International Survey Research Articles

Internal Psychometric Validation of an International Burden of Illness Survey for Idiopathic Multicentric Castleman Disease.

Idiopathic multicentric Castleman disease (iMCD) is a rare, chronic, debilitating lymphoproliferative disorder where the mainstay of treatment is symptom management. Our recent international patient survey showed that patients with iMCD have a high symptom burden that has a significant negative patient-reported impact on several aspects of daily life. As part of our ongoing work towards the development of an iMCD symptom burden scale, assessing the survey's psychometric properties is a critical step in understanding its adequacy, relevance, and usefulness. As iMCD is a rare disease, there are challenges to conducting such psychometric analyses which we describe. As part of the exploratory psychometric analysis, three a priori hypothesis sets (HS) were generated by interviewing an iMCD-experienced clinician, a patient, and a caregiver to explore the iMCD patient survey's internal construct validity, given no gold standard iMCD measure exists for external construct validation. HS-1hypothesized that a convergent or discriminant relationship exists with the patients' self-assessment of symptom effect on daily life between two potentially related or unrelated symptoms, respectively. HS-2hypothesized that having a greater number of symptoms has a positive convergent relationship with the patients' assessment of symptoms' effect on daily life. Finally, HS-3hypothesized that patients receiving treatment versus no treatment was associated with patients reporting less effect of symptom burden on their daily life. Spearman's rank absolute correlation strength (ACS) was used for HS-1 and HS-2 (convergent relationship, ACS ≥ 0.3 and pvalue < 0.05; divergent relationship, ACS < 0.3), and Cohen's d to quantify standardized absolute effect sizes (AES) for HS-3 (AES ≥ 0.5 and pvalue < 0.05). Our analyses partially supported HS-1. None of the three positive convergent relationships were supported. Of the six discriminant relationships, only dizziness with impaired cognitive function and tiredness with dizziness were supported. HS-2 analyses showed there was convergent validity between the number of symptoms and their effect on aspects of daily life. HS-3 analyses did not provide evidence to support the hypothesis. These internal psychometric construct analyses provide initial support for the bespoke iMCD patient survey and will guide additional work towards the development of the first iMCD-specific symptom burden scale.

Perceptions of interventional cardiologists on diversity and discrimination.

There are limited data on diversity and discrimination against interventional cardiologists (ICs). We performed an online, anonymous, international survey of interventional cardiologists on their perceptions of diversity and discrimination in their field. A total of 445 ICs participated in the survey. The median age of participants was 46 to 50 years and most (60%) practice in the United States. Among the respondents, 13% identified as women, while 31% identified as Asian, 10% as Latino, and 3.2% as Black/African American. Women ICs were less likely to be married (62% vs 92%; P < .001) or have children (48% vs 87%; P < .001). Women, non-native English speakers, and non-white individuals had a higher likelihood of reporting discrimination from patients/families, peers, supervisors, support staff, and nursing staff, compared with men, native English speakers, and non-Hispanic white individuals, respectively. Women were less satisfied with the level of gender diversity in their workplace (25% vs 45%; P = .015) and were more likely to believe that women physicians have fewer opportunities in the field of IC compared with men (69% vs 35%; P < .001). Non-white individuals were more likely to believe that their race/ethnicity may impede the progress of their career (54% vs 15%; P < .001), that their race/ethnicity negatively impacted their fellowship prospects/acceptance (35% vs 11%; P < .001), and that their religion negatively impacted their fellowship prospects/acceptance (17% vs 4%; P = .003). Several participants (41%) expressed concerns that diversity, equity, and inclusion initiatives might result in unintended consequences. Our survey suggests that ICs perceive high rates of discrimination in their field.

