Incomplete Surveys Research Articles

Adverse childhood experiences and the development of Down syndrome regression disorder

Down syndrome regression disorder (DSRD) is a clinical symptom cluster of acute or subacute neurocognitive regression in otherwise health persons with Down syndrome. The objective of this study was to evaluate if adverse childhood experiences (ACEs) were more prevalent in children with DSRD than those with DS alone. A survey-based, cohort-based study was performed. Caregivers of individuals with DSRD with onset of symptoms between age 10 and 30 years and DS alone were administered the ACEs questionnaire via an online REDCap survey. A total of 159 responses were collected after excluding incomplete surveys and those not meeting criteria for DSRD. Individuals with DSRD were not more likely to experience ACEs (p = 0.18, 95% confidence interval [CI]: 0.43-1.17). In those with ACEs prior to the onset of symptoms, the median time prior was 7 months (interquartile range: 5-10). Individuals with DSRD were more likely to report three or more ACEs (52, 33%) compared to those with DS alone (39, 22%) (p = 0.02, 95% CI: 1.08-2.87). Exposure to ACEs were not predictive of response to particular therapeutic interventions although those with multiple ACEs 3 months prior to the onset of symptoms was associated with lower response rates to benzodiazepines and immunotherapy (p = 0.02, 95% CI: -3.64--1.13). This study provides preliminary data that individuals with DSRD experience ACEs at a similar rate to individuals with only DS alone, although three or more ACEs, often preceding the onset of symptoms, was more prevalent in individuals with DSRD.

Generalized results of raising the determination of high school students in the process of physical education

The article presents the generalized results of raising the determination of high school students in the process of physical education. With the help of the study of psychological and pedagogical literature on raising the determination of high school students in the process of physical education, it was established that, under modern conditions, little attention is paid to this problem in general secondary education institutions. A number of studies devoted to certain aspects of the problem of raising moral and volitional qualities of education seekers in the process of physical education have been analyzed. The stages of experimental research (declarative, formative and generalizing) are thoroughly described. The components of education of determination of the individual are revealed, namely: cognitive (knowledge about determination and education of determination, awareness of the content and meaning of determination in the life of the individual); emotional and valuable (perceived interest of education seekers and emotionally positive perception of determination as a quality of will, identification of the desire to show determination); arbitrary impulse (manifestation of spiritual determination, readiness to show determination, volitional desire to participate in the process of physical education); activity-practical (willingness to translate determination into practical activity in the process of physical education; ability to be creative, independently carry out assignments); self-worth (self-worth as the attitude of a participant in the educational process to himself (self-esteem); the activity of education seekers whose content is self-worth). Diagnostic methods of research are presented: questionnaires, the method of incomplete sentences, surveys, debates, psychological testing, group and individual conversations, test tasks, the method of incomplete sentences, the method of competition, pedagogical observation, and others. It is noted about the effectiveness of pedagogical conditions for raising the determination of high school students in the process of physical education. A methodology for raising the determination of high school students in the process of physical education has been developed and implemented. The calculation of the results of the research at the formative stage proved the effectiveness of the introduction into the educational process of the developed method of raising the determination of high school students in the process of physical education, pedagogical conditions, etc.

Exploring Motivations and Barriers To Accreditation Adoption Among Physician Assistant and Nurse Practitioner Emergency Medicine and Orthopedic Surgery Residency and Fellowship Programs.

Althoughthere has beenarapidincrease in thenumber of physician assistant(PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relativelynew phenomenon. There is little research examiningwhich factors may be predictorsof accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigatewhich motivating factors influencepostgraduate programs choiceon whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November2022and February2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most commonreasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were notdeterminingfactors of whether to pursue accreditation or not. Reasons for not pursuing accreditation includedhigh costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.

An Exploratory Study of Primary Care Clinicians' Perspectives on 2021 New and Updated Cancer Screening Guidelines.

