Attitudes Of Members Research Articles

Principals’ and Teachers’ Perception of the Impact of Conflict Management Strategies on Effective Teaching in Secondary Schools in Enugu State, Nigeria

This study investigated principals’ and teachers’ perception of the impact of conflict management strategies on effective teaching in secondary schools in Enugu State. The main problem of the study is the mismanagement of school conflict that leads to nonchalant attitude of school members and rebellious behaviour towards instructions. The study objective is to examine principals’ and teachers’ perceptions of the impact of the two conflict management strategies on effective teaching in secondary schools in Enugu State. Two research questions and two hypotheses guided the study. Krejcie and Morgan technique was employed to select the sample size at 669 respondents. A self-developed Questionnaire on Principals’ and Teachers’ Perception of the Impact of Conflict Management Strategies on Effective Teaching was used for data collection. The data was subjected to analysis using SPSS and Cronbach Alpha statistics was applied. The findings revealed that the 6 items of the instrument yielded reliability co-efficient of .837, at 95% level of confidence, 0.05. Conflict management strategies have significant perceptions on effective teaching. The study concluded that, there is no one conflict management style that can be exclusively attributed to teaching effectiveness. Principals and teachers have to blend them well in their daily managerial activities in school for quality results to be realized. The study recommended that principals’ and teachers' education curriculum at all levels of training should include conflict management in order to empower principals and teachers to handle the same when in the field.

Impact of educational interventions on pharmacovigilance and adverse drug reaction reporting by resident doctors and faculty members: A prospective comparative study.

Adverse drug reactions (ADRs) are significantly under-reported worldwide. The aim of this study was to assess the impact of educational interventions (EIs) on knowledge, attitude, and practice (KAP) of hospital resident doctors and faculty members and compare ADR reporting in EI (medical specialties) vs. non-EI (surgical specialties) in these two cadres of doctors. This study was a prospective comparative study conducted in two groups (EI and non-EI) in resident doctors and faculty members working at a tertiary care hospital. EI group (medical specialties) were provided with EI to increase awareness about ADR reporting, whereas in non-EI group (surgical specialties), no EI was provided and they served as control. Respondents were asked to fill a pretest questionnaire followed by interactive EI in EI group and posttest questionnaire in both groups. The impact of EI among respondents was evaluated by their response to questionnaire and number of ADRs reported after intervention. Total (n = 202) respondents were enrolled in the study. The number of resident doctors and faculty members in each group were (n = 101 [50%]). Overall, (n = 100 [49.5%]) were from the medical and (n = 102 [50.5%]) from surgical specialty. Post-EI period, there was statistically significant improvement in KAP domains. Our study serves as credible evidence that through EI; statistically significant improvement in KAP of resident doctors and faculty members in both medical and surgical specialties toward ADR reporting and existing pharmacovigilance system can be achieved.

Российское IT-сообщество в контексте социокультурной модернизации. Результаты интервью. Часть 1

The article presents the results of interviewing Russian IT specialists, which is part of the study of the socio-cultural characteristics of the Russian community of IT specialists. The first part examines the cultural identity of the interviewees. The authors infer that the identity of Russian specialists is determined by two main value “centers of attraction”: Russian and Western cultures. At the same time, Eastern culture does not have a significant impact on the value characteristics of specialists. Thus, the basis for the cultural identity of the respondents is Russian culture with a strong value bias towards Western culture. The specialists attributed the multiculturalism of Russian society, universality, hard work, as well as enterprise to the positive qualities of Russian culture, and conservatism, patience and inertia to the negative ones. Among the main differences between a Russian IT specialist and a foreign one mentioned in the interviews were: versatility, ability to adapt, proficiency, workaholism, stubbornness, commitment to results, high learning ability and collegiality as an ability to collective action, readiness for mutual assistance, as well as the fact that Russian specialists start working earlier and therefore gain experience faster than foreign colleagues. Collegiality, in the authors' opinion, is an exceptional quality in the context of the socio-cultural potential of the studied community because it is the ability for collective values that can be considered as a modernization value and a condition for the implementation of large social projects, and can be a factor in the consolidation of various social groups. The negative differences were: lack of specialized knowledge, the stereotype of the need for vocational education, focus on quick results, problems with the balance between work and personal life. The analysis of the attitude of community members to political life indicated the presence of a request for participation in the social life of society, accompanied by distrust of existing institutions.

