Mail Survey Research Articles

Are functional foods used as self-medication? Subjective health, self-reported disease symptoms, current medical treatment and functional food choices

PurposeFunctional foods have been marketed as promoting health and reducing the risk of disease. While the market of functional foods is increasing across the globe, little is known about how actual and subjective health status are related to functional food choices and existing research evidence is inconsistent. Therefore, the purpose of this paper is to systematically explore the relationship between functional food choices and perception related dimensions vs medical dimensions.Design/methodology/approachThe study used data collected from a large-scale mail survey in Japan (N = 8,368) and a representative Internet survey in Lithuania (N = 900). It used structural equation modeling (SEM) to test the proposed conceptual model.FindingsThe general results indicated that functional foods could be used to maintain one’s subjective health status – the frequency of using functional food products was positively related to consumers’ subjective health status (p = 0.04). However, if consumers were experiencing health-related issues (self-reported disease symptoms or current medical treatment), there was no systematic relationship between such experience and the usage of functional food products.Originality/valueTo the best of the authors’ knowledge, this study is among the first to systematically analyze the relationship between subjective health status, self-reported disease symptoms, current medical treatment and the frequency of using different functional food product groups. The findings indicated that it is important to simultaneously consider different underlying factors, such as specific to functional food targeted disease symptoms and specific food product groups, which contributed to a more thorough understanding of functional food consumption.

Aging trajectories of subscales in higher-level functional capacity among community-dwelling older Japanese adults: the Otassha study

BackgroundMaintaining higher-level functional capacity is important for independent living in older age. The aging trajectory of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) has three patterns; however, the subscale patterns are unclear.AimsThis study aimed to clarify the aging trajectory patterns of the TMIG-IC subscales among community-dwelling older Japanese.MethodsParticipants were 3,169 community-dwelling older Japanese who participated in the 2012–2022 mail survey of the Otassha study. The aging trajectory patterns of the TMIG-IC total and subscale scores for those aged 65–90 years were identified using group-based trajectory modeling. Further, the combination frequency of the subscale trajectory patterns was determined.ResultsThree patterns were identified: early-onset decreasing, late-onset decreasing, and high-stable.DiscussionThe instrumental activities of daily living (IADL) trajectory was maintained until approximately 80 years of age; however, chronic disease prevailed the most in the early-onset decreasing pattern. The early-onset decreasing pattern of intellectual activity (IA) was present in 25% of participants, showing impaired IA from 65 years of age. The late-onset decreasing pattern of social roles (SR) was present in 30% of participants, showing a sharp decline compared to other subscales. For many people, the patterns of decrease in SR and IA overlapped.ConclusionsTo maintain higher-level functional capacity, interventions that include disease management and prevention of decline in IADL and increase the awareness of the social support provided throughout old age and interventions for people with an early decline in IA should be implemented.

Soft plastic fishing lures as a potential source of chemical pollution - Chemical analyses, toxicological relevance, and anglers’ perspectives

Soft plastic lures (SPLs) are commonly used artificial lures in recreational angling. Anglers regularly lose SPLs while fishing and there is little knowledge about the environmental impacts of lost SPLs. As with other plastic items, SPLs contain phthalates and other persistent additives that may leach into water. In this study, 16 randomly chosen SPLs of common models were analyzed for the leaching of persistent, water-soluble plastic additives, including phthalates. The estrogenicity of sample extracts from a subsample of 10 SPLs was assessed using luciferase reporter gene bioassays. Over a period of 61 days, 10 of the 16 SPLs leached the targeted phthalates dimethyl phthalate (DMP), diethyl phthalate (DEP), benzyl butyl phthalate (BBP) and di-n-butyl phthalate (DnBP) at median detectable concentrations ranging from 10 ng/g sample BBP to a median of 1001 ng/g DMP as well as 45 persistent, mobile, and toxic (PMT) plastic additives. DEP was detected most frequently in 8 SPLs, followed by BBP (2 SPLs), DMP (2 SPLs) and DnBP (1 SPL). The extract from one SPL with comparatively low phthalate and PMT plastic additive levels was active in the bioassay, indicating high endocrine-disruptive potential, presumably due to unknown additives that were not among the target substances of the methodology used in this study. The study was supplemented by a mail survey among anglers, in which attitudes of anglers towards SPLs were investigated. The survey indicated that SPL loss is a common event during angling. Most participants were concerned about potential ecological impacts of SPLs, wanted the ingredients of SPLs to be labelled and supported legal restrictions concerning toxic ingredients of SPLs. The study shows that SPLs are a potential source of environmental pollution, may pose human health risks and need further investigation, considering the frequent use of SPLs in recreational angling.