Muscle biopsy practices in the evaluation of idiopathic inflammatory myopathies: An international survey of expert clinicians

BackgroundMuscle biopsy is an important test in the evaluation of individuals with suspected myopathy, including those with suspected idiopathic inflammatory myopathy (IIM). Various approaches, including open surgical biopsy, needle biopsy and conchotome forceps, have been reported. However the real-world utilisation of these approaches remains unclear. There are no established guidelines for the use of muscle biopsy, or selection of biopsy technique, in investigating IIM and international practices are not well-documented. This study describes current approaches to muscle biopsy amongst clinicians with expertise in IIM. MethodsA survey regarding muscle biopsy practices was disseminated among members of the International Myositis Assessment and Clinical Studies (IMACS) group. Data were analysed using descriptive statistics. ResultsOne-hundred and sixteen clinicians completed the survey, primarily rheumatologists. Open surgical biopsy was the most commonly employed technique (74.5 %), followed by needle (11.3 %) and conchotome (9.4 %) approaches. Clinical examination was the most common method of muscle selection, with 85.2 % of respondents reporting they ‘always or almost always’ relied on it. MRI and electromyography were also frequently utilised for muscle selection (51.9 %, 45.4 % respectively). There was variability in the perceived utility of muscle biopsy in certain clinical contexts, such as presence of myositis specific antibodies or cutaneous manifestations of dermatomyositis. While respondents generally reported low complication rates following muscle biopsy, non-diagnostic histopathology was commonly reported, regardless of procedural approach. ConclusionClinicians managing IIM report muscle biopsy to be well tolerated however, non-diagnostic results are common. Substantial heterogeneity regarding perceived indications for biopsy, procedural approaches, and muscle selection strategies were observed within this expert group. Future research is needed to establish best practice and determine the role of muscle biopsy in the context of continued advancements in serological profiling of IIM.

An international delphi survey and consensus meeting to define the risk factors for ureteral stricture after endoscopic treatment for urolithiasis.

Iatrogenic ureteral strictures (US) after endoscopic treatment for urolithiasis represent a significant healthcare concern. However, high-quality evidence on the risk factors associated with US is currently lacking. We aimed to develop a consensus statement addressing the definition, risk factors, and follow-up management of iatrogenic US after endoscopic treatment for urolithiasis. Utilizing a modified Delphi method, a steering committee developed survey statements based on a systematic literature review. Then, a two-round online survey was submitted to 25 experts, offering voting options to assess agreement levels. A consensus panel meeting was held for unresolved statements. The predetermined consensus threshold was set at 70%. The steering committee formulated 73 statements. In the initial survey, consensus was reached on 56 (77%) statements. Following in-depth discussions and refinement of 17 (23%) statements in a consensus meeting, the second survey achieved consensus on 63 (86%) statements. This process underscored agreement on pivotal factors influencing US in endoscopic urolithiasis treatments. This study provides a comprehensive list of categorized risk factors for US following endoscopic urolithiasis treatments. The objectives include enhancing uniformity in research, minimizing redundancy in outcome assessments, and effectively addressing risk factors associated with US. These findings are crucial for designing future clinical trials and guiding endoscopic surgeons in mitigating the risk of US.

An international survey of recalcitrant and recurrent tinea of the glabrous skin-A potential indicator of antifungal resistance.

There has been a global rise in cases of dermatophytosis and, in particular, recalcitrant and recurrent cases on tinea of the glabrous skin. This phenomenon, particularly prevalent in India, has been linked to the concerning rise of antifungal resistance. The challenge is amplified by a dearth of comprehensive, international data to understand the global scope and characteristics of such cases. This study aims to collate international insights, focusing on areas outside Europe (as this was previously published), to map the extent and characteristics of clinical and, where possible, laboratory confirmed tinea of the glabrous skin through an online survey administered to dermatologists globally. An online survey was distributed from February 2022 to July 2023 and captured data on respondents' experience of recalcitrant and recurrent tinea of the glabrous skin over the preceding 3 years. A total of 260 responses were received spreads across 36 countries, excluding Europe. In total, 91.7% reported seeing cases of recalcitrant or recurrent tinea of the glabrous skin over the preceding 3 years. Common anatomical sites affected were the trunk and groin. T. mentagrophytes and T. rubrum were the predominant species implicated, and there were low rates of laboratory confirmed dermatophyte resistance. The high rates of reported recalcitrant and recurrent tinea of the glabrous skin underscore an urgent need for global collaborative efforts and enhanced diagnostic measures. The findings advocate for the establishment of a standardized global disease registry, regulation of over-the-counter antifungal and steroid combinations, correlation of clinical suspicion with laboratory confirmed drug resistance and exploration of alternative therapeutic strategies to mitigate the burgeoning challenge of dermatophyte resistance.

