Majority Felt Research Articles

Survey on the role of nutrition in first-opinion practices in Austria and Germany: An evaluation of knowledge, preferences and need for further education.

A survey was conducted among first-opinion practices in Germany and Austria on dog nutrition consultation, food sold in the practice, recommendations given to owners, most commonly encountered consequences of malnutrition, need for further education and feeding of own dogs. Of the 169 participants, one third was from Austria, two thirds from Germany. Most practiced in the countryside or in suburbs, were female and between 36 and 55years old. The majority felt that nutrition has become an important topic, and that "feeding myths" were on the rise. However, only in 18% of the practices at least one staff member had further education in nutrition, while none of the participants had a national or international degree. Only half of our participants felt qualified to give nutrition advice. A nutritional assessment was not regularly performed, and the Body Condition Score was not regularly assessed, often only when health problems were obvious. If a homemade diet was requested, practitioners rather referred to a nutritionist, while 25% left it up to the owners. Most relied on traditional premium diets for their patients and also for their own dogs. Feeding myths seemed to be widespread among veterinarians, too; even Biologically Appropriate Raw Feeding and diets not complying with EU legislation were recommended. There is obvious need for further education and specialization to establish nutrition consultation as a profitable service in small animal practice.

Operative Case Volume Minimums Necessary for Surgical Training Throughout Rural Africa.

Resident operative case volumes are an important aspect of surgical education, and minimums are required in Accreditation Council for Graduate Medical Education (ACGME) programs. Minimum operative case volumes for training do not exist in rural Africa. Our objective was to determine the optimal minimum operative case volume necessary for general surgery training in rural Africa. A cross-sectional census electronic survey was conducted among faculty (N = 24) and graduates (N = 56) of Pan-African Academy of Christian Surgeonstraining programs. Three equally weighted exposures (median minimum case volume suggested by participants, operative experience of prior graduates, and comparisons with ACGME minimums), adjusted from responses to targeted questions, were utilized to construct an optimal minimum operative case volume for training. Sixty-four surgeons were contacted and 40 (13 faculty, 24 graduates, and 3 graduates who became faculty) participated. All participants thought operative case minimums were necessary, and the majority (98%) felt current training adequately prepared surgeons for their setting. Constructed optimal case volumes included 1000 major cases with fewer required cases than ACGME in abdomen, breast, thoracic, vascular, endoscopy, and laparoscopy and more required cases than ACGME for alimentary tract, endocrine, operative trauma, skin and soft tissue, pediatric, and plastic surgery. Other categories (gynecology, orthopedics, and urology) were deemed necessary for surgical training, with regional differences. Prior graduates satisfied the overall, but not category-specific, proposed minimums. The surveyed surgeons highlighted the need for diverse surgical training with minimum exposures. They described increased need for cases reflecting regional variations with a desire for more experience in categories less common at their institutions.

The immediate effect of vocal technique associated with virtual reality game in people with Parkinsons disease

Abstract Introduction People with Parkinson’s Disease (PD) have difficult motor hearing calibration, which affects the monitoring of vocal production. Therefore, employing visual stimulus associated with vocal therapy may benefit the voice of this population. For this purpose, some techniques favour the competence of the glottis, such as pushing, which consists of movements of the arms with a simultaneous effort to phonation and, associated with virtual reality games, provide playful therapeutic intervention through the simulation of experiences that can foster glottal adjustments and generate changes in the voice. Objectives To determine the immediate effect of the technique of pushing with plosive sounds associated with the use of a virtual reality game in the voice of people with Parkinson's disease. Methodology The participants were 17 men and 14 women, mean age of 62.61 (± 11.24) years, meantime of diagnosis 6.93 years, distributed in stages I (32.5%), II (22.59%), III (45.16%) of Hoehn and Yahr. scale. The vocal evaluation pre and post pushing technique with plosive sounds associated with virtual reality game consisted of analysing vocal, acoustic parameters from the record of the issuance of the vowel /ε/. The parameters extracted were Jitter, Shimmer, corresponding to signs of disturbance of the sound source and Glottal-to Noise Excitation (GNE), corresponding to the energy of the glottis on the noise. The satisfaction questionnaire on the implementation of this technique associated with virtual reality was used. Results The values of disturbance of the sound wave decreased, and the glottal energy on the noise increased, respectively, Jitter (p = 0.0075); Shimmer (p = 0.0048); GNE (p = 0.0008). Regarding the satisfaction questionnaire, 74.20% of them felt very satisfied and 25.80%, satisfied. Conclusion The vocal technique associated with virtual reality game improved the acoustic parameters of the participants' voice and the majority felt great satisfaction with the intervention.

EVALUATE THE DEGREE OF CHRONIC PELVIC PAIN AND DEGREE OF ADHESION: A CLINICO-OBSERVATIONAL STUDY.

Aim: To evaluate degree of chronic pelvic pain and degree of adhesion.
 Materials and Methods: The present clinico-observational study was conducted in the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna, from December 2016 to December 2017.among 40 women diagnosed with endometriosis. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously.
 Results: Mean age of study cohort was 30 ±5.75 years. As per VAS, majority felt moderate pain (47.5%) in present study. The presenting symptoms were dysmenorrhoea (45.0%), dyspareunia (17.5%) and chronic pelvic pain (35.5%).
 Conclusion: Degree of tubal involvement was more in all the women as compared to ovarian involvement. Post-operatively the intensity of the pain subsides.
 Keywords: VAS, Adhesion, Endometriosis, Tubal, Ovarian

Assessing overall patient satisfaction among cancer patients: A radiotherapy survey.

e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patients. Published reports suggest a variety of characteristics that are considered important. We decided to survey our patients undergoing radiotherapy to determine what they considered desirable traits and characteristics. Methods: An ethics approved 35-item patient satisfaction survey evaluating respondent experience was developed by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality of care patients received, and was administered to patients undergoing radiotherapy. Results: A total of 199 patients completed the survey. The median age was 68, with approximately 54% women and 45% men (1% unreported). Most patients (85%) had been diagnosed with their cancer within the previous year, and the commonly reported malignancies (61%) were breast, prostate and lung cancers. Almost all (95%) “agreed" or "strongly agreed" about the importance of physicians being sensitive and compassionate. Over 90% felt they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. They reported the 5 most important qualities among the HCPs as follows (in descending order): knowledge, kindness, honesty (answering questions/giving information), good communicator and cheerful attitude. Most (>70%) reported feeling connected with their HCPs. Although overall satisfaction was high, there were areas for improvement identified. These included patients being offered future appointments to discuss their diagnosis and treatment, receiving information about clinical trials and other treatment options, and being given contact information for psychosocial and community resources. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed (<10%). Conclusions: Reassuringly, cancer patients receiving radiation report high rates of satisfaction across many aspects of their care. The qualities most appreciated serve as a reminder to clinicians that their role is more than just that of a medical expert. These findings also reinforce the different aspects of holistic care that can be improved.

A pilot study to determine the feasibility of a customized low glycemic load diet in patients with stage I-III colorectal cancer.

4643 Background: Observational evidence associates energy balance factors, particularly diet, with survival in patients with colorectal cancer (CRC). Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes, but there is limited prospective evidence that alterations in dietary habits improve cancer outcomes. This was a pilot study to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III CRC and to assess the nutritional resources necessary to follow the diet. Methods: 18 patients with stage I-III CRC, who completed definitive cancer therapy and consumed an avg daily GL > 150 participated in a 12 week, tailored, in-person dietary intervention with a target GL of ≤102. Compliance was assessed using 24 hour telephone recalls. Acceptability of the diet was assessed using a food acceptability questionnaire, and exploratory correlative laboratories were assessed monthly. Results: 67% of patients were compliant with a low GL diet ≥ 75% of the time, over a 12 week time period. Majority of participants experienced a decrease in BMI and waist circumference, 28% experienced meaningful weight loss defined as ≥ 5%. The nutritionist spent an avg of 6.97 hours (SD 2.18) in-person and 1.58 hours (SD 0.68) by phone with each participant. In the overall group, significant decreases were seen in total cholesterol (7.2% decrease; t = -2.33, p = 0.03), VLDL (26.8% decrease; t = -2.33, p = 0.03) and triglycerides (26.6% decrease; t = -2.29; p = 0.04). All participants were satisfied with the diet; 43% were extremely satisfied. 75% of participants liked the foods they were able to eat “very much” or “extremely”. All participants felt the in-person meetings were helpful. 77% did not feel an online video could replace the in-person meetings. 62% of participants did not feel a virtual meeting (e.g skype, etc.) could replace the in- person meeting while 38% felt it could. Conclusions: Patients with stage I-III CRC are able to follow a low GL diet with an in-person dietary intervention. Significant decreases in laboratory measures confirm the efficacy of the diet in altering metabolic indices. All participants who completed the study were satisfied with the diet, the majority of whom enjoyed the foods and planned to continue to follow the diet after study completion. The majority felt in-person contact with the nutritionist was essential to their success. This study was an essential step in designing a larger scale trial to evaluate the impact of low GL diet on cancer outcomes. Clinical trial information: NCT02129218 .

Surgical Trainee Experience with Open Cholecystectomy and the Dunning-Kruger Effect

Laparoscopic cholecystectomy has become the standard approach to gallbladder surgery, but open cholecystectomy retains a role in complex cases. The aim of this study was to evaluate exposure of senior trainees in general surgery to open cholecystectomy and their experience and confidence in independent performance. General surgical trainees on a higher surgical training programme from surgical training years 5 (ST 5) to 8 (ST8) were invited to partake in an online anonymous survey. Data pertaining to case numbers, whether supervised or independently performed and level of comfort were collated and analyzed. Twenty-six of 40 trainees responded (65%). Twenty-one (81%) had performed over 40 laparoscopic cholecystectomies with their trainer either scrubbed or un-scrubbed in theatre. As to open cholecystectomy experience, 12 trainees had assisted in 5 or fewer cases and only 3 assisted in over 20; 17 (65%) had performed 2 or fewer cases whilst assisted by their trainer while 24 of 26 trainees (92%) had no independent experience of open cholecystectomy. However, 16 felt they would be "somewhat comfortable" and 2 reported feeling "very comfortable" while only 8 reported they were "not comfortable" converting to open cholecystectomy. This study confirms a steep decline in training opportunities in open cholecystectomy, but also raises concern about a Dunning-Kruger effect as, despite this lack of experience, the majority felt "somewhat comfortable" or "very comfortable" in converting to open surgery. Trainees need first to be familiar with safer alternatives to conversion. Surgical trainers need to consider the assessment of confidence as well as competence as an endpoint of trainee evaluation.

P138: Parental leave policies and culture for physicians in emergency medicine

Introduction: Medicine demands a sacrifice of physicians’ personal life, but culture has slowly changed towards valuing a balanced work life. Parental leave is linked to better physical and mental health, but policies and culture surrounding parental leave are largely unstudied in the Canadian Emergency Medicine landscape. Anecdotally, experiences vary widely. This study was designed to determine what proportion of Canadian Emergency Departments have formal parental leave policies (maternity, paternity, and other ex. adoption) and what proportion of Canadian EM physicians are satisfied with their department's parental leave policies. Methods: Two surveys were generated; one to assess attitudes and experiences of emergency physicians, and a second survey for department chiefs assessed the policies and their features. These were approved by the UBC REB and distributed through the CAEP Research Committee. Primary outcomes were physician satisfaction with their department's parental leave policy (4-5/5 Likert Scale), and departments with a formal parental leave policy (Y/N). Results: 38% (8/21) of department chiefs reported having a formal policy for maternity leave, 29% (6/21) for paternity leave, and 24% (5/21) other. The survey of Emergency Physicians revealed similar rates at 48% (90/187) maternity, 40% (70/184) paternity, 29% (53/181) other. Among physicians who were aware of them, 69% (62/90) were somewhat or very satisfied with the maternity leave policies, 58% (51/88) with paternity leave policies, and 48% (39/81) with other parental leave. Less than 10% were somewhat or very dissatisfied with any of these. Several department chiefs commented that they had never refused anyone parental leave, but have no formal policy. However, 87% (147/187) of physicians reported a formal maternity leave policy was somewhat or very important to them; similarly 80% (134/187) paternity leave. Less than 15% felt each was somewhat or extremely unimportant. Conclusion: Presence and type of parental leave policy varies across the country. Most physicians were satisfied with the support they had available, but the vast majority felt that a formal maternity and paternity leave policy itself was important. This study would suggest that, without actually changing practice, the introduction of a formal parental leave policy is of value. Our research group will use this data to collaborate on a template parental leave policy to be made available for this purpose.

\u201cThe Real Thing I Struggle with is Other People\u2019s Perceptions\u201d: The Experiences of Autistic Performing Arts Professionals and Attitudes of Performing Arts Employers in the UK

This research examined in-depth the employment experiences of autistic performing arts professionals and the attitudes and adjustments of performing arts employers. We interviewed 18 autistic performing arts professionals and 19 performing arts employers. Autistic performing arts professionals described facing challenges in the workplace. Some autistic professionals had access to support, but the majority felt that there was not enough available and highlighted many ways in which they could be better supported. Performing arts employers varied in their experiences of working with autistic people, many had limited knowledge about autism-specific support or relied on other professionals to provide it. These findings shed light on current unmet support needs of autistic performing arts professionals, and provide key recommendations for research and practice.

The potential for computational IT tools in disaster relief and shelter design

The expanding use of IT has brought an increase in productivity to the world of business, industry and commerce. However, this is not mirrored by an equivalent growth in the use of IT by aid agencies in post-disaster situations. We report a pioneering two-stage study which tested the appetite for the increased use of computational IT tools in this sector, assessed their level of usefulness and whether they can be practically implemented. Thirty aid workers across nineteen countries were surveyed on their use of IT and computational tools in shelter design and provision. The key finding was that none of the participants used any building simulation tools or software packages in any of the design stages of shelter construction. Using this result, two example tools were created—one assessing daylighting and the other environmental impact. A second survey involving 48 aid workers was then carried out to record their experience of using the new tools and 97% of the participants identified a need for such shelter design tools. The majority felt that the new tools were useful and that they would like to use similar tools in their work, most of them preferring tools in the form of web applications. It is concluded that humanitarian workers in the shelter sector are very willing to adopt IT-based computational tools in their work and would appreciate doing so, but only if they have access to suitably simple tools which are quick to use and easy to learn.

Factors affecting attitudes toward reintroduction of wolves in Japan

Japanese wolves (Canis lupus hodophilax) became extinct in the early 1900s. Because the country is experiencing growth in populations of ungulates, the potential of reintroducing wolves to promote self-regulating biodiverse ecosystems has been discussed by various Japanese and international researchers. However, limited research exists regarding public attitudes toward the reintroduction of wolves, which is indispensable to the success of such projects. We conducted a survey of 360 undergraduate students at a university in Japan and found that while most respondents believed that government officials and local residents should be responsible for the decision-making, a majority felt that this responsibility should not rest with the general citizens. Multiple regression analysis revealed that respondents disagreed with the reintroduction of exotic species generally, while those who thought wolves are necessary to a healthy ecosystem were supportive. Text mining analysis revealed that those who disagreed with the reintroduction were thinking about “people” while those who agreed emphasized the need to control an increasing deer population and to prevent related damage. In contrast to previous research, our survey revealed that it is not people’s propensity for wolves (i.e., whether they like or hate wolves), but their understanding of the ecological impact of reintroduced wolves, that influences their support. In summary, our findings suggest that public attitudes toward the reintroduction of wolves may become more favorable if people were informed of the scientific findings that Japanese and continental wolves are the same species and that their presence will positively impact the ecosystem.

Patient satisfaction with a new skin cancer teledermatology service.

Rising numbers of two-week-wait (2WW) skin cancer referrals have caused increasing pressure on UK dermatology departments. Initiatives to address this include teledermatology. Previous studies have indicated good patient acceptability but most have focused on general dermatology rather than skin cancer referrals, and have taken place in rural settings, where teledermatology may be preferable. To evaluate patient satisfaction of teledermatology 2WW services in a London-based tertiary National Health Service (NHS) setting. A literature search was performed and a patient satisfaction survey was designed to evaluate: (i) ease of completing a questionnaire about the skin lesion; (ii) lifestyle impact; (iii) preferences regarding electronic data collection and communication of results; and (iv) confidence in the service. A five-point Likert scale was used to assess responses. The study took place over a 20-week period. Over half (51%; n=31 of 60 patients) were female; 78% (47) were aged ≤55years and 65% (39) were Caucasian. Over 80% (49) would recommend the service, and the majority felt confident with the teledermatology model. Overall, patients would be happy to complete electronic questionnaires and receive results electronically, with younger patients being more amenable to this. Patients with better health status, those of younger age and those with less frequent visits to a dermatologist were more accepting of teledermatology. To our knowledge, this is the first comprehensive study evaluating patient satisfaction with teledermatology specifically for 2WW referrals in an NHS setting. As skin cancer referrals increase, dermatology departments must adjust. Patient involvement and feedback is paramount in implementing and expanding teledermatology services.

Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health

PurposeThis study aims to explore current attitudes among doctors working in psychiatry, with regard to their perceived role and their confidence in managing their patients’ physical health problems.Design/methodology/approachA 20-item electronic questionnaire was distributed to doctors working in psychiatry within two large UK mental health trusts in 2018. Quantitative analysis was conducted, alongside qualitative analysis of free-text comments made by participants.FindingsMany participants perceived their physical examination skills to have deteriorated since working in psychiatry (78 per cent). Participants were questioned on which professional group should hold responsibility for managing the physical health of patients under psychiatric services. A minority felt it should be psychiatrist-led (5 per cent), followed by general practitioner (GP)-led (42 per cent) and then shared responsibility (47 per cent). The majority felt there should be more focused training on physical health in the Core (72 per cent) and Advanced (63 per cent) psychiatry training. Key themes from a framework analysis of qualitative data included potential barriers to shared care, psychiatrists’ concerns regarding their experience and confidence in managing physical health, reasons in favour of shared responsibility, ideas for training and suggestions for improving the current situation.Originality/valuePsychiatric patients may engage less well with health services, yet psychiatric medication often impacts significantly on physical health. In this context, there is often a blurring of role boundaries between a psychiatrist and a GP, and there is considerable variation between individual teams. There is a consistent call for more physical health training opportunities for psychiatrists and for mental health services to more proactively promote the physical health of their patients.

Usage of smart devices amongst medical practitioners in Universitas Academic Hospital.

BackgroundThere has been a rapid rise in the use of smart devices amongst medical practitioners throughout the world. This study aimed to identify how smart devices were being used by medical practitioners at the Universitas Academic Hospital (UAH), Bloemfontein, and the associated factors thereof. We also identified the views of medical practitioners regarding the usage of smart devices at their workplace.MethodsA prospective cross-sectional study was conducted. Anonymous questionnaires were distributed to medical practitioners working at UAH during weekly departmental meetings or monthly morbidity and mortality meetings. The following largest departments were included: Surgery, Anaesthetics, Paediatrics, Internal Medicine, Family Medicine, and Obstetrics and Gynaecology.ResultsThe response rate was 82.7% of those attending the meetings. All the respondents owned a smart device and brought it to their workplace. The most common applications used on these smart devices were that for drug references (65.9%), medical textbooks (63.6%) and medical calculators (58.1%). Significantly larger percentages of doctors aged 21–39 years compared with those aged 40–65 years used drug reference applications and medical calculators. A quarter (24.8%) of respondents communicated with patients through a smart device, 21.7% used an online storage platform to backup patient data, whilst 56.6% used their devices to store and view patient information. More than one-third (36.7%) agreed that smart devices threatened patient confidentiality, but the majority (58.8%) did not agree that these devices hinder patient communication. The majority felt that these devices improved both personal performance (69.2%) and patient care (79.0%).ConclusionSmart devices usage is common in this setting. Hence, integration of such usage in medical curricula, discussion on professionalism, ethics and confidentiality in this context, and guidance from institutions and professional bodies become necessary.

Confidentiality concerns for surgical residents as educational research subjects: A pilot study

BackgroundResearch within the field of surgical education has been expanding rapidly in order to guide future curricula. However, education studies often have minimal IRB oversight and evolving concerns exist regarding issues of informed consent of trainees. MethodsWe conducted an electronic, single center, anonymous survey of general surgery residents. The survey study was IRB approved and subjects were provided with information and opt-out sheets. ResultsThe response rate was 43.5% (37/85). Approximately 76% of residents felt that education research was important and that they should participate. If a faculty member conducted the study, 18% of residents would feel coerced to participate and 21% would feel uncomfortable refusing to participate. The majority (81%) felt uncomfortable with peers viewing their identifiable records and a sizeable minority (24%) were uncomfortable with peers viewing de-identified records. ConclusionSurgical residents believe that educational research is important, but researchers should be cognizant of unintended consequences on resident autonomy and confidentiality.