Cancer screening rates remain low in rural, racial and ethnic minority, low-income, and uninsured populations. Prior studies showed that cancer screening recommendations vary based on clinicians' factors. We conducted an exploratory study on primary care clinicians' beliefs about new or updated cancer screening guidelines according to clinician demographics. This cross-sectional study involved administering a web-based survey in July and August of 2021 to primary care clinicians practicing in diverse ambulatory settings in the Pacific Northwest belonging to the same health system. The survey assessed clinician demographics, attitudes about the impact of cancer screening on mortality, and how clinicians stay up-to-date with guidelines. Of the 191 clinicians, 81 responded (42.4%), after removing 13 incomplete surveys, we analyzed 68 (35.6%). The majority agreed/strongly agreed that breast (76.1%), colorectal (95.5%), and cervical (90.9%) cancer screening, and HPV vaccination (85.1%) prevent early cancer mortality: there were no differences according to clinician gender or years in practice. Female compared to male clinicians were more likely to agree/strongly agree that tobacco smoking cessation (female: 100% vs male: 86.4%, P = .01) prevents early cancer mortality, whereas male compared to female clinicians were more likely to agree/strongly agree that lung cancer screening (male: 86.4% vs female: 57.8%, P = .04) prevents early cancer mortality. One-third (33.3%) of clinicians were unaware of the 2021 update on lung cancer screening and females were more likely than males to say they did not know about this change (females: 43.2% vs males: 13.6%, P = .02). This study suggests that clinicians' attitudes are not likely the primary factor affecting low cancer screening rates in some populations and that few differences exist in beliefs based on gender, and none based on years in practice.

Fostering Sustainable Community-Based Tourism in Marine and Coastal Regions: Examining the Influence of Destination Social Responsibility on Environmentally Responsible Behavior, Mediated by Destination Image

The study aims to explores the impact of Destination Social Responsibility (DSR) and Destination Image (DI) on Environmentally Responsible Behaviour (ERB)-based tourism. This study collected data using the convenience sampling method, specifically through a survey administered to residents in a community of marine parks. Initially, a total of 300 questionnaires were distributed, resulting in the return of 200 completed surveys. After removing incomplete surveys, a total of 195 usable questionnaires have been included in the analysis.Given that the study employed composite measures and focused on predictive as well as explanatory purposes, the researchers utilized Partial Least Squares-Structural Equation Modeling (PLS-SEM 4) to test the developed model. Moreover, the findings suggest that DSR positively influenced both ERB and DI. However, DI did not significantly impact ERB and did not act as a mediator between DSR as well as ERB. The findings show the local population’s involvement entails mitigating detrimental environmental impacts in coastal and marine areas.The local community, as a key stakeholder in a tourism destination, plays a significant role in promoting sustainable tourism growth in the area.The study offers valuable insights for destination management organizations as well as stakeholders in formulating environmental policies to promote sustainable development in Redang’s community.

Metapopulation persistence can be inferred from incomplete surveys.

Habitat destruction and fragmentation are principal causes of species loss. While a local population might go extinct, a metapopulation-populations inhabiting habitat patches connected by dispersal-can persist regionally by recolonizing empty patches. To assess metapopulation persistence, two widely adopted indicators in conservation management are metapopulation capacity and patch importance. However, we face a fundamental limitation in that assessing metapopulation persistence requires that we survey or sample all the patches in a landscape: often these surveys are logistically challenging to conduct and repeat, which raises the question whether we can learn enough about the metapopulation persistence from an incomplete survey. Here, we provide a robust statistical approach to infer metapopulation capacity and patch importance by sampling a portion of all patches. We provided analytic arguments on why the metapopulation capacity and patch importance can be well predicted from sub-samples of habitat patches. Full-factorial simulations with more complex models corroborate our analytic predictions. We applied our model to an empirical metapopulation of mangrove hummingbirds (Amazilia boucardi). On the basis of our statistical framework, we provide some sampling suggestion for monitoring metapopulation persistence. Our approach allows for rapid and effective inference of metapopulation persistence from incomplete patch surveys.