Mostly Stability and Some Change in Lower-Secondary Pre-Service Teacher Education in the United States from 1990-2018: Evidence from TALIS 2018

This study leverages cross-sectional data collected via the 2018 Teaching and Learning International Survey (N = 1907) to estimate national “trends” in pre-service teacher education (PSTE) from 1990 to 2018 in the United States. In particular, the study examines linear trends in the content emphases of U.S. lower-secondary PSTE and in this teacher population’s initial level of preparedness in various domains. Results indicate more stability than change over this period nationally. PSTE emphasis on classroom practice in some or all subject(s) taught, and on monitoring students’ development and learning, decreased in frequency over time. PSTE emphasis on use of information and communication technology for teaching increased over time. Only teacher preparedness ratings for the use of information and communication technology for teaching statistically increased from 1990-2018.

The role of African universities in handling climate change

BackgroundAfrican countries are among the most vulnerable and affected by climate change. Comprehending climate change poses a major hurdle for the African population, politicians, and the African Union alike, presenting a substantial challenge for all involved. It is generally accepted that universities and other higher education institutions must play a leading role as drivers of change. Therefore, it is very important that African universities educate students about both mitigation and adaptation measures, develop the necessary initiatives to foster research in climate change-related topics and promote cooperation and alliances with key stakeholders.ResultsThis research reports on a study aimed at identifying the extent to which higher education institutions in Africa are engaging in efforts to deal with the challenges posed by climate change. The objectives were accomplished through a mixed method approach, incorporating a review of literature, an international survey, and the inclusion of selected case studies from African universities that have developed successful initiatives. The research has brought to light significant disparities, such as varying perceptions regarding the potential outcomes of climate change and its associated extreme events in African countries. In addition, the study highlighted areas where there is a notable consensus on specific issues. It also offers a comprehensive view of the different strategies that universities are implementing to contribute to climate change mitigation and adaptation in several areas. Although there is a growing interest in the need to contribute to the joint task of mitigating the effects of climate change and adapting to its consequences, HEIs need to increase their efforts to enhance the work of their professors and researchers. To this end, the involvement of public authorities and other private sector actors is essential.ConclusionsThis article outlines some actions that need to be undertaken so that universities may play a more active role in global efforts to handle the problems associated with a changing climate. There is a notable focus from academic actors on addressing climate change challenges in Africa. In addition, there is a proactive emphasis on utilizing science and research to comprehend climate change issues and offer widely applicable tools for adaptation and mitigation to safeguard both people and the environment. Consequently, it is crucial and time-sensitive for African universities to enhance their expertise in the field of climate change, fostering the capacity to conduct innovative research that addresses the various challenges linked to the evolving climate. This study offers several useful lessons for African universities to replicate experiences that have generated results in different countries and contexts.

“I’m like, whatever you want me to be. I’m the flavor of the day”: A mixed-methods study of the food dispositions and behaviors of mixed-race individuals

