Fact Sheet Research Articles

Pharmacists’ experiences dispensing misoprostol and readiness to dispense mifepristone

BackgroundMifepristone, followed by misoprostol, is commonly used for medication abortion and early miscarriage care. Since mifepristone’s approval in 2000, the Food and Drug Administration (FDA) has placed restrictions on where and how it could be dispensed, including applying a Risk Evaluation and Mitigation Strategy in 2011. In December 2021, the FDA removed the in-person dispensing requirement and, in January 2023, began allowing certified pharmacies to dispense the drug directly to patients. ObjectivesTo explore pharmacist knowledge about misoprostol and mifepristone, experience dispensing misoprostol, as well as comfort and readiness to dispense mifepristone should federal regulations allow. MethodsWe conducted in-depth interviews with 21 U.S.-based pharmacists and pharmacy trainees between June and December of 2021, a time when few pharmacists were allowed to dispense mifepristone. ResultsParticipants reported varied knowledge about medications for miscarriage and abortion but described themselves as generally knowledgeable about medications and reported strategies for learning about new medications. Most said they would feel ready to dispense mifepristone, and many described dispensing misoprostol without difficulty. Potential challenges specific to mifepristone dispensing included employer hesitation and colleague refusals. To assure successful dispensing, participants recommended basic training and fact sheets; relationships with prescribers for follow-up; and policies for prescription transfers in the event of refusal. ConclusionsWe found that nearly all participants would feel ready to dispense mifepristone with some basic training. Pharmacists self-report having the skills and resources to learn about new medications quickly. Our findings support the FDA’s rule change allowing pharmacist dispensing of mifepristone and suggest that most challenges would stem from individual or institutional refusals.

Fact Sheet on Cardiac Rehabilitation for Cardiovascular Disease in South Korea.

Cardiovascular disease (CVD) poses a significant health challenge globally, including in Korea, due to its status as a leading cause of death and its impact on cardiopulmonary function. Cardiac rehabilitation (CR) is a well-established program that not only aids in restoring cardiopulmonary function, but also improves physical and social conditions. The benefits of CR are widely recognized, and it is implemented globally. While the effectiveness of CR has been proven in Korea, it is underutilized. This fact sheet summarizes the current status of CR in Korea, including the prevalence of CVD, the clinical practice guidelines for CR programs, and the challenges of implementing CR in Korea.

5.L. Workshop: School health literacy as a means to achieve European public health goals

Abstract Background In recent years, health literacy has been acknowledged as crucial in context of school health promotion, prevention, and education. In 2020, the Schools for Health in Europe Network, linking the 53 WHO European Region Member States to collaborate on school health, released a milestone fact sheet on health literacy in schools, including an evidence synthesis on how health literacy impacts not only health goals but educational outcomes. In 2021, the World Health Organization Regional Office for Europe produced an evidence informed report, recommending the way forward regarding school health literacy in the realm of European public health. Organizational health literacy of schools is named a key responsibility for educational establishments alongside activities to address digitalization in education, climate and planetary health, the commercial determinants of health, the role of social media, and the aftermath of the Covid-19 pandemic. Achieving health literacy development throughout childhood and adolescence requires an early and systematic approach, ideally implemented in schools. Classroom learning and instruction by teachers qualified in health education are key to strengthen skills, behaviours, knowledge, and attitudes that schoolchildren will need to appropriately manage health information from various sources and form health decisions to promote their health in everyday life. Schools are widely accepted as the ideal setting for children to learn about and take responsibility for their own health and self-directed learning, bringing together all elements of health literacy including digital, mental, and organizational health literacy. Teaching materials and targeted sessions on health literacy, either embedded into a subject or as a cross-cutting topic, have several benefits: they reach all children regardless of their social, cultural or development background, they can be delivered over the course of a decade and longer, they can be repeated to enhance learning effects, with increasing grades the complexity and content can be expanded, and in schools it is possible to swiftly respond to contemporary health concerns of children. Objectives This workshop will present empirical findings and intervention research results from various school health literacy studies. (i) The first presentation will discuss findings of school principal's health literacy. (ii) The second presentation will provide key findings from the first ever study on organizational health literacy in schools. (iii) The third presentation will present the evaluation of a mental health literacy programme for students and teachers. (iv) The fourth presentation will introduce a digital health literacy intervention for schoolchildren. The format of this workshop will be 4x7-minute presentations followed by a 20-minute panel discussion, reflecting the relevance of the results to public health research, practice and policy. Key messages • School health literacy is an important topic within the context of school health promotion, prevention, and education. • Addressing health literacy as early as in schools will enable children and adolescent to become health literate, enabling them to face health challenges over the life-course.

