Interest In Further Education Research Articles

Integrative nursing interventions: knowledge, attitudes and practice in home nursing services in Germany-a quantitative and qualitative online survey.

Integrative nursing interventions (INI) play a significant role in healthcare, particularly in the prevention and treatment of chronic diseases. Integrating evidence-based INI into healthcare aligns with global initiatives such as the WHO's Decade of Healthy Aging 2020-2030. Many INI are low-threshold practices, empowering patients to independently manage health. However, the extent to which INI are used by home-care nursing-services (HNS) remains largely unknown. This study aims to explore the field of INI in German HNS regarding nurses' use of INI as well as attitudes, subjective knowledge, and information needs on the subject. A cross-sectional anonymous online survey with 29 Likert scale items and two open-ended questions was conducted between April 2023 and July 2023. The survey targeted nurse managers of HNS in Baden-Württemberg, Germany. Descriptive analysis was performed for quantitative data, while content analysis according to Kuckartz was applied to analyze open-ended text responses. In total, n = 68 out of n = 1,331 HNS took part in the survey yielding a response rate of 5.1%. Their overall attitude toward INI was clearly positive (10-point Likert scale M ± SD: 8.37 ± 2.22). The average self-assessed knowledge level about INI was moderate (M ± SD: 5.39 ± 2.76). Almost half of the participants (45.6%) declared to incorporate INI in patient care. Most participants (84.2%) lacked employees with additional qualifications in INI. The INI used most were medicinal herbal teas (61%), compresses (57%), and aromatherapy (48%). Acupressure showed the greatest disparity between actual use in participating HNS (4.3%) and interest in further education (61%). The most common symptoms for which INI are used are pain, respiratory problems, anxiety, and palliative care. The main challenges reported for the use of INI in HNS are financial aspects, qualification and limited resources (staff and time). This exploratory study provides the first insights into nurses' attitudes, self-assessed knowledge, and utilization of INI in German HNS. Overall response rate was low (5.1%), therefore, the results should be interpreted with caution. Urgent action is needed to address financial aspects and further education on INI, to promote integration of INI in HNS to the best possible extent.

Parental Knowledge and Practices of Sleep Hygiene Among Children in Saudi Arabia: A Cross-Sectional Study.

Sleep hygiene is crucial for child development, influencing physical health, cognitive function, and emotional well-being. Parental knowledge and practices significantly influence children's sleep habits, yet gaps in understanding persist, impacting sleep quality and overall health outcomes. In Saudi Arabia, rapid societal changes and modern lifestyles pose unique challenges to maintaining healthy sleep habits among children. This study aims to assess parental knowledge and management of sleep hygiene, providing insights for targeted interventions tailored to Saudi cultural contexts. This cross-sectional study assessed parental knowledge and management of sleep hygiene among children in Saudi Arabia. Participants (N=729) were recruited from pediatric clinics and online forums, comprising parents with at least one child aged 0-18 years who completed surveys in Arabic or English. A comprehensive survey collected demographic data, parental sleep hygiene knowledge, practices, and concerns. Data were gathered between January and March 2024 via online and clinic-based distribution and analyzed using SPSS version 25 for descriptive statistics. The survey was completed by 729 participants, predominantly aged 25-44 years (70.4%), holding predominantly bachelor's degrees (34.7%), and employed full-time (49.7%). The majority reported having 2-3 children (54.9%). Findings indicated that 69.1% (504 participants) correctly identified school-aged children's sleep needs, and 71.0% (518 participants) recognized the importance of limiting electronic device use before bedtime. Sleep management practices revealed that 81.3% (592 participants) of parents adhered to bedtime routines, and 65.6% (478 participants) managed electronic device use appropriately. Bedtimes typically ranged from 7 to 9 PM for 90.5% (658 participants) of children, with wake-up times clustered between 6 and 8 AM for 75.6% (551 participants). Parental concerns showed reliance on online resources (60.4%) and pediatricians (54.7%) for sleep information, with 73.9% (539 participants) expressing interest in further education on sleep hygiene. This study highlights parental awareness of sleep hygiene practices in Saudi Arabia but underscores gaps in knowledge regarding caffeine effects and optimal napping practices. Tailored educational interventions are essential to enhance parental understanding and promote healthier sleep habits, thereby optimizing child well-being in the region.