Relationships among age, motivation, and exercise among women Veterans

Physical activity (PA) and exercise are central to maintaining health, however research has shown steep declines in PA and exercise among women Veterans as they age. Though motivation may be an important contributor to initiating and sustaining exercise that may change across the lifespan, little is known about exercise motivation and its relation to age and exercise behavior among women Veterans. This cross-sectional study sought to describe exercise motivations, examine relationships among exercise motivations and age, and explore the degree to which age and motivation predict self-reported exercise behavior among women Veterans. We conducted a secondary data analysis from a regional mail survey of 197 women Veterans (mean age = 51; SD = 10.5) enrolled in Veterans Health Administration primary care in a northeastern region (N = 180 in analysis). Measures included demographics (age, body mass index), self-reported exercise motivation, and an estimate of average weekly exercise. Participants endorsed multiple motivators for exercise, most prominently fitness and health management. Age was significantly negatively related to amount of exercise and with socializing as an exercise motivation. After accounting for body mass index, age was a significant predictor of exercise behavior, and exercise motivations accounted for an additional 7.3% of variance in self-reported weekly exercise. Our results suggest that although motivation is a potentially important predictor of exercise, factors beyond motivation may better predict exercise in women Veterans. Further research is needed on personal and practical facilitators and barriers to exercise in this population.

Association of Social Isolation and Loneliness With Chronic Low Back Pain Among Older Adults: A Cross-sectional Study From Japan Gerontological Evaluation Study (JAGES).

Per the biopsychosocial model, pain, especially chronic low back pain, which often presents with nonspecific pain, requires a comprehensive approach involving social factors. However, the association of social factors, including social isolation and loneliness, with this condition remains unclear. This study examined the cross-sectional association of social isolation and loneliness with chronic low back pain among older adults. We recruited functionally independent older adults through a mail survey in 2019 from the Japan Gerontological Evaluation Study (JAGES). Chronic low back pain was defined as low back pain lasting more than 3 months. Social isolation was identified based on face-to-face and non-face-to-face interactions ("not isolated," "isolated tendency," and "isolated"). Loneliness was assessed using the University of California, Los Angeles Loneliness Scale ("not lonely," "lonely tendency," and "lonely"). Consequently, 21,463 participants were analyzed (mean age: 74.4 years; 51.5% females); 12.6% reported chronic low back pain. Multivariable Poisson regression analysis revealed that loneliness was significantly associated with the likelihood of chronic low back pain; compared with "not lonely", the prevalence ratio (PR) was 1.14 (95% confidence interval [CI], 1.05-1.25) for "lonely tendency" and 1.40 (95% CI, 1.27-1.54) for "lonely." Social isolation was not associated; compared with "not isolated," the PR was 0.96 (95% CI, 0.88-1.05) for "isolated tendency" and 0.99 (95% CI, 0.89-1.10) for "isolated." A positive multiplicative interaction between social isolation and loneliness for chronic low back pain was found. Lonelier individuals were more likely to experience chronic low back pain, and those with loneliness and social isolation were synergistically more likely for this condition.