Criteria for best practice in health promotion

Abstract There are many interventions that take a health-promoting approach. But are they really good and do their implementation lead to results that are also a sustainable improvement for the target group in a setting? Can this improvement be scientifically evaluated and even measured or is it based on a well-intentioned perception only? The criteria for good practice from Germany, which were developed in 2003 by the Advisory Working Group of the nationwide Collaborative Network for Equity in Health of BZgA, aim in particular for professionals in community health promotion to reflect on their work and to support them in further developing and strengthening the quality of their health promotion services. The (twelve) good practice criteria, in practical language and in the form of twelve fact sheets, each contain a definition, implementation stages of the criterion, their explanation (illustrated with examples from practice) as well as further literature. The good practice criteria include conception and target group reference and take into account participation and empowerment, but also sustainability and cost-effectiveness. These criteria also serve as selection criteria for interventions to be included in the German Good Practice Portal which has a particular focus on tackling health inequalities. In a brief presentation these criteria will be presented to the participants of the workshop in order to subsequently discuss and exchange approaches from other countries.

Protect Jewish students from antisemitism, discrimination

Earlier this year, the Office for Civil Rights published a fact sheet focused on how colleges and universities can protect students from discrimination related to “shared ancestry or ethnic considerations” (bit.ly/3iPfyZP). Campus Legal Advisor covered this fact sheet in‐depth in our March 2023 issue (bit.ly/48gwhdu).

Efficacy of Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases, hospital admissions, type of variants, and deaths.

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) epidemic has instigated enormous damage to the global healthcare system and economies. A large number of vaccines have been developed. However, confidence in any COVID-19 vaccine is essential for its sustainable success. The present study aimed to investigate the efficacy of the Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against SARS-COV-2 cases, hospital admissions, type of variants and deaths. This study recorded data using electronic platforms PubMed, Web of Science, World Health Organization, US-Food and Drug Authorities-FDA, Facts sheets, and Pharmaceutical Websites. Initially, 278 articles and reports were identified, and after revising the abstracts, 39 studies, clinical trials and organizations, reports were selected for a detailed analysis. The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases after the first dose was 60.59% (p=0.00001) and after the second dose was 66.84% (p=0.00001). The highest efficacy was against the Alpha variant 58.80% (p=0.00001) and the lowest efficacy was against the Beta variant 30.83% (p=0.00001). However, the overall efficacy against the SARS-CoV-2 variants after the first dose was 49.20%. The highest efficiency of SARS-CoV-2 variants after the second dose against the Beta (B.1.351) variant was 90.34% (p=0.00001), while the lowest efficacy was against the Omicron (B.1.1.529) variant 46.46% (p=0.00001), with overall efficacy against SARS-CoV-2-2 variants after the second dose 73.73%. The highest efficacy against emergency admission was 94.42% (p=0.00001), while the lowest efficacy was 86.57% (p=0.00001), with overall efficacy against ICU, hospital, and emergency admissions after the second dose was 87.74%. Furthermore, the efficacy of the Oxford-AstraZeneca vaccine against deaths after the second dose was 87.44% (p=0.00001). The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases, various variants, ICU, and emergency admissions, and against deaths was high. The present study results provide valuable insights for healthcare workers, policymakers, and researchers about the precise efficacy levels against symptomatic cases, hospitalization, and mortality across the diverse populations and age groups.

