International Web-based Survey Research Articles

What is the adult experience of Perthes' disease? : initial findings from an international web-based survey.

AimsPerthes’ disease is an uncommon hip disorder with limited data on the long-term outcomes in adulthood. We partnered with community-based foundations and utilized web-based survey methodology to develop the Adult Perthes Survey, which includes demographics, childhood and adult Perthes’ disease history, the University of California Los Angeles (UCLA) Activity Scale item, Short Form-36, the Hip disability and Osteoarthritis Outcome Score, and a body pain diagram. Here we investigate the following questions: 1) what is the feasibility of obtaining > 1,000 survey responses from adults who had Perthes’ disease using a web-based platform?; and 2) what are the baseline characteristics and demographic composition of our sample?MethodsThe survey link was available publicly for 15 months and advertised among support groups. Of 1,505 participants who attempted the Adult Perthes survey, 1,182 completed it with a median timeframe of 11 minutes (IQR 8.633 to 14.72). Participants who dropped out were similar to those who completed the survey on several fixed variables. Participants represented 45 countries including the USA (n = 570; 48%), UK (n = 295; 25%), Australia (n = 133; 11%), and Canada (n = 46; 4%). Of the 1,182 respondents, 58% were female and the mean age was 39 years (SD 12.6).ResultsAges at onset of Perthes’ disease were < six years (n = 512; 43%), six to seven years (n = 321; 27%), eight to 11 years (n = 261; 22%), and > 11 years (n = 76; 6%), similar to the known age distribution of Perthes’ disease. During childhood, 40% (n = 476) of respondents had at least one surgery. Bracing, weightbearing restriction, and absence of any treatment varied significantly between USA and non-USA respondents (p < 0.001, p = 0.002, and p < 0.001, respectively). As adults, 22% (n = 261) had at least one total hip arthroplasty, and 30% (n = 347) had any type of surgery; both more commonly reported among women (p = 0.002).ConclusionWhile there are limitations due to self-sampling, our study shows the feasibility of obtaining a large set of patient-reported data from adults who had childhood Perthes’ from multiple countries.Cite this article: Bone Jt Open 2022;3(5):404–414.

Ideal types’ strategies related to handling early stages of the COVID-19 pandemic: A thematic analysis of comments from an international survey

People (re)act differently when facing the pandemic. Multiple opinions about COVID-19 and related issues prevail, both in personal meetings and in (social) media. This article aims to illuminate different ideal types and handling strategies in early stages of the pandemic. A thematic Braun and Clark, and Weber inspired analysis of qualitative data from an international web-based survey was carried out in two steps. First, five ideal types related to handling the COVID-19 pandemic were constructed: the Stickler for the rules, the Challenger, the Fact hunter, the Idealist, and the Entertainer. Second, the ideal types were represented throughout four themes: Divided opinions on politico-medico restrictions, Multifaceted picture of the pandemic, Social media as a lookout point and source of insight, and The future between hope and fear. The results illustrated the complexity of people’s understanding of, (re)actions to and handling of the pandemic.

Identifying the priorities in nursing research on disaster management: A Delphi study and international survey

The aim in this study was to explore and determine the priorities in nursing research for disaster management. A systematic literature review was conducted to identify and compile a list of statements on research priorities in disaster nursing. Next, a Delphi survey was conducted among experts identified from international disaster nursing professional societies and disaster nursing education programs to obtain their insights on the priorities in nursing research for disaster management. Lastly, an international web-based survey was conducted to collect data from frontline nursing practitioners, researchers, educators, and leaders. Through the systematic literature review, 327 research statements on disaster-related issues were derived from 28 publications. The Delphi survey generated a final list of 90 nursing research statements on disaster management. There were 133 responses to the web-based survey from 26 different countries/areas. The top three research priorities were “education and preparedness in the nursing profession” (mean = 4.45, SD = 0.79), “nurses’ competency to respond to disasters” (mean = 4.44, SD = 0.82), and “emergency management planning in healthcare, community and aged care facilities” (mean = 4.40, SD = 0.84). Significant differences were observed among those of different age groups, lengths of experience in disaster management, primary work settings, affiliated nursing society memberships, and WHO regions. The findings of this research provide a general picture of the priorities in nursing research for disaster management, and led to the identification of the overarching research priorities in this area and of areas in need of further research. Furthermore, it provided valuable suggestions for funding organizations and policymakers to decide on those areas of disaster nursing that warrant further research.

Knowledge, attitude, and practice of artificial intelligence in emergency and trauma surgery, the ARIES project: an international web-based survey

AimWe aimed to evaluate the knowledge, attitude, and practices in the application of AI in the emergency setting among international acute care and emergency surgeons.MethodsAn online questionnaire composed of 30 multiple choice and open-ended questions was sent to the members of the World Society of Emergency Surgery between 29th May and 28th August 2021. The questionnaire was developed by a panel of 11 international experts and approved by the WSES steering committee.Results200 participants answered the survey, 32 were females (16%). 172 (86%) surgeons thought that AI will improve acute care surgery. Fifty surgeons (25%) were trained, robotic surgeons and can perform it. Only 19 (9.5%) were currently performing it. 126 (63%) surgeons do not have a robotic system in their institution, and for those who have it, it was mainly used for elective surgery. Only 100 surgeons (50%) were able to define different AI terminology. Participants thought that AI is useful to support training and education (61.5%), perioperative decision making (59.5%), and surgical vision (53%) in emergency surgery. There was no statistically significant difference between males and females in ability, interest in training or expectations of AI (p values 0.91, 0.82, and 0.28, respectively, Mann–Whitney U test). Ability was significantly correlated with interest and expectations (p < 0.0001 Pearson rank correlation, rho 0.42 and 0.47, respectively) but not with experience (p = 0.9, rho − 0.01).ConclusionsThe implementation of artificial intelligence in the emergency and trauma setting is still in an early phase. The support of emergency and trauma surgeons is essential for the progress of AI in their setting which can be augmented by proper research and training programs in this area.

P641 Implementation and short-term adverse events of anti-SARS-CoV-2 vaccines in Inflammatory Bowel Disease patients: an international web-based survey

BackgroundPivotal anti-SARS-CoV-2 vaccines clinical trials did not include patients with immune-mediated conditions such as inflammatory bowel disease (IBD). We aimed to describe the implementation of anti-SARS-CoV-2 vaccines among IBD patients, patients’ concerns before vaccination and side-effect profile of the anti-SARS-CoV-2 vaccines using real-world data.MethodsAn anonymous web-based self-completed survey was distributed in 36 European countries between June and July 2021. The results of patients’ characteristics, concerns, vaccination status and side-effect profile were analysed using descriptive statistics and logistic regression.ResultsAmong the 3272 IBD patients completing the survey (0.1% of the IBD European population), 79.6% had received at least one dose of the anti-SARS-CoV-2 vaccine, and 71.7% had completed the vaccination process. Most of the patients (70.6%) were vaccinated with the Pfizer-BioNTech (BNT162b2) vaccine. Patients over 60 years old had a significantly higher rate of vaccination (OR 2.98, 95% CI 2.20–4.03, p<0.001). Patients’ main concerns before vaccination were the possibility of having worse vaccine-related adverse events due to their IBD (24.6%), having an IBD flare after vaccination (21.1%) and reduced vaccine efficacy due to IBD or associated immunosuppression (17.6%). After the first dose of the vaccine, 72.4% had local symptoms at the injection site and 51.4% had systemic symptoms (5 patients had non-specified thrombosis). Adverse events were less frequent after the second dose of the vaccine and in older patients. When comparing with previous studies from the general population, the IBD patients answering the survey did not seem to have increased side effects (Table 1). Only a minority of the patients were hospitalized (0.3%), needed a consultation (3.6%) or had to change IBD therapy (13.4%) after anti-SARS-CoV-2 vaccination. ConclusionAlthough IBD patients raised concerns about the safety and efficacy of anti-SARS-CoV-2 vaccines, the implementation of vaccination in those responding to our survey was high and the adverse events were comparable to the general population, with minimal impact on their IBD.

Implementation and Short-term Adverse Events of Anti-SARS-CoV-2 Vaccines in Inflammatory Bowel Disease Patients: An International Web-based Survey.

IntroductionAnti-SARS-CoV-2 vaccines clinical trials did not include patients with immune-mediated conditions such as inflammatory bowel disease (IBD). We aimed to describe the implementation of anti-SARS-CoV-2 vaccination among IBD patients, patients’ concerns and side-effect profile of the anti-SARS-CoV-2 vaccines using real-world data.MethodsAn anonymous web-based self-completed survey was distributed in 36 European countries between June and July 2021. The results of the patient characteristics, concerns, vaccination status and side-effect profile were analysed.Results3272 IBD patients completed the survey, 79.6% had received at least one dose of anti-SARS-CoV-2 vaccine, and 71.7% had completed the vaccination process. Patients over 60 years old had a significantly higher rate of vaccination (p<0.001). Patients’ main concerns before vaccination were the possibility of having worse vaccine-related adverse events due to their IBD (24.6%), an IBD flare after vaccination (21.1%) and reduced vaccine efficacy due to IBD or associated immunosuppression (17.6%). After the first dose of the vaccine, 72.4% had local symptoms and 51.4% had systemic symptoms (5 patients had non-specified thrombosis). Adverse events were less frequent after the second dose of the vaccine and in older patients. Only a minority of the patients were hospitalized (0.3%), needed a consultation (3.6%) or had to change IBD therapy (13.4%) after anti-SARS-CoV-2 vaccination.ConclusionAlthough IBD patients raised concerns about the safety and efficacy of anti-SARS-CoV-2 vaccines, the implementation of vaccination in those responding to our survey was high and the adverse events were comparable to the general population, with minimal impact on their IBD.

Male and Senior Surgeons are Less Likely to Support Preoperative Palliative Care Referral for Patients with Resectable Pancreatic Cancer: Results from an International Survey

Background: Preoperative palliative care (PC) consultation has been proposed for patients with resectable gastrointestinal cancers. Two randomized trials are evaluating PC and surgeon co-management in the perioperative setting. We hypothesized that pancreatic surgeons harbor significant reservations regarding providing palliative care in parallel with potentially curative surgery. Methods: An anonymous international web-based survey was conducted in 2021. Chi-square and Wilcox tests were used for categorical and for Likert scaled questions respectively. Statistical significance set at p<0.05. Results: 138 surveys were completed. 83% of surgeons were male, 85% completed a fellowship, 80% practice in academia, 46% perform >30 annual curative-intent operations for PDAC and 90% have been in practice ≤ 30 years. 88% of surgeons were from the US. 65% of surgeons support introducing PC preoperatively; female surgeons (p=0.018) and fellowship-trained surgeons (p=0.002) were significantly more likely to support this practice, however, surgeons in practice >30 years do not support preoperative PC referral (p=0.003). 94% of surgeons identified benefits associated with preoperative PC consultation; female surgeons (p=0.048; OR 3.03 [CI:097.-9.45]) and surgeons with fellowship training (p=0.016; OR 4.17 [CI:1.30-13.33]), were more likely to report that preoperative PC consultation may improve symptoms management. US surgeons identified more benefits and challenges related to preoperative PC consultation compared to non-US surgeons (Table 1). Discussion: Most surgeons recognize potential benefits of preoperative PC consultation and co-management. However, gender, fellowship training, and years in practice impact surgeon’s preference. Further studies are needed to elucidate patient and other stakeholder perspectives on preoperative PC-surgeon co-management.

Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey.

BackgroundExpanding access to the internet has resulted in more and earlier consumption of online pornography. At the same time, a higher prevalence of erectile dysfunction (ED) among young men is seen. Increased pornography consumption has been suggested as a possible explanation for this rise.ObjectiveThe aim of this study was to better understand associations between problematic pornography consumption (PPC) and ED.MethodsA 118-item survey was published online, and data collection took place between April 2019 and May 2020. Of the 5770 men who responded, the responses from 3419 men between 18 years old and 35 years old were analyzed. The survey used validated questionnaires such as the Cyber Pornography Addiction Test (CYPAT), International Index of Erectile Function (IIEF-5), and Alcohol Use Disorders Identification Test-Concise (AUDIT-C). The estimated amount of porn watching was calculated. Univariable and multivariable analyses were performed. For the multivariable analysis, a logistic regression model using a directed acyclic graph was used.ResultsAccording to their IIEF-5 scores, 21.48% (444/2067) of our sexually active participants (ie, those who attempted penetrative sex in the previous 4 weeks) had some degree of ED. Higher CYPAT scores indicating problematic online pornography consumption resulted in a higher probability of ED, while controlling for covariates. Masturbation frequency seemed not to be a significant factor when assessing ED.ConclusionsThis prevalence of ED in young men is alarmingly high, and the results of this study suggest a significant association with PPC.Trial RegistrationResearch Registry researchregistry5111; https://tinyurl.com/m45mcaa2

Digital Health Literacy in Bipolar Disorder: International Web-Based Survey.