Impact of Incomplete Surveys on Data Analysis of Sexual Health Concerns in Adults with Sickle Cell Disease

Introduction: Studies focusing on sexual health in relation to sickle cell disease are rare, with a PubMed search producing only 70 results, and research in this area focusing specifically on incomplete data is severely limited. The objective of this analysis is to uncover differences between completed surveys and incomplete surveys among adult survey participants with sickle cell disease to reveal a more comprehensive picture of the sexual health concerns of patients with sickle cell disease. Methods: A study targeting sexual health concerns among adults aged 18 years old and older with a sickle cell disease diagnosis was conducted between August 2019 and August 2020 at Duke's Adult Comprehensive Sickle Cell Center. Survey questions consisted of demographic questions as well as categories of sexual health concerns for both male and female participants. Study participation was not compensated and was completely voluntary. Patients were approached and consented by clinic staff following appointment check-in. Surveys were then aggregated into an Excel sheet and underwent data analysis. Incomplete surveys were sorted out on the basis of one or more incomplete questions and/or demographic responses. Incomplete and complete surveys were further analyzed in Microsoft Excel. Results: The demographic breakdown of completed surveys and incomplete surveys showed significant differences. Completed surveys consisted of 48% (N=48) female and 52% (N=51) male responses. Incomplete surveys consisted of more female responses with a 59% (N=32) female and 41% (N=22) male. Chiefly, the analysis of incomplete surveys revealed that male participants were more concerned about relationship changes with an intimate partner than female participants, with 9% of males and 6% of females reporting this concern. This presents a contrast to the completed survey group in which 6% of males and 8% percent of females were concerned about relationship changes with an intimate partner. Though female respondents had more incomplete surveys, male respondents expressed fewer concerns as compared to the completed surveys group. A full analysis of incomplete surveys revealed that the concerns of scrotal tenderness, penile tenderness, pain and discomfort with masturbation, pelvic pain, and difficulty achieving a comfortable position for intercourse were completely missing from male respondents with incomplete surveys. However, these same categories had a reporting percent in the completed surveys category among male respondents, with each category having 2% to 10% of male respondents reporting it as a concern. For female respondents, only one category, pain or discomfort with masturbation was absent from the analysis of incomplete surveys and had a 2% reporting rate among completed surveys. Conclusion: Overall, our results show that there are discrepancies in survey results that may disproportionately affect the measurement of sexual health concerns among adults with sickle-cell disease. Female participants were shown to comprise 59% percent of incomplete surveys versus 48% percent of complete surveys, indicating that there is an area of improvement to encourage more female responses. Additionally, male participants with incomplete surveys had many more concerns unreported, indicating there may be discomfort with addressing these concerns. Cliniciansshould be encouraged to takethe opportunity to allow more open discussions of such topics with male patients. In conclusion, incomplete surveys offer additional insight into the pressing issues of the sexual health concerns of adult patients with sickle cell disease that may be under-reported otherwise in this understudied demographic. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