Building Agricultural Knowledge of Soil-biodegradable Plastic Mulch

The use of polyethylene (PE) mulch causes environmental pollution where incomplete removal leaves fragments susceptible to escape to ecosystems, such as the ocean, where they can cause ecological harm. PE mulch is generally nonrecyclable due to contamination with soil and crop debris after use, leaving growers with few end-of-life options for used PE mulch. Research studies have shown that soil-biodegradable plastic mulch (BDM) is comparable to PE mulch in terms of performance, soil health, and overall economics and is preferred from an environmental perspective, but the adoption of BDM by producers is still low. Previous research has shown that the primary barriers to BDM adoption are insufficient knowledge about BDM, high purchase cost, and unpredictable breakdown of BDM in the soil. The high purchase cost of BDM compared with PE mulch is offset by the costs for PE mulch removal, transport, and disposal fees. This project was conducted to develop BDM training materials, to educate and assess BDM knowledge gained by extension personnel and other agricultural professionals through trainings and webinars, and to educate producers about BDM through hands-on experience. Thirty-six research and extension publication outputs from two previous US Department of Agriculture Specialty Crop Research Initiative BDM projects were reviewed and transcribed into 45 new extension publications that included 11 slide presentations, 5 lecture slides, 10 fact sheets, and 3 videos. All the training materials are posted on a public university website. Professional development trainings were conducted at local, regional, national, and international levels to provide agricultural professionals the current, science-based information on BDM and resources for information. Survey results showed that at a local level, the greatest change of knowledge among participants was observed for “BDM use in organic production” (60%), and the lowest reported change of knowledge was observed for “limitations to PE mulch disposal” (19%). At a regional level, out of 58 participants, 23% to 35% of participants learned “a lot” and 35% to 51% learned “some new information” regarding BDM from the webinar. At the national level, out of 30 participants, 48% responded that they learned “a lot” and another 48% learned “some new information” on BDM from the training. Growers were trained about BDM via field days and on-farm demonstrations where five strawberry (Fragaria ×ananassa) growers volunteered to participate in BDM trials. The participant growers observed no difference in weed control and fruit yield between the PE mulch and the BDM. Growers expressed concerns about slow biodegradation of BDM after soil incorporation, potential impacts on soil biological activity, food safety concerns with BDM fragments and that BDM is not currently permitted for use in organic production.

The Effect of Information Sources on Trust and Investment: Evidence from Economic Experimentation

This study aims to provide evidence from an economic experiment that explores the effect of different financial information sources on people’s trust and investment decisions. Research participants consisted of 128 individuals aged between 18 and 30. An experiment design divided participants into three treatment groups and a control group. The participants in each treatment group were assigned to receive different presentations of financial information, namely, an official styled fact sheet (T1), a post on social media (T2), and in- person advising (T3). The study measured the level of participants’ trust and investment in each treatment and compared it with the control group. The findings demonstrated that participants in T1 trusted their information and made significant investment, while those in T2 did not trust and invest. The participants in T3 trusted their information but did not decide to invest. These results suggest that traditional channels remain essential in communicating financial information, and financial institutions must take this into account when considering their communication strategies

Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community.

Cannabidiol (CBD) is a known pain modulator that is garnering increased attention in the orthopaedic world. There may be a considerable knowledge gap among orthopaedic sports medicine providers and their perception of its therapeutic value. To (1) examine the knowledge and beliefs of sports medicine orthopaedic providers with respect to CBD, (2) deliver an educational component, and (3) elucidate potential barriers to its widespread application. Cross-sectional study. A 3-component, 25-question online survey was distributed to members of the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America between July and October 2022. The first 20 questions assessed baseline knowledge and opinions regarding CBD, followed by an educational component, and then 5 questions assessing whether the respondents' opinions had changed after learning more about CBD. Responses were compared according to age, practice setting, and state's cannabinoid legalization status using the chi-square test, and changes in opinions from before to after the educational component were compared using the paired t test. There were 101 survey responses, for a response rate of approximately 1%. Most respondents believed that there is a role for CBD in postoperative pain management (76%), acute pain and inflammation after an injury (62%), and chronic pain (94%). Most respondents admitted that they were not knowledgeable about the mechanism of action (89%) or their state's laws (66%) concerning CBD. A minority (25%) believed that CBD has psychoactive properties. While most respondents (76%) did not believe that they would be stigmatized if they were to suggest CBD to a patient, only 48% had ever suggested CBD. Notably, 94% of respondents had encountered patients who reported trying CBD to treat pain. After reading the fact sheet, 51% of respondents stated that their opinion on CBD had changed, and 63% felt inclined to investigate the topic further. Most survey respondents believed that CBD has a role in postoperative and chronic pain management. Although there was a relative familiarity with CBD, there was a knowledge gap, suggesting that increased attention, education, and research are necessary.

Citrus Pest Quick Guide: Citrus Rust Mite and Pink Citrus Rust Mite (Phyllocoptruta oleivora Ashmead) (Aculops pelekassi Keifer)

This publication is a brief description of the life cycle and damage of citrus rust mite and pink citrus rust mite. It is one publication in a series of quick guides to citrus pests. Each fact sheet is designed to be a quick reference of citrus pests for both residential and commercial industry audiences.