Can the arts enhance postgraduate GP training?

ABSTRACTThe value of arts-based medical education is becoming increasingly well established in undergraduate curricula. However, little is known about its value, and acceptability, to qualified doctors undertaking postgraduate training. In this work we examined GP trainees’ views on whether arts-based education was useful for their professional development and, if so, what they perceived its value to be. All first and second year GP trainees on the Dorset Vocational Training Scheme attended a one day course which showcased how the arts (film, poetry, painting, photography, theatre) could enhance their professional development as doctors. GP trainees rated the day as interesting, enjoyable and thought proving. The majority felt that the arts could contribute to making them more competent and humane doctors. Following this, we ran a mandatory six months arts based course for six GP trainees, and evaluated their feedback through qualitative analysis of a focus group discussion. Overall, GP trainees found the course enjoyable and valuable to their learning. It not only gave them a deeper appreciation of the patient’s perspective, but also encouraged them to think about their own health and wellbeing.

Psychological Impact and Associated Factors during the Initial Stage of the Coronavirus (COVID-19) Pandemic among the General Population in Spain.

The outbreak of COVID-19 in Spain started at the end of February. By 9th April 2020 Spain was the second country in confirmed cases and in deaths. On March 14, 2020, the Spanish Government declared the state of alarm to limit viral transmission. During such state, citizens must stay confined at home with few justified exceptions. This whole situation drastically changed the life of the population, which can cause a wide range of psychosocial impacts. This study explored the psychological impact of the COVID-19 pandemic in the general adult population (N = 3055) during the first stages of the outbreak in Spain, as well as their anxiety, stress and depression levels. We also examined the extent to which the following variables were associated to participants’ mental health: 1) demographics; 2) degree of concern about the pandemic; 3) environmental conditions during the home confinement; 4) changes in daily life as a consequence of the pandemic; 5) contact with the COVID-19 disease; 6) actual and perceived severity of the crisis; 7) information about the COVID-19; 8) perceived health status and; 9) leisure activities conducted within the last 24 hours. Our results show that Spanish consider the current COVID-19 health crisis as fairly severe, and the majority felt that the COVID-19 crisis had greatly impacted on their daily life, including changes in their daily routines and cancellation of important activities. About 36% of the participants reported moderate to severe psychological impact, 25% showed mild to severe levels of anxiety, 41% reported depressive symptoms, and 41% felt stressed. Women, young, and those who that lost their job during the health crisis showed the strongest negative psychological symptoms. What worried Spaniards the most was the likelihood of suffering an economic crisis derived from the pandemic. We found factors associated with better mental health, such as being satisfied with the information received about the health crisis, conducting leisure activities, and the perception of being in good health. These findings can be used to design psychological interventions to help coping with COVID-19 pandemic, both in Spain and other countries.

Knowledge, attitude, and practice of reporting transfusion reactions in hemovigilance among health-care professionals in a tertiary care teaching hospital of northern India