Sustainability of a Pediatric Neurointensive Care Unit Model Within a Mixed Pediatric Intensive Care Unit and Its Effect on Nursing Sentiment.

BACKGROUND: Pediatric neurocritical care (PNCC) and pediatric neurointensive care units (neuro-PICU) are growing fields. Although some institutions have established independent neuro-PICUs meeting most Neurocritical Care Society (NCS) standards for neurocritical care units, many centers lack the resources to do so. We describe an alternative neuro-PICU model as a designated unit within a mixed pediatric intensive care unit (PICU) and its effects on nursing sentiment. METHODS: We established a 6-bed neuro-PICU within a 36-bed noncardiac PICU. Charge nurses were tasked with admitting PNCC patients into these beds. For nursing expertise, we used a core group of 12 PNCC specialty nurses and instituted PNCC nursing education to PICU nurses. We observed the number of PNCC patients admitted to neuro-PICU beds and surveyed charge nurses to identify barriers to assigning patients. We surveyed PICU nursing staff to explore sentiment regarding PNCC before and after establishing the neuro-PICU. Nursing criteria were compared with NCS standards. RESULTS: In the 40-month period, our PICU saw 2060 PNCC admissions. Overall, occupied neuro-PICU beds housed PNCC patients 74.1% of the time. The biggest barriers to patient placement were too many competing placement requests, not enough neuro-PICU beds when specialty census was high, and difficulty assigning one nurse to two PNCC patients. In surveys after establishing the neuro-PICU, compared to before, experienced nurses reported being more interested in obtaining Emergency Neurological Life Support certification (94.2% vs 80.6%, P = .0495), and inexperienced nurses reported being more familiar with PNCC clinical pathways (53.5% vs 31.7%, P = .0263). Most NCS criteria related to nursing organization were met. CONCLUSIONS: Focused neuro-PICUs should be developed to complement advances in the field of PNCC. Alternative neuro-PICU models are possible and can increase nursing interest in further education and awareness of clinical pathways, but barriers exist that require institutional commitment to nursing development to sustain the delivery of specialized care to this population.

Analysis of Longitudinal Assessment: Role of Radiology Online Longitudinal Assessment–Type Questions

ObjectiveThe purpose of this investigation was to assess gaps in radiologists’ medical knowledge using abdominal subspecialty online longitudinal assessment (OLA)-type questions. Secondarily, we evaluated what question-centric factors influenced radiologists to pursue self-directed additional reading on topics presented. MethodsA prospective OLA-type test was distributed nationally to radiologists over a 4-month period. Questions were divided into multiple groupings, including arising from three different time periods of literature (≤5 years, 6-15 years, and >20 years), relating to common versus uncommon modalities, and guideline-based versus knowledge-based characterization. After each question, participants rated their confidence in diagnosis and perceived question relevance. Answers were provided, and links to answer explanations and references were provided and tracked. A series of regression models were used to test potential predictors of correct response, participant confidence, and perceived question relevance. ResultsIn all, 119 participants initiated the survey, with 100 answering at least one of the questions. Participants had significantly lower perceived relevance (mean: 51.3, 59.2, and 62.1 for topics ≤5 years old, 6-15 years old, and >20 years old, respectively; P < .001) and confidence (mean: 48.4, 57.8, and 63.4, respectively; P < .001) with questions on newer literature compared with older literature. Participants were significantly more likely to read question explanations for questions on common modalities compared with uncommon (46% versus 40%; P = .005) and on guideline-based questions compared with knowledge-based questions (49% versus 43%; P = .01). DiscussionOLA-type questions function by identifying areas in which radiologists lack knowledge or confidence and highlight areas in which participants have interest in further education.

Assessment of Pediatricians' and General Practitioners' Knowledge and Practice Regarding Oral Health, Dental Caries and Its Prevention in Children: A Cross-Sectional Study.