31 Identifying Child Maltreatment in Virtual Medical Appointments - What Are We Missing?

Abstract Background Throughout the COVID-19 pandemic, concerns have emerged regarding missed cases of child maltreatment. Evidence suggests an increased incidence of child maltreatment despite a documented decline in reports to child protective services. In Ottawa, reports dropped by 30-40% at the start of the pandemic in 2020. Pediatricians play an important role in the detection of child maltreatment and many have shifted from in person to virtual care. However, there is a paucity of published literature on this topic. We hypothesize that the shift to virtual visits is a barrier to identifying cases of child maltreatment and may contribute to missed cases. Objectives Our survey assesses if and how Canadian pediatricians are identifying child maltreatment over virtual medical appointments, as well as the barriers and enabling factors to doing so. Design/Methods The Canadian Paediatric Surveillance Program (CPSP) is a joint effort with the Canadian Paediatric Society and Public Health Agency of Canada towards national pediatric surveillance through monthly surveys to 95% of Canadian pediatricians. Using their infrastructure, a one-time survey was sent to 2770 pediatricians between November 2021 and January 2022 with data analyzed for qualitative themes and descriptive statistics. Results There was a 34% response rate (n= 928) and 704 valid responses. Exclusions were for no provision of virtual care, incomplete surveys or no reported cases of child maltreatment in their career (n=93, 10%). The average number of years in independent practice was 17.5 years, and 69% had not provided virtual care prior to the pandemic. Based on a virtual visit, at least one case of child maltreatment was reported by 16% of physicians prior to the pandemic, and by 11% following March 2020. Nearly one-third (30%) of these cases required a subsequent in-person visit prior to making the report. Social stressors and clear disclosures from patients and caregivers were the main factors leading to reports. The virtual physical exam was not a factor that triggered concerns of maltreatment in any case. Respondents reported at a rate of 68% that it was slightly or much more difficult to detect child maltreatment over virtual visits. Concerns that a case had been missed or identified late in association with virtual care were reported by 29% of physicians (n=206) with some commenting that clear harm resulted. Conclusion This survey shows that virtual medical care presents barriers to identifying child maltreatment and may be an important factor in missed cases of child maltreatment.

Cleft Orthodontic Care in Europe: A Cross-Sectional Survey.

(1) Background: Orthodontists have an important role in cleft care. Over the two decades since the Eurocleft studies, a significant improvement in healthcare systems has been achieved but there has been no critical assessment regarding the establishment of proposed standard protocols. This study aimed to describe the current provider characteristics, orthodontic appliances, services offered, orthodontic complications, and cost analysis of cleft treatment in Europe. (2) Methods: A cross-sectional 22-question online survey, accessible from January 2021 to July 2021, was sent to 214 practitioners, pertaining to provider characteristics, orthodontic appliances, services offered, orthodontic complications, and cost analysis. Descriptive statistics were calculated for each question. Fisher’s exact test was used to assess the association between categorical variables. (3) Results: A total of 79 responses from 23 European countries completed the survey (response rate = 37%), with 69 surveys being assessed after the exclusion of incomplete surveys. Rapid maxillary expansion was the preferred expansion protocol (45%). Distraction osteogenesis was the most reported alternative treatment to secondary bone grafts (19%), with private practitioners being less likely to perform these treatments (Fisher’s exact test, p = 0.001). Orthodontic services offered were, however, rather similar in the various locations of provision (hospital and/or university, private). Compromised oral hygiene (77%) was the most reported orthodontic complication. The National Health Services support the majority of cleft orthodontic care (67%) in Europe. (4) Conclusion: An apparent improvement in orthodontic healthcare provision has been achieved within Europe in the last two decades, but there are several discrepancies, namely regarding treatment timing and the appliances offered.

World Federation of Athletic Training and Therapy World Congress 2022 Peer-Reviewed Track Abstracts, May 5–7, 2022, Winnipeg, Manitoba, Canada

World Federation of Athletic Training and Therapy World Congress 2022 Peer-Reviewed Track Abstracts, May 5–7, 2022, Winnipeg, Manitoba, Canada

Validation of Veterans RAND 12-Item Physical Function Survey in Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Veterans RAND 12-item (VR-12) physical component score (PCS) has been validated in both veteran and US citizen populations; however, its use for spine surgery populations has not been evaluated. This study aims to correlate the VR-12 PCS survey with legacy patient-reported outcome measures (PROMs) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). A prospective surgical database was retrospectively assessed for MIS TLIFs performed at 1 level from March 2015 to June 2019. Inclusion criteria were elective procedures for degenerative spinal pathology. Patients were excluded if they had surgery for metastatic, traumatic, or infectious etiologies or had incomplete preoperative 12-item Short Form (SF-12) PCS or Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF) survey. Additionally, patients with any incomplete VR-12 PCS surveys through 1 year were excluded. Demographics and perioperative characteristics were recorded. Mean postoperative PROM scores and score difference from preoperative baseline were calculated at each postoperative timepoint through 1 year. The relationship of VR-12-PCS with SF-12-PCS and PROMIS PF was evaluated with a Pearson's correlation coefficient and time-independent partial correlation. A total of 59 patients underwent single-level MIS TLIFs. The cohort was 44.1% women with an average age of 53.8 years, and 52.5% were obese (body mass index ≥30 kg/m2). The VR-12 PCS, SF-12 PCS, and PROMIS PF surveys had significant improvements from baseline to the 6 month through 1 year postoperative timepoints (P ≤ 0.001, all). All timepoints revealed strong VR-12-PCS correlations with SF-12-PCS and PROMIS PF (all P ≤ 0.001). VR-12 PCS, SF-12 PCS, and PROMIS PF scores all indicate statistically significant improvements in physical function for patients following MIS TLIF. VR-12 PCS was strongly correlated with the historically validated SF-12 PCS system as well as with the more recent PROMIS PF survey. Our observations give weight to utilizing the VR-12 PCS survey as a valid measure of physical function among patients undergoing MIS TLIF. This study validates VR-12 PCS to measure physical function for TLIF patients.

