National Questionnaire Survey Research Articles

A National Cross-Sectional Survey Dataset on Common Disease and Influencing Factors of Chinese Internal Migrants in 2017

This data article describes the dataset from a national cross-sectional questionnaire survey on Chinese internal migrants in 2017. The survey was part of the Chinese Migrants Dynamic Survey, which is an annually conducted large-scale national questionnaire survey on internal migrants. The respondents in the described dataset were migrants and registered local residents aged over 15 years old. A multistage stratified probability-proportional-to-size (PPS) sampling method based on the 2016 annual report data of China Migrant Population was adopted. The questionnaire was designed to collect demographic information of respondents and their family members, intention of migration or settlement, health status, health services accessibility, social integration, and epidemic influencing factors of common diseases, including hypertension, type 2 diabetes, diarrhea, fever, rash, icterus, conjunctival redness, cold, and other illnesses or injuries. The sample population in this survey include 13,998 internal migrants and 14,000 registered local residents from eight domestic cities / prefecture / districts across China. It is the most widely covering and highly representative dataset on common diseases and influencing factors of internal migrants in China. The dataset can be used to study common diseases and influencing factors among floating Chinese population. It provides data support for government to improve healthcare accessibility and the equity of public health services for internal migrants in China.

Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey

BackgroundNurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension.MethodsSecondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted.ResultsPerceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions.ConclusionsAlthough stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.

Relationship between the Appearance of Symptoms and Hospital Visits in Childhood Based on Japanese Statistical Data.

Background: Childhood health problems affect healthy growth. This study aimed to assess the symptoms and diseases requiring hospital visits commonly found in children in Japan and analyze their effects on health status. Methods: Anonymized data on 1315 children aged 6–14 years were obtained from a national survey questionnaire. The survey items addressed symptoms, disease names, and hospital visits. Associations between symptoms and other factors were examined by means of a contingency table analysis and logistic regression. Results: The proportions of responses for health status were compared for each question item; significant differences were found in age group (p < 0.01), subjective symptoms (p < 0.01), hospital visits (p < 0.01), and lifestyle (p < 0.01). The proportion of responses indicating “poor” perceived health status was high among those with subjective symptoms (4.8%) and hospital visits (4.7%). From the logistic regression, significant odds ratios were found for subjective symptoms (2.10, 95% confidence interval (C.I.) 1.15–3.83) and age group (1.98, 95% C.I. 1.05–3.72). Conclusion: Among measures to improve quality of life from childhood, comprehensive health guidance that emphasizes understanding symptoms and includes age and living conditions is important.

Constructability Reviews Utilization Practices for Traditional and Alternative Project Delivery Methods Across State Transportation Agencies

State Transportation Agencies (STAs) recognized that to enhance the quality of construction documents, a review process must be incorporated into project planning, design, and procurement to evaluate projects for constructability. The benefits promised by constructability reviews (CRs) encouraged STAs to adopt it as part of their operations. This approach soon evolved into a structured process, recognized by researchers and practitioners as, the constructability review process (CRP). A significant component to the CRP success is to involve experienced construction personnel in CRs during the design phase; a major limitation of the traditional design-bid-build (DBB) delivery method. To overcome this limitation, more emphasis is being placed towards alternative project delivery methods (APDMs). As such, design–build (DB) and construction manager/general contractor (CM/GC) are among the APDMs most utilized by STAs to deliver transportation projects. Although extensive research has investigated CRs under DBB projects, research on CRs implementation under APDMs is remarkably absent. This study examines CRs utilization and staffing practices adopted by STAs across DBB, DB, and CM/GC projects. The results of this study were drawn utilizing data collected through a national survey questionnaire and interviews with selected STAs. The study found that CRs are initiated and implemented at proportionally similar phases across DBB, DB, and CM/GC projects. Investigation of staffing needs revealed that although the agency holds the executive role in implementation of CRs on DBB projects, their role shifts on DB projects to become more administrative. The agency continues to be involved in CRs under CM/GC projects, along with their allocated design consultant, in conjunction with the GC. The results of this study are anticipated to provide STAs with guidance for CRs utilization on DBB, DB and CM/GC projects.