Preterm Çocuğu Olan Babalara Web Ortamında Yapılan Planlı Eğitimin Babalık Rolü Algısı ve Bakım Becerilerine Etkisinin İncelenmesi

Objective: This study aims to determine the effect of planned educatıon made on the web envıronment for fathers wıth preterm chıldren on the perceptıon of the role of fathers and care skılls Methods: This research, planned in a quasi-experimental type, involved 30 study-30 control groups of fathers. The data were collected web-based using the Introductory fact sheet, marriage fit scale, fatherhood role perception scale, and successful test for prematurely born baby care. In the analysis of the data, descriptive statistics, chi-square, t-test in independent groups, and analysis of variance were used in repeated measurements. Results: The mean age of fathers was 29.46±4.52 for working group fathers and 31.6±4.78 for control group fathers. After web-based education, it was found that the average score for marital compliance was higher in working group fathers than fathers in the control group. It was determined that the perceptions of the fatherhood role were high after education, especially among fathers in the study group. Positive perceptions of fatherhood role from the lower dimensions of the scale and perceptions of fatherhood role in child sexuality were found to be high in the lower dimension of the scoring average, and negative perceptions of fatherhood role were low in the lower dimension score average. Conclusion: According to our research results, the web-based education-oriented initiative was found to be effective in fathers' marital harmony, fatherhood role perception, and success tests. This study is a good indicator that an innovative approach can be effective in education. It is recommended that this topic be examined in a qualitative dimension with different research designs with more widely attended samples.

Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly

BackgroundThe Korean Society of Hypertension has published the Korea Hypertension Fact Sheet 2022 to provide an overview of the magnitude and management status of hypertension and their recent trends.MethodsThe Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 1998–2020 Korea National Health and Nutrition Examination Survey and the 2002–2020 National Health Insurance Big Data.ResultsAs of 2020, 29.4% of the adult population aged 20 or older in Korea, about 12.6 million people, have high blood pressure, of which 5.0 million (40%) are 65 years of age or older and 1.2 million (10%) are 80 years of age or older. Among those with hypertension, the awareness rate is 69%, the treatment rate is 65%, and the control rate is 47%. The number of people diagnosed with hypertension increased from 3.0 million in 2002 to 10.5 million in 2020. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.9 million, and the number of people adherent to treatment increased from 0.6 million to 7.4 million. Among those treated for hypertension in 2020, 74% used angiotensin blockers, 61% used calcium channel blockers, 24% used diuretics, and 15% used beta blockers. Combination therapy with at least two classes of antihypertensive medication consisted of 60% of all antihypertensive prescriptions. The number of people with hypertension aged 65 or older is increasing very rapidly compared to those aged 20–64. Awareness and treatment rates of hypertension improved rapidly, especially in those aged 65 or older, but the rate of improvement slowed since 2012.ConclusionsIn Korea, the level of hypertension management is improving, but the absolute number of people with hypertension, especially elderly hypertension, is increasing due to the rapid aging of the population. It is necessary to develop more efficient and target-specific policies to control blood pressure and prevent cardiovascular disease.

APA releases education resources on maternal mental health

Annually, one in five childbearing persons in the United States experiences a mental health or substance use disorder before, during or after pregnancy, the American Psychiatric Association (APA) stated in an Aug. 1 news release. To ensure that psychiatrists and mental health clinicians are best positioned to respond to this need, the APA, with support from the CDC [Centers for Disease Control and Prevention] Foundation, has released a series of educational materials for addressing perinatal mental health in its Psychiatric Toolkit. The toolkit includes eight fact sheets for clinicians and patients, a white paper, and a four‐part webinar series covering this understudied and underserved area of mental health. These materials can be accessed at APA's Perinatal Mental Health website (https://www.psychiatry.org/psychiatrists/practice/professional‐interests/women‐s‐mental‐health/maternal‐mental‐health‐toolkit). The white paper calls for revisions to academic and continuing education curricula to improve competency and confidence within the behavioral care workforce for treating this population. It examines the care of vulnerable populations, raising such issues as cultural competency and lack of access. This “Mental Health Needs Assessment in the Management of Perinatal Psychiatric Disorders” is supported by the CDC and the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $447,209 funded by the CDC/HHS.

Dyslipidemia Fact Sheet in South Korea, 2022.

This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia-more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)-was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL. Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.