There is a dearth of research on how food serves a tool for the formation and enaction of the social identities of mixed-race people, how these social identities shape the unique food dispositions and behaviors of mixed-race individuals, and how, by virtue of their liminal status, mixed-race consumers are apt to blend and adapt food behaviors from their dual heritages, and subsequently diffuse these adaptations into the broader population. This mixed methods study, entailing semi-structured interviews with mixed-race individuals, followed by an international survey involving 645 mixed-race consumers living in Canada, the USA, and the UK, aims to address these knowledge gaps. Induced from the qualitative data, we disclose four overarching themes regarding the food practices and perceptions, in relation to our mixed-race informants’ identity and their position astride two cultures: (1) ‘you are what you eat’ (food as instrumental for ethnic identity), (2) ‘mixing the best of both worlds’ (integration and transmutation), (3) situational authenticity and awareness of cultural appropriation, and (4) double marginalization, denigration, and self-valorization. The quantitative findings revealed that blending cultural customs, blending food practices, and using products to express mixed-race identity, were all a positive function of the racialized-minority parent’s ethnic maintenance, as well as both independent and interdependent self-construals—demonstrating that racial and cultural blending promulgates these behaviors. Theoretical and practical implications and directions for future research are elucidated.

Engaging primary care professionals in OECD’s international PaRIS survey: a documentary analysis

Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities—how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD’s international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals.

A Global Measure of Professional Learning Communities

ABSTRACT The concept of professional learning communities (PLCs) has received considerable attention in research as well as in school practice since the late 1990s. PLCs have been positively associated with a variety of outcomes for both teachers and students, but differences in the way the concept is operationalised, and the fact that most of the research is related to specific national contexts, make it difficult to accumulate and compare research related to PLCs. In order to give PLC research an international scope, the aim of this paper is to develop a global measure of PLCs. The paper includes an overview of the literature on PLCs, as well as an examination of existing measures. Informed by these findings, multi-level confirmatory factor analysis is applied to develop a measure of PLCs in the Teaching and Learning International Survey 2018. This measure includes three distinct dimensions and an overall measure of PLCs at school level in 42 countries/economies, and is available for researchers interested in the concept of PLCs and international perspectives. The measure is applied in an example which investigates the relationship between PLCs and teacher job satisfaction in the Nordic countries. Strengths, limitations, international comparability and possibilities for future developments are discussed.

More we or more me? How collaboration and autonomy connect with school climate, team innovativeness and school satisfaction among Korea’s teachers

ABSTRACT Prior large-scale research on teacher collaboration and autonomy has failed to distinguish effects within and between schools or among elementary and middle school teachers. This lack of research has implications for professional development in countries like Korea, where national policies have increasingly favoured teacher collaboration. We therefore employed multilevel structural equation modelling to analyse Teaching and Learning International Survey 2018 responses from 5,601 Korean elementary and middle school teachers. Our findings revealed significant direct and indirect effects among the variables of teachers’ perceptions of teacher collaboration, teacher autonomy, school climate, team innovativeness and school satisfaction. At the teacher level, the main differences between elementary school and middle school teachers related to classroom autonomy and team innovativeness. Collaboration and autonomy significantly predicted school satisfaction among elementary school teachers but not middle school teachers. There were also key differences in effects from teacher collaboration and classroom autonomy at the teacher and school levels. The most notable finding was that school climate mediated the relationship between classroom autonomy and school satisfaction at the teacher level. As these factors relate to the uptake and implementation of professional development, we provide key recommendations for local and national policy-makers hoping to optimise learning opportunities for teachers.

Iron deficiency and supplementation in patients with heart failure: Results from the IRON-HF international survey.

Iron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, regardless of anaemia status. Iron supplementation has been demonstrated to improve exercise capacity and quality of life in patients with HF with an ejection fraction <50% and ID. This survey aimed to provide data on real-world practices related to ID screening and management. We designed and distributed an online survey (23 questions) regarding ID screening and management in the HF setting. Overall, 256 cardiologists completed the survey (59.8% male, mostly between 30 and 50 years). The majority of physicians defined ID according to the most recent HF recommendations (98.4%) and reported screening for ID in more than half of their patients (68.4%). However, only 54.3% of the respondents performed periodic screening (every 6 months to 1 year). A total of 93.0% of participants prescribed and/or administered iron supplementation, using intravenous iron as the preferred method of administration (86.3%). After iron supplementation, 96.1% of the respondents reassessed ID, most frequently at 3-6 months (67.6%). Most physicians (93.8%) perceived ID as an underestimated comorbidity in HF. Cardiologists' age, training status, subspecialty and work setting (academic vs. non-academic hospitals) were associated with heterogeneity in the answers. The results of this survey highlight the need for more consistent strategies of ID screening and treatment for patients with HF.