Atheism, anti-church, feminism and the Women’s Strike. Group case study: Gals 4 Gals (Dziewuchy Dziewuchom)

Poland has been entering a period of accelerated secularisation in recent years. The results of the CBOS survey indicate that this process is visible especially in the youngest cohorts of Poles. The Women’s Strike, which took place between 2016 and 2020, is described in the academic literature as one of the factors accelerating secularisation processes, mainly in the population of young women with feminist views. In 2021, we surveyed members of the Facebook group “Gals 4 Gals” (Dziewuchy Dziewuchom) to describe the diverse relationship between feminism and atheism and to verify our hypothesis that the Women’s Strike was an expression, rather than a cause, of respondents’ atheist attitudes. It was also important for our quantitative research to determine the attitudes of the group members surveyed towards issues such as the political activities of the Catholic Church, the operation of the moral principles of Catholicism, and perceived spiritual needs.

Attitudes Of Faculty Members Towards Applying E-Learning In The Applied Colleges In Kuwait

Attitudes Of Faculty Members Towards Applying E-Learning In The Applied Colleges In Kuwait

An Analysis on Leisure Attitudes and Organizational Commitment of Student Community Members

Bu araştırma, öğrenci toplulukları üyesi öğrencilerin boş zaman tutumları ve örgütsel bağlılıklarını belirlemek amacı taşımaktadır. Araştırmanın çalışma evrenini, Muğla Sıtkı Koçman Üniversitesi öğrenci topluluklarına bağlı üye öğrenciler oluşturmaktadır. Örneklem grubunu ise, araştırma evreni içerisinden gönüllü katılım sağlayan 362 üye öğrenci oluşturmaktadır. Veri toplama aracı olarak, kişisel bilgi formu, Akgül ve Gürbüz (2011) tarafından Türkçe uyarlaması yapılan “Boş Zaman Tutum Ölçeği” ile Ergün ve Çelik (2019) tarafından Türkçe uyarlaması yapılan “Örgütsel Bağlılık Ölçeği” kullanılmıştır. Araştırmada, iki bağımsız değişken arasındaki farkın ortaya konmasında T-Testi ve ikiden fazla değişkenler arası farkın belirlenmesinde ise One-Way ANOVA testleri yapılmıştır. Ayrıca değişkenler arasındaki ilişkinin belirlenmesinde ise Korelasyon testi kullanılmıştır. Araştırmada elde edilen bulgulara göre, kadınların erkeklere göre bilişsel tutum alt boyut puanının daha yüksek olduğu görülmektedir. Sağlık bilimleri alanında öğrenim gören öğrencilerin fen bilimlerinde öğrenim gören öğrencilere göre bilişsel tutum alt boyut puanının daha yüksek olduğu tespit edilmiştir. Araştırmaya katılan erkek üyelerin kadın üyelere göre zoraki bağlılıklarının daha yüksek olduğu görülmektedir. Üye öğrencilerin boş zamana yönelik tutumları bilişsel, duyuşsal ve davranışsal alt boyutlar ile örgütsel bağlılık alt boyutlarından çıkarcı ve ahlaki alt boyut ile pozitif yönde ilişki görülürken, bilişsel ve duyuşsal alt boyut ile zoraki bağlılık alt boyutunda ise negatif yönde ilişki tespit edilmiştir. Sonuç olarak, öğrenci topluluklarına katılarak faaliyette bulunan öğrencilerin üniversite eğitimi ve öğretimi döneminde boş zamana yönelik farkındalıklarının arttığı, kişisel gelişim, sosyalleşme ve gönüllülük faaliyetlerine yönelmelerine katkı sağladığı söylenebilir.