Impact of a Potential 20-Week Abortion Ban on Likelihood of Completing Required Views in Second-Trimester Fetal Anatomy Ultrasound.

The aim of this study was to quantify the likelihood of assessing all mandated fetal views during the second-trimester anatomy ultrasound prior to the proposed federal 20-week abortion ban. Retrospective cohort study of a random sample of 1,983 patients undergoing anatomy ultrasound in 2017 at a tertiary referral center. The difference in proportion of incomplete anatomic surveys prior compared with after 20-week gestation was analyzed using X 2 and adjusted logistic regression; difference in mean days elapsed from anomaly diagnosis to termination tested using t-tests and survival analysis. Incomplete views were more likely with initial ultrasound before 20 weeks (adjusted relative risk: 1.70; 95% confidence interval: 1.50-1.94); 43.5% versus 26.1% were incomplete before and after 20 weeks, respectively. Fetal structural anomalies were identified in 6.4% (n = 127/1,983) scans, with 38.0% (n = 49) identified at follow-up after initial scan was incomplete. 22.8% (n = 29) with an anomaly terminated. A complete assessment of fetal views during an anatomy ultrasound prior to 20-week gestation is often not technically feasible. Legislation limiting abortion to this gestational age would greatly impact patient's ability to make informed choices about their pregnancies. · It is often not technically possible to complete anatomy ultrasound prior to 20-week gestation.. · Often, anomalies are missed during early, incomplete anatomy ultrasounds.. · After the diagnosis of a structural anomaly, one in five chose to terminate the pregnancy..

Attitudes about use of preoperative risk assessment tools: a survey of surgeons and surgical residents in an academic health system

BackgroundFormal surgical risk assessment tools have been developed to predict risk of adverse postoperative patient outcomes. Such tools accurately predict common postoperative complications, inform patients and providers of likely perioperative outcomes, guide decision making, and improve patient care. However, these are underutilized. We studied the attitudes towards and techniques of how surgeons preoperatively assess risk.MethodsSurgeons at a large academic tertiary referral hospital and affiliate community hospitals were emailed a 16-question survey via REDCap (Research Electronic Data Capture) between 8/2019-6/2020. Reminder emails were sent once weekly for three weeks. All completed surveys by surgical residents and attendings were included; incomplete surveys were excluded. Surveys were analyzed using descriptive statistics (frequency distributions and percentages for categorical variables, means, and standard deviations for continuous variables), and Fisher’s exact test and unpaired t-tests comparing responses by surgical attendings vs. residents.ResultsA total of 108 surgical faculty, 95 surgical residents, and 58 affiliate surgeons were emailed the survey. Overall response rates were 50.0% for faculty surgeons, 47.4% for residents, and 36.2% for affiliate surgeons. Only 20.8% of surgeons used risk calculators most or all of the time. Attending surgeons were more likely to use prior experience and current literature while residents used risk calculators more frequently. Risk assessment tools were more likely to be used when predicting major complications and death in older patients with significant risk factors. Greatest barriers for use of risk assessment tools included time, inaccessibility, and trust in accuracy.ConclusionsA small percentage of surgeons use surgical risk calculators as part of their routine practice. Time, inaccessibility, and trust in accuracy were the most significant barriers to use.