Lung ultrasound in respiratory therapy: a global reflective survey.

Lung ultrasound (LUS) is a non-invasive point of care diagnostic tool used to assess the presence and severity of various lung disorders for more than two decades. Within the healthcare professionals are the respiratory therapists (RTs) who play a vital role in managing ventilated and other patients requiring respiratory support, but the incorporation of LUS into their scope of practice has not been well highlighted. This international cross-sectional survey was specifically designed to evaluate the knowledge, attitude, and practice of RTs with respect to LUS. This observational cross-sectional study was conducted among RTs from different parts of the world using a questionnaire-based study tool. 514 RTs responded to all the questions and were considered for statistical analysis. Descriptive statistics, Analysis of variance, Fisher's exact, Chi-square, Bonferroni post-hoc analysis, and Binomial logistic regression analyses were performed to identify the significance of the data. From 22 countries, 514 RTs responded to the survey, with the major share from the middle eastern countries. Out of the 514 responders, 44.9% of the responders were in the age group of 23-30 years; 67.1% were bachelor's degree holders; and 40.9% of participants had more than 10 years of experience. The knowledge-based questions revealed that RTs with higher experience and academic qualification provided more positive responses. While in the attitude-related domain it is observed that standardized training in LUS helps them to enhance the current practice and to add LUS to the academic curriculum of respiratory therapy schools; however there remains barriers to practice LUS based on their responses. The practice-based questions revealed that RTs expect some additional seminars/workshops/webinars to be done on LUS frequently. More than half of the participants are found to be knowledgeable with a positive attitude and working towards the inclusion of LUS in respiratory therapy profession. It is concluded that respiratory therapists have a positive attribute towards the inclusion of lung ultrasound in their clinical practice. Providing more structured training for professional respiratory therapists and including lung ultrasound modules in the respiratory therapy school curriculum may facilitate mastering their diagnostic skills, thereby expanding the scope of practice.

Diagnosis and management of selective fetal growth restriction in monochorionic twin pregnancies: A cross-sectional international survey.

To identify current practices in the management of selective fetal growth restriction (sFGR) in monochorionic diamniotic (MCDA) twin pregnancies. Cross-sectional survey. International. Clinicians involved in the management of MCDA twin pregnancies with sFGR. A structured, self-administered survey. Clinical practices and attitudes to diagnostic criteria and management strategies. Overall, 62.8% (113/180) of clinicians completed the survey; of which, 66.4% (75/113) of the respondents reported that they would use an estimated fetal weight (EFW) of <10th centile for the smaller twin and an inter-twin EFW discordance of >25% for the diagnosis of sFGR. For early-onset type I sFGR, 79.8% (75/94) of respondents expressed that expectant management would be their routine practice. On the other hand, for early-onset type II and type III sFGR, 19.3% (17/88) and 35.7% (30/84) of respondents would manage these pregnancies expectantly, whereas 71.6% (63/88) and 57.1% (48/84) would refer these pregnancies to a fetal intervention centre or would offer fetal intervention for type II and type III cases, respectively. Moreover, 39.0% (16/41) of the respondents would consider fetoscopic laser surgery (FLS) for early-onset type I sFGR, whereas 41.5% (17/41) would offer either FLS or selective feticide, and 12.2% (5/41) would exclusively offer selective feticide. For early-onset type II and type III sFGR cases, 25.9% (21/81) and 31.4% (22/70) would exclusively offer FLS, respectively, whereas 33.3% (27/81) and 32.9% (23/70) would exclusively offer selective feticide. There is significant variation in clinician practices and attitudes towards the management of early-onset sFGR in MCDA twin pregnancies, especially for type II and type III cases, highlighting the need for high-level evidence to guide management.