EXPLORING TEACHERS’ ATTITUDES TOWARDS USING CHATGPT

ChatGPT has the potential to revolutionize education. By allowing machine learning and natural language processing (NLP) algorithms to interact with students in real-time, ChatGPT can provide students with personalized and interactive learning experiences that are tailored specifically for their individual needs. This study uses Technology Acceptance Model to explore the attitudes of faculty members towards using ChatGPT. Semi-structured interviews with 20 faculty members of a private university in Pakistan were conducted. The responses from the interviews indicate that university faculty are generally cautious in their approach to using ChatGPT. The faculty members had a negative perception and attitude towards using ChatGPT. Potential risks such as cheating and plagiarism were cited as major concerns, while potential benefits such as ease in lesson planning and assessment were also noted. The results of this study suggest that university faculty need more information and education about ChatGPT in order to make informed decisions about its use. Additionally, future research should focus on student perceptions and the use of quantitative methods to gain further insight into how university faculty are using ChatGPT for teaching and learning purposes.

The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China.

To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. Among nurses, the belief scale score was 2.87 ± 0.33 (range 2-4), and the attitude scale score was 5.53 ± 1.12 (range 2.33-7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96-4) and 6.18 ± 1.20 (range 1.67-7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management.

The Influence of Long Time and Quality of Mother's According Through Peer Group Support on Behavior Changes and Debris Index in Children with Disabilities

Children with special needs have limited intelligence and motor skills that cause a lack of dental and oral health maintenance. Children with special needs are at risk of developing dental and oral diseases. Therefore, it is very necessary to assist parents in maintaining the dental and oral health of children with special needs. Assistance for parents of children with special needs has been carried out 4 times in a period of 2 years on an ongoing basis. The purpose of this study was to determine the effect of the length and quality of maternal assistance on behavioral changes and the debris index of children with special needs in Meteseh. This type of research is pre-experimental with a pretest and posttest one group design. The sample in this study were 30 parents and children with special needs. Data analysis used univariate and bivariate analysis, Wilcoxon test to determine differences in knowledge and attitudes of crew members and debris index before and after treatment. The Mann-Whitney Test was used to determine differences in the knowledge and attitudes of parents of children with disabilities to changes in debris index of children with disabilities. The results obtained indicate an increase in the knowledge and attitudes of children with disabilities Sparents. The debris index of children with disabilities Shas decreased but is still not enough to change the children with disabilities 's actions in maintaining dental and oral health into a good category. Assistance to parents of children with special needs needs to be carried out further and children with special needs still need more parental participation to achieve good dental and oral health measures.

A scale to measure attitude of farmer members towards farmer producer organizations

Attitudes are individually attributed emotions, beliefs and behavioural tendencies an individual has towards a specific abstract or concrete object. To measure the attitude of farmer members towards Farmers Producer Organizations (FPOs), need was realized to use a scale. So, Likert’s summated rating scale was developed by following the methodology given by Likert (1932) and Edward (1957). After in-depth reviewing of secondary sources and discussion with primary sources, six indicators were finalized to form the items for scale development. Based on 80 judge’s response 57 statements were selected for item analysis. The split half method was used to testing reliability and the reliability coefficient was 0.92. The face validity and content validity were examined. The developed final scale consists of 16 statements in which 11 were positive statements and 5 were negative statements. The developed scale was found highly reliable and valid.

Perspectives of Rare Disease Social Media Group Participants on Engaging With Genetic Counselors: Mixed Methods Study.

Social media provides a potential avenue for genetic counselors to address gaps in access to reliable genetics information for rare disease communities. However, only limited research has examined patient and family attitudes toward engaging with genetic counselors through social media. Our study assessed the attitudes of members of rare disease social media groups toward engaging with genetic counselors through social media, characteristics associated with greater interest, and the benefits and potential pitfalls of various approaches to such engagement. We conducted a mixed methods survey of patients and family members recruited from a systematic sample of rare disease Facebook groups. Patient characteristics and their associations with interest in engagement with genetic counselors were evaluated using univariate and bivariate statistics. Responses to open-ended questions were analyzed using thematic content analysis. In total, 1053 individuals from 103 rare disease groups participated. The median overall interest in engaging with genetic counselors on social media was moderately high at 7.0 (IQR 4.0-9.0, range 0-10). No past experience with a genetic counselor was associated with greater interest in engaging with one through social media (µ=6.5 vs 6.0, P=.04). Participants expressed greatest interest (median 9.0, IQR 5.0-10.0) in engagement models allowing direct communication with genetic counselors, which was corroborated by the majority (n=399, 61.3%) of individuals who responded to open-ended questions explicitly stating their interest in 1-on-1 interactions. When asked what forms of support they would request from genetic counselors through social media, participants desired individualized support and information about how to access services. However, participants also expressed concerns regarding privacy and confidentiality. Patients and family members in rare disease social media groups appear interested in engaging with genetic counselors through social media, particularly for individualized support. This form of engagement on social media is not meant to replace the current structure and content of genetic counseling (GC) services, but genetic counselors could more actively use social media as a communication tool to address gaps in knowledge and awareness about genetics services and gaps in accessible patient information. Although encouraging, concerns regarding privacy and feasibility require further consideration, pointing to the need for professional guidelines in this area.

A review of the framework and strategy for disability and rehabilitation services in South Africa.

Rehabilitation is imperative for the successful integration of persons with disabilities into their social environments. The Framework and strategy for disability and rehabilitation services (FSDR) in South Africa, 2015-2020.was developed to strengthen access to rehabilitation services and ensure the inclusion of persons with disabilities in all aspects of community life. Despite the FSDR being commissioned, access to rehabilitation is a challenge for persons with disabilities and further compounded in rural communities. The study aimed to describe the barriers and facilitators that influenced the process of development, implementation and monitoring of the FSDR. This qualitative study employed a single case study design. Data was collected through document analysis and in-depth interviews utilising the Walt & Gilson policy analysis framework that outlines the context, content, actors and process of policy development and implementation. In-depth interviews were conducted with twelve key informants (N=12) who were selected purposively for the study. Data obtained from the in-depth interviews were analysed using inductive thematic analysis. We found many factors that influenced the implementation of the framework. Actor dynamics, insufficient resources, the rushed process, poor record-keeping, inappropriate leadership, negative attitudes of staff members and the insufficient monitoring impeded the successful implementation of the framework. While positive attitude, mentorship and support amongst the task team facilitated the implementation process, albeit with challenges. There is a need to address implementation gaps so that the FSDR is responsive to the current rehabilitation needs of persons with disabilities in South Africa. This study may inform future disability policy, and can be used as a tool to advocate for the rights for persons with disabilities.

The Impact of the Application of the Total Quality Management System on Performance (An Empirical Study on the Ministry of Hajj and Umrah)

The purpose of the study is to show the reality of the applying the quality management system through the following: Administrative Participation, Accountability and Transparency, Delegation of Authority, Decentralization, and Optimization), and its impact on performance in the Ministry of Hajj and Umrah. To achieve the goal of the study, we made a questionnaire consisting in its final form (45) paragraphs divided into four axes. It made sure from its stabile and honesty. The study population consisted of workers in the Ministry of Hajj and Umrah in the Makkah region. The study sample consisted of (100) workers who were randomly selected from the original study population. The results of the study showed the lack of necessary information and data impedes the implementation and application of total quality requirements in the ministry, the lack of clarity and ambiguity in the Ministry's total quality strategies, and the weak participation of the competent department in the ministry in research centers and studies related to total quality globally and locally. The results of the study showed that there were statistically significant differences at the significance level of (0.05) or less in the attitudes of the study sample members about: the principle of administrative participation, the principle of accountability and transparency, and the principle of delegation of authority. In viewing the results that reach through the study, it can make a range of recommendations including the need to put an appropriate strategy for the employees of the Ministry of Hajj and Umrah and work on the participation of managers in it, present it to the workers and clarify it to them, work to implement it in the required time, and provide training workshops or training laboratories in the Ministry of Hajj and Umrah on total quality.

An Analysis of the Indo-Pacific Economic Framework (IPEF): Essence, Impacts and Prospects

The Indo-Pacific Economic Framework (IPEF) proposed by the Biden administration has gone through three major stages — conception, preparation and engagement, and initial negotiation — and focuses on four key pillars: Connected Economy, Resilient Economy, Clean Economy, and Fair Economy. In fact, this initiative supplements and reinforces the Trump administration’s Indo-Pacific Strategy, while carrying forward and advancing the “America First” policy. It is a new attempt of the US to build an economic club exclusive of China in the Indo-Pacific and to lead in building a new structure for regional cooperation, as well as a diplomatic signal deliberately released by the Biden administration to its Eurasian allies during the Russia–Ukarine conflict. As the prospects of the IPEF are still of much uncertainty, it might exert few substantial impacts on China in the short term. However, we should still be alert to its long-term adverse influence on China–US relations, China’s surrounding international environment and foreign relations, the development of regional economic cooperation and world economy, as well as the stability of international order. Given the domestic situation in the US and the attitude of the other members, the progress of IPEF negotiations in the four pillars may vary significantly in the coming period.

Experiences of Social Isolation Among People with Disabilities During the COVID-19 Pandemic

<h3>Research Objectives</h3> The COVID-19 pandemic has worsened existing disparities in social participation among people with disabilities. However, there is little evidence to describe the causes of these disparities and their impact on participation. Thus, there is little to guide intervention development and delivery in rehabilitation and community settings. The purpose of this study was to describe experiences with community participation throughout the COVID-19 pandemic among people with disabilities. <h3>Design</h3> Focus groups and community asset mapping were conducted. Focus groups explored experiences with social isolation and social participation, and ongoing challenges related to the pandemic. Community asset mapping identified community resources and supports that have promoted better community participation. Two investigators independently coded results, which were shared with participants and other members of the disability community for member checking at a Town Hall event. <h3>Setting</h3> N/A. <h3>Participants</h3> Seventeen participants with diverse disabilities were enrolled. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> N/A. <h3>Results</h3> Results suggest that people with disabilities have experienced significant social isolation throughout the pandemic, which is perceived to have worsened their physical and emotional health. Lack of equitable health care, attitudes of professionals and family members, lack of employment and volunteer opportunities, and lack of access to pre-pandemic social activities, services, and supports were identified as contributing to social isolation. Social supports, telework and telehealth options, virtual events, and online and social media platforms were identified as critical supports for community participation. <h3>Conclusions</h3> The results of this study can inform design of an intervention to improve community participation. Interventions should focus on accessing available community resources and supports, use of virtual and remote services and opportunities, and strengthening social support networks. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to disclose.

BENEFICIOS DE LA ACREDITACIÓN AACSB COMO PREDICTOR DE LA ACTITUD DE LOS DOCENTES HACIA EL PROCESO DE ACREDITACIÓN: UN ESTUDIO EXPLORATORIO

The purpose of the study is to investigate the attitude of faculty members of the College of Business Administration at Kuwait University (CBA-KU) toward the AACSB accreditation system and the way they perceive the benefits of accreditation. The level of association and the causal effect of perceived benefits on shaping faculty attitude are also addressed. A questionnaire was administered to all faculty members at CBA-KU resulting in a final response of 43 observations. While the one-sample t-test and Pearson correlation were used to investigate faculty attitude and perceived benefits and their level of association, Regression analysis was utilized in testing the effect of perceived benefits on faculty attitudes. Findings revealed a relatively high positive attitude toward AACSB accreditation and a significant above-average level of agreement with all addressed benefit statements. Significant positive correlation between benefits and attitudes and a significant effect of academic benefits on faculty attitude were also confirmed. The study is the first AACSB accreditation survey in Kuwait which enriches the understanding of the value of earning the accreditation and highlights some factors that enhance faculty positive attitude toward AACSB accrediting.

Occupational Well-Being of Multidisciplinary PHC Teams: Barriers/Facilitators and Negotiations to Improve Working Conditions

Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers' attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers' proactivity in negotiating improved working conditions.

Satisfaction of family physician team members in the context of contract system: A cross-sectional survey from Shandong Province, China.

Family physicians play a key role in responding to the growing demand for primary healthcare due to aging. The work attitude of family physician team members (FPTMs) impacts their work efficiency and quality. Knowing how satisfied they are with their jobs can help identify potential directions and entry points for incentives. The purpose of this study is to analyze the job satisfaction status and influencing factors of grassroots health service personnel after the implementation of the family physician contract system in China. The study conducted a cross-sectional survey with 570 FPTMs in three prefecture-level cities in the Shandong Province. Satisfaction was measured using 30 items across seven dimensions. Responses were recorded on a 5-point Likert scale. Descriptive statistical analysis was used to analyze the general information and satisfaction of FPTMs. Multiple linear regression analysis was used to analyze the factors influencing job satisfaction. The overall job satisfaction among FPTMs was not high. Among the seven dimensions, interpersonal relationships had the highest satisfaction (4.10 ± 0.78), while workload had the lowest satisfaction (3.08 ± 0.56). The satisfaction levels of the three sample regions were different, and the results were opposite to their regional economic development levels. The results of the multifactor analysis showed that gender, income level, educational background, working years, daily working hours, number of training sessions per year and the proportion of performance pay had significant impact on overall job satisfaction. The development of a family physician contract system has increased the workload of FPTMs. In addition to the implementation of the new policy, attention should be paid to the workload and working attitude of family physicians. The fundamental measures should focus on attracting more personnel to work at the grassroots level by accelerating education and training to solve the problem of insufficient health personnel at the grassroots level. Simultaneously, attention should be paid to the improvement of the medical staff's salary level and the need for self-promotion, such as training.

Prevalence and characteristics of family history of sudden unexplained death and predictors of negative attitude of family members toward medical autopsy and family screening in Saudi Arabia: A cross-sectional study.

Little is known about sudden unexplained death (SUD) in Saudi Arabia. Moreover, family screening and medical autopsy are not routinely performed due to perceived religious and cultural resistance. However, this has never been systematically examined. We sought to describe the prevalence and characteristics of family history of SUD and the attitude of family members toward medical autopsy and family screening. This was a cross-sectional study utilizing an online survey distributed though social media platforms from August 15 to September 15, 2021. Participants' characteristics, details about SUD cases, and the attitude toward medical autopsy and family screening were collected. Multivariable logistic regression was used to identify independent predictors of negative attitude toward medical autopsy. A total of 11374 were included in the final analysis after excluding children. The prevalence of FHx of at least one first degree relative (FDR) with SUD was found to be 9.4% [95% CI (8.9% - 10%)]. Among participants with any FHx of SUD, 1346/3489 (38.6%) had ≥ 2 family members affected. Only 183 participants with a FHx of SUD visited a physician for the purpose of family screening (183/3489, 5.3%). The total number of SUD cases reported was 5474. Of those, 22% were 35-year-old or younger. Only 22% of participants (2458/11374) had a negative attitude towards medical autopsy, and the most common reason was the perceived lack of benefit. Older age (> 35 years), family history of SUD, female gender, and lack of knowledge about the yield of medical autopsy were associated with negative attitude in the adjusted analysis. SUD occurred at young age and affected multiple family members in a significant proportion of families. Despite that, family screening was seldom performed. There is an urgent need to improve the care of SUD by incorporating medical autopsy and developing clinical pathways to screen family members.

Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology

BackgroundTriple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached.MethodsAffiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement.ResultsConsensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases.ConclusionExpert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions.