Email Invitation Research Articles

The Perspectives of General Nephrologists Toward Transitions of Care and Management of Failing Kidney Transplants.

The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population.

Pedagogy, ICT Skills, and Online Teaching Readiness as Factors on Digital Competency Practices among Secondary School Teachers in Malaysia

COVID-19 has impacted the globe in the most disastrous ways. The widespread COVID-19 has affected the education system from kindergarten to the university level. Most nations responded with alacrity with numerous alternatives to teaching and learning (T&L) strategies. Home-based T&L took place although this belligerent strategy did not fully benefit all students due to their inaccessibility to technology. However, as far as the matter is concerned, home-based T&L was the only option that the ministry could execute. Even if the technology is accessible and usable, the concern is the teachers' abilities and knowledge to integrate ICT in their T&L. Teacher digital competency becomes the forefront issue in this study since risks to students' learning process are disdain. This research explained the relationship between the pedagogical method, the information, and communication technologies (ICT) skills, and online teaching readiness among secondary school teachers in Malaysia. A descriptive and correlational study was employed to determine the level of teacher competency in three aspects: digital pedagogy, ICT skill, and online teaching readiness and the relationship among the aforementioned variables. One hundred and twenty-two teachers from selected high schools in Klang Valley were invited voluntarily to participate in the study. The validated questionnaire was uploaded in the google form and the link was distributed to teachers via email invitation. The results indicated the teacher's digital competency based on pedagogical approaches, ICT, and online teaching was ranked at a high level. It is important to note that there was a strong and positive relationship among the studied variables. The findings projected salient integration of the variables to inspire digital competency practices among teachers successfully.

Mississippi School Food Service Directors' Interest and Experience With Local Food Procurement and Farm to School Activities.

The purpose of this study was to collect updated school food service purchasing practices from K-12 public school food service directors (SFSD) in Mississippi and to determine their current abilities, experiences, and desires to engage in Farm to School (F2S) activities. The online survey was created using questionnaire items from existing F2S surveys. The survey opened in October 2021 and closed in January 2022. Descriptive statistics were used to summarize the data. Of the 173 SFSD sent email invitations, 122 (71%) completed the survey. The most common fresh fruit and vegetable purchasing practices included Department of Defense Fresh Program (65%) and produce vendor (64%). Forty-three percent of SFSD purchased at least one locally sourced fruit and 40% purchased at least one locally sourced vegetable, while 46% did not purchase any locally sourced foods. The most common challenges for purchasing from farmers included no relationship with farmers (50%) and food safety regulations (39%). Sixty-four percent of SFSD were interested in at least one F2S activity. Most SFSD do not purchase local foods directly from farmers and almost half do not purchase any local foods regardless of source. Lack of connection with local farmers is a significant challenge to F2S. Recently proposed framework by USDA for shoring up the food supply chain and transforming the food system may help reduce or remove ongoing challenges to F2S participation.

SARS-CoV-2 Antibodies Seroconversion in Healthcare Workers at a Tertiary Cancer Center

Background:
 Implementation of strict measures to ensure the safety of cancer patients during the coronavirus disease (COVID-19) pandemic includes modification of treatment plans, strict physical distancing measures between healthcare workers (HCWs) and patients alike, and early detection of suspected cases. Serological testing can identify immunological responses, i.e., seroconversion, in HCWs presenting with subclinical symptoms. The detection of immunoglobulin (Ig) M specific antibodies demonstrates active disease, while (Ig) G specific antibodies indicate previous exposure to SARS-CoV-2.
 
 Methods:
 Among HCWs in a tertiary cancer center in Jordan, a cross-sectional study was conducted to detect those who had positive serology albeit previous negative diagnosis with COVID-19. We sent an invitation e-mail, and those who met the criteria were invited to a privately designated room to sign an informed consent form and obtain a blood sample for analysis. Results and demographic data were analyzed using SAS version 9.4.
 
 Findings:
 We recruited 583 participants between December 2020 and January 2021, with an equal distribution between genders and a mean age of 34.04 years (±9.29). The majority of participants were from the nursing department (n=390, 66.89%). A history of an upper respiratory tract infection was reported by 144 individuals (24.7%) with varying symptoms. Positive exposure was reported in 441 participants (75.6%). IgG seroconversion was detected in 41 participants (7%), while IgM seroconversion was only detected in three (0.5%).
 
 Interpretation:
 There was no correlation between positive IgG seroconversion and history of upper respiratory tract infection, exposure to infected patients, or profession. Therefore, subclinical COVID-19 is hard to detect, facilitating transmission of infection. Alongside polymerase chain reaction testing, strict physical distancing, and prompt vaccination among HCWs to mitigate disease spread, frequent serological surveillance can offer a way to understand the number of infections at different times and locations within different populations.

Prevalence of urinary incontinence and anal incontinence: an internet-based cross-sectional study of female Turkish University students.

The objective of this cross-sectional, epidemiological study was to characterize urinary tract and bowel symptom prevalence and the extent of discomfort/bother associated with them. Additionally, the authors aimed to explore factors associated with both conditions among Turkish female university students. Also, an insight into women's "communication regarding urinary incontinence and anal incontinence" with their family members was sought. This is an internet-based national cross-sectional study. A study-specific 30-item questionnaire containing validated measures of symptom prevalence and bother (Urogenital Distress Inventory questionnaire short form and Colorectal-Anal Distress Inventory) were incorporated into the survey. Out of a total of 2,125 e-mail invitations that were sent, 1,226 responded with data included in this analysis. The age and BMI of all respondents were 26.53 ± 10.082, 23.45 ± 6.609 respectively. Nine hundred and eighty-five (80.5%) respondents claimed that they did not suffer a UI episode in the last year, whereas 10 people (0.08%) claimed that they had a urinary incontinence episode every day. Three hundred and fifty-seven responders (29.1%) stated that they suffered from "gas incontinence," 6 (0.5%) stool incontinence, and 20 (1.6%) declared that they had episodes of both stool and gas incontinence. Five hundred and forty-four participants (44%) reported that they had family relatives with a problem of "urinary incontinence" and 576 (47%) stated they had a conversation on "urinary incontinence." Seventy-five of the responders (6.1%) stated that they had a family member with "anal incontinence" and 246 (20.1%) responded that they had a conversation regarding "anal incontinence" with them. We have demonstrated that the prevalence of UI was 19.5%. Twenty-nine percent stated they suffered "gas incontinence," 0.5% stool incontinence, and 1.6% declared that they had episodes of both stool and gas incontinence.

Perioperative clinical practice in liver transplantation: a cross-sectional survey.

The objective of this study was to describe some components of the perioperative practice in liver transplantation as reported by clinicians. We conducted a cross-sectional clinical practice survey using an online instrument containing questions on selected themes related to the perioperative care of liver transplant recipients. We sent email invitations to Canadian anesthesiologists, Canadian surgeons, and French anesthesiologists specialized in liver transplantation. We used five-point Likert-type scales (from "never" to "always") and numerical or categorical answers. Results are presented as medians or proportions. We obtained answers from 130 participants (estimated response rate of 71% in Canada and 26% in France). Respondents reported rarely using transesophageal echocardiography routinely but often using it for hemodynamic instability, often using an intraoperative goal-directed hemodynamic management strategy, and never using a phlebotomy (medians from ordinal scales). Fifty-nine percent of respondents reported using a restrictive fluid management strategy to manage hemodynamic instability during the dissection phase. Forty-two percent and 15% of respondents reported using viscoelastic tests to guide intraoperative and postoperative transfusions, respectively. Fifty-four percent of respondents reported not pre-emptively treating preoperative coagulations disturbances, and 91% reported treating them intraoperatively only when bleeding was significant. Most respondents (48-64%) did not have an opinion on the maximal graft ischemic times. Forty-seven percent of respondents reported that a piggyback technique was the preferred vena cava anastomosis approach. Different interventions were reported to be used regarding most components of perioperative care in liver transplantation. Our results suggest that significant equipoise exists on the optimal perioperative management of this population.

Using Social Influence Strategies to Improve Rates of Online Mental Health Survey Participation: Results from Two Experiments.

Online surveys are routinely used in mental health screening and treatment follow-up assessment, though they can yield low response rates. We tested the effects of social psychology-informed influence strategies for increasing rates of participation in an online mental health screening survey (Experiment 1) and a treatment follow-up survey (Experiment 2). In Experiment 1 (N = 45,569), embedding one or any combination of three motivational appeals (personal gain, community gain, and inclusivity) in screening survey invitation and reminder emails unexpectedly led to lower rates of survey participation compared to when the appeals were not included (overall participation rate = 12.02%, ORs = 0.75 to 0.97, ps < .001). In Experiment 2 (N = 873), a video of a TikTok influencer encouraging survey participation embedded in treatment follow-up survey invitation and reminder emails did not significantly affect survey completion compared to a humorous gif unrelated to survey participation (overall participation rate = 47.88%, OR = 1.18, p = .200). Moderator analyses revealed that the video led to higher rates of participation than the gif among White participants (OR = 1.39, p = .031) and non-Hispanic participants (OR = 1.35, p = .029) only, whereas the video led to lower rates of participation than the gif among students who did not disclose their race (OR = 0.31, p = .010). Results suggested that efforts to improve online survey participation should be balanced with possible downsides (e.g., added email length) and should be evaluated for differential performance among population subgroups prior to widespread implementation.

NIGHT-TIME BLOOD PRESSURE AND BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE PATIENTS WITH OR WITHOUT INSOMNIA. A PILOT STUDY

Objective: Recent studies found that insomnia is an independent risk factor for cardiovascular diseases, particularly arterial hypertension. Among the hypertensive population, insomnia could contribute to a worse blood pressure (BP) profile. In a sample of hypertensive patients, we compared those with and without insomnia with the aim of evaluating possible differences in BP, its variability, and breathing pattern. Design and method: We conducted a case-control study on patients with and without insomnia, based on the Insomnia Severity Index (ISI) questionnaire. Patients were recruited from the general practitioner's registry and were sent an invitation e-mail. All of them had long-lasting hypertension. One-hundred-and-fifty patients replied to the ISI questionnaire. Among them, twenty people with insomnia were selected (ISI greater than or equal to 15) and matched, based on their gender and age (±3 years), to 20 controls (with ISI lower than 15). All participants underwent night-time cardiorespiratory and 24-hour blood pressure monitoring by using a new cuff-less device that can estimate beat-to-beat BP (SomnoTouch-NIBP). Results: Comparing the two groups (insomnia vs. non-insomnia), no differences were observed in BP profile and all the respiratory indices, including the apnea-hypopnea index(AHI), the number of desaturations, and peripheral oxygen saturation (SpO2) values. Even the average BP and the indices of BP variability, such as the standard deviation (SD), the pressure coefficient of variation (CV), the BP dipping, and the nocturnal BP fluctuations (NBPF), were similar between the groups. Interestingly, to obtain the same average BP control, the insomnia group required a greater number of antihypertensive drugs (2,85 ± 0,88 vs. 1,95 ± 1,00 in the non-insomnia group; p&lt;0.01). Conclusions: Patients with insomnia may need more antihypertensive medications to achieve the same average BP as patients without insomnia. Anyhow, they did not show, as expected, higher BP variability. How much beat-to-beat BP estimations are reliable compared to BP measurements by standard cuff-based devices is still under debate.

KNOWLEDGE, PERCEPTION, AND PRACTICE OF QUEBEC HEALTH PROFESSIONALS REGARDING AMBULATORY AND CLINIC BLOOD PRESSURE MEASUREMENT METHODS

Objective: Hypertension Canada Guidelines recommend using standardized methods of blood pressure measurement (BPM), namely home (HBPM), ambulatory (ABPM), office (OBPM), and automated (AOBP) for hypertension management. Health professionals (HP), namely nurses, physicians, and pharmacists, routinely perform BPM, but their knowledge, perception, and practice concerning all methods is understudied, including in Canada, and results show critical gaps with the guidelines. This descriptive study is the first to establish a portrait primary care HP's in Quebec concerning the four BPM methods. Design and method: All licensed primary care HP's in Quebec were targeted. A validated and pretested investigator-initiated BPM questionnaire in English and French was used for data collection. In December 2019, physicians and pharmacists were recruited through their associations’ monthly newsletter, while nurses received a personalized email invitation with a link to a secured platform. UQTR issued the certificate of ethics. Results: A total of 453 nurses, 45 physicians, and 30 pharmacists participated in the study. The median age was 40 ± 11 years for nurses, 50 ± 13 years for physicians, and 42 ± 12 for pharmacists. The overall knowledge and perception scores for BPM methods are presented in Table 1. In practice, physicians frequently use HBPM for diagnostic purposes (73%), treatment (91%), and follow-up (86%), while HBPM was recommended by 47% of nurses and 53% of pharmacists. Overall, ABPM was used less frequently (&lt;50% of the time) by all HP's. In the clinic, the auscultatory method is still used by a significant percentage of nurses (11%), physicians (32%) and pharmacists (7%), while only 25% nurses, 13% physicians and 30% pharmacists use the AOBP method. Conclusions: Overall, knowledge was suboptimal for nurses and somewhat optimal for physicians and pharmacists. Practice was unsatisfactory for all HPs. Training and continuing education should be encouraged and should be renewed with the newest education methods along with practice assessment.

0612 Understanding Narcolepsy Treatments From the Patient’s Perspective: A Survey of People Living With Narcolepsy

Abstract Introduction Individuals with narcolepsy were surveyed to better understand desired treatment outcomes and how those outcomes map to commonly experienced symptoms, treatment awareness, and medication usage. Methods In February 2022, an email invitation to a 27-question online survey was sent to US members of MyNarcolepsyTeam, a social network of &amp;gt;9,800 members. Results In total, 110 members completed the survey. The most frequently mentioned desired treatment goals aligned with the most commonly reported symptoms: being able to stop sleeping during the day (77%); increased energy (62%); improved memory (36%); improved productivity (29%); improved sleep continuity (22%); and for patients with narcolepsy type 1, reducing cataplexy (28%). A common theme was desire for a medication that would treat the underlying cause and not just improve specific symptoms. In one patient’s own words: “I want to see treatments that target the root problem of poor nighttime sleep rather than just being a band-aid for [excessive daytime sleepiness] EDS, like stimulants are.” Only a small percentage of respondents (13%) were not currently taking any type of medication to address narcolepsy symptoms. 64% were currently taking ≥2 medications to address both the daytime and nighttime symptoms. Most commonly mentioned current treatments were dextroamphetamine-amphetamine (30%), modafinil (22%), melatonin (16%), armodafinil (15%), venlafaxine (14%), and oxybate (14%). Notably, 33% of patients taking sodium oxybate chose sleeping through the night as a desired outcome. Most common sources for learning about treatments were narcolepsy-specific websites (53%), MyNarcolepsyTeam specifically (45%), the patient’s doctor (42%), scientific articles (42%), and advocacy groups (37%). Conclusion Patients experience a wide range of both daytime and nighttime symptoms and seek relief from both sets of symptoms including EDS (93%), fatigue (79%), cognitive challenges (74%), as well as sleep disruptions (63%). As a result, the majority need multiple medications. Understanding the experiences and needs of people with narcolepsy provides significant opportunities for clinicians to support, educate, and treat their patients holistically. Additionally, content readily available on the internet, whether it is narcolepsy-specific content or social networks, helps patients proactively discuss options with their clinician. Support (if any) Avadel Pharmaceuticals

Surrogates' experience during the COVID-19 pandemic: mental health, social support, and relationship with intended parents.

To examine surrogates' mental health, social support, and relationship with intended parents (IPs) during the COVID-19 pandemic from March 2020 to February 2022. Data were collected between April 29, 2022 and July 31, 2022, at an academic IVF center in Canada using an 85-item online anonymous cross-sectional survey that included three standardized scales measuring mental health (PHQ-4), loneliness, and social support. Eligible surrogates actively involved in surrogacy during the study period received email invitations. The response rate was 50.3% (338/672); 320 submitted surveys were analyzed. Two-thirds (65%) of respondents experienced mental health concerns during the pandemic and were significantly less comfortable about seeking mental health support than those without concerns. Nonetheless, 64% were highly satisfied with their surrogacy experience; 80% received a high level of support from their IPs, and 90% reported a good relationship with them. The final hierarchical regression model identified five significant predictors, explaining 39.4% of the variance in PHQ-4 scores: a prior mental health history, COVID-19 impact on personal life, surrogacy satisfaction, loneliness, and social support. COVID-19 created an unprecedented challenge to surrogacy care, increasing surrogates' risk of experiencing mental health symptoms. Our data show that IP support and the surrogate-IP relationship were fundamentals to surrogacy satisfaction. The findings are relevant to fertility and mental health practitioners in identifying surrogates who are more susceptible to mental health challenges. Fertility clinics should ensure adequate psychological screening of surrogate candidates and proactively offer mental health support services.

Engaging Public Health Alumni in the Tracking of Career Trends: Results From a Large-Scale Experiment on Survey Fielding Mode.

We sought to understand the relative impact of fielding mode on response rate among public health alumni. As part of the 2021 Career Trends Survey of alumni from the University of Minnesota School of Public Health, we designed a fielding mode experiment to ascertain whether a paper survey, a postcard with a custom survey link ("postcard push-to-web"), a mobile telephone call or text (mobile), or an email invitation would garner the highest response rates. Invitations were randomly assigned from available contact information. Of 8531 alumni invited, 1671 alumni (19.6%) completed the survey. Among the initial fielding modes, the paper survey had the highest response rate (28%), followed by mobile (19%), email (10%), and postcard push-to-web (10%). More robust recent engagement with alumni relations, paper survey invitation or mode switch, and recent graduation were all significantly associated with a higher likelihood of response. Paper and mobile invitations had the highest response rates to our survey among public health alumni. Findings from this fielding mode experiment are relevant to schools and programs of public health seeking to capture similar information among their alumni, especially given current trends in investment in the public health workforce.

Visual complaints during the COVID-19 pandemic in Spain and Portugal

PurposeThis study reports visual health during the COVID-19 pandemic in 2021 in Spain and Portugal, focusing on eye complaints and population habits. Material and methodsCross-sectional survey through an online email invitation to patients attending ophthalmology clinics in Spain and Portugal from September to November 2021. Around 3833 participants offered valid anonymous responses in a questionnaire. ResultsSixty percent of respondents identified significant discomfort related to dry eye symptoms for increased screen time and lens fogging using facemasks. 81.6% of the participants used digital devices for more than 3 h per day and 40% for more than 8 h. In addition, 44% of participants referred to worsening near vision. The most frequent ametropias were myopia (40.2%) and astigmatism (36.7%). Parents considered eyesight the most important aspect of their children (87.2%). ConclusionsThe results show the challenges for eye practices during the initial COVID-19 pandemic. Focusing on signs and symptoms that lead to ophthalmologic conditions is an essential concern, especially in our digital society highly dependent on vision. At the same time, the excessive use of digital devices during this pandemic has aggravated dry eye and myopia.

147 Needs assessment: Evaluating interest in the Nebraska horse racing industry

Nebraska passed an expanded legalized gambling bill in 2020 allowing casinos at licensed horse racing tracks. As of January 2023, Nebraska has 5 operational horse racing tracks that have been approved for expanded gambling. As a result, a positive impact on the horse racing industry in Nebraska is expected. As the number of tracks, races, and casinos increases there is also a growing need for horses to compete. Since passage of the bill, there has been an increase in the number of mares bred (72%), registered foals (55%), and active stallions (38%) in Nebraska as reported by The Jockey Club in 2023. To determine individuals' current and potential level of interest in actively participating in Nebraska horse racing a 16-question needs assessment survey was made using Qualtrics to develop extension programming. The survey included quantitative and qualitative items and was distributed online through various equine related social media platforms and sent via email invitation to multiple listservs targeting Nebraska residents. Survey questions focused on basic demographics, current and potential involvement in horse racing, personal goals, and management topics related to Nebraska horse racing. Data was collected from 123 respondents who were approximately 70% female (n = 85) and 30% male (n = 36) and 33.8% of the respondents (n = 45) work in the agriculture industry. Respondents completed a 5-point Likert scale (1 = no involvement to 5 = extremely involved) over their current involvement in different aspects of horse racing. The top 3 levels of involvement were breeding mares (1.91 ± 1.38 SD), mare and foal care (1.80 ± 1.23 SD), and working as a groom (1.64 ± 1.23 SD). When asked about their goals most (23.60%) were unsure and 21.12% identified wanting to own a quality racehorse. The top 3 areas respondents were most interested in being involved in were breeding mares (15.12%), caring for mares and foals (14.63%), and 13.17% were unsure. Respondents ranked 14 horse racing industry related topics 1 to 14 (1 = most interested, 14 = least interested, lowest mean = most interested) based on their level of interest in learning more about them. Based on rankings, they were most interested in learning about racehorse care (5.39 ± 3.11 SD), Nebraska bred races (5.66 ± 3.83 SD), and racehorse nutrition (5.68 ± 3.16 SD). Participants indicated their interest in horse racing stems from family being involved in the industry. Respondents show interest in both Thoroughbred and Quarter Horse racing. From these data, a conference is being developed to educate individuals on the topics identified with the goal of bringing more individuals into Nebraska horse racing.

Implementation of Australia’s primary human papillomavirus (HPV) cervical screening program: The STakeholders Opinions of Renewal Implementation and Experiences Study

In this study, we aimed to document stakeholders’ experiences of implementing Australia’s renewed National Cervical Screening Program. In December 2017, the program changed from 2nd yearly cytology for 20–69 year olds to 5 yearly human papillomavirus (HPV) screening for women 25–74 years. We undertook semi-structured interviews with key stakeholders including government, program administrators, register staff, clinicians and health care workers, non-government organisations, professional bodies, and pathology laboratories from across Australia between Nov 2018 - Aug 2019. Response rate to emailed invitations was 49/85 (58%). We used Proctor et al’s (2011) implementation outcomes framework to guide our questions and thematic analysis. We found that stakeholders were evenly divided over whether implementation was successful. There was strong support for change, but concern over aspects of the implementation. There was some frustration related to the delayed start, timeliness of communication and education, shortcomings in change management, lack of inclusion of Aboriginal and Torres Strait Islander people in planning and implementation, failure to make self-collection widely available, and delays in the National Cancer Screening Register. Barriers centred around a perceived failure to appreciate the enormity of the change and register build, and consequent failure to resource, project manage and communicate effectively. Facilitators included the good will and dedication of stakeholders, strong evidence base for change and the support of jurisdictions during the delay. We documented substantial implementation challenges, offering learnings for other countries transitioning to HPV screening. Sufficient planning, significant and transparent engagement and communication with stakeholders, and change management are critical.

Psychological distress among Afghan refugees in Norway as a function of their integration.

Often, refugees are susceptible to mental health problems due to adversities experienced before, during, and after the flight. Through a cross-sectional study, the present study examines the relationship between different aspects of integration and psychological distress among Afghans living in Norway. The participants were recruited through e-mail invitations, refugee-related organizations, and social media platforms. The participants (N = 114) answered questions about integration across multiple dimensions (psychological, social, navigational, economic, and linguistic) in line with the Immigration Policy Lab index (IPL -12/24). Hopkins symptoms checklist (HSCL-25) was used to assess psychological distress. Based on hierarchical multiple regression analysis, both the psychological dimension (0.269 p < 0.01) and the navigational dimension (0.358 p < 0.05) of integration predicted psychological distress. The results suggest that the psychological aspects of integration, such as being part of a community, having feelings of security, and a sense of belonging, are beneficial for the mental health and well-being of the Afghans in Norway and contribute further to other aspects of integration.

Diagnostic yield of genetic screening in a diverse, community-ascertained cohort

BackgroundPopulation screening for genetic risk of adult-onset preventable conditions has been proposed as an attractive public health intervention. Screening unselected individuals can identify many individuals who will not be identified through current genetic testing guidelines.MethodsWe sought to evaluate enrollment in and diagnostic yield of population genetic screening in a resource-limited setting among a diverse population. We developed a low-cost, short-read next-generation sequencing panel of 25 genes that had 98.4% sensitivity and 99.98% specificity compared to diagnostic panels. We used email invitations to recruit a diverse cohort of patients in the University of Washington Medical Center system unselected for personal or family history of hereditary disease. Participants were sent a saliva collection kit in the mail with instructions on kit use and return. Results were returned using a secure online portal. Enrollment and diagnostic yield were assessed overall and across race and ethnicity groups.ResultsOverall, 40,857 people were invited and 2889 (7.1%) enrolled. Enrollment varied across race and ethnicity groups, with the lowest enrollment among African American individuals (3.3%) and the highest among Multiracial or Other Race individuals (13.0%). Of 2864 enrollees who received screening results, 106 actionable variants were identified in 103 individuals (3.6%). Of those who screened positive, 30.1% already knew about their results from prior genetic testing. The diagnostic yield was 74 new, actionable genetic findings (2.6%). The addition of more recently identified cancer risk genes increased the diagnostic yield of screening.ConclusionsPopulation screening can identify additional individuals that could benefit from prevention, but challenges in recruitment and sample collection will reduce actual enrollment and yield. These challenges should not be overlooked in intervention planning or in cost and benefit analysis.

Toward Optimum Light Curing of Resin Composite Restorations: A survey on Current Awareness and Practice among General Dentists in Saudi Arabia

Introduction: This study aimed to assess the current awareness and practices of resin composite light curing of general dental practitioners (GDPs) in Saudi Arabia and to set several evidence-based recommendations to improve the quality of the outcome of concern. Methods: An online questionnaire was created. Two hundred and fifty email invitations were sent to GDPs appointed in general governmental hospitals in five main cities in Saudi Arabia to join the survey voluntarily and anonymously. The survey consisted of 24 questions classified into the following domains: 1-Demographic criteria 2- frequency and technical aspects of resin composites application 3- criteria of the currently used light curing units and curing light. Descriptive statistics and chi-square test were used to analyse the obtained responses. Results: One hundred and fifty-six responses were received. A significant number of GDPs are significantly satisfied with the quality of their light curing, not aware of the thermal hazards of light curing, and do not check power output of their LCUs (light curing units) (P&lt;0.05). An insignificant number of respondents use eye shields for eye protection during light curing. Conclusion: There was no uniform light curing protocol followed by respondent GDPs. GDPs in Saudi Arabia should improve their knowledge and clinical skills of light-curing resin composite.