This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children's oral health. This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with 81.6% being general (family) practitioners and 18.4% pediatricians. The survey comprised five sections, gathering information on participants' sociodemographic characteristics, routine oral cavity examination in clinical practice, knowledge about dental caries and its prevention, teething symptoms, and alternatives to fluorides for preventing dental caries. The findings revealed an overall poor understanding of dental caries and its prevention, with an average score of 5.1 ± 1.6 out of a possible 10 points. Notably, practitioners with fewer pediatric patients during the workday, no training on oral health, and uncertainty about physicians' active role in oral health prevention exhibited lower knowledge levels (p ˂ 0.05). Over 90% of participants conducted dental and oral mucosal examinations on their patients. About 25% had received continuing education on children's oral health, and 70.6% expressed interest in further education on the subject. This study highlights insufficient knowledge among physicians regarding dental caries and its prevention. With most participants eager to learn and actively promote children's oral health, providing training is essential to boost their knowledge and support children's oral health.

Use of Intranasal Analgesia in French Armed Forces: A Cross-Sectional Survey.

Pain management is essential in military medicine, particularly in Tactical Combat Casualty Care (TCCC) during deployments in remote and austere settings. The few previously published studies on intranasal analgesia (INA) focused only on the efficacy and onset of action of the medications used (ketamine, sufentanil, and fentanyl). Side-effects were rarely reported. The aim of our study was to evaluate the use of intranasal analgesia by French military physicians. We carried out a multicentric survey between 15 January and 14 April 2020. The survey population included all French military physicians in primary-care centers (n = 727) or emergency departments (n = 55) regardless of being stationed in mainland France or French overseas departments and territories. We collected 259 responses (33% responsiveness rate), of which 201 (77.6%) physicians reported being familiar with INA. However, regarding its use, of the 256 physicians with completed surveys, only 47 (18.3%) had already administered it. Emergency medicine physicians supporting highly operational units (e.g., Special Forces) were more familiar with this route of administration and used it more frequently. Ketamine was the most common medication used (n = 32; 57.1%). Finally, 234 (90%) respondents expressed an interest in further education on INA. Although a majority of French military physicians who replied to the survey were familiar with INA, few used it in practice. This route of administration seems to be a promising medication for remote and austere environments. Specific training should, therefore, be recommended to spread and standardize its use.

Australian General Practitioners' Current Knowledge, Understanding, and Feelings Regarding Breast Density Information and Notification: A Cross-Sectional Study.

Background: There is a lack of evidence around Australian general practitioners’ (GPs) views of issues surrounding breast density. The current study aimed to quantitatively assess GPs’ current knowledge, understanding, and feelings around breast density information and notification. Methods: This study involved a cross-sectional survey using an online platform to collect quantitative data from Australian GPs. Survey data were analysed with descriptive statistics. Results: A total 60 responses from GPs were analysed. Most (n = 58; 97%) had heard or read about breast density and nearly 90% (n = 52; 87%) have had discussions about breast density with patients. Three-quarters (n = 45; 75%) were supportive of making breast density notification mandatory for patients with dense tissue and a similar proportion (n = 45/58; 78%) felt they need or want more education on breast density. Conclusions: There is strong support for notifying patients of breast density, and interest in further education and training among the surveyed GPs. As GPs play a central role in cancer prevention and control, their involvement in discussions related to breast density notification, evaluation and appraisal of evidence, development of communication strategies, and participation in ongoing research on the topic will be indispensable.

A novel multimodal needs assessment to inform the longitudinal education program for an international interprofessional critical care team

BackgroundThe current global pandemic has caused unprecedented strain on critical care resources, creating an urgency for global critical care education programs. Learning needs assessment is a core element of designing effective, targeted educational interventions. In theory, multimodal methods are preferred to assess both perceived and unperceived learning needs in diverse, interprofessional groups, but a robust design has rarely been reported. Little is known about the best approach to determine the learning needs of international critical care professionals.MethodWe conducted multimodal learning needs assessment in a pilot group of critical care professionals in China using combined quantitative and qualitative methods. The assessments consisted of three phases: 1) Twenty statements describing essential entrustable professional activities (EPAs) were generated by a panel of critical care education experts using a Delphi method. 2) Eleven Chinese critical care professionals participating in a planned education program were asked to rank-order the statements according to their perceived learning priority using Q methodology. By-person factor analysis was used to study the typology of the opinions, and post-ranking focus group interviews were employed to qualitatively explore participants’ reasoning of their rankings. 3) To identify additional unperceived learning needs, daily practice habits were audited using information from medical and nursing records for 3 months.ResultsFactor analysis of the rank-ordered statements revealed three learning need patterns with consensual and divergent opinions. All participants expressed significant interest in further education on organ support and disease management, moderate interest in quality improvement topics, and relatively low interest in communication skills. Interest in learning procedure/resuscitation skills varied. The chart audit revealed suboptimal adherence to several evidence-based practices and under-perceived practice gaps in patient-centered communication, daily assessment of antimicrobial therapy discontinuation, spontaneous breathing trial, and device discontinuation.ConclusionsWe described an effective mixed-methods assessment to determine the learning needs of an international, interprofessional critical care team. The Q survey and focus group interviews prioritized and categorized perceived learning needs. The chart audit identified additional practice gaps that were not identified by the learners. Multimodal methods can be employed in cross-cultural scenarios to customize and better target medical education curricula.

