National Questionnaire Survey Research Articles

Causes of suicidal behaviors in men who have sex with men in China: a national questionnaire survey

BackgroundMen who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the psychological characteristics in Chinese MSM, especially the prevalence of suicidal ideation and attempts.MethodsA questionnaire survey was conducted on 2,250 MSM recruited from gay bars in 9 large cities in mainland China. Data on the prevalence of suicidal ideation and attempts as well as the underlying causes in the respondents were analyzed.ResultsA total of 1530 MSM responded to the question regarding previous suicidal ideation and attempts. Of these respondents, 26.01% had ever considered suicide and 12.55% actually attempted suicide at least once. Romantic gay relationship breakup was the number one cause of suicide behaviors, followed by self-objection to homosexuality, difficulties in finding gay partners or in getting used to heterosexual marriage life, sudden emotional hurts from unexpected events, illegal status of gay marriage in China and disclosure of homosexuality.ConclusionsThe survey study has led to a better understanding of the factors contributing to suicide behaviors of MSM in China, which may have significant implications in developing preventive strategies against suicide behaviors in this unique group of individuals.

Analyze Female Entrepreneurship: Evidence from Greece

The aim of this paper is to identify the profile of existing female entrepreneurs in Greece, highlight their main characteristics, and interpret their beliefs in relation to their entrepreneurial and personal life. To this end we conducted an on-line national questionnaire survey from November 2012 to January 2013, using a sample of 300 women entrepreneurs. The main findings indicate that the majority of the participants feel strong, successful, proud and well respected due to practicing entrepreneurship. However, despite their great potential in becoming successful entrepreneurs, they also reported fears related to the entrepreneurial reality. Further, most of them expressed guilty feelings for the limited time they devote to their families. Also, almost half of them stated that entrepreneurship has no gender thus implying that the debate on women’s entrepreneurship is outdated. 70% of the sample stated that economic crisis will bring out more women entrepreneurs despite the realized risks associated with new business ventures. Finally, the limitations of this work and policy implications are discussed.

Exploring critical delivery selection risk factors for transportation design and construction projects

Purpose – The purpose of this paper is to investigate the impact of risk on the project delivery selection process of three primary methods in use in the USA, including design-bid-build (DBB); design-build (DB); and construction manager/general contractor (CMGC). Design/methodology/approach – The review of empirical studies, national survey questionnaire, multivariate analysis, and cross-validating discussion are adopted for this research. The risk factors were identified through an exhaustive literature review and empirical studies that included more than $10 billion of transportation projects. Experts with an average of 25 years of professional experience related to risk and project delivery methods in the transportation industry were invited to participate in the survey. Findings – There were six critical risk factors for DBB, seven for DB, and six for CMGC. These critical risk factors are ranked differently from each delivery method. The most critical risk factor for DBB is construction risk, for DB is scope risk, and for CMGC is constructability and documentation risk. Research limitations/implications – Knowledge of the risk factors will allow researchers to better understand the impact of risk on DBB, DB, and CMGC projects. The chief limitation of this research is that the primary data were mostly opinions from experts although several empirical data were collected for cross-validation. The future research may take into account the role of participant's risk aversion in project delivery decision frameworks. Practical implications – Transportation agencies and other practitioners can use these risk factors to make more effective and defensible decisions on which delivery method is the most suitable for their projects. The result from this study provides a foundation for decision makers to use a risk-based approach in the project delivery decision. Originality/value – This research is the first attempt to examine the impact of risk on the project delivery selection process.

UK doctors and equal opportunities in the NHS: national questionnaire surveys of views on gender, ethnicity and disability.

To seek doctors' views about the NHS as an employer, our surveys about doctors' career intentions and progression, undertaken between 1999 and 2013, also asked whether the NHS was, in their view, a good 'equal opportunities' employer for women doctors, doctors from ethnic minority groups and doctors with disabilities. Surveys undertaken in the UK by mail and Internet. UK medical graduates in selected graduation years between 1993 and 2012. Respondents were asked to rate their level of agreement with three statements starting 'The NHS is a good equal opportunities employer for…' and ending 'women doctors', 'doctors from ethnic minorities' and 'doctors with disabilities'. Of first-year doctors surveyed in 2013, 3.6% (78/2158) disagreed that the NHS is a good equal opportunities employer for women doctors (1.7% of the men and 4.7% of the women); 2.2% (44/1968) disagreed for doctors from ethnic minorities (0.9% of white doctors and 5.8% of non-white doctors) and 12.6% (175/1387) disagreed for doctors with disabilities. Favourable perceptions of the NHS in these respects improved substantially between 1999 and 2013; among first-year doctors of 2000-2003, combined, the corresponding percentages of disagreement were 23.5% for women doctors, 23.1% for doctors from ethnic minorities and 50.6% for doctors with disabilities. Positive views about the NHS as an equal opportunities employer have increased in recent years, but the remaining gap in perception of this between women and men, and between ethnic minority and white doctors, is a concern.

Demographic characteristics of doctors who intend to follow clinical academic careers: UK national questionnaire surveys

ObjectivesIt is well recognised that women are underrepresented in clinical academic posts. Our aim was to determine which of a number of characteristics—notably gender, but also ethnicity, possession of an...

Workplace violence against clinicians in Cypriot emergency departments: a national questionnaire survey.

To identify perceived prevalence, characteristics, precipitating factors and suggestions for improving workplace violence in all nine public emergency departments in the Cyprus Republic. Workplace violence is a common phenomenon in emergency departments, but little is known about this phenomenon in Cyprus. A retrospective cross-sectional survey. Two hundred and twenty of 365 emergency nurses (85·7%) and doctors (14·3%) participated in this study, of which 62% were female. Data were collected via a Greek language version of the Violent Incident Form. Additional questions examined perceived frequencies, encouragement for reporting, satisfaction with actions taken and suggestions for improvement. Descriptive analysis, chi-square tests and multiple logistic regression analyses were used to describe and associate characteristics with workplace prevalence. During the previous 12 months, the vast majority of nurses and doctors (76·2%) were exposed to verbal abuse (88·8%), mainly by relatives or friends of the patient (59·1%). Relatively inexperienced clinicians were at greater risk. Waiting time was identified as the most significant organisational factor. Alcohol intoxication, substance abuse and mental illness were individual factors for workplace violence. Severe underreporting (72·2%) and a belief that workplace violence is part of the work (74·1%) were also identified. Workplace violence was highly correlated with several factors, including a lack of encouragement for reporting, a feeling in advance that a violent incident was about to happen and having to handle the incident personally. Suggestions for improvement included more security measures (26·7%) and public education about the proper use of emergency services (15·2%). Verbal abuse is common in Cypriot emergency departments, but clinicians are increasingly worried about physical assaults. Training, security policies, encouragement of reporting and support for staff after a violent incident are needed. Future research should try to include the perpetrator's viewpoint.

Skin reactions amongst Greek endodontists: a national questionnaire survey.

To investigate amongst Greek endodontists in the past 5years the prevalence, aetiologic factors, severity and treatment for skin reactions. One hundred and 47 endodontists met the inclusion criteria and were invited to participate in the survey. Participants were asked for personal/professional data, prevalence, aetiologic factors, symptoms, severity and treatment for skin reactions in the past 5years. The type of gloves used and frequency of hand washing as well as information on history of atopy and eczema were also recorded. Data were analysed using chi-square test and independent samples t-test. The level of significance was set at P=0.05. The response rate was 84%. Skin reactions were reported by 32.5% of participants. Hands were the body part most frequently affected (66% of cases); glove powder accounted for 73% of skin reactions. Medical care was sought by 28.2% of the affected participants. Endodontists with a history of atopy (P<0.001) and dermal eczema (P<0.001) as well as females (P=0.023) were more likely to report skin reactions. Replacement of powdered latex gloves with powder-free or vinyl/nitrile gloves, avoidance of potential allergens and use of pharmaceutical ointments were adopted by 48.7%, 23.1% and 2.6% of the affected endodontists, respectively, to manage skin reactions. Approximately one-third of participants reported skin reactions. History of atopy and dermal eczema as well as gender was significantly associated with such reactions. The use of powder-free latex gloves instead of powdered ones was the measure most frequently adopted to manage reactions.

A national questionnaire survey of consultants and middle grade doctors' perception of foundation doctors in obstetrics and gynaecology in the United Kingdom.

The aim of this study was to compare foundation doctors in obstetrics and gynaecology to the former grade of senior house officer, as perceived by their consultant and middle grade colleagues. A self-construct questionnaire was sent to College District Tutors in obstetrics and gynaecology in all hospitals in the United Kingdom, for circulation to all consultants and middle grade doctors in obstetrics and gynaecology in their departments. A total of 155 questionnaires were returned, 143 completed