Acute day units in non-residential settings for people in mental health crisis: the AD-CARE mixed-methods study

Background For people in mental health crisis, acute day units provide daily structured sessions and peer support in non-residential settings as an alternative to crisis resolution teams. Objectives To investigate the provision, effectiveness, intervention acceptability and re-admission rates of acute day units. Design Work package 1 – mapping and national questionnaire survey of acute day units. Work package 2.1 – cohort study comparing outcomes during a 6-month period between acute day unit and crisis resolution team participants. Work package 2.2 – qualitative interviews with staff and service users of acute day units. Work package 3 – a cohort study within the Mental Health Minimum Data Set exploring re-admissions to acute care over 6 months. A patient and public involvement group supported the study throughout. Setting and participants Work package 1 – all non-residential acute day units (NHS and voluntary sector) in England. Work packages 2.1 and 2.2 – four NHS trusts with staff, service users and carers in acute day units and crisis resolution teams. Work package 3 – all individuals using mental health NHS trusts in England. Results Work package 1 – we identified 27 acute day units in 17 out of 58 trusts. Acute day units are typically available on weekdays from 10 a.m. to 4 p.m., providing a wide range of interventions and a multidisciplinary team, including clinicians, and having an average attendance of 5 weeks. Work package 2.1 – we recruited 744 participants (acute day units, n = 431; crisis resolution teams, n = 312). In the primary analysis, 21% of acute day unit participants (vs. 23% of crisis resolution team participants) were re-admitted to acute mental health services over 6 months. There was no statistically significant difference in the fully adjusted model (acute day unit hazard ratio 0.78, 95% confidence interval 0.54 to 1.14; p = 0.20), with highly heterogeneous results between trusts. Acute day unit participants had higher satisfaction and well-being scores and lower depression scores than crisis resolution team participants. The health economics analysis found no difference in resource use or cost between the acute day unit and crisis resolution team groups in the fully adjusted analysis. Work package 2.2 – 36 people were interviewed (acute day unit staff, n = 12; service users, n = 21; carers, n = 3). There was an overwhelming consensus that acute day units are highly valued. Service users found the high amount of contact time and staff continuity, peer support and structure provided by acute day units particularly beneficial. Staff also valued providing continuity, building strong therapeutic relationships and providing a variety of flexible, personalised support. Work package 3 – of 231,998 individuals discharged from acute care (crisis resolution team, acute day unit or inpatient ward), 21.4% were re-admitted for acute treatment within 6 months, with women, single people, people of mixed or black ethnicity, those living in more deprived areas and those in the severe psychosis care cluster being more likely to be re-admitted. Little variation in re-admissions was explained at the trust level, or between trusts with and trusts without acute day units (adjusted odds ratio 0.96, 95% confidence interval 0.80 to 1.15). Limitations In work package 1, some of the information is likely to be incomplete as a result of trusts’ self-reporting. There may have been recruitment bias in work packages 2.1 and 2.2. Part of the health economics analysis relied on clinical Health of the Nations Outcome Scale ratings. The Mental Health Minimum Data Set did not contain a variable identifying acute day units, and some covariates had a considerable number of missing data. Conclusions Acute day units are not provided routinely in the NHS but are highly valued by staff and service users, giving better outcomes in terms of satisfaction, well-being and depression than, and no significant differences in risk of re-admission or increased costs from, crisis resolution teams. Future work should investigate wider health and care system structures and the place of acute day units within them; the development of a model of best practice for acute day units; and staff turnover and well-being (including the impacts of these on care). Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 18. See the NIHR Journals Library website for further project information.

Facilitating Building Projects’ Short-Term and Long-Term Value Creation

Real estate and buildings are some of facility managers’ most costly resources. Thus, knowledge about how to get the most out of building or renovation projects both in the short term and in the long term are of great importance for facility managers. This paper investigates which factors are most important for building and renovation projects’ output or short-term value creation, and outcome or long-term value creation, i.e., the completed building’s effect for owners and users. Thus, the focus is not primarily financial and the buildings’ asset value. The study is based on a national questionnaire survey in Norway (550 respondents). Multivariate statistics (Principal Component Analysis and Linear Multiple Regressions validated with bootstrapping) were used to test the hypotheses. Short-term project management priorities, such as early involvement of technical contractors and FM providers, contract strategy and involvement of owners and users largely decide the qualities of the building, and thus the potential for long-term value creation. The most important factors for long-term value creation, i.e., buildings that facilitate the demand organisation’s value creation are the qualities of the completed building, project governance and involvement of owners and users during early phase planning.

A cross-sectional national questionnaire survey assessing the views of members of the British Menopause Society on the management of patients with unscheduled bleeding on hormone replacement therapy.