Association between the change in the job facilitating and inhibiting factors of care staff due to the employment of older assistant workers and the emotional exhaustion among care staff

Objectives The mental health condition of care staff in Japan is becoming problematic. Older assistant workers are currently being employed to assist care staff with their jobs and alleviate their job burden. This employment of older assistant workers is drawing attention; however, their influence on the job facilitating and inhibiting factors of care staff and the association with the care staff's emotional exhaustion remains unclear. In this study, we aim to examine how the employment of older care assistant workers relates to the job-facilitating and job-inhibiting factors of care staff and explore that association with the care staff's emotional exhaustion.Methods Data from a mail survey of geriatric health services facilities with older assistant workers were analyzed. Among the answers obtained from the care staff, answers from 5,185 who reported working in facilities that employ older assistant workers (over the age of 60) were analyzed. The Emotional Exhaustion subscale of the Japanese Version of the Burnout Questionnaire was used as the dependent variable. The change in job-facilitating and job-inhibiting factors of care staff due to the employment of older assistant workers (improve, maintain/exacerbate) was explored for nine contents.Results Care staff reported a decrease in the total volume of the task (63.6%), less stress during daily tasks (39.8%), and more concentration on the tasks that require expert care knowledge (38.0%). The results of multiple regression analysis showed that the emotional exhaustion score of care staff was low when the total volume of tasks decreased (β=－0.383, 95%CI=－0.719, －0.047), when less stress was perceived during daily tasks (β=－0.432, 95%CI=－0.796, －0.068), when concentration on tasks that required expert care knowledge increased (β=－0.574, 95%CI=－0.937, －0.210), and when human relationships among staff improved (β=－0.871, 95%CI=－1.263, －0.480). Conversely, an increase in tasks requiring work with regional personnel and organizations (β=0.800, 95%CI=0.162, 1.437) was associated with a high emotional exhaustion score.Conclusion The employment of older care workers was related to the job-facilitating or job-inhibiting factors of care staff, and the change in these factors was associated with lower emotional exhaustion. The employment of older personnel may lower the risk of burnout among care staff.

Prevalence and Correlates of Unstable Housing Among US Children

Housing instability is an important public health issue, particularly for children. This study provides nationally representative estimates of unstable housing among US children. To examine unstable housing prevalence; differences by sociodemographic characteristics, health, and state of residence; and associations with other hardships. This survey study examined data from the 2022 National Survey of Children's Health, a population-based, nationally representative survey of randomly selected children whose parent or caregiver responded to an address-based mail or web-based survey. Participants were children aged 0 to 17 years living in households in the 50 US states and District of Columbia (N = 54 103). Bivariate analyses tested for observed differences in unstable housing between groups; logistic regression models tested for significant disparities. Associations between unstable housing and health care and food-related hardships, neighborhood conditions, and adverse childhood experiences were examined. Unstable housing experiences. Unstable housing, comprising 3 indicators: inability to pay mortgage or rent on time in the past 12 months, 2 or more moves in the past 12 months, and homelessness in the child's lifetime. Analyses were adjusted for child age and family poverty ratio. Secondary analyses examine caregiver-reported stress or worry about eviction, foreclosure, or condemned housing in the past 12 months. Weighted prevalence estimates accounted for probability of selection and nonresponse. In 2022, 17.1% (95% CI, 16.4%-17.8%) of children living in US households, representing more than 12.1 million children, experienced 1 or more forms of unstable housing: 14.1% (95% CI, 13.4%-14.7%) lived in households that were unable to pay mortgage/rent, 2.9% (95% CI, 2.6%-3.3%) moved frequently, and 2.5% (95% CI, 2.2%-2.8%) experienced lifetime homelessness. Additionally, 9.0% (95% CI, 8.5%-9.5%) of children had caregivers who reported stress/worry over housing. Prevalence of unstable housing varied across states (range, 12.0%-26.6%). Unstable housing was highest among American Indian or Alaska Native children (27.9%; 95% CI, 21.3%-35.6%), Black or African American children (30.4%; 95% CI, 27.8%-33.1%), and Native Hawaiian or Pacific Islander children (27.6%; 95% CI, 16.6%-42.1%) and also differed by special health care needs, family poverty ratio, caregiver education and unemployment status, and whether the family rented or owned their home. Unstable housing was associated with all other types of hardships examined. This study found that 1 in 6 US children experienced unstable housing, varying by state and sociodemographic factors. The prevalence is likely underestimated because the sample excluded children who are currently institutionalized or experiencing homelessness. Results may help move the field toward a unified national definition of unstable housing for families with children and lead to clinically appropriate and evidence-based screening and interventions to support housing stability and improve children's health.

