Mail Questionnaire Research Articles

Anthropometric Measures and Risk of Rheumatoid Arthritis in the French E3N Cohort Study.

We aimed to assess the relationships between anthropometric measures and risk of rheumatoid arthritis (RA). The E3N cohort included 98,995 women (aged 40–65 years at the recruitment) who completed mailed questionnaires on reproductive factors, lifestyle, and health-related information, including anthropometric measures, every 2–3 years. Cox proportional hazards regression models with age as the time scale and adjusted on known RA risk factors were used to estimate hazard ratios (HRs) and 95% confidence intervals for the risk of incident RA in the overall population (n = 78,452) and after stratification on smoking exposure. Incident RA diagnosis was validated in 698 women. Abdominal obesity (waist circumference >88 cm) was associated with RA (HR = 1.2 (1.0–1.5)), independent of BMI; whereas obesity, defined as BMI ≥ 30 kg/m2, was marginally associated with RA (HR = 1.26 (0.9–1.5), ptrend = 0.0559). Taking lean body shape (BS) as reference, medium BS at puberty (HR = 1.3 (1.0–1.7)) and medium-large BS at perimenopausal period (HR = 1.5 (1.1–1.9)) were associated with the risk of RA among never-smoker women, independent of BMI. Regarding BS trajectory, taking constantly lean BS as reference, constantly large BS from puberty to perimenopause was associated with RA among non-smokers (HR = 2.10 (1.2–3.6)), independent of BMI.

Dementia Risk in Older Veterans With Frailty: A Cross-Sectional Study

Frailty, a clinical syndrome characterized by vulnerability to stressors resulting from multisystemic loss of physiological reserve, predicts future cognitive decline. However, frailty has also been proposed as a dementia risk factor, predicting future cognitive impairment. The study aim was to determine frailty in older veterans and its association with risk of dementia. Community-dwelling Veterans ≥50 years completed a mailed socio-demographic questionnaire and Self-Administered Gerocognitive Examination (SAGE), July 2019-May 2020. The information was complemented with EHR data. We calculated the CAIDE score, a validated tool predicting dementia (≥6 points= high risk 20 years later) and the 31-item VA frailty index data (frail ≥.20, non-frail ≤.20). After adjusting for socio-demographic characteristics, smoking, alcohol/substance abuse, OSA and anticholinergic use, odds ratio (OR) and 95% CI were calculated using BLR to assess the cross-sectional association between frailty and dementia risk (CAIDE ≥6 points and MCI). The survey response rate was 19.75% (1,073 of 5,432). Participants mean age was 68.38 (SD=8.49) years, 57.50% (n=617) Caucasian, 69.34% (n=744) non-Hispanic, 95.81% (n=1,028) male, and 36.72% (n=394) frail. 11.84%(n=127) screened positive for MCI and 15.38% (n=165) for dementia. 689 (75.88%) veterans were at high risk for dementia of whom 426 (61.83%) were non-frail and 263 (38.17%) were frail. Frailty was cross-sectionally associated with higher risk for dementia in older Veterans, adjusted OR:1.45 (95%CI:1.016-2.070), p=.041. The mailed screening was a feasible and practical approach to screen for dementia risk. Early identification of patients with frailty can help in the implementation of interventions aimed at preventing or delaying dementia.

Impact of Benazir Income Support Program (BISP) on consumption, health and education

Introduction. Benazir Income Support Program (BISP) is one of such efforts promulgated by the Government of Pakistan (GoP) in July 2008, as a premier national safety net initiative aimed at eradicating extreme and chronic poverty in the country. The main aim of this empirical study to examined the impact of BISP on consumption, education and health in case study of district Swat Pakistan. Methodology. This study used the qualitative research strategy because qualitative research strategy provided a variety of opportunities in identifying a problem. The data were collected through key informant interviews and mailed questionnaires. Interviews were conducted face to face using a semi-structured interview guide and as well a mail questionnaire. Results. The following respondents were well-acknowledged from the situation Covid-19 and have better knowledge about the BISP as a source of income. A total of 4 interviews were conducted from the targeted respondents using a semi-structured interview guide. And sent the mailed questionnaire to 45 respondents, only 7 respondents are replied. Conclusion. The main aim of this empirical study is to examine the Impact of Benazir income support program (BISP) on consumption, health and education during the COVID 19 pandemic. The finding reveled that BISP have positive effect on consumption, health and education. This empirical study has several recommendations based on research findings; (1) the government should pay the BISP income on monthly basis. (2) The government should increase the BISP income.

Satisfaction of Public Land Hunters During Long‐term Deer Population Decline

ABSTRACTWhite‐tailed deer (Odocoileus virginianus) populations and deer hunter participation on federal public lands within the Appalachian Mountains of the southeastern United States have been declining over the last 30 years. Our study focused on Chattahoochee National Forest hunters in North Georgia, a region that has sustained a 64% decline in buck harvest success rates and 68% decline in hunter participation during 1979–2018. To better understand factors influencing satisfaction of remaining hunters, we sent mail questionnaires to 1,271 hunters in February 2019. We received 441 completed questionnaires for a 36% adjusted response rate. First, we used principal component analysis to identify 4 unique motivations for deer hunting: 1) escaping the daily routine and spending time outdoors, 2) harvesting deer for food, 3) socializing with hunting partners, and 4) harvesting trophy bucks. Second, we used ordinal logistic regression, which indicated that perception of a low deer population density was associated with lower levels of satisfaction. Perception of the right number of hunters on the landscape was associated with higher levels of satisfaction. In addition, greater importance ratings of harvesting trophy bucks were associated with lower satisfaction levels. Last, we applied revised importance‐performance analysis to 19 aspects of WMA deer hunting, which revealed that managers should focus on increasing opportunities for hunters to see deer and harvest bucks for the best chance at improving hunter satisfaction. Considering the 64% decline in harvest success rates between 1979 and 2018, the positive relationship between hunter satisfaction and perception of deer density, and hunter desires to see more deer and have more opportunities to harvest bucks, we recommend managing the deer population to increase numbers. Overall, our findings suggested that hunters and managers agree on the direction of deer management on North Georgia public lands for the near future. © 2021 The Wildlife Society.

The influence of alcohol intake in myopia development or progression: The SUN cohort study

BackgroundMyopia is a highly prevalent disorder, and one of the first causes of blindness. In turn, alcohol consumption has been shown to be a risk factor for many diseases and a main contributor to the global burden of disease. However, no studies have investigated the relationship between alcohol intake and myopia. Our aim was to prospectively assess the association between alcohol intake and the development or progression of myopia. MethodsIn a Spanish dynamic prospective cohort (the SUN Project) we assessed 15,642 university graduates, recruited between 1999 and 2018 and followed up biennially through mailed questionnaires. Alcohol intake was assessed with a validated 136-item food frequency questionnaire. Development or progression of myopia was collected in subsequent questionnaires during follow-up every two years. ResultsAlcohol intake was linearly and significantly associated with a higher risk of myopia development or progression: the OR for 10-year incidence/progression of myopia was 1.05, 95% CI 1.01–1.09 per each 10-grams increase in alcohol intake. ConclusionsAlcohol consumption might lead to the development or progression of myopia, although confirmation is needed for the mechanisms through which this association may occur, thus further research is needed to verify these findings.

Factors associated with visiting freshwater blue space: The role of restoration and relations with mental health and well-being

Blue space exposure may benefit health and well-being, but salutogenic effects remain underexplored in non-coastal and non-urban areas, as do correlates of visit frequency to freshwater blue space (FBS). We mailed a questionnaire to adults in 40 small towns in central and northeast Pennsylvania, USA, with varying proximity to the region’s primary waterbody to assess FBS visits, benefits and barriers of visiting, restoration experienced, and mental health and well-being (perceived stress, general mental health, life satisfaction). We used multivariate multinomial regression to examine predictors of FBS visit frequency and linear and logistic regression to evaluate associations of FBS visit frequency with health outcomes, using mixed effects models that accounted for spatial clustering. Of 10,871 mailed questionnaires, 1,122 individuals (11%) responded and provided information to characterize FBS visits. Responders were older than non-responders but did not differ by sex or community setting. Nearly one-fifth (19%) never visited FBS, and 27%, 35%, and 19% reported low, moderate, and high visit frequency, respectively. Correlates of visit frequency included perceived proximity, higher education, younger age, better self-reported health, and more frequent physical activity. Relaxation/stress-relief was identified as the most important benefit to visiting FBS, and among the 868 individuals who visited FBS, restoration was associated with visit frequency. FBS visit frequency was associated with perceived stress, but not mental health or life satisfaction. Findings highlight the socioeconomic patterning of FBS visits, the importance of access in facilitating visits, and reveal opportunities to develop FBS access points that increase its use, bringing potential restorative benefits.

Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities

Reasons for acquiring insurance outside Department of Veterans Affairs (VA) health care coverage among VA enrollees are incompletely understood. To assess Veterans’ decision-making and acquisition of non-VA health care insurance in the Affordable Care Act era, we used mailed questionnaires and semistructured interviews in a stratified random sample of VA enrollees <65 years in the Midwest. Of the 3,666 survey participants, 32.1% reported non-VA insurance. Frequently reported reasons included wanting coverage for emergency situations or family members. Those without non-VA insurance cited unaffordability as the main obstacle. Analysis of the semistructured interview data revealed similar findings. In multivariable logistic regression analyses, characteristics associated with non-VA insurance included higher income (>$50,000 vs. <$10,000, odds ratio [OR] = 5.95, 95% confidence interval [CI]: 3.45–10.3, p < .001). As financial barriers exist for acquisition of non-VA insurance and hence community care, it is critically important that VA enrollees’ health care needs are met through VA or community providers financed through VA.

Vertical disease programs and their effect on integrated disease surveillance and response: perspectives of epidemiologists and surveillance officers in Nigeria

BackgroundIntegrated Disease Surveillance and Response (IDSR) is a cost-effective surveillance system designed to curb the inefficiency associated with vertical (disease-specific) programs. The study determined the existence and effect of vertical programs on disease surveillance and response in Nigeria.MethodsA cross-sectional study involving 14 State epidemiologists and Disease Notification Surveillance Officers (DSNOs) in 12 states located within the 6 geopolitical zones in Nigeria. Data was collected using mailed electronic semi-structured self-administered questionnaires. Response rate was 33.3%. The data was analyzed using SPSS version 20.ResultsHalf of the respondents were males (50.0%) and State epidemiologists (50.0%). Malaria, HIV/AIDS, tuberculosis, and other diseases were ongoing vertical programs in the States surveyed. In over 90% of cases, vertical programs had different personnel, communication channels and supportive supervision processes different from the IDSR system. Although less than 50% acknowledged the existence of a forum for data harmonization, this forum was ineffectively utilized in 83.3% of cases. Specific disease funding was higher than that of IDSR (92.9%) and only 42.9% reported funding for IDSR activities from development partners in the State. Poor data management, low priority on IDSR priority diseases, and donor-driven programming were major negative effects of vertical programs. Improved funding, political ownership, and integration were major recommendations preferred by the respondents.ConclusionWe found that vertical programs in the surveyed States in the Nigerian health system led to duplication of efforts, inequitable funding, and inefficiencies in surveillance. We recommend integration of existing vertical programs into the IDSR system, increased resource allocation, and political support to improve IDSR.

Alcohol dependence severity determines the course of treatment-seeking patients.

While accumulating evidence suggests a relation between the severity of alcohol dependence and the risk of its recurrence, the impact of dependence severity on the course of the disorder has not been carefully evaluated. The present study examined the impact of several severity indices of alcohol dependence on the drinking course after inpatient treatment. This prospective study was conducted over a 12-month period following alcohol treatment at a specialized hospital. A total of 712 consecutively admitted alcohol-dependent patients were targeted for enrollment at the time of their hospitalization, with 637 patients registered and followed. The characteristics and severity of the subjects were assessed using multiple methods at admission, with their course after discharge followed continuously using mailed questionnaires that queried them regarding their drinking behavior. Greater severity of dependence, assessed using the number of ICD-10 diagnostic criteria met, was associated with a lower rate of abstinence during the study period (p=0.035). The rate of abstinence also decreased significantly as the baseline blood gamma-glutamyl transferase value and Alcohol Dependence Scale (ADS) score increased (p=0.031 and p=0.0002, respectively). In multivariate Cox proportional hazards analyses, the group with the most severe ADS scores had a significantly greater risk of relapse to drinking than the group with the least severe scores (HR=2.67, p=0.001). Dependence severity also associated with the drinking pattern; participants in both the controlled drinking group and the abstinence group had lower ADS scores at admission and a later age at first drinking (p=0.001 and p<0.001, respectively) than those with poorer drinking outcomes. The present study showed that more severe alcohol dependence predicts a poorer course after alcohol treatment, as reflected by findings on multiple measures. These results suggest that assessing the dependence severity at the outset of treatment could be useful both in predicting treatment outcome and targeting interventions to alcohol-dependent individuals who need additional support in their recovery.

COVID-19: Access to Information, Health Service, Daily Life Facility and Risk Perception of Foreigners during Coronavirus pandemic in South Korea

IntroductionCoronavirus disease outbreak has become a top global challenge. Critical issues have emerged regarding access to information, health services, and daily necessities. Effective access to such components is expected to promote public safety and survival as well as to help combat social fear and risk perception. This study aims to fill this gap by exploring public perceptions of access, risk, and government response during the COVID-19 outbreak.Material and methodsA quantitative field survey using a structured mailed questionnaire was conducted to collect primary data from 100 foreigners living in various cities in South Korea. Access to information, health and daily necessities, and overall risk perception were examined based on individual reports regarding sources, availability, credibility, and overall satisfaction.ResultsOur finding suggest that foreigners are receiving reliable information from public and private sources. Although access to health services, daily necessities, and protection measures were perceived as limited due to government protection measures, survey respondents tended to perceive an overall satisfactory government response in terms of providing resources and reducing risks related to COVID-19.ConclusionsModel analysis indicates that gender, home location, and duration of stay are significantly related to lower levels of risk perception. This study provides a new lens for policymakers, administrators, and academicians by which they can ensure smooth public access to information, health, and daily necessities regarding the protection and containment of coronavirus.

US Federal Aviation Administration Neighborhood Environmental Survey: Study Design and Survey Methodology

As part of the agency's broader noise research program, the Federal Aviation Administration (FAA) has undertaken a multi-year research effort to quantify the impacts of aircraft noise exposure on communities around commercial service airports in the United States (U.S.). The overall goal of the study was to produce an updated and nationally representative civil aircraft dose-response curve; providing the relationship between annoyance and aircraft noise exposure around U.S. airport communities. To meet this goal, the FAA sponsored a research team to help design and conduct a national survey, known as the Neighborhood Environmental Survey (NES). Residents from households around 20 airports were selected for participation in the survey; the detailed sampling process is covered in another paper. Two survey instruments were administered to adult residents within the NES: a mail questionnaire and a follow-up telephone interview for the mail respondents. The mail survey was administered to samples of individuals in the selected airport communities in six separate "waves" over a 12-month period starting in October 2015. All mail survey respondents were invited to complete a follow-up telephone interview, which asked detailed questions on several areas including respondents' opinions on noise, exposure to aircraft noise, relationship to the airport, concerns about aircraft operations, views on airport community relations, among others. Analysis of the survey responses on annoyance levels and the associated DNL was used to estimate dose-response curves for each individual airport and a national dose-response curve. The national dose-response curve created from the mail questionnaire shows considerably more people are highly annoyed by aircraft noise at a given noise exposure level compared to historical FICON data. This paper provides a detailed discussion of the survey design and methodology. Additional information describing the motivation to conduct the NES and how its findings will help inform ongoing work to address aircraft noise concerns; and the noise methodology are provided in companion papers.

Changes In Physical Activity And Health Indicators In The Covid-19 Disasters: Results Of A Mail Questionnaire Survey Of Community-based Group Exercise Elderly Participants In Fujisawa, Japan

PURPOSE: In the COVID-19 disaster, physical and social activities are restricted. Since 2015, as part of a community-wide intervention, we have continued to support groups of elderly who meet regularly in their close neighborhood community to engage in voluntary exercise in Fujisawa City, Kanagawa Prefecture, Japan. In this study, we conducted a mailed questionnaire survey to understand the current situation and the situation at the time of the declaration of a state of emergency, while activities are restricted under the spread of COVID-19 infection. METHODS: The questionnaire was sent by mail in August 2020, and valid responses were obtained from 145 participants (76.3%). Questions were asked about physical activity, mental health, and quality of life, as well as about changes in daily life and communication during and after the declaration of the state of emergency. For those who had completed the similar questionnaire in 2019 (n = 78), we compared the data from that time with the current data and discussed the characteristics. RESULTS: The mean (standard deviation) age of the subjects was 77.4 (5.7) years. Eighty-eight (61%) were female, and 21 (14.5%) lived alone. The median time for activities of daily living other than exercise, exercise time, and sitting time were 60, 9.3, and 300 minutes/day at the time of the declaration of the state of emergency, and 60, 12.9, and 300 minutes/day at the present time, respectively (all median values). In the comparison between last year and the present, the time for daily activities and exercise decreased significantly, while the time for sitting increased. There was a significant decrease in WHO5 and a downward trend in apathy. The following actions were taken to prevent the spread of infection: hand washing and alcohol disinfection (99%), wearing a mask (97%), indoor ventilation (90%), checking body temperature (67%), avoiding crowds (91%), and not eating except with family members (67%). CONCLUSIONS: For those who performed group exercise, the amount of physical activity improved from the time when the state of emergency was declared but remained lower than the previous year, and sedentary behavior increased. Some of them have decreased QOL and increased apathy. It is necessary to take countermeasures.

U.S. Federal Aviation Administration Neighborhood Environmental Survey: Noise Methodology

As part of the agency's broader noise research program, the Federal Aviation Administration (FAA) has undertaken a multi-year research effort to quantify the impacts of aircraft noise exposure on communities around commercial service airports in the United States (U.S.). The overall goal of the study was to produce an updated and nationally representative civil aircraft dose-response curve; providing the relationship between annoyance and aircraft noise exposure around U.S. airport communities. To meet this goal, the FAA sponsored a research team to help design and conduct a national survey, known as the Neighborhood Environmental Survey (NES). A multi-stage and statistically rigorous process was used to select a representative sample of US airports, including a balanced sampling frame that included six factors: geographic distribution, temperature, day-night split, operational tempo, fleet mis, and population density. The research team computed Day-Night Average Sound Levels (DNL) for the 20 airports in two waves: first for survey respondent selection, and then for pairing with respondent locations to create the dose response curve. Analysis of the responses and the associated DNL was used to generate dose-response curves for each individual airport and a national dose-response curve showing the percent "Highly Annoyed" for a given noise level. The National dose-response curve created from the mail questionnaire shows considerably more people are highly annoyed by aircraft noise at a given noise exposure level compared to historical FICON data. This paper presents the airport selection and noise modeling process used to support the creation of the National dose-response curve. Additional information describing the motivation to conduct the NES and how its findings will help inform ongoing work to address aircraft noise concerns; and the survey methodology are provided in companion papers.

Surgical Decision-Making Surrounding Contralateral Prophylactic Mastectomy: Comparison of Treatment Goals, Preferences, and Psychosocial Outcomes from a Multicenter Survey of Breast Cancer Patients.

Differences in patient characteristics and decision-making preferences have been described between those who elect breast-conserving surgery (BCS), unilateral mastectomy (UM), or contralateral prophylactic mastectomy (CPM) for breast cancer. However, it is not known whether preferred and actual decision-making roles differ across these surgery types, or whether surgery choice reflects a woman's goals or achieves desired outcomes. Women diagnosed with stage 0-III unilateral breast cancer across eight large medical centers responded to a mailed questionnaire regarding treatment decision-making goals, roles, and outcomes. These data were linked to electronic medical records. Differences were assessed using descriptive analyses and logistic regression. There were 750 study participants: 60.1% BCS, 17.9% UM, and 22.0% CPM. On multivariate analysis, reducing worry about recurrence was a more important goal for surgery in the CPM group than the others. Although women's preferred role in the treatment decision did not differ by surgery, the CPM group was more likely to report taking a more-active-than-preferred role than the BCS group. On multivariate analysis that included receipt of additional surgery, posttreatment worry about both ipsilateral and contralateral recurrence was higher in the BCS group than the CPM group (both p < 0.001). The UM group was more worried than the CPM group about contralateral recurrence only (p < 0.001). Women with CPM were more likely to report being able to reduce worry about recurrence as a very important goal for surgery. They were also the least worried about ipsilateral breast recurrence and contralateral breast cancer almost two years postdiagnosis.

Citizen advisory groups for the creation and improvement of decision aids: experience from two Swiss centers for primary care

BackgroundGuidelines for patient decision aids (DA) recommend target population involvement throughout the development process, but developers may struggle because of limited resources. We sought to develop a feasible means of getting repeated feedback from users.MethodsBetween 2017 and 2020, two Swiss centers for primary care (Lausanne and Bern) created citizen advisory groups to contribute to multiple improvement cycles for colorectal, prostate and lung cancer screening DAs. Following Community Based Participatory Research principles, we collaborated with local organizations to recruit citizens aged 50 to 75 without previous cancer diagnoses. We remunerated incidental costs and participant time. One center supplemented in-person meetings by mailed paper questionnaires, while the other supplemented meetings using small-group workshops and analyses of meeting transcripts.ResultsIn Lausanne, we received input from 49 participants for three DAs between 2017 and 2020. For each topic, participants gave feedback on the initial draft and 2 subsequent versions during in-person meetings with ~ 8 participants and one round of mailed questionnaires. In Bern, 10 participants were recruited among standardized patients from the university, all of whom attended in-person meetings every three months between 2017 and 2020. At both sites, numerous changes were made to the content, appearance, language, and tone of DAs and outreach materials. Participants reported high levels of satisfaction with the participative process.ConclusionsCitizen advisory groups are a feasible means of repeatedly incorporating end-user feedback during the creation of multiple DAs. Methodological differences between the two centers underline the need for a flexible model adapted to local needs.

Databases and Organisational Agility in the Nigerian Content Development and Monitoring Board in Bayelsa State, Nigeria

This paper investigated the relationship between databases and organisational agility in the Nigerian Content Development and Monitoring Board in Bayelsa State. To guide this study, the researcher adopted the case study design. 67 management level staff of theBoard made up the population. Data was collected using a mail questionnaire. The validity of the instrument was ensured through expert opinion and reliability was measured using the Cronbach-alpha technique with all the items scoring above 0.70%. The Nunnally (1978) alpha threshold of 0.7 constituted the basis for determining reliability. The Likert 5-point scale was adopted. The hypotheses were tested using the Pearson Product Correlation coefficient. The paper concluded that a strong positive and significant association exists between databases and organisational agility. Based on the findings, the researcher recommends that the management Board should strategically position and make information readily available to facilitate learning and sensing the changing market conditions, as well as developing a strategy for gathering and storing quality information to enable them to make timely decisions to improve the organization's effectiveness. It should encourage the promotion, dissemination and transfer of information to facilitate and enhance the firm’s performance in a dynamic environment.

POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels &gt; 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

Sensory Health for Residents with Dementia in Care Homes in England: A Knowledge, Attitudes, and Practice Survey

BackgroundMost residents with dementia (RwD) in long-term care (LTC) facilities experience hearing and vision problems, yet these sensory deficits, which are associated with poor outcomes, are frequently under-recognized or incompletely managed. ObjectiveWe investigated the knowledge, attitudes, and practice (KAP) of LTC facility staff in England regarding sensory-cognitive health of RwD. DesignA cross-sectional survey using self-administered online or mail-in questionnaires. Setting and ParticipantsThe study included 117 LTC facilities throughout England, involving 887 staff of different grades (managers, n=79; nurses/allied health professionals, n=160; care workers, n=648). MethodsUsing a sampling frame of all LTC facilities nationwide, we included a stratified random selection of facilities, surveying staff regarding KAP of sensory-cognitive health. Analysis was descriptive, followed by a regression model for predictors of overall KAP capacity of staff, based on a Rasch analysis of survey items. ResultsStaff of all grades reported high knowledge and awareness of sensory-health concerns amongst RwD, but training opportunities were infrequent and most front-line staff felt they lacked the skills necessary to support the use of hearing and vision aids. The most reported reason for poor use of hearing aids/glasses related to lack of maintenance and care procedures (ie, broken and lost devices), and poor adherence support (ie, not tolerating the devices). Staff willingness to receive training was high. Most managers reported that training in communication skills and “sensory-friendly” environments was not provided. Finally, higher overall KAP capacity of staff was predicted by smaller facility size and public, rather than private, facility type. Conclusions and ImplicationsTraining and practice of sensory health care in RwD in LTC in England is lacking. To improve sensory-cognitive care for LTC RwD, there is a clear need for (1) practice recommendations and (2) multifaceted interventions that include staff training, tailored sensory support, and environmental modification.

Association between received treatment elements and satisfaction with care for patients with knee osteoarthritis seen in general practice in Denmark

Objective While education, exercise, and weight reduction when indicated, are recommended first-line treatments for knee osteoarthritis patients, they remain poorly implemented in favour of pain killer treatment, imaging and referral to surgery. A reason could be that patients are more satisfied with receiving these adjunctive treatment elements. This study aimed to investigate the associations between the received elements of care and the patient’s satisfaction with the care for knee osteoarthritis in general practice. Design Cross-sectional study. Setting A Danish general practice. Subjects All consecutive patients ≥30 years of age who consulted the general practitioner (GP) with chronic knee complaints during 18 months and who replied to a mailed questionnaire (n = 136). Main outcome measures The questionnaire addressed patient’s knee-related quality of life, and overall satisfaction with care, as well as reception of seven types of information, which are known quality indicators. Information on reception of adjunctive treatment elements was obtained from electronic medical records. Results Patient satisfaction (versus neutrality/dissatisfaction) was positively associated with reception of information on: physical activity and exercise (relative risks [RR] 1.38, 95% bootstrap percentile interval [BPI] 1.02–4.33), and the relationship between weight and osteoarthritis (1.38, 1.01–4.41). No significant associations were found for the five remaining types of information and all the adjunctive treatment elements. Conclusion Providing information as education to patients with knee osteoarthritis as part of the treatment is positively associated with satisfaction with care. KEY POINTS General practitioners worry about the doctor–patient relationship when addressing recommended lifestyle changes. However, this study revealed: •Patients in general practice with knee osteoarthritis are satisfied with care after having received information on lifestyle changes, such as exercise and the relationship between weight and osteoarthritis. •Patient satisfaction was not associated with the reception of adjunctive treatment elements for osteoarthritis.

A preliminary prospective study of health-related quality of life among Chinese-American breast cancer survivors.

This study examined the predictors of health-related quality of life (HRQOL) and changes in HRQOL over a 1-year period among Chinese-American breast cancer survivors (BCS). A two-wave longitudinal research design included participants from hospital-based cancer registries and community organizations in Los Angeles. Participants completed mailed questionnaires at baseline and 12-month follow-up. HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G v.4). Change in HRQOL was assessed using a 7-point meaningful change score. Participants were 73 Chinese-American BCS, a majority of whom were middle-aged (M = 54.6, SD = 9.2), lower income (63% < 45K), and diagnosed with stage I-II (83%) breast cancer. Regression analyses showed that multilevel contextual factors including general health perception, quality of care, life stress, and improvement in general health perception significantly predicted HRQOL at baseline and follow-up. The final model explained 72% of the variance of HRQOL. The examination of meaningful change indicated that improvement was reported by 32% (n = 22) and deterioration by 25% (n = 17); the majority indicated minimal change (43%, n = 30). Improvement was associated with increases in family communication, social support, and general health perception, while deterioration was associated with declines in social support, family communication, and general health perception. Findings indicate that among Chinese-American BCS, HRQOL is influenced by socioecological factors such as family communication and life stress. Results suggest that cancer survivorship outcomes research may benefit from theoretical foundations that examine the broader contextual dimensions that seem to impact and predict HRQOL. Implications for research are discussed.