To explore the views of members of the British Menopause Society on the management of women with unscheduled bleeding on hormone replacement therapy. An electronic cross-sectional questionnaire survey. Investigations, treatment options and preferences for the management of women with unscheduled bleeding on hormone replacement therapy. A total of 91/178 (51%) clinicians investigate patients with unscheduled bleeding within three to six months of starting sequential hormone replacement therapy (seq-HRT) versus 83/178 (47%) for continuous combined hormone replacement therapy (con-HRT). A total of 52/178 (29%) versus 54/178 (30%) would investigate unscheduled bleeding continuing beyond six months while 18/178 (10%) versus 26/178 (15%) would investigate within three months. Assessment is requested as urgent by 88/176 (50%) clinicians, routine by 47/176 (27%) and a two-week-wait-suspected cancer referral by 41/176 (23%). A total of 97/178 (55%) clinicians would continue seq-HRT and refer versus 117/178 (66%) for con-HRT. A total of 46/178 (26%) clinicians would change the progestogen preparation in women with unscheduled bleeding on seq-HRT. For women on con-HRT, 12/178 (7%) clinicians would change to seq-HRT and 8/178 (5%) to the Mirena IUS. The Mirena IUS is the preferred progestogen for 81/178 (45%) of clinicians when prescribing hormone replacement therapy. There is a varied approach in the practise amongst British Menopause Society members to managing women with unscheduled bleeding on hormone replacement therapy. Further research is needed to determine the optimal assessment pathways for women with unscheduled bleeding on hormone replacement therapy.

Impact of the COVID-19 pandemic on biopsychosocial health and quality of life among Danish children and adults with neuromuscular diseases (NMD)-Patient reported outcomes from a national survey.

The purpose was to investigate the impact of the COVID-19 pandemic on biopsychosocial health, daily activities, and quality of life among children and adults with neuromuscular diseases, and to assess the prevalence of COVID-19 infection and the impact of this in patients with neuromuscular diseases. The study was a national questionnaire survey. Responses were obtained from 811 adults (29%) and 67 parents of children (27%) with neuromuscular diseases. Many patients reported decreased health or physical functioning, and changes in access to physiotherapy or healthcare due to the pandemic. Participants generally perceived themselves or their child to be at high risk of severe illness from COVID-19, but only 15 patients had suffered from COVID-19 and experienced mild flu-like symptoms. 25.3% of adults and 46.6% of parents experienced anxiety. 20.4% of adults and 27.6% of parents experienced symptoms of depression. In general, the pandemic contributed to anxiety, a depressed mood as well as to fewer leisure activities, less social contact, isolation from work/school and a reduced quality of life, in particular for patients who perceived themselves to be at high risk of severe illness. The results demonstrate that the pandemic has had a negative impact on biopsychosocial health and quality of life of patients with neuromuscular diseases.

The Pain Nurse Practitioner and Pain Nurse's Role and Views on Opioid Management in Australia: A National Questionnaire Survey

BackgroundThe demand for access to Australian pain management services is growing. The dual crisis of opioid misuse and chronic pain, means pain nurses and nurse practitioners (NPs) have a unique opportunity to meet clinical demands and advance their scope of practice. AimsTo understand the role of pain nurses and pain NPs across Australia and explore their perceptions of current opioid management. DesignThis cross-sectional study involved pain nurses or pain NPs working in Australia who are a members of a pain interest group, which are subgroups of The Australian Pain Society. MethodsThis cross-sectional study involved pain nurses or pain NPs working in Australia who are a members of a pain interest group, which are subgroups of The Australian Pain Society. Survey respondents were contacted via the eight nursing Pain Interest Groups in Australia. ResultsAcute pain management (92.7%) and chronic pain management (80.5%) were the primary services provided, with pain specialty nurses providing nurse education (100.0%), patient support, clinician education, and policy development. Pain nurses believed there was an over prescription of opioid analgesics in Australia (97.6%), with NPs able to reduce opioid medication doses as part of opioid harm mitigation. ConclusionsPain nurses have a breadth of knowledge and experience highlight they can contribute to opioid management in the future, with the support of policy and organizations.

Nurses\u2019 perception of patient safety culture and its relationship with adverse events: a national questionnaire survey in Iran

BackgroundPatient safety culture is an important factor in determining hospitals’ ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses’ perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses’ perception of patient safety culture and their perceived proportion of adverse events.MethodsA cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients’ safety culture between October 2018 and September 2019.ResultsPositive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2–63.0% in the past year. The higher nurses’ perceptions of “Staffing”, “Hospital handoffs and transitions”, “Frequency of event reporting”, “Non-punitive response to error”, “Supervisor expectation and actions promoting safety”, “Communication openness”, “Organizational learning continuous improvement”, “Teamwork within units”, and “Hospital management support patient safety” were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46).ConclusionsOur findings demonstrated that nurses’ perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses’ perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events’ reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events.

What does it take to become a neurosurgeon? A mixed methods cross-sectional analysis of professional identity formation amongst neurosurgical trainees

Introduction The concept of professional identity (as distinct from technical skills development), and how it can be cultivated by trainees in neurosurgical training has not been explored before. Aims This study aimed to assess neurosurgical trainees’ perceptions of professional identity, how it develops and how it might be enhanced during the course of training. Methods A mixed methods cross-sectional analysis was conducted consisting of semi-structured, in-depth interviews with a small group of neurosurgical trainees to qualitatively identify common themes around professional identity. These themes were then quantitatively analysed via a national on-line questionnaire survey amongst the wider United Kingdom neurosurgical trainee cohort. Results Interviewed participants were fiveteen British neurosurgical trainees spanning across junior (n = 5), intermediate (n = 5) and senior (n = 5) levels of training at two University teaching hospitals representing high-volume tertiary centres for Neurosurgery in the United Kingdom. The on-line questionnaire survey returned complete responses by 80 trainees (30% response rate). These data demonstrated that at different stages of training, neurosurgical trainees self-identified differently, and engaged in different practices to develop their identity. However, all trainees irrespective of level appeared to perceive a common set of qualities that define the identity of a fully-fledged neurosurgeon. Conclusion A model has been constructed that describes professional identity formation amongst neurosurgical trainees at different stages of training, and how these feed into an aspired core identity profile of a Neurosurgeon. Based on this model, suggestions have been made to potentially improve professional identity formation amongst neurosurgical trainees.

Burnout in nurses working in China: A national questionnaire survey.

This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. This was a national cross-sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self-administered questionnaire. A total of 51406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented.

Knowledge of iatrogenic premature ovarian insufficiency among Chinese obstetricians and gynaecologists: a national questionnaire survey

BackgroundWith increasing cases of iatrogenic premature ovarian insufficiency (POI), more clinicians are required to counsel patients regarding the gonadotoxic effects of iatrogenic treatments. This survey aimed to explore obstetricians and gynaecologists’ knowledge regarding iatrogenic POI. A national online questionnaire survey was conducted across China. Respondents were asked to select the iatrogenic condition(s) that can cause POI based on their experience and knowledge.ResultsOf the 5523 returned questionnaires, 4995 were analysed. Among tumour therapies causing POI, most respondents agreed that radiotherapy (73.5% of respondents) and chemotherapy (64.1%) are risk factors for POI. While only 6.5 and 7.8% of the gynaecological oncologists believed that tumour immunotherapy and tumour-targeting therapy, respectively, may cause ovarian impairment, 31.8 and 22.2% of the non-gynaecologic oncologists believed that these therapies could affect ovarian health. Most respondents believed that ovarian cystectomy (54.4%) was a risk factor for POI. In contrast, only a few respondents believed that hysterectomy with bilateral salpingectomy (39.6%) and uterine artery embolisation (33.5%) could cause ovarian impairment. Only 30.5% of respondents believed that immunosuppressants (ISs) increased the risk of POI. Views differed with experience and hospital setting.ConclusionsThe knowledge of gonadal toxicity due to traditional tumour treatments is generally high among Chinese obstetricians and gynaecologists. A misunderstanding may exist in primary care hospitals and general gynaecologists regarding a link between novel tumour treatments and POI, owing to the lack of convincing evidence. Knowledge of POI caused by hysterectomy and ISs should be improved.

Trends in Work Conditions and Associations with Workers' Health in Recent 15 Years: The Role of Job Automation Probability.

Job automation and associated psychosocial hazards are emerging workplace challenges. This study examined the trends in work conditions and associations with workers’ health over time in jobs with different automation probabilities. We utilized data from six waves of national questionnaire surveys of randomly selected 95,762 employees between 2001 and 2016. The Job Content Questionnaire, the Copenhagen Burnout Inventory, and the Self-Rated Health Scale were applied, and working time was self-reported. Automation probability was derived for 38 occupations and then categorized into three groups. Trends in work conditions and the associations between automation probability, work conditions and health were examined. We observed a 7% decrease in high automation probability jobs, an overall increase in job demands for and prevalence of shift work, and a decrease in job control. Workers with high automation probability jobs had low job demands, low job control and high job insecurity. Low automation probability was associated with burnout in logistic regression models. The odds ratio of job insecurity, long working hours, and shift work relating to health was higher in the later years of the surveys. In conclusion, there has been a decrease in high automation probability jobs. Workers employed in jobs with different levels of automation probability encountered different work condition challenges.