Santé mentale des médecins libéraux français pendant la deuxième vague de COVID 19

IntroductionThe 2019 coronavirus (COVID-19) pandemic has caused a public health crisis worldwide. Concerns have been expressed about the rapid deterioration of mental health among primary care physicians among whom burnout already had a high prevalence prior to the pandemic. However, there is little data on private doctors during the pandemic. France experienced a second wave with a second lockdown. We aimed to assess and compare physicians’ burnout, anxiety and depression symptoms and insomnia between general practitioners (GP) and all other private specialists during the second Covid-19 wave. MethodsWe conducted an online survey of private practitioners registered on Doctolib® (n=32,655), the interface software most used by private practitioners for booking medical appointments in France. Doctors were invited by email to complete an online survey in November 2020. Inclusions were closed on 1st December. The 2nd lockdown lasted from 30th October to 15th December 2020. We used the Copenhagen Burnout Inventory (CBI) to assess burnout syndrome. A mean score of>50 in at least one subscale defined burnout. The Hospital Anxiety and Depression Scale assessed anxiety and depression symptoms. We used two cut-offs, 8 (>7) and 11 (>10), as both are validated in the ability to find cases. The Insomnia Severity Index (ISI) measures sleep-related complaints among physicians (cut-off >7). To link variations in the psychological scales to the COVID-19 pandemic, one of the items asked explicitly whether participants considered that “the COVID-19 epidemic we are currently experiencing is a source of excess stress, psychological suffering or burnout”. Approval for this study was obtained from the local institutional review board of the University of Paris-Saclay, France. The questionnaires were collected anonymously. Statistical significance was tested using the chi-square test and student's t-test to compare the prevalence between GPs and other specialities. Subsequently, logistic regression models were run for statistically significant associations. Results1992 physicians replied, a response rate of 12.8% of those who received the invitation email. Among them, 79.4% suffered from psychological distress (symptoms of anxiety or depression or burnout), of which 71.3% suffered from burnout, 26.7% from depressive symptoms, 58.9% from anxiety symptoms and 45.8% from insomnia. There was no difference in gender between GPs and specialists, but there was an age difference (P<0.001). GPs had a higher prevalence of burnout (OR=1.33 CI95 [1.09;1.63]) and took more psychotropic drugs (1.38 CI95 [1.05;1.81]). They were also more likely to perceive their stress as work-related (OR=1.50 CI95 [1.23;1.81]) or COVID-19-related (OR=1.43 CI95 [1.16;1.77]). ConclusionOur study is the first to assess the mental health of private practitioners in the second wave in association with COVID-19 stress. Firstly, GPs who provide primary care have a significantly higher burnout rate than other doctors. Secondly, COVID-19 stress is associated with more significant psychological distress. Thirdly, almost 80% of the private doctors surveyed suffer from psychological pain, and 71% suffer from burnout. This study has strengths and limitations. Firstly, this study assesses mental health and stress related to its COVID-19 association. Second, this is the largest population of private physicians during the COVID-19 pandemic. The low response rate is the main limit of this study. The alarming rates of psychological distress among private doctors and, in particular, GPs should lead to intervention to help doctors reduce stress, burnout and other mental disorders. This study gives a picture of the situation during the second wave and the lock-in, and we need to be cautious with the next waves.

The State of Health and Intentions for Action to Advance Mental Health and Well-being for the Nursing Workforce.

The aims of this study were to explore the health of nurse leaders and assess intentions to integrate workplace mental health/wellness practices. National efforts address high rates of poor mental health and lifestyle behaviors among nurses. Few studies describe the extent to which nurse leaders in academic and clinical environments can influence a strategic mission for health/well-being among the nursing workforce. Two hundred seventeen email invitations were distributed to nurse leaders from 5 Kentucky nursing organizations to complete a 1-time 46-item online survey assessing individual health behaviors and intentions to build a culture of workplace health/well-being. Most respondents reported positive physical health (86%), positive mental health/intentions for action to change behaviors (80%), improved self-care practices (86%), integration of self-care practices in the workplace (79%), and commitment to integrate suicide prevention training (55%). Overall, nurse leaders reported positive healthy behaviors. The finding that the highest intentions were reported to integrate, sustain, and/or advance lifestyle behaviors for self-care practices as well as to integrate practices for mental health and well-being in the work environment is encouraging. Enhanced strategies and efforts are needed to prioritize workplace cultures of wellness to benefit nurses and further promote well-being among nurse leaders.