BackgroundWeb-based resources can support people with bipolar disorder (BD) to improve their knowledge and self-management. However, publicly available resources are heterogeneous in terms of their quality and ease of use. Characterizing digital health literacy (the skillset that enable people to navigate and make use of health information in a web-based context) in BD will support the development of educational resources.ObjectiveThe aim of this study was to develop understanding of digital health literacy and its predictors in people with BD.MethodsA web-based survey was used to explore self-reported digital health literacy (as measured by the e-Health Literacy Scale [eHEALS]) in people with BD. Multiple regression analysis was used to evaluate potential predictors, including demographic/clinical characteristics and technology use.ResultsA total of 919 respondents (77.9% female; mean age 36.9 years) completed the survey. Older age (β=0.09; P=.01), postgraduate education (β=0.11; P=.01), and current use of self-management apps related to BD (β=0.13; P<.001) were associated with higher eHEALS ratings.ConclusionsLevels of self-reported digital health literacy were comparable or higher than other studies in the general population and specific physical/mental health conditions. However, individuals with BD who are younger, have completed less education, or are less familiar with mental health apps may require extra support to safely and productively navigate web-based health resources. Relevant educational initiatives are discussed. Future studies should evaluate skill development interventions for less digitally literate groups.

Use of smartphone apps in bipolar disorder: An international web-based survey of feature preferences and privacy concerns

BackgroundSmartphone apps have potential for delivering interventions and supporting self-management in bipolar disorder (BD), however clinical trials of mental health apps have high dropout rates and low sustained use in real-world contexts. To support the development of app-based interventions, we explored use of and attitudes towards apps amongst people with BD, specifically concerns about privacy and preferences for various app features. MethodsAn international web-based survey was used to investigate concerns about privacy and the perceived importance of various app features among people with BD. Quantitative findings were summarised using descriptive statistics. Qualitative content analysis was used to investigate free-text responses. ResultsA total of 919 people completed the survey; 97.5% reported using smartphone apps in general. Concerns regarding data security were prevalent. Commonly prioritised mHealth features included content quality/accuracy, ease and flexibility of use, cost, and data security. The ability to share data with others, rewards for use, inter-app connectivity, and peer support were endorsed as important by fewer than half of respondents. Qualitative findings suggested that sustained app use could be supported by novel and positive content, customisation, meaningful use of data, interactivity, and perceived real-world benefits. ConclusionsThe findings of the present study offer important design considerations for the development and evaluation of future app-based interventions for BD. Importantly, some features that have previously been suggested as clinically beneficial or likely to support engagement were perceived ambivalently, emphasising the need for in-depth consultation with potential end users during app development.

Sociodemographic Factors’ Influence on the Consumption and Assessment of COVID-19 Related Information–An International Web-Based Survey

Information flows can affect people’s apprehension of the pan- demic and related behaviors. The aim is to explore how people access and assess COVID-19 information and whether sociodemographic factors are associated with these processes. Quantitative data from 928 persons from 29 countries who participated in an international web-based survey was ana- lyzed with descriptive and analytic statistics. Television, newspapers and social media were common sources to search for certain types of COVID-19 information. Age, educational level, employment status and sex were as- sociated with differences in terms of reported sources, types, and reliability assessments of retrieved information. Sex and education levels were associ- ated with differences pertaining to main sources and kinds of information searched. Younger respondents reported more frequent uses of social media than older respondents. Older respondents assessed information from tra- ditional media as more reliable information from social media. The current results show trends about where and how information is accessed and assessed during the pandemic. Some associations with sociodemographic factors were found, but the study’s cross-sectional design prevents causal inferences. Further research on consumption patterns of COVID-19 infor- mation and its effects on consumers is motivated, as this may in turn affect people’s attitudes and behavior relating to the pandemic.

Influence of intravenous alteplase on endovascular treatment decision-making in acute ischemic stroke due to primary medium-vessel occlusion: a case-based survey study

BackgroundIntravenous alteplase is currently the only evidence-based treatment for medium-vessel occlusion stroke (MeVO; M2/3, A2/3, and P2/3 vessel segment occlusions), but due to its limited efficacy, endovascular treatment (EVT) is...