Declining hunter and trapper mail survey response rates between 1976 and 2020 in illinois

ABSTRACT We examined mail survey response rates between 1976 and 2020. All 129 studies analyzed: (a) were conducted by the Illinois Natural History Survey, (b) sampled the same population (Illinois hunters/trappers), (c) followed identical administration protocols, and (d) had the same structure. The unit of analysis was study year. Across all surveys, the average response rate was 67% (SD=.13) and ranged from a high of 86% (1982) to a low of 36% (2018). Among the waterfowl hunters, response rates ranged from 83% (1981) to 36% (2018). The comparable ranges for upland game hunters were 86% (1982) to 41% (2020), and for trappers the range was 85% (1989) to 50% (2020). The bivariate correlation between study year and response rate was −.95 for waterfowl surveys, −.86 for upland game surveys, and −.84 for trapper surveys. Results highlighted dramatic declines in response rates for all three activities over time.

Physical activity volume, frequency, and intensity: Associations with hypertension and obesity over 21 years in Australian women

BackgroundOptimal patterns of accrual of recommended levels of physical activity (PA) for prevention of hypertension and obesity are not known. The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years. Specifically, we investigated whether, for the same weekly volume of PA, the number of sessions (frequency) and vigorousness of PA (intensity) were associated with a reduction in the occurrence of hypertension and obesity in women. MethodsData from the 1973–1978 and 1946–1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed (n = 20,588; 12%–16% with a Bachelor's or higher degree). Self-reported PA, hypertension, height, and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021. Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume (metabolic equivalent min/week) (none; 33–499; 500–999; ≥1000, weekly frequency (none; 1–2 times; 3–4 times; 5–7 times; ≥8 times), and the proportion of vigorous PA to total volume of PA (none; 0%; 1%–33%; 34%–66%; 67%–100%) with odds of hypertension and obesity from 2000 to 2021. ResultsThe cumulative incidence of hypertension was 6% in the 1973–1978 and 23% in the 1946–1951 cohort; 27% of women in the 1973–1978; and 15% in the 1946–1951 cohort developed obesity over the period. Overall, a higher volume of PA was associated with reduced odds of hypertension and obesity. When the volume of PA was considered, the odds of hypertension did not vary according to the frequency or intensity of PA. However, increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obesity. ConclusionPA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity. Incorporating more sessions, particularly of vigorous-intensity PA, may provide extra benefits for the prevention of obesity.

Veteran Experiences With an mHealth App to Support Measurement-Based Mental Health Care: Results From a Mixed Methods Evaluation.