Academic staff governors’ power and professional status in the governance of further education colleges in England

ABSTRACT At a time of the British government’s heightened interest in Further Education (FE) college governance, this paper explores Academic Staff Governor (ASG)’s professional and power status at three colleges in England. The study draws upon relevant literature to identify concepts related to ASGs’ power and professional status in governance. An interpretivist stance is used to collect predominantly qualitative data through a combined methods approach. During fieldwork, evidence from semi-structured interviews; questionnaire responses, observations of governance meetings and governance documents was analysed. Findings suggest that ASGs’ insiderness; relationships, professional status and the decision-making circumstances may limit their influence in the governance of the colleges, with implications for governance quality. From the exploration, ‘The Restricted Professional Model’ has been developed to highlight the restricted nature of the ASG role with implications for good governance. For governors, organisations and policymakers, the research recommends avoiding low-power and low-status governance roles; taking action to develop ASGs’ professionality as educators; removing structural and power barriers and allowing more opportunities for ASGs to contribute to governance. Finally, future research is identified including research to establish ASGs’ professional profiles in FE and the wider impact educators’ professionality has on governance in a variety of educational institutions.

The main parameters of and mechanisms for the development of lifelong education of the adult population in the economically developed countries

Lifelong education is gradually becoming the main challenge for the education system and for a significant part of the working population. The demand for it is influenced by the growth of interest in further education in a variety of forms, content and duration among the highly educated adult population; by the growth in the number of people who lack skills and qualifications to perform current work assignments, and by the increasing needs of employers operating in conditions of frequently changing requirements for the competence of employees due to technical and organizational changes. The author considers the indicators of the involvement of the adult population of economically developed countries in various forms of lifelong education, as well as incentives and barriers to such activities. It may be especially useful for the Russian public to learn about collective funds of professional training, and the use of instruments of state subsidization and reimbursement of expenses: educational loans and vouchers; individual and saving accounts which can become promising means to expand participation in lifelong education, including for a growing number of non-standard workers.

50. Pilot Study on Offering HIV Pre-Exposure Prophylaxis (PrEP) to People Who Inject Drugs (PWID) in the Inpatient Setting

BackgroundDue to the ongoing opioid epidemic, PWID represent an increasingly high-risk population for HIV infections in the United States, accounting for 10% of all new HIV diagnoses in 2018 and 12.5% of all deaths among people living with HIV. PrEP is an effective means of preventing HIV, though uptake has been low among PWID, possibly due to low access to care. Inpatient admissions may represent missed opportunities for provision of PrEP to PWID.MethodsInpatient prescriptions for tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) from 10/2019 to 8/2020 were analyzed to assess baseline provision of PrEP to PWID. Physicians on the Infectious Diseases ward service were anonymously queried on perceived barriers and their practices regarding provision of PrEP to PWID. PWID admitted from 9/2020 to 5/2021 were approached at bedside, provided counseling on PrEP and offered initiation prior to discharge. We analyzed patient perceptions and acceptance of PrEP.Results16 total prescriptions for TDF-FTC were provided at discharge from 10/2019 to 8/2020, with 0 being for PrEP in PWID. The 8 physicians surveyed estimated caring for an average 4 PWID per week of service. 5/8 physicians reported that at least one PWID was offered PrEP during their most recent week of service. The most commonly reported physician barrier to prescribing PrEP was uncertainty regarding adherence and follow up (5/8). 30 patients were approached, with 14 reporting prior knowledge of PrEP. 18 were willing to engage in further education. Only 4 were accepting of PrEP, with 2 provided prescriptions. Of those declining, 13 denied equipment sharing, 4 denied active drug use, 7 stated a commitment to future abstinence, 3 were unwilling to adhere to a daily medication, 2 declined due to concerns of adverse effects and 1 due to concerns regarding stigma.Table 1. Physician Reported Barriers to Prescribing PrEP (n = 8) Table 2. Patient Knowledge and Acceptance of PrEP (n = 30) Table 3. Patient Reasons for Declining PrEP (n = 30) ConclusionIn this pilot study, few admitted PWID were accepting of PrEP. Attempts to initiate PrEP in PWID in the inpatient setting may not be effective at our institution. The most common reason for declining was low self-perceived risk of HIV acquisition; however, a significant proportion of patients showed interest in further education. Therefore, the inpatient setting may be a valuable site of initial counseling and referral for future potential provision of PrEP in the outpatient setting.Disclosures All Authors: No reported disclosures