Background: Blood transfusion is a lifesaving procedure but has potential to cause adverse events. Hemovigilance is a program that ensures safety of transfusion reactions by monitoring every step of transfusion process from donor to recipient. However, reporting of adverse reactions is far less in our country. Aim and Objective: The aim of the study was to assess the knowledge, attitude, and practice (KAP) of health-care professionals and examine various causes of underreporting in our tertiary care hospital. Material and Methods: This observational cross-sectional questionnaire-based study was conducted in Department of Pharmacology Government Medical College (GMC) Kathua in associated hospital for the period of 1 month after obtaining approval from Institutional Ethics Committee of the college under no-IEC/GMCK/18/Pharma/dated-18/2/2020. Fifty randomly selected health-care professionals including doctors, nurses, and pharmacists were the volunteers. They were provided with a sheet containing 37 pre-validated questions and the time period of 30 min was provided to respond to the questions. The questionnaire contained 37 questions composed of nine questions of knowledge, six questions for attitude, four for practice, 11 for underreporting, and eight for possible ways to improve reporting of reactions. Results: The sheets of responses were analyzed and results revealed that awareness of hemovigilance was 84%, while knowledge to report adverse events was 76%, whereas 88% volunteers were aware that reporting is essential and can benefit patient care. Among these, 24% of volunteers had attended coronal mass ejection (CME’s). As per attitude meaning agreed that reporting of reactions is essential and hemovigilance should be taught to health-care professionals, practices that revealed that a few had attended CME’s and only 20% of these volunteers had ever reported adverse reactions related to blood transfusion. As for as underreporting is concerned majority felt where to report reaction (72%) and lack of time (56%) followed by legal liability issues (52%) were main causes of under-reporting. Conclusion: Although the health-care professional volunteers had good knowledge and attitude but the practice score was far less. Therefore, to report adverse reactions of blood transfusion and lack of time was major perceived causes of under-reporting. Such results underscore the importance of incorporating the education of hemovigilance in their duty curriculum to address their problems.

Assessment of knowledge, attitude and practice towards e-learning among undergraduate medical students, Andhra Medical College, Visakhapatnam

Background: E-learning refers to utilization of internet technologies to enhance knowledge and performance of the learners and to improve the effectiveness of educational interventions. From the review of literature it was evident that e-learning has gained popularity in past decade, however its use is variable among medical colleges. The objectives of the present study were to assess knowledge, attitude and practice towards e-learning among undergraduate medical students.Methods: A cross-sectional study was done among 150 medical students (50 each from 1st, 2nd and 3rd year) of Andhra Medical College, Visakhapatnam in the Month of December 2018. A pre-tested semi-structured questionnaire was administered to access the knowledge and practices. Students’ responses in attitude were collected and rated on 5-point Likert scale from 1=strongly disagree to 5=strongly agree. Results are displayed in frequencies and proportions. A p value of <0.05 is considered as statistically significant.Results: A total of 150 undergraduate medical students were included, among them 67 (40.6%) were males, 98 (59.4%) were females. Majority were aware of e-learning. Nearly 46.7% students used both laptop and smart phones for purpose of e-learning. About 53% were confident in using software applications. Most of students agreed that e-learning has important role in acquiring clinical skill along with other learning methods and 88% of students agreed that it should be supplemented in regular teaching curriculum. The 3rd year students were found to have better attitude towards e-learning than other students.Conclusions: Majority felt that e-learning plays an important role in acquiring clinical skill along with other learning methods in educational institute. So, there is need to provide necessary infrastructure and include e -learning as a part of curriculum in medical education.

Spinocerebellar Ataxia Patient Perceptions Regarding Reproductive Options.

In vitro fertilization with preimplantation genetic testing is a growing reproductive option for people who want to avoid passing a single-gene condition on to their offspring. The spinocerebellar ataxias are a group of rare, autosomal-dominant neurodegenerative disorders which are strong candidates for the use of this technology. This study aimed to assess knowledge of genetic risk and perceptions of reproductive options in individuals with a diagnosis of spinocerebellar ataxia. We administered an online survey to U.S. residents of reproductive age who have been clinically or genetically diagnosed with spinocerebellar ataxia. We assessed their understanding of inheritance and their reproductive opinions. Of 94 participants, 70.2% answered all four inheritance questions correctly. The majority felt they could describe each reproductive option except prenatal diagnosis. Individuals were most interested in in vitro fertilization with preimplantation genetic testing: 48.4% (45 of 93) said they would consider it. They were least interested in prenatal diagnosis and donated embryos or gametes. Having spinocerebellar ataxia with anticipation and choosing inheritance risk as an important factor were both significantly associated with interest in preimplantation genetic testing. Choosing religion/morality as an important factor was associated with less interest in preimplantation genetic testing and prenatal diagnosis. Our population displayed basic knowledge of inheritance risk, and the majority wanted to avoid having affected children. Consistent with literature for other autosomal-dominant adult-onset conditions, individuals showed a preference for preimplantation genetic testing. Health care providers should continue to educate patients about reproductive options and their risks and limitations.