Mental health conditions are highly prevalent among US veterans. The Veterans Health Administration (VHA) is committed to enhancing mental health care through the integration of measurement-based care (MBC) practices, guided by its Collect-Share-Act model. Incorporating the use of remote mobile apps may further support the implementation of MBC for mental health care. This study aims to evaluate veteran experiences with Mental Health Checkup (MHC), a VHA mobile app to support remote MBC for mental health. Our mixed methods sequential explanatory evaluation encompassed mailed surveys with veterans who used MHC and follow-up semistructured interviews with a subset of survey respondents. We analyzed survey data using descriptive statistics. We then compared responses between veterans who indicated having used MHC for ≥3 versus <3 months using χ2 tests. We analyzed interview data using thematic analysis. We received 533 surveys (533/2631, for a 20% response rate) and completed 20 interviews. Findings from these data supported one another and highlighted 4 key themes. (1) The MHC app had positive impacts on care processes for veterans: a majority of MHC users overall, and a greater proportion who had used MHC for ≥3 months (versus <3 months), agreed or strongly agreed that using MHC helped them be more engaged in their health and health care (169/262, 65%), make decisions about their treatment (157/262, 60%), and set goals related to their health and health care (156/262, 60%). Similarly, interviewees described that visualizing progress through graphs of their assessment data over time motivated them to continue therapy and increased self-awareness. (2) A majority of respondents overall, and a greater proportion who had used MHC for ≥3 months (versus <3 months), agreed/strongly agreed that using MHC enhanced their communication (112/164, 68% versus 51/98, 52%; P=.009) and rapport (95/164, 58% versus 42/98, 43%; P=.02) with their VHA providers. Likewise, interviewees described how MHC helped focus therapy time and facilitated trust. (3) However, veterans also endorsed some challenges using MHC. Among respondents overall, these included difficulty understanding graphs of their assessment data (102/245, 42%), not receiving enough training on the app (73/259, 28%), and not being able to change responses to assessment questions (72/256, 28%). (4) Interviewees offered suggestions for improving the app (eg, facilitating ease of log-in, offering additional reminder features) and for increasing adoption (eg, marketing the app and its potential advantages for veterans receiving mental health care). Although experiences with the MHC app varied, veterans were positive overall about its use. Veterans described associations between the use of MHC and engagement in their own care, self-management, and interactions with their VHA mental health providers. Findings support the potential of MHC as a technology capable of supporting the VHA's Collect-Share-Act model of MBC.

Longitudinal patterns of posttraumatic stress disorder symptoms among sexual assault survivors: A latent transition analysis.

The aim of this study was to identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a community sample of sexual assault survivors whose assaults occurred varying lengths of time in the past and to explore patterns of transition between those latent classes over time. Latent class analysis was used to identify naturally occurring subgroups of PTSD symptoms in a sample of sexual assault survivors who completed two mailed surveys 1 year apart (N = 1,271). Latent transition analysis was then used to examine individuals' probabilities of transitioning into each latent class at Time 2 based on their latent class membership at Time 1. A four-class model emerged as the best fitting model at both Time 1 and Time 2. Classes demonstrated overall severity and symptom cluster severity differences. Transition into a lower severity class was more common than transition into a higher severity class, though escalation was demonstrated by 6-20% of participants in each latent class. The substantial heterogeneity in sexual assault survivors' PTSD symptoms highlights the variety of ways that posttraumatic stress may be experienced years after a sexual assault. Future research should explore factors that affect long-term symptoms, including cumulative lifetime trauma and social support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Electronic Health Record Implementation Enhances Financial Performance in High Medicaid Nursing Homes.

The nursing home (NH) industry operates within a two-tiered system, wherein high Medicaid NHs which disproportionately serve marginalized populations, exhibit poorer quality of care and financial performance. Utilizing the resource-based view of the firm, this study aimed to investigate the association between electronic health record (EHR) implementation and financial performance in high Medicaid NHs. A positive correlation could allow high Medicaid NHs to leverage technology to enhance efficiency and financial health, thereby establishing a business case for EHR investments. Data from 2017 to 2018 were sourced from mail surveys sent to the Director of Nursing in high Medicaid NHs (defined as having 85% or more Medicaid census, excluding facilities with over 10% private pay or 8% Medicare), and secondary sources like LTCFocus.org and Centers for Medicare & Medicaid Services cost reports. From the initial sample of 1,050 NHs, a 37% response rate was achieved (391 surveys). Propensity score inverse probability weighting was used to account for potential non-response bias. The independent variable, EHR Implementation Score (EIS), was calculated as the sum of scores across five EHR functionalities-administrative, documentation, order entry, results viewing, and clinical tools-and reflected the extent of electronic implementation. The dependent variable, total margin, represented NH financial performance. A multivariable linear regression model was used, adjusting for organizational and market-level control variables that may independently affect NH financial performance. Approximately 76% of high Medicaid NHs had implemented EHR either fully or partially (n = 391). The multivariable regression model revealed that a one-unit increase in EIS was associated with a 0.12% increase in the total margin (p = 0.05, CI: -0.00-0.25). The findings highlight a potential business case -long-term financial returns for the initial investments required for EHR implementation. Nonetheless, policy interventions including subsidies may still be necessary to stimulate EHR implementation, particularly in high Medicaid NHs.