Body dysmorphic disorder of female genitalia: a qualitative study of Swiss obstetrician\u2013gynecologists\u2019 experiences and practices

PurposeThis work focuses on the experiences and practices of obstetrician–gynecologists (ob–gyns) with patients suffering from body dysmorphic disorder (BDD) and issues with their aesthetics, specifically focusing on female genitalia. Ob–gyns are likely to play an important role in the recognition and treatment of women facing such issues.MethodsThis study took a qualitative, explorative approach. Semi-structured interviews were conducted with 11 ob–gyns about their experiences with patients who presented symptoms of BDD of female genitalia, their treatments, and interest in further education and supportive material. Interviews were analyzed through qualitative content analysis.ResultsA categorization system was created. The results showed that the participating ob–gyns are often confronted with genital dissatisfaction of patients. The study sample demonstrated a lack of mental health literacy concerning BDD. The treatments that the ob–gyns of this sample suggested for BDD of female genitalia were not in line with what evidence suggests. Finally, interest in further education and supportive material for consultation was evidenced in this sample.ConclusionsThe findings encourage further studies to identify the recognition of BDD concerning genitalia or etiological factors. Furthermore, practical implications (e.g., need of supportive material) can be derived from the results.

Use of a nurse with advanced practice in chronic wound management

Aim: To map the interest in further education in wound management in the context of advanced nursing practice, to find out whether a nurses with certification in chronic wound management according to current legislation is desirable from the point of view of management for job creation, and to find out how management perceives legislative and working conditions of application for the performance of independent practice in the profession of nurse in the management of chronic wounds.Design. Quantitative exploratory descriprive.Participants. 48 nurses with advanced experience working with patients with chronic, non-healing or difficult to heal wounds in the position of manager working in the institutionalized or community area of healthcare.Methods. Questionnaire with own structure. Data processing by descriptive and inductive statistics program SPSS 25.0.Results. The results represent a positive level of perception of the enforcement of a nurse with advanced experience with a certificate in the management of chronic wounds to create a job position. A similar result was achieved in the perception of cooperation with a nurse with advanced experience with a certificate in the management of chronic wounds in the context of consultations. We found out that a higher level of perception was among respondents working in the community area in homecare, who are licensed to perform the duties of a professional representative.Conclusions. The self-concept of a nurse with advanced experience in the field of chronic wound management shows a positive evaluation among managers in the community area of care working in ADOS. The results of the research show the need for visibility of a certified nurse in the management of chronic wounds and its implementation and application in practice.

Non-medical caregivers and the use of intraperitoneal chemotherapy in the operating theatre: A survey on the perception of safety.

In the last two decades, intraperitoneal(IP) chemotherapy during surgery achieved recognition in the management of peritoneal metastases. Occupational hazard became a concern leading to standardized safety measures. The aim of this study is to evaluate the perceived level of information and protection among the non-medical caregivers involved in HIPEC and PIPAC in a high-volume center. All non-medical caregivers in the operating theatre of our institution were asked to answer a questionnaire between April and May 2018. The questionnaire included multiple choice questions and open questions structured in four parts: demographic variables, perceived level of information, perceived level of protection, interest in further education. Forty-nine caregivers agreed to answer the questionnaire. All identified IP chemotherapy as an occupational risk. Thirty-eight persons (77.55%) trusted the protective value of safety measures during HIPEC compared to 32 (65.3%) during PIPAC. A total of 29 persons (59.18%) used some of the measures while 16 (32.65%) used all of them. Main reasons of non-use were slips and lapses (7 persons) and lack of comfort (4 persons). A total of 34 caregivers considered the level of information about safety protocols as good or very good (69%). A total of 46 persons considered the level of protection as satisfying or excellent (93.87%). A total of 36 (73.47%) interviewees expressed the need of receiving more information. The present study shows that non-medical caregivers in the operating theatres are aware of the occupational hazards related to the use of IP chemotherapy. The use of protective measures is associated with decreased level of perceived risk. However there is a high need of continuous education on this subject for the involved personnel.

Medical, Dental, and Nursing Students' Knowledge about Early Childhood Oral Health Care.

Gaps in knowledge of physicians and nurses about early childhood oral health care were reported and are likely due to the poorly focused education on oral health issues; therefore, the purpose of this study was to assess the knowledge level of Qassim University medical, dental and nursing students about early childhood oral health care and its relation to demographic variables, students’ perceived knowledge, satisfaction with their knowledge and interest in further education about the topic. A total of 571 medical, dental, and nursing students received a questionnaire that included demographic questions, questions to assess knowledge level of the students about early childhood oral health care, and questions to assess their perceived knowledge level, satisfaction with their knowledge and interest in further education about the topic. Results of the study revealed that knowledge of dental students was highest (score 7.72 out of 10) followed by nursing students (4.79), and medical students (4.43). Additionally, students with a higher level of perceived knowledge were more likely to score higher. In view of the inadequate knowledge level of medical and nursing students about early childhood oral health care when compared to dental students, improvements in medical and nursing education programs are necessary at Qassim University.

Women with physical disability in pregnancy resident education: a national survey as a needs assessment for curriculum improvement in obstetrics and gynaecology in Canada

ObjectivesTo explore the current status to which Canadian obstetrics and gynaecology (Ob-Gyn) programmes teach residents about pregnancy in patients with physical disabilities, and to assess the level of interested in...

Survey of practice patterns for the management of ophthalmic genetic disorders among AAPOS members: report by the AAPOS Genetic Eye Disease Task Force

To better understand AAPOS member pediatric ophthalmologists' knowledge and needs regarding genetic eye disorders, the AAPOS Genetic Eye Disease Task Force developed a 16-question survey that was circulated to national and international AAPOS members. Responses to questions on practice patterns, baseline knowledge, and educational interests regarding patients with suspected ophthalmic genetic disorders were collected. A majority of respondents (93%) evaluate patients with suspected genetic disorders. Knowledge gaps were present in heritability of certain conditions, genetic testing strategies, and referral to clinical trials. Most respondents expressed interest in further education in these areas. A model for care is proposed as a first step in the education process.

P009 INFREQUENT COUNSELING BY PHYSICIANS ON IBD AND REPRODUCTIVE HEALTH ISSUES REPORTED BY PATIENTS IN CONJUNCTION WITH LOW CCPKNOW KNOWLEDGE SCORES IN AN EDUCATED COHORT

IBD and reproductive health counseling (IBD-RHC) is associated with higher knowledge, lower voluntary childlessness and greater medication adherence during pregnancy. Yet prior studies show documentation of IBD-RHC is low in both women and men, and few patients are satisfied with advice received on family planning and pregnancy. 1. Quantify rates of IBD-RHC. 2. Investigate factors associated with IBD-RHC. 3. Assess knowledge and interest in further education on IBD and reproductive health. We anonymously surveyed women and men ages 18-45 with IBD over a 6-month period in 2018 regarding their reproductive health histories and education experiences. We administered the CCPKnow questionnaire to assess IBD and reproductive health knowledge. STATA was used to summarize descriptive statistics and compare categorical variables using Fisher’s exact test. Sixty-six patients (58% F) completed the survey and the majority (85%) had at least a college degree. Only 30% of all patients and 18% of patients with IBD surgery reported prior reproductive health counseling by a physician (Table 1). Both men and women considered not having a child due to IBD (34% F, 18% M). The majority (83%) who considered voluntary childlessness did not receive prior IBD-RHC. Less than half (42%) of women had at least an adequate (≥8/17) CCPKnow score. Of the 11 women with an IBD diagnosis before pregnancy, 82% had no prior IBD-RHC, 60% did not seek GI care pre-conception and 36% did not seek GI care during pregnancy, yet 36% reported flares in the pre-conception, pregnancy or postpartum period. Additionally, 50% stopped or changed medications during pregnancy and 40% did so without consulting a physician. Patients reporting current immunomodulator use were more likely to have reported prior IBD-RHC (50% vs 22%, p=0.04, Table 2). Overall 71% of people reported interest in receiving more information on IBD and reproductive health. In an educated cohort at a tertiary care center, patients reported low rates (30%) of IBD-RHC on heritability, fertility and medication safety. Rates were lower (<20%) in patients who considered not having children due to IBD and those diagnosed with IBD prior to pregnancy. Current immunomodulator use was significantly associated with prior IBD-RHC, suggesting that counseling is provided on medications with negative effects on fertility (i.e. methotrexate) but not on the importance of pre-conception care and medication adherence. The majority of patients pregnant after an IBD diagnosis did not seek GI care pre-conception and many stopped or changed medications during pregnancy without consulting a physician. This highlights an urgent need for proactive counseling by gastroenterologists on IBD and reproductive health issues, supported by the majority of patients (71%) expressing a need for more education on these topics. Participants reporting prior counseling by a physician on specific topics related to IBD and reproductive health #If patient had taken the specified medication. *If patient had prior IBD surgery or planned to have surgery for IBD. #*IBD-RHC: IBD and reproductive health counseling is a composite of patient-reported counseling on heritability, fertility and IBD or fertility and medication. Participants reporting prior counseling by a physician on specific topics related to IBD and reproductive health #If patient had taken the specified medication. *If patient had prior IBD surgery or planned to have surgery for IBD. #*IBD-RHC: IBD and reproductive health counseling is a composite of patient-reported counseling on heritability, fertility and IBD or fertility and medication. Factors associated with prior IBD and reproductive health counseling IBD-RHC: IBD and reproductive health counseling is a composite of patient-reported counseling on heritability, fertility and IBD or fertility and medication. Fisher’s exact test was used to calculate p-values. *Immunomodulator: 6-MP, azathioprine or methotrexate. Factors associated with prior IBD and reproductive health counseling IBD-RHC: IBD and reproductive health counseling is a composite of patient-reported counseling on heritability, fertility and IBD or fertility and medication. Fisher’s exact test was used to calculate p-values. *Immunomodulator: 6-MP, azathioprine or methotrexate.

Workforce analysis of psychological practice with older adults: Growing crisis requires urgent action.

As the proportion and sheer number of older adults in the United States continues to increase, we need to plan for their behavioral health care. Access to accurate data about current workforce characteristics in psychology can provide essential information to inform workforce planning. In this paper, we present results of the American Psychological Association's Center for Workforce Studies survey of psychologists, with a focus on older adults. Participants (N = 4,109) were doctoral psychologists identified through state licensing boards. Only 1.2% of those surveyed described geropsychology as their specialty area, although 37.2% reported seeing older adults frequently or very frequently, most often from the specialties of rehabilitation psychology, clinical neuropsychology, and clinical health psychology. Frequent providers of aging services were more likely to be older, nonethnic minority, working in independent practice as their primary work setting, and self-employed as compared to other respondents. In addition, frequent providers of services to older adults were more likely to be in practices colocated with medical professionals and to accept Medicare as payment. Low reimbursement rates were cited as a reason for not accepting Medicare by those who did not. There was strong interest in further education in aging from all psychologists in areas including adjustment to medical illness/disability, depression, bereavement, dementia, anxiety, psychotherapy, and caregiver stress. The results of this survey suggest a continued urgent need to train psychologists across subfields in foundational geropsychology competencies that all psychologists should possess to be prepared for the rapidly growing and increasingly diverse population of older adults.

A survey across four European countries to determine rheumatology health professionals’ awareness of physical activity measures in people with inflammatory joint diseases

ObjectivesThe objectives of this study were to determine rheumatology health professionals' (HPs)' awareness of and confidence in using physical activity (PA) measures in people with inflammatory joint diseases (IJDs), their...