Cost of Care Conversations: Perspectives from Rural Health Care Providers and Older Adult Patients

Older adults often struggle with health care costs. Cost of care (CoC) conversations are conversations between health care providers and patients to discuss direct and indirect costs associated with health care. These conversations have been found to increase patient compliance, but patients and health care providers often do not have these discussions. This article describes a project to provide Extension education to encourage CoC conversations for older adults and health care providers in rural counties in a southern state. To inform educational material development, 125 older adults and 51 health care providers completed surveys about their cost-related barriers to health care, attitudes and frequency of CoC conversations, and preferred educational methods. Older adults reported that they were most comfortable discussing health care costs with physicians and pharmacists but that health care providers rarely initiated these conversations. Health care providers indicated that they were comfortable talking about health care costs with patients and reported that they often initiate these conversations. Both older adults and health care providers indicated fact sheets as a top educational method. This project demonstrates how Extension educators can partner with health care providers to educate older adults about communicating cost-related challenges and needs.

Addressing Uncertainties in Potential Human Dietary Exposure to Mercury in the Watershed of the South River, Virginia, USA.

Much has been published about the harmful effects to humans when they are exposed to mercury (Hg) in environmental media including their diet. Numerous health advisories around the world, including for the South River, Virginia, USA, warn against consumption of Hg-contaminated fish species. Fewer studies have focused on other dietary sources of Hg and how to advise humans potentially exposed by this route. In undertaking a human health risk assessment for the former DuPont facility in Waynesboro, Virginia, USA, and the nearby South River and surrounding watershed, the available published information on Hg exposure through dietary consumption of nonfish items proved unsuitable for extrapolation purposes. In response, an evaluation of potential Hg exposure to residents who might consume livestock, poultry, and wildlife raised or collected in the South River watershed was conducted to inform the risk-assessment process. The newly collected data on Hg in these dietary items filled an important data gap, suggesting that there was little concern about limiting dietary consumption for most items. These results were communicated to the public through print and electronic platforms, in the form of "fact sheets." We describe the studies and actions taken to better explain the potential for human exposures to Hg in nonfish dietary items from a portion of the watershed of the South River. Environ Toxicol Chem 2023;42:2237-2252. © 2023 SETAC.

A Systematic Review on the Effects of Statins in the Management of Ischemic Stroke

Stroke is considered to be the fourth leading cause of death and became the fifth leading cause of disability. The global stroke fact sheet released in 2022 reveals that the risk of stroke has increased by 50% over the last 17 years and at present 1 in 4 people is estimated to have a stroke in their lifetime. According to the centre for disease control and prevention, over 2.7 million people die from Ischemic stroke globally. High cholesterol may increase the risk of stroke by boosting the risk of vascular disease, which is a risk factor of stroke. The relationship between the lipids and stroke is complex, on investigation, the total cholesterol level, LDL-C, the total cholesterol to HDL-C ratio and non HDL-C are significantly associated with the increased risk of ischemic stroke. Statins are effective in preventing the vascular diseases and are widely recommended for the secondary prevention and management of ischemic stroke by significantly decreasing the cardiovascular risk and improving functional performance to improve clinical outcome in preventing the recurrence of ischemic stroke.

Public health infection prevention: An analysis of existing training during the COVID-19 pandemic

ObjectivesIn response to the COVID-19 pandemic, agencies and organizations required trainings to support the needs of the public health workforce. To better understand the training resources available, this study identified, organized, and classified infection prevention and control (IPC) training and educational opportunities. Study designEnvironmental scan. MethodsA total of 306 IPC training resources were compiled between January and April 2021. Key themes and topics were identified and compared to the Healthcare Infection Control Practices Advisory Committee's (HICPAC) core IPC practices. ResultsThree hundred and six training resources, including webinars, fact sheets, module-based learning activities, infographics, and professional practice guidance materials, were identified. Common themes included proper use of personal protective equipment (e.g., masks, gloves), community reopening guidance, and mass vaccination resources. A large proportion (74.9%) of trainings were under 60 min. Using the HICPAC framework, the most frequently addressed content included standard precautions (40%), leadership support (31.6%), and transmission-based precautions (25.8%). Few trainings addressed performance monitoring and feedback (17.1%). ConclusionsA wide range of organizations developed IPC-specific content during the pandemic. However, these resources did not address the breadth of knowledge required to implement IPC concepts effectively. The creation of universally applicable IPC core competencies and the development of high-quality IPC education and trainings for public health and the overall responder workforces should be prioritized. Accessible high-quality online and just-in-time trainings are critical for future pandemic and disaster preparedness.