Should We Offer Web, Paper, or Both? A Comparison of Single- and Mixed-Response Mode Treatments in a Mail Survey

Abstract This article leverages a five-treatment response mode experiment (paper-only, web-only, sequential web-mail, choice, and choice-plus [choice with a promised incentive for responding online]) that was conducted within a nationally representative survey. Because this survey’s sample was drawn from respondents to another nationally representative survey, we have rich frame data that includes multiple indicators of comfort using the internet for our sample members and we can compare their response behavior across two surveys. We find that the paper-only treatment yielded a lower response rate than most of the other treatments, but there were not significant differences between the response rates for the other treatments. Among our mixed-mode treatments, the sequential web-mail treatment had the highest percentage of response by web and the lowest cost per response. When focusing on the subgroups that we expected to be the least—and the most—comfortable with the internet, we found that the paper-only treatment generally performed worse than the others, even among subgroups expected not to be comfortable with the internet. We generally did not find significant differences in the effect of response mode treatment on the response rate or percentage of response by web between the subgroups who were the most and least comfortable with the internet. In terms of the consistency of response mode choice over time, our results suggest that some people respond consistently—but also that response mode preferences are weak enough that they can be influenced by the way in which the modes are offered. We ultimately recommend using a sequential web-mail design to minimize costs while still providing people who cannot or will not respond by web with another response mode option. We also find evidence that there may be a growing lack of interest in responding by paper; more research is needed in this area.

Building Micro-Foundations for Digital Transformation: A Moderated Mediation Model of the Interplay between Digital Literacy and Digital Transformation

In an era where digital transformation (DGT) is pivotal for organizational resilience and competitiveness, integrating sustainability into the digitalization process has emerged as a strategic imperative. By employing the resource-based view (RBV) and the dynamic capability theory (DCT), this study delves into the micro-foundations of DGT in medium- and large-sized enterprises, highlighting the synergistic role of managerial digital literacy in fostering digital transformation through the mediation role of digital readiness and the moderation role of the top management team (TMT). To fulfill the objectives of this study, data were collected through a cross-sectional mail survey, yielding responses from 235 senior and mid-level managers across medium- and large-sized firms in various industries within Turkey. Results have confirmed that digital literacy significantly enhances digital transformation and readiness, laying the groundwork for successful digital transformation initiatives. Digital readiness significantly mediates the relationship between digital literacy and digital transformation, indicating that enhancing digital literacy is a crucial step that indirectly influences digital transformation through improving digital readiness. The moderating effect of top management team (TMT) behavioral integration on the digital literacy and digital readiness link is affirmed, highlighting its critical role in facilitating organizational digital adaptation. TMT behavioral integration does not positively moderate the direct relationship between digital literacy and digital transformation. The study’s findings offer a novel lens on digital transformation, revealing that the interplay between digital literacy, readiness, and TMT behavioral integration crafts a strategic scaffold for enhancing organizational agility and competitive edge in the digital era.

Rediscovering circularity in productive urban landscapes

The recycling of urban green waste generated from urban forests is important in enhancing urban circularity; however, most green waste remains underutilized. An effective way to recycle green waste is composting. Recent studies show the effectiveness of decentralized composting in home and community gardens; however, little is yet known about linkage to commercial urban agriculture, which could play a critical role in urban food supply. This study aims to investigate the community-scale composting system of green waste integrated into commercial farming, using Tokyo as a case study where urban and agricultural land uses are mixed historically. We conducted mailed questionnaire surveys and in-person semi-structured interviews with urban farmers. The results revealed that approximately one-third of professional urban farmers still produced compost from green waste, especially leaf litters, to improve soil quality. They have adapted urbanization by expanding leaf litter sources beyond their own woodlands to various neighboring urban forests within a few kilometers, including parks, schools, and shrines. Although urbanization has drastically changed the tangible landscape, urban farmers have handed down the intangible system for hundreds of years by retrofitting their system. While the system can contribute to reducing green waste and enhancing urban circularity, urban farmers are motivated by economic reasons rather than such environmental reasons. In cities that encompass productive urban landscapes, decentralized composting systems work effectively in commercial urban agriculture due to its geographic proximity of waste supply and demand sites. This study suggests the potential benefits of having urban farms in cities abundant in underutilized organic wastes. Further research is needed on how to scale up waste recycling through urban agriculture to foster urban circularity and sustainability.

Single-center experience of thoracoscopic sympathectomy for palmar hyperhidrosis with long-term postoperative questionnaire survey

ObjectivesThoracoscopic sympathectomy is an effective treatment for palmar hyperhidrosis. However, compensatory hyperhidrosis occurs frequently as a postoperative complication of the procedure. The goal of this study was to elucidate the clinical significance of thoracoscopic sympathectomy using our surgical procedure.MethodsConsecutive 151 patients who underwent thoracoscopic sympathectomy for palmar hyperhidrosis were studied. In addition, to investigate patients’ satisfaction and long-term quality of life, 111 patients were asked to complete a mailing questionnaire survey, and 84 responded (response rate of 75.7%).ResultsAll of the 151 patients reported a reduction in palmar sweating during the immediate postoperative period. None of the patients had pneumothorax, hemothorax, Horner’s syndrome, or worsening of bradycardia. Based on the questionnaire, the surgical success rate was 98.8%. None of the patients had a recurrence of palmar hyperhidrosis during the long-term postoperative period. However, compensatory hyperhidrosis was reported in 82 patients (97.6%). In total, 94.0% of patients had high levels of postoperative satisfaction.ConclusionsThoracoscopic sympathectomy is an effective surgical treatment for palmar hyperhidrosis. By contrast, the careful preoperative explanation of compensatory hyperhidrosis is considered to be very important.

Oral frailty is associated with mortality independently of physical and psychological frailty among older adults

BackgroundAlthough oral frailty is independently associated with an increased risk of mortality, evidence for the usefulness of screening tools for oral frailty is less than that for physical frailty screening tools. We aimed to investigate the relationship between oral frailty and mortality in older adults. MethodsThis prospective cohort study included 11,374 adults aged ≥65 years, who provided valid responses to a baseline mail survey questionnaire from the Kyoto-Kameoka study. Oral frailty status was evaluated using the Oral Frailty Index-8 (range, 0 [best] to 10 [worst]). Participants were classified into four categories according to the Oral Frailty Index-8: robust (score, 0–2), oral pre-frailty (score, 3), oral frailty (score, 4–6), and oral severe frailty (score ≥ 7). Physical and psychological frailty were evaluated using the validated frailty-screening index and defined as a score of ≥3 out of a possible 5 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. ResultsDuring the 5.3-year median follow-up period (57,157 person-years), 1184 deaths were recorded. After adjusting for confounders, including physical and psychological frailty, medical history, and lifestyle, in comparison with a robust oral status, oral pre-frailty (HR, 1.29; 95 % confidence interval [CI], 1.02–1.63), oral frailty (HR, 1.22; 95 % CI, 1.01–1.48), and oral severe frailty (HR, 1.43; 95 % CI, 1.16–1.76) were associated with higher HRs of mortality (p for trend = 0.002). ConclusionOral frailty is associated with mortality independent of physical and psychological frailty in older adults. The Oral Frailty Index-8 may be useful for identifying individuals at high risk of mortality.