Vocal Health and Vocal Health Knowledge Among Occupational Voice Users in the Province of Quebec

Voice disorders are frequent among occupational voice users such as teachers. Although these disorders can have serious personal and professional consequences, they are not often recognized as occupational diseases and little attention is paid to their prevention. This study aimed to provide a portrait of the self-reported vocal health and vocal health knowledge of occupational voice users in Quebec, Canada, and to identify risk factors associated with voice disorder symptoms. We conducted an online survey targeting occupational voice users in the province of Quebec, Canada, with a focus on those involved in teaching or training. The final sample, after excluding incomplete surveys, included 808 respondents (665 women, M = 41.5 ± 10.4 years old). The survey responses were analyzed using descriptive and inferential statistics. Results indicated that 9.8% of the respondents had a history of a diagnosed voice disorder and 68.8% of the respondents experienced at least one voice symptom on a regular basis. Ordinal logistic regressions revealed that several personal and environmental factors are associated with an increased risk of developing voice disorders symptoms: being a woman, suffering from a breathing disorder, allergies, acid reflux and/or hearing impairment, having less work experience, working with elementary school children and/or with continuous or speech noise in the background. Most of the respondents (94.6%) had never received information regarding voice disorders during their academic training and less than half of them (47.7%) knew which professionals can treat voice disorders. These findings highlight the need for formal vocal health education among both occupational voice users and their employers to improve prevention and treatment for voice disorders in an at-risk population.

Knowledge, attitudes, and self-reported practices (KAP) towards hand hygiene in medical students versus the public

BackgroundThe COVID-19 pandemic and its associated morbidity, mortality, and economic disruption has reignited interest in simple protective and preventive measures.AimsThe aim of this study was to assess the knowledge, attitudes, and practices (KAP) of hand hygiene in a sample of medical students in Ireland and members of the public to evaluate these within the context of the COVID-19 pandemic. We also explored any differences between the two groups.MethodsA 35-question survey was formulated and circulated to potential participants comprising Irish medical students and members of the public. The data was analysed using Microsoft Excel with P-values being calculated using chi-squared goodness-of-fit analysis.ResultsThere were 356 responses to the survey, categorised into medical students and general public populations. Incomplete surveys were removed leaving 303 responses. There was no statistical difference between the groups for attitudes and self-reported practices towards hand hygiene. Statistical differences were found between the two groups in terms of knowledge.ConclusionsThe study showed that medical students and the public had a good knowledge base and positive attitude in regards to hand hygiene. Both groups displayed consensus that the practices are essential, especially within the current pandemic context. However, larger studies, involving multiple universities and a larger portion of the public, may be useful to ascertain whether there is a true difference in the KAP between healthcare students and the general public.

E-health literacy of secondary school students in Saudi Arabia

BackgroundThe internet has become the most important source for information access across the globe. However, it is essential that the users need a few essential skills and knowledge tips for identifying reliable sources of information, analyzing and evaluating the information, and applying the knowledge gained in real-life contexts, which is referred to as E-Health literacy. With increasing reliance on internet technologies, it is essential that school curriculums incorporate computer literacy and E-Health concepts in order to enable students to make better use of internet technologies and to prevent information misuse. ObjectiveThe aim of this study is to investigate the E-Health literacy levels among the secondary school students in Saudi Arabia. MethodsA questionnaire-based (E-Heals) survey was adopted for collecting the data from students. Twenty-Four schools in six major cities in Saudi Arabia were selected for the study. Purposive sampling was adopted for identifying the schools, and random sampling was adopted for selecting the classes (Grade 10) in secondary schools. A total of 3134 students participated in the survey, out of which 476 incomplete surveys were identified, resulting in a final sample of 2658. ResultsMedium to High E-Health literacy levels were identified among the participants. Significant differences in E-Health literacy levels was identified among male and female students (T-Value = 26.5518, p < 0.0001), and also among students in public and private schools (T-Value = 4.666, p < 0.0001). In addition, younger students exhibited a higher E-Health literacy compared to older students. ConclusionsSecondary school students reflected good E-Health literacy levels in Saudi Arabia. However, there are discrepancies in literacy levels in relation to gender and type of schools, which need to be addressed by improving more engaging pedagogic strategies for achieving good E-Health literacy rates among all students. In addition, future studies should focus on the influencing factors of E-Health literacy across various population samples.