WHO fact sheet on infertility (definition of infertility), published in Global Reproductive Health (2021)

To the Editor, I have read the article entitled “WHO fact sheet on infertility” published in Global Reproductive Health (2021), this was initially published by the World Health Organization (WHO) International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018. This article has given a concise definition of infertility as “Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.” This has been a helpful guide in the diagnosis, classification, treatment, and epidemiological survey of infertility all over the world. I will like to thank WHO for this definition and make some contribution based on my experience. The definition focused on the individual rather than the union between the couple or the 2 individual that is trying to reproduce or have a child. A couple can be infertile due to pathology in one of the 2 members or due to lack of compensation from other members of the union thus labeled infertile. However, each member may have a chance of having a pregnancy if he or she had unprotected intercourse with another individual for the specified time frame and such relationship will not be clinically presented as infertile. The definition of infertility would have been more encompassing if it is based on couple or union rather than considering individual entities. The individual involved should be labeled as “suspected infertile” as there is the possibility of pregnancy if he or she has unprotected intercourse over the time frame of a year with another individual. A critical look at this suggestion can change the orientation, psychology, management, and every other factor related to infertility.

Poster 373: Perceptions &amp; Opinions on Cannabidiol Among Sports Medicine Orthopaedic Surgeons

Objectives: Cannabidiol (CBD) is a known pain modulator which is beginning to garner increased attention in the orthopaedic world, with many patients now presenting to clinics having tried CBD for pain relief. However, there may be a considerable knowledge gap with particular reference to orthopedic sports medicine surgeons and how they perceive the use of this therapeutic agent in clinical practice. The purpose of this study is to (1) examine the knowledge and beliefs of sports medicine orthopaedic surgeons with respect to the role of cannabidiol (CBD) in a multi-modal post-operative pain management regimen (2) deliver an educational component regarding CBD to practicing surgeons, and to (3) elucidate potential future barriers to the widespread use of this treatment modality by providing an anonymous forum for surgeons to voice their opinions. Methods: A three-component, 25-question online survey was distributed to fellowship-trained sports medicine orthopaedic surgeons. The first 20 questions were designed to assess baseline knowledge and opinions of sports surgeons regarding cannabidiol. These were followed by a 1-page summary sheet detailing the current legal status of CBD, as well as a brief literature review of its potential role in pain management within the field of orthopaedics. Lastly, 5 additional questions assessed whether the respondents’ opinions had shifted after learning more about CBD. A Visual Analog Scale (VAS) was used for one question (“Please indicate the likelihood you would recommend CBD as part of a pain management regimen.”), which was repeated before and after the summary sheet to see if respondents modified their answer after completing the educational component. Results: One hundred responses were collected from sports medicine surgeons. Most surgeons (76.2%) believe there is a role for CBD in post-operative pain management. While only 62.4% of respondents believe that CBD could be effective in managing acute pain and inflammation following injury, an overwhelming majority (94.1%) believed that CBD has a role in chronic pain management. A large majority stated that CBD would have no effect on soft tissue (89.1%) or bony (90.1%) healing post- operatively. Most surgeons admitted they were not knowledgeable about the mechanism (84.2%), modes of administration (73.3%), or their states’ laws (66.3%) concerning CBD. A minority (24.8%) believe that CBD has psychoactive properties and 18.8% believe CBD has addictive potential. While most surgeons (76.2%) did not believe they would be stigmatized if they were to suggest CBD to a patient, only 47.5% have ever suggested CBD to a patient. Notably, 94.1% of surgeons have encountered patients who reported trying CBD to treat pain. In the optional open-response section, 32 respondents elaborated on their concerns with most sentiments falling into three predominant themes: a) more evidence is required (10, 31.3%); b) stigmatization from patients (8, 25.0%); c) more regulation is required (5, 15.6%). After reading through the fact sheet, 51.4% of the survey respondents stated that their opinion on CBD had changed, and 62.9% stated they felt inclined to investigate the topic further on their own. Conclusions: A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management. Surgeons are somewhat familiar with CBD, in part due to its remarkable prevalence among their patient populations, however there is clearly a knowledge gap, suggesting more education is necessary involving what is currently known about the subject and that more research should be targeted toward this developing industry. Current barriers to its routine use in clinical practice include unfamiliarity of the mechanism and dosing, limited evidence and regulation, and patient concerns or patient/surgeon stigmatization.