Making the invisible visible: the availability and desirability of adherence data in routine CF care- findings from a national questionnaire survey.

Background: Inhaled medications for cystic fibrosis (CF) are effective but adherence is low. Clinicians find it difficult to estimate how much treatment people with CF (PWCF) take, whilst objective adherence measurement demonstrates that patients are poorly calibrated with a tendency to over-estimate actual adherence. The diagnostic approach to a PWCF with deteriorating clinical status and very low adherence is likely to be different to the approach to a deteriorating patient with optimal adherence. Access to objective adherence data in routine consultations could help to overcome diagnostic challenges for clinicians and people with CF. Attitudes of clinicians to the use and importance of routinely available adherence data is unknown. Methods: We conducted an online questionnaire survey with UK CF centres. We asked five questions relating to the current use and perception of objective measurements of adherence in routine care. Results: A total of eight CF centres completed the questionnaire. Few of the responding centres have adherence data readily available in routine clinics (13% of centres use medicines possession ratio; of centres with access to I-nebs® it was estimated that 17% of patients had I-neb data regularly available in clinics). All centres considered the availability of objectively measured adherence data to be important. Respondents identified that systems developed to provide adherence data in clinical practice must provide data to both clinicians and patients that is readily understood and easy to use. Conclusions: Centres perceived the availability of adherence data in routine care to be important but objective measures of adherence is rarely available at present.

Bleeding Management Practices of Australian Cardiac Surgeons, Anesthesiologists and Perfusionists: A Cross-Sectional National Survey Incorporating the Theoretical Domains Framework (TDF) and COM-B Model.

PurposeExcessive bleeding is an acknowledged consequence of cardiac surgery, occurring in up to 10% of adult patients. This clinically important complication leads to poorer patient outcomes. Clinical practice guidelines are available to support best practice however variability in bleeding management practice and related adverse outcomes still exist. This study had two objectives: 1) to gain insight into current bleeding management practice for adult cardiac surgery in Australia and how that compared to guidelines and literature; and 2) to understand perceived difficulties clinicians face implementing improvements in bleeding management.MethodsA national cross-sectional questionnaire survey was utilized. Perspectives were sought from cardiac surgeons, cardiac anesthesiologists and perfusionists. Thirty-nine closed-ended questions focused on routine bleeding management practices to address pre and intra-operative care. One open-ended question was asked; “What would assist you to improve bleeding management with cardiac surgery patients?” Quantitative data were analysed with SPSS. Qualitative data were categorized into the domains of the Theoretical Domains Framework; the domains were then mapped to the COM-B model.ResultsSurvey responses from 159 Anesthesiologists, 39 cardiac surgeons and 86 perfusionists were included (response rate 37%). Four of the recommendations queried in this survey were reported as routinely adhered to < 50% of the time, 9 queried recommendations were adhered to 51–75% of the time and 4 recommendations were routinely followed >76% of the time.ConclusionThere is a wide variation in peri-operative bleeding management practice among cardiac anaesthesiologists, surgeons and perfusionists in Australian cardiac surgery units. Conceptualizing factors believed necessary to improve practice with the TDF and COM-B model found that bleeding management could be improved with a standardized approach including; point of care diagnostic assays, a bleeding management algorithm, access to concentrated coagulation factors, cardiac surgery specific bleeding management education, multidisciplinary team agreement and support, and an overarching national approach.

Japanese National Questionnaire Survey in 2018 on Complications Related to Cranial Implants in Neurosurgery.

Cranial implants are commonly used throughout the world, yet the data on complications remain partly clarified. The aim of this study was to gather real data in 2018 on complications related to cranial implants in neurosurgery. The survey population consisted of 1103 institutes supplying neurosurgical treatment. The survey consisted of two-stage questionnaire. First the incidence of complications was investigated, then the secondary questionnaire was e-mailed to the respondents about the detailed of the complications. As the result, the annual incidence of complications related to cranial implants was 0.558% in Japan. Titanium plate and mesh were used predominantly in craniotomy and cranioplasty, respectively. The second survey collected data on 449 cases with complications (infection: 63%, implant exposure: 46%, multiple answer). Postoperative infection was associated with male sex, brain tumor, short interval between surgery and complication, usage of ceramics, hydroxyapatite, resin, and artificial dura, hyponutrition, multiple surgeries, dirty wound, and sinusitis as patient factors, and CSF leakage, ruptured sutures, and sinus maltreatment as surgery factors. Meanwhile, long hospital stay was associated with age, male sex, mRS 3–5 before complication, short interval between initial surgery and complication, large craniotomy, long operative time, usage of ceramics and artificial dura, multiple surgeries and dirty wound as patient factors, ruptured suture as a surgical factor, and bacterial infection, especially MRSA infection, as the complication and treatment consisting of removal as complication factors. In conclusion, this is the first Japanese national survey on complications related to cranial implants in neurosurgery. It is important to recall that complications may arise years after surgery and to be aware of the risk factors associated with complications.

Making the invisible visible: the availability and desirability of adherence data in routine CF care– findings from a national questionnaire survey

Background: Inhaled medications for cystic fibrosis (CF) are effective but adherence is low. Clinicians find it difficult to estimate how much treatment people with CF (PWCF) take, whilst objective adherence measurement demonstrates that patients are poorly calibrated with a tendency to over-estimate actual adherence. The diagnostic approach to a PWCF with deteriorating clinical status and very low adherence is likely to be different to the approach to a deteriorating patient with optimal adherence. Access to objective adherence data in routine consultations could help to overcome diagnostic challenges for clinicians and people with CF. Attitudes of clinicians to the use and importance of routinely available adherence data is unknown. Methods: We conducted an online questionnaire survey with UK CF centres. We asked five questions relating to the current use and perception of objective measurements of adherence in routine care. Results: A total of eight CF centres completed the questionnaire. Few of the responding centres have adherence data readily available in routine clinics (13% of centres use medicines possession ratio; of centres with access to I-nebs® it was estimated that 17% of patients had I-neb data regularly available in clinics). All centres considered the availability of objectively measured adherence data to be important. Respondents identified that systems developed to provide adherence data in clinical practice must provide data to both clinicians and patients that is readily understood and easy to use. Conclusions: Centres perceived the availability of adherence data in routine care to be important but objective measures of adherence is rarely available at present.

Effects of psychological distance perception and psychological factors on pro-environmental behaviors in Taiwan: Application of construal level theory

This study applied construal level theory (CLT) to the perceived psychological distance of climate change to investigate Taiwanese people’s psychological distance perception of climate change. It also considered how this psychological distance perception of climate change and other crucial psychological factors (i.e., values, ecological worldviews, and environmental concerns) may influence people’s pro-environmental behaviors (PEBs). A national self-administered questionnaire survey was performed in Taiwan and 733 responses were analyzed empirically. Structural equation modeling analysis indicated that an individual’s altruistic values are positively related to his or her ecological worldviews. An individual’s ecological worldviews are positively related to his or her psychological distance perception of climate change and environmental concerns regarding the negative consequences of climate change. Such environmental concerns positively motivate engagement in PEBs. However, an individual’s psychological distance perception of climate change does not positively relate to his or her PEBs.

Home and away: A national mixed-methods questionnaire survey of host and migrant Registered Nurses in New Zealand

BackgroundThere are numerous studies examining the experiences of migrant nurses. However, there is less literature related to the concomitant experience of host nurses. ObjectiveThis is the first identified study of the cultural influences on perceptions, practices and cross-cultural communication interface between Registered Nurses (RNs) from diverse ethnicities across the Aotearoa-New Zealand (NZ) health sector. DesignA mixed-methods online questionnaire survey was designed to identify key influences on RNs in a rapidly culturally-diversifying healthcare environment. The critical incident technique provided further insight into cultural influences on communication and practice. Participants259 respondents completed the questionnaire sent to a random sample of RNs in the New Zealand Nurses Organisation (NZNO) database. MethodsThe survey identified key factors present in the cross-cultural interface between host and migrant nurses. Principal components analysis uncovered the underlying structure of variables and thematic analysis of the qualitative data provided enhanced insight. ResultsThree key areas accounted for 57.23% of variance: Factor 1: teamwork (40.2%); Factor 2: management (12.2%) and Factor 3: Organisational culture (4%). Sub-themes accompanied each factor to illustrate the impact on both groups of RNs. ConclusionThere was a clear desire for RNs, both host and migrant nurses, for support to enable them to foster good working relationships in collaborative teams. Empathetic, culturally-competent managers and organisational resources are required to facilitate this process.