Adding Centralized Electronic Patient-Reported Outcome Data Collection to an Established International Clinical Outcomes Registry

The importance of patient-reported outcomes (PROs) in cellular therapies, including hematopoietic cell transplantation (HCT) is highlighted in this study. Longitudinal collection of PROs in a registry is recommended for several reasons, yet to date, PROs are not routinely collected from HCT patients to augment clinical registry data. The aim of this study was to determine the feasibility of electronic PRO data collection by a national clinical outcomes registry, by assessing differences between who does and does not report PROs. We conducted a cross-sectional pilot collection of PROs from HCT recipients after treatment using computer-adapted tests from the Patient-Reported Outcome Measurement Information System (PROMIS). We implemented centralized data collection through the Center for International Blood and Marrow Transplant Research (CIBMTR) among patients who underwent HCT for myelodysplastic syndromes (MDS), were at least 6 months post-HCT, and spoke English or Spanish. The main objective was identifying patient, disease, and transplant-related differences associated with completion of electronic PROs. Patients were excluded from analysis if they were determined to be ineligible (deceased, did not speak English or Spanish, refused to be contacted by the CIBMTR). A total of 163 patients were contacted and potentially eligible to participate; of these, 92 (56%) enrolled and 89 (55%) completed the PRO assessment. The most frequent reason for incomplete surveys was inability to contact patients (n=88), followed by declining to participate in the study (n=37). There were no sociodemographic or age differences between those who completed the PRO survey (n=89) and eligible nonresponders (n=155). Patient scores were within 3 points of the US average of 50 for all symptoms and functioning except physical functioning. Responders and nonresponders did not exhibit meaningfully different sociodemographic characteristics. Difficulty contacting patients posed the greatest barrier and also provided the greatest opportunity for improvement. Once enrolled, survey completion was high. These results support standardizing centralized PRO data collection through the CIBMTR registry.

Belgian rheumatologists' preferences regarding measures of disease activity in patients with rheumatoid arthritis: results from a mixed-methods study.

The reliability and clinical usefulness of the different composite disease activity scores and their individual components in Rheumatoid Arthritis (RA) are still debated. This study investigated which measures of disease activity were preferred by rheumatologists. A mixed-method study was performed. First, ten Belgian rheumatologists were invited for individual interviews on their current practice and preferences for measurement of RA disease activity. Results of this qualitative study and evidence from literature served as input for developing a survey. This survey asked rheumatologists to rate preferred standard disease activity score(s), their individual components, ultrasound and related patient-reported outcomes (PROs), by maximum difference scaling. The relative importance score (RIS) for each indicator was calculated using hierarchical Bayes modeling. The qualitative study included 6/10 invited rheumatologists. Composite scores and components were perceived as useful, while PROs were found subjective. Interestingly, ultrasound was used to mediate discrepancies between physician and patient. The survey based on this was sent to 244 Belgian rheumatologists, 83/244 (34%) responded, including 66/83 (80%) complete and 17/83 (20%) incomplete surveys (two missing essential information). Most rheumatologists (75/81, 93%) used a disease activity score and 68/81 (84%) preferred the DAS28-CRP. Swollen joint count obtained the highest mean ± SD RIS (22.54 ± 2.64), followed by DAS28 ESR/CRP (20.61 ± 4.06), ultrasound (16.47 ± 7.97), CRP (13.34 ± 6.11) and physician's global assessment (12.59 ± 7.83). PROs including fatigue, pain, and patient's global assessment, and Health Assessment Questionnaire, obtained the lowest mean RIS (0.34-2.54). Rheumatologists place more faith in self-assessed disease activity components or in laboratory tests. Trust in PROs to evaluate disease activity is low in clinical practice.