Internationalization of higher education institutions: a comparative study in Taiwan and Japan

PurposeThe internationalization of higher education institutions (HEIs) is the top stage of international relations among universities, and it is no longer regarded as a goal but as a means to improve the education of sustainability. As institutional commitments to internationalize higher education continue to grow, so does the need to critically consider the intended purposes and actual outcomes of the resulting programs and policies. This study aims to explore how institutional international policies influence outcomes of HEIs internationalization in the East Asian region, specifically in Taiwan and Japan.Design/methodology/approachThe study used quantitative design. 3,158 participants, including 1,192 participants from Taiwan and 1,966 participants from Japan, were randomly recruited to complete the Academic Profession in the Knowledge Society (APIKS), an international survey examining the change in academic work in HEIs. The study adopted quantitative data and used two variables (institutional international policies and outcomes of internationalization) with descriptive, correlational, and moderated multiple hierarchical regression analysis with SPSS computer software to answer the research questions.FindingsThe study showed that both Taiwanese and Japanese academics have high agreements on the outcomes of internationalization for enhancing academic quality and increasing mobility of students. In both countries, two institutional international policies of HEIs internalization-- clear internationalization strategies and funding for faculty members to undertake research abroad-- can significantly influence the process of internationalization in the teaching-oriented and research-oriented HEIs respectively.Originality/valueThis study provides insight into the relationship between institutional international policies and the outcomes of HEIs internationalization in Taiwan and Japan. It provides university leaders with empirical evidence for implementing managerial strategies of internationalization that promote education for sustainability in HEIs.

Patterns of harassment and violence against women in Central and Eastern Europe: the role of the socio-economic context and gender norms in international comparisons

ABSTRACT We use data from an international survey conducted in eight countries of Central and Eastern Europe and apply the method of multivariate reweighting to study the role of socio-economic characteristics and gender norms for the extent of underreporting of the prevalence of more discreet forms of gender-based abuse and harassment. We find that gender norms and attitudes towards abuse are responsible for a large part of the underreporting of harassment in Georgia and Russia, while differences in socio-economic characteristics are the key driving factors behind the underestimated levels of harassment in Belarus. We argue that a better understanding of the cross-country variation in the scale of discriminative behaviours against women needs to be based on a careful methodological design of internationally comparable surveys. In countries with high gender inequalities there is a clear need for policies aimed at increasing awareness and sensitivity towards more discreet abusive behaviours towards women.

Financial Toxicity in Cancer Supportive Care: An International Survey.

The study aims to explore unmet social needs and sources of financial toxicities in patients as noted by health care professionals and researchers in cancer supportive care, shedding light on potential health disparities. In this cross-sectional survey, we anonymously surveyed active members of the Multinational Association of Supportive Care in Cancer (MASCC). The survey, structured in three sections, included questions regarding the routine assessment of social needs during patient consultations, sociodemographic aspects, factors influencing financial toxicity (FT), perceived support for managing FT, and available/desirable resources. A total of 218 MASCC members were included, predominantly from high-income countries (HIC, 73.4%), with many age 41-60 years (56.5%) and female (56.9%). Drug/treatment cost and insurance coverage were the main sources for FT among the HIC, whereas participants from low-middle-income countries (LMIC) considered transportation cost, loss of employment because of cancer diagnosis, and unavailability of return-to-work services as the top three sources of FT. Respondents from LMIC (adjusted odds ratio [aOR], 3.01 [95% CI, 1.15 to 7.93]) and physicians (aOR, 2.67 [95% CI, 1.15 to 6.21]) were more likely to routinely assess financial coverages. Socioeconomic status was consistently ranked as one of the top three sources of financial toxicities by participants from LMIC (34%), HIC excluding the United States (38%), those who do not self-identify as racial/ethnic minority (36%), and physicians (40%). This global survey of health care professionals and researchers in HIC and LMIC revealed varying approaches to assessing financial coverage and social needs. Socioeconomic status emerged as a consistent concern across countries, affecting financial toxicities. The study highlights the need for tailored approaches and improved resource visibility while emphasizing clinicians' pivotal role in addressing financial aspects of cancer care.

Application of dermal substitutes in the surgical treatment of full‐thickness wounds: Outcomes of an international survey

AbstractDermal substitutes have been introduced to improve the outcome of wound healing. Despite proven efficacy in trials, these skin constructs do not have a firm footing in treatment protocols. This survey aimed to gain insight into the international perspective on dermal substitutes. An open, voluntary and anonymous internet‐based international survey was conducted. Eligible to complete the survey were professionals involved in the surgical treatment of patients with wounds. Information was collected on participant demographics, appointed facilitators, barriers, indications and contraindications related to the use of dermal substitutes, as well as participants' perceptions on the current available evidence and treatment protocols. A total of 148 professionals from 30 countries completed the survey. The majority of participants were male (57%), with 60% being plastic surgeons. Eighty‐three percent of the professionals had experience in using dermal substitutes. The primary facilitators were ‘increased scar elasticity’ and ‘reduction of contractures’, while primary barriers included ‘costs’ and ‘contamination risk’. Sixty‐two percent of the professionals acknowledged the efficacy of dermal substitutes; however, the majority emphasised the absence of clear indications and treatment protocols. This study emphasises the acknowledged efficacy of dermal substitutes while highlighting the need for clearer indications and treatment protocols.

Development of a core outcome set for physiotherapy trials in adults with bronchiectasis (the COS-PHyBE study): A Delphi study and consensus meeting

BackgroundPhysiotherapy is recommended for bronchiectasis management, but there is disparity in evidence supporting its use. This is partly because of inconsistency and poor reporting of outcomes in available studies. A Core Outcome Set (COS) may improve trial consistency and decrease reporting bias. This study aimed to develop a COS for physiotherapy clinical trials in adults with bronchiectasis. MethodsA comprehensive list of outcomes was developed using a systematic review and qualitative semi-structured interviews with patients with bronchiectasis and physiotherapists.An international two-round online Delphi survey was conducted. Outcomes scored 7–9 (crucial) by ≥ 70 % of participants and 1–3 (not that important) by ≤ 15 % of participants from each stakeholder in the Likert scale were nominated for inclusion in the COS. Nominated outcomes and those considered crucial by only one of the stakeholders’ groups were further discussed and voted in an international consensus meeting. ResultsA list of 137 outcomes was generated; 104 from literature and 33 from interviews. A Delphi survey containing 59 outcomes was completed by 171 participants from 20 countries. After the consensus meeting, representatives agreed on seven outcomes: health-related quality of life, respiratory symptoms, physical functioning, emotional and psychological functioning, fatigue, adherence to treatment, and functional exercise capacity. ConclusionA minimum set of seven outcomes are recommended to be included as measurements in future trials evaluating physiotherapy interventions for bronchiectasis.

Segmenting social media users in international tourism: Insights integrated from multi‐homing theory and international visitor survey data

AbstractThis study utilizes multi‐homing theory to assess international travelers' usage of social media platforms, revealing insights into their gender, country of origin, generation cohorts, and travel purposes. These insights can guide the development of effective social media marketing strategies for national destination management organizations (DMOs). Data from South Korea's 2019 International Visitor Survey (with 12,194 participants) was analyzed using chi‐square and correspondence analysis techniques. The results revealed distinctive preferences of international visitors among generational cohorts with different travel purposes across 19 countries in the usage of online travel communities, social network platforms, video‐sharing platforms, and travel blogs. Understanding the dynamics of social media platforms helps national DMOs enhance their social media marketing strategies for international visitors, based on the multi‐sided platform usage paradigm. Nevertheless, acknowledging the study's limitations points towards potential avenues for future research.