burden on endoscope makers is likely to increase, calling for increased reimbursement for facilities to cover the added expense for capital equipment purchase, disposables, and the endoscopic spine surgery program's maintenance. 3. End user surgeon survey study.

AN ASSESSMENT OF UMS PRE-UNIVERSITY STUDENTS’ READINESS ON ONLINE EXAMINATION

Pandemic COVID-19 has given a significant impact on the education culture whereby online learning has become the main way in teaching and learning activities. In line with the important use of online learning, it is very important to identify whether the students are ready enough for an online class or not. The study on ‘An Assessment of UMS Pre-University Students’ Readiness on Online Examination’ sought to answer the questions about students’ readiness on the preferred mode of learning and the student's readiness on an online examination. The respondents of the study were UMS Pre-University students who enrolled in the Foundation in Science program (AUMS) in the year 2020. Specifically, there was 105 male, and 153 female students were included in the study. Through Google form online survey, the questionnaires were sent through their email and WhatsApp group. Then, the data were gathered, collected, and analysed. Descriptive statistics analysis and item level mean related to students’ internet connectivity is provided in the form of percentage, mean and standard deviations. The study reveals that AUMS students’ internet connectivity was moderately ready for their online examinations, as it depends mainly on their location. If the students are staying in an urban areas, then their internet connections should be good and vice versa. This study also reveals that problems in Wi-Fi connection are the main concern of students’ accessibility to online learning.

Homesickness, Anxiety and Depression among Pakistani International Students in Indonesia during Covid-19 Outbreak

International students are exposed to multiple mental health crisis due to social, environmental and culture shocks in foreign lands but it gets worse in presence of life- threatening disease outbreak. This research was conducted to evaluate the homesickness, anxiety and depression among Pakistani international students in Indonesia during Covid-19 Outbreak. Methods: This study was conducted on 86 random students that are pursuing their studies in different public and private universities in Indonesia. The data were collected by distributing google forms via email and social media groups and the responses from the respondents were recorded and analyzed statistically. The study findings revealed that there is a correlation between Covid-19 pandemic and the development of various mental health crisis where 33 students (38.37 %) developed homesickness, 11 students (12.79%) developed anxiety and 2 students (2.33 %) manifested low-grade depression. Homesickness was outstandingly observed in females (72.72 %) whereas anxiety was highly reported in males (90.90%). The study findings demonstrated that there is a strong negative correlation between student financial statuses and the development of homesickness (r: -0.977, P: 0.023) and anxiety (r: -0.944, P: 0.056). All in all, the fear to contract coronavirus, lockdowns, financial instability, death toll of citizens and medical professionals, run out of medical facilities and social media hoaxes are significant risk factors of mental health crisis among Pakistani international students in Indonesia.

NS-63: Adapting and improving a Myeloma Support group during the pandemic

<h3>Introduction</h3> The COVID-19 pandemic has been extremely challenging for myeloma patients and their families. Avenues of support previously available were closed and our regular Myeloma support group was unable to meet. Patients' anxiety levels higher than ever before, we looked at new methods of contact, communication, information and support. Aims: To transfer our longstanding support group to a virtual platform and to maintain the level of access, provision and quality of care throughout the pandemic. <h3>Methods</h3> An anonymised patient email group was created with weekly email contact, shielding guidance, webinar and support group invitations. Clinical Nurse Specialists facilitated the virtual support group via Microsoft teams. Prior to engaging in events patients were advised of online safety measures and a consent form was given. At the start of each meeting we explained to patients how to utilise the online platform in a straightforward way, including chat function and hand raising. A survey was created to evaluate patients' experience in this new virtual format and provide us with both qualitative and quantitative statistics. <h3>Results</h3> We compared satisfaction ratings of the virtual group to meetings in the previous 2 years. Comparably 100% of attendees indicated that support was beneficial whether in person or virtually. 94% agreed that they felt better supported from attending the face to face group last year in comparison with 100% of patients in the virtual meetings. 89% of attendees agreed they benefited from meeting others living with myeloma during meetings last year compared to 100% of patients in virtual meetings. <h3>Conclusion</h3> The support group evolved over the course of the pandemic in response to patient need and feedback. Many virtual educational events were created with leading specialists discussing the international impact of COVID19 on Myeloma patients around the world and later the vaccine effect in our patients. We looked at empowering our patients shielding at home by creating separate webinars with a physiotherapist, a psychologist and a pain specialist. Through these webinars they received tools and coping mechanisms. A much needed subgroup for younger Myeloma patients in their 30's and 40's was also created due to the rising numbers of patients in this age-group and their unique issues. There have been many positives to the virtual platform including larger capacity (60+ patients in attendance at some events) and increased frequency (at least monthly). On surveying, there was 100% satisfaction and 66% of patients were indifferent to returning to ‘in person' meetings in the future proving that quality is still being attained. It was challenging to provide support over a different medium and we were apprehensive that the change in method would alienate or discourage patients. However as one of our patients stated, ‘This is all unchartered territory and your calm expertise is even more welcome than usual'.

The perceptions and beliefs of cannabis use among Canadian genitourinary cancer patients.

The legalization of recreational cannabis in Canada in 2018 has led to many patients being curious about the benefits of taking cannabis in conjunction with their cancer treatment. We investigated the perceptions among genitourinary (GU) cancer patients regarding cannabis use as part of their care plans. A survey was created to explore current cannabis use behaviors, reasons for cannabis use, and the beliefs of cannabis usefulness towards cancer-related care, including cancer treatment, among GU cancer patients. The survey was distributed across Canada online via RedCAP through social media platforms, email, and patient advocacy groups. The survey was active from August to December 2020. Of eighty-five responses, 52 met inclusion for analysis. Participants included 11 bladder, 26 kidney, and 15 prostate cancer patients. Many (48.1%) participants used cannabis daily and 75% had been using it for more than one year. Cannabis was consumed through oil-based products, edibles, and smoking. The most common reasons for using cannabis were cancer-related anxiety, to prevent cancer progression, cancer-related pain, recreational use, and other, non-cancer-related illness or symptoms. Participants believed cannabis improved their sleep (70.2%), anxiety (65.9%), and overall mood (72.3%). Most participants were either unsure (38.3%) or neutral (31.9%) in the belief that cannabis might decrease their cancer progression. GU cancer patients use cannabis for a variety of cancer- and non-cancer-related symptoms. Many patients believe cannabis has benefited their cancer-related symptoms. These findings highlight the importance of healthcare providers remaining familiar with current evidence on cannabis to support patient conversations about cannabis use.