Attitudes and Beliefs Towards Medical Checklists in Radiation Oncology

<h3>Purpose/Objective(s)</h3> Pre-procedural medical checklists have been robustly shown in the surgical literature to be associated with numerous clinical improvements, including reductions in postoperative complications and death. The use of pre-procedure checklists within radiation oncology is poorly understood. We sought to assess the use of checklists by radiation oncologists in the U.S. and identify factors associated with their use. <h3>Materials/Methods</h3> A survey consisting of seven questions was created using Qualtrics (an online survey platform). Each question followed a multiple-choice format, with some questions allowing multiple responses. These questions aimed to examine radiation oncologists' perceptions regarding the value of checklists in medical practice. This survey was distributed to radiation oncology residents and attending physicians. Responses to each question along with demographic data from each respondent were collected and examined. Where applicable, univariate analysis via Fisher's exact test was performed. Incomplete surveys were excluded from data analysis. The survey and methods of collection were approved by institutional review board. <h3>Results</h3> A total of 349 respondents completed the survey. The majority of respondents were physicians who have been in practice for "greater than ten years" (78.5%). The majority of respondents work in private practice (47.6%), followed by academic institutions (42.7%). Of these, 296 respondents indicated that they used checklists (84.8%). Of those individuals, 207 reported routine use (69.9%). Neither amount of time in practice nor type of practice were found to be significantly associated with use of checklists (<i>P</i>-values 0.344 and 0.715, respectively). Most respondents felt that checklists played an important role in ensuring patient safety, accountability, and procedure efficiency (92.8%, 88.8%, 88.2%), but significantly fewer respondents felt that checklists played a role in decreasing mortality (75.6%). The majority of respondents believed that the usefulness of checklists is supported by retrospective quality assurance studies (64.1%). Significantly fewer respondents believed that randomized clinical trials supported their usefulness (35.3%) and some believed that checklists have not been formally evaluated (13.4%). <h3>Conclusion</h3> We present data characterizing radiation oncologists' perceptions of medical checklist use, demonstrating significant interest and frequent use across the community. Given widespread interest in checklists, initiatives within radiation oncology professional societies may facilitate advancement of medical checklists while increasing awareness of the data supporting their use. Additional studies exploring automated methods of checklist creation and outcomes following implementation within radiation oncology are warranted. IRB approval: PRO00036824

Neonatal Abstinence Syndrome Practices in the United States.

To survey current practices for the treatment of neonatal abstinence syndrome (NAS) among institutions in the United States to identify changes in national practice over time. Previous NAS management reports were referenced in the development of our 26-question electronic survey, which was distributed in the fall of 2019 to pediatric practitioners of 2 national clinical pharmacy organizations via email list servers. Not all questions required a response and responses from incomplete surveys were included. Institution demographics and NAS management strategies, including location of care, observation period, and inpatient and outpatient pharmacotherapy, were queried. Seventy respondents representing institutions from all US geographic regions participated in the survey The most commonly reported inpatient observation durations were 3 (18 of 61, 29%) and 5 (22 of 61, 36%) days. Respondents indicated that neonates were typically transferred to the NICU if pharmacologic management was required (38 of 56, 68%). According to participants, first-line agents used for NAS management were morphine (45 of 56, 80%), methadone (5 of 56, 9%), clonidine (2 of 56, 4%), and buprenorphine (2 of 56, 4%). Among respondents, only 20% (11 of 56) reported that infants may be discharged home on pharmacotherapy, including morphine (n = 6), phenobarbital (n = 3), clonidine (n = 1), and methadone (n = 1). Opioids are the most commonly used first-line agents for NAS management in the United States. The primary site of NAS management is the inpatient setting, as only 20% of institutions report discharging patients on pharmacotherapy.