Perceptions and effects of COVID-19 related information in Denmark and Sweden – a web-based survey about COVID-19 and social media

AimExtensive COVID-19 information can generate information overload and confusion. Denmark and Sweden adopted different COVID-19 management strategies.AimThis study aimed to compare search strategies, perceptions and effects of COVID-19 information, in general and specifically in social media, in residents in Denmark and Sweden.Subject and methodsQuantitative data from a sample of respondents (n = 616) from Denmark and Sweden on an international web-based survey was analysed using descriptive and analytical statistics.ResultsThe results showed similarities between the countries regarding preferred and trusted information sources, use of (social) media, and psychosocial and behavioural effects of such information. Traditional media and social media were frequently used for COVID-19 information. Especially health authorities and researchers were trusted sources, representing the dominant medico-political discourse. There were no differences in negative effect and social behaviour. Residents in Denmark experienced significantly more positive effects than residents in Sweden.ConclusionSummarily, the study showed similarities and small differences among residents in both countries related to usage patterns, perceptions and effects of COVID-19 information from (social) media, despite diverging strategies.

Identifying the unmet needs of individuals with Type 2 diabetes: an international web-based survey.

Aim: To identify and understand the main unmet needs of individuals with Type 2 diabetes (T2D). Materials & methods: An online survey was conducted in Brazil, China and Russia of individuals with recently diagnosed T2D. Results: The survey, involving 300 individuals with T2D, identified a need for more information regarding food/diet and for increased awareness of T2D symptoms. While most participants (94%) had experienced symptoms prior to their diagnosis, only 55% of symptomatic individuals sought medical attention. Conclusion: Novel strategies to increase awareness of diabetes should be developed and tested, and may enable earlier diagnosis and improve patients' quality of life.

Misoprostol treatment for early pregnancy loss: an international survey

Research questionWhat is the global variability in misoprostol treatment for the management of early pregnancy loss (EPL)? DesignAn international web-based survey of fertility specialists and obstetrics and gynaecology clinicians was conducted between August and November 2020. The survey consisted of 16 questions addressing several aspects of misoprostol treatment for EPL. ResultsOverall, 309 clinicians from 80 countries participated in the survey, of whom 67.3% were fertility specialists. Nearly one-half (47.9%) of the respondents let the patient choose the first line of treatment (expectant management, misoprostol treatment or surgical aspiration) according to her own preference. The 248 respondents who administer misoprostol in their daily practice were asked further questions; 59.7% of them advise patients to take the medication at home. The most common dose and route of administration is 800 µg administered vaginally. Only 28.6% of participants use mifepristone pretreatment. Variation in the timing of the first follow-up visit after misoprostol administration was wide, ranging from 24 h to 1 week in most clinics. In case of incomplete expulsion, only 42.3% of the respondents routinely administer a second dose. The timing of the final visit and the definition of successful treatment also differed greatly among respondents. ConclusionsThere is large variability in the use of misoprostol for the management of EPL. High-quality research is necessary to examine several aspects of the treatment. Particularly, the timing and effectiveness of a second dose administration and the criteria to decide on treatment failure or success deserve more research in the future.

International Observational Survey of the Effectiveness of Personal Protective Equipment during Endoscopic Procedures Performed in Patients with COVID-19

Introduction and Aims: This international survey was performed to evaluate the cumulative incidence of nosocomial novel coronavirus disease 2019 (COVID-19) among healthcare professionals during endoscopic procedures. Methods: We performed an international web-based self-reported questionnaire survey. Participants completed the questionnaires every week for 12 weeks. The questionnaire elicited responses regarding the development of COVID-19 and details of the personal protective equipment (PPE) used. Results: All 483 participants were included in the analysis. Participants had a mean age of 42.3 years and comprised 68.3% males. The geographic distribution of the study population was Asia (89.2%), Europe (2.9%), North and South America (4.8%), Oceania (0.6%), and Africa (1.5%). The most common endoscopy-related role of the participants was endoscopist (78.7%), and 74.5% had >10 years of experience. Fourteen participants had performed 83 endoscopic procedures in patients positive for COVID-19. During the mean follow-up period of 4.95 weeks, there were no cases of COVID-19 when treating COVID-19 positive patients. The most common PPE used by participants treating patients with COVID-19 was a surgical mask plus N95 mask plus face shield, goggles, cap, long-sleeved isolation gown, and single pair of gloves. The most common PPE used by participants treating patients without COVID-19 was a surgical mask, no face shield but goggles, cap, long-sleeved isolation gown, and single pair of gloves during all endoscopic procedures. Conclusions: The risk of COVID-19 transmission during any endoscopic procedure was low in clinical practice.

Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources' Allocation.

SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources' allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal regression analysis was performed. There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified according to region, macrospecialty, and organ of interest. Answers were analyzed using univariate-multivariate ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop (continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10% indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19 temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed, the organ will be wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to "urgent" cases. At the multivariate analysis, factors identified in favor of continuing transplant were Italy, ethicist, partially disagreeing on the equity question, a high number of COVID-19-related deaths on the day of the answer, a high IHDI country. Factors predicting to stop SOTs were Europe except-Italy, public university hospital, and strongly agreeing on the equity question. In conclusion, the majority of responders suggested that transplant activity should be continued through the implementation of isolation measures and the adoption of the COVID-19-free pathways. Differences between professional categories are less strong than supposed.

Risk Management in Information Systems Projects

Information technologies (IT) and information systems (IS) are the backbone of any developed business, and organizations without them cannot compete. In recent decades, many best practices standards, and guides have been made available to project managers and organizations aimed to improve project management. Unfortunately, IS projects continue to show a poor track record, and problems related to project management performance persists. Risk management has a vital role in this context since it can increase the likelihood and impact of positive events, and decrease the likelihood and impact of adverse events in the project. This article presents the results of an international web-based survey, studying if risk management processes are being implemented consistently in IS project management. The obtained results show low levels of risk management processes implementation and reinforce the idea that “it can be risky not to do risk management,” demanding more research in this area.

COVD-31. THE STATE OF NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: A WORLDWIDE ASSESSMENT

To assess the impact of the pandemic on the field, we performed an international web-based survey of practitioners, scientists, and trainees from 21 neuro-oncology organizations across 6 continents from April 24 through May 17. Of 582 respondents, 258 (45%) were in the US, and 314 (55%) were international. 80.4% were affiliated with academic institutions. 94% respondents reported changes in clinical practice; 95% reported conversion to telemedicine for at least some appointments. However, almost 10% practitioners felt the need to see patients in person specifically because of billing concerns and perceived institutional pressure. Over 50% believed neuro-oncology patients were at increased risk of contracting COVID-19. 67% practitioners suspended enrollment for at least one clinical trial: 53% suspended phase II and 62% suspended phase III trial enrollment. 71% clinicians feared for their or their families’ safety, specifically because of their clinical duties. 20% percent said they did not have enough PPE to work safely; about the same percentage were unhappy with their institutions’ response to the pandemic. 43% believed the pandemic would negatively affect their academic career, and 52% fellowship program directors were worried about losing funding for their training programs. While 69% respondents reported increased stress, 44% were offered no psychosocial support. 37% had their salary reduced. 36% researchers had to temporarily close their laboratories. In contrast, the pandemic created positive changes in perceived patient and family satisfaction, quality of communication, and use of technology to deliver care and interactions with other practitioners. CONCLUSIONS: The pandemic has altered standard treatment schedules and limited investigational treatment options for patients. In some cases, clinicians felt institutional pressure to continue conducting billable in-person visits when telemedicine visits would have sufficed. A lack of institutional support created anxiety among clinicians and researchers. We make specific recommendations to guide clinical and scientific infrastructure moving forward.

Does greater morning sickness predict carrying a girl? Analysis of nausea and vomiting during pregnancy from retrospective report.

The prevalence of severe nausea and vomiting during pregnancy (NVP) requiring hospitalization has been associated with female fetal sex. However, the question of whether fetal sex and less severe forms of NVP share that association has not been investigated. The objective of this study was to evaluate the relationship between fetal sex and the frequency of NVP. We collected self-reported data from mothers via an international web-based survey on the Amazon Mechanical Turk (MTurk) platform about pregnancy and first trimester NVP history. We considered the covariables of maternal age, parity status, proneness to nausea, geographic cohort, and preconceived notions of a relationship between fetal sex and NVP. Two-thousand five hundred and forty-three mothers met the inclusion criteria, yielding data from 4320 pregnancies. Women gestating a female fetus reported higher frequencies of NVP (M = 6.35 on a 1-9 scale) than did women gestating males (M = 6.04, p = .007). This effect held true when all other variables were included in the regression. General proneness to nausea, maternal age, and parity were also significant independent predictors of NVP. Women that carried a female fetus, as opposed to a male fetus, reported significantly higher frequency of NVP during the first trimester of pregnancy. Further research should evaluate both the proximate and ultimate causes of this relationship.