An Overview of Data Collection in Health Preference Research.

This paper focuses on survey administration and data collection methods employed for stated-preference studies in health applications. First, it describes different types of survey administration methods, encompassing web-based surveys, face-to-face (in-person) surveys, and mail surveys. Second, the concept of sampling frames is introduced, clarifying distinctions between the target population and survey frame population. The discussion then extends to different types of sampling methods, such as probability and non-probability sampling, along with an evaluation of potential issues associated with different sampling methods within the context of health preference research. Third, the paper provides information about different recruitment methods, including web-surveys, leveraging patient groups, and in-clinic recruitment. Fourth, a crucial aspect addressed is the calculation of response rate, with insights into determining an adequate response rate and strategies to improve response rates in stated-preference surveys. Lastly, the paper concludes by discussing data management plans and suggesting insights for future research in this field. In summary, this paper examines the nuanced aspects of survey administration and data collection methods in stated-preference studies, offering valuable guidance for researchers and practitioners in the health domain.

Drug Use Stigma and Public Preferences for Public Health Versus Legal System Responses

This study explored what perceptions and beliefs about substances and substance users, personal experiences, and network experiences with substance use were related to people’s preferences for public health and legal system responses to substance use. Social context was also considered, including location of residence, political ideology, and a sense of insecurity. Data were from the Nebraska Annual Social Indicators Survey, a cross-sectional omnibus mail survey of public attitudes in Nebraska, conducted in fall 2021. Approximately 1700 adults completed the survey. Controlling for demographic characteristics, the study found stigmatized attitudes about substance use, limited or no personal history with substance use, rural residence, and political conservatism were associated with more support for legal system responses. In contrast, less stigmatized attitudes about substance use, personal history of marijuana use, urban residence, political liberalism, and a sense of security were all associated with more support for public health responses.

Factors influencing patient selection of orthopaedic surgeons for total hip (THA) and total knee arthroplasty (TKA).

The importance of identifying how patients choose their healthcare providers has grown with the prevalence of consumer-centric health insurance plans. There is currently a lack of studies exploring the factors associated with how patients select their hip and knee joint arthroplasty surgeons. The purpose of this study was to determine how patients find their arthroplasty providers and the relative importance of various arthroplasty surgeon characteristics. An electronic mail survey was sent to 3522 patients who had visited our institution for an arthroplasty surgeon office visit between August 2022 and January 2023. The survey consisted of multiple-choice questions, which aimed to inquire about the patients' referral sources for their current arthroplasty surgeon. In addition, patients were requested to rate the significance of 22 surgeon-related factors, on a scale of 1 (Not Important At All) to 5 (Very Important), in choosing their arthroplasty surgeon. Of the 3522 patients that received the survey, 538 patients responded (15.3%). The most common referral sources were physician referral (50.2%), family/friend referral (27.7%), and self-guided research (24.5%). Of those that were referred by a physician, 54.4% of respondents were referred by another orthopaedic provider. Patients rated board certification (4.72 ± 0.65), in-network insurance status (4.66 ± 0.71), fellowship training (4.50 ± 0.81), bedside manner/personality (4.32 ± 0.86), and facility appearance (4.26 ± 0.81) as the five most important factors in picking an arthroplasty surgeon. Television (1.42 ± 0.83), print (1.50 ± 0.88), and online (1.58 ± 0.93) advertisements, along with social media presence (1.83 ± 1.08), and practice group size (2.97 ± 1.13) were rated as the five least important factors. Patients are most likely to select an arthroplasty surgeon based on referral from other physicians, namely orthopedic surgeons, in addition to board certification status, in-network insurance, and fellowship training. Overall, these findings highlight the importance of physician credentials and reputation within the orthopaedic community in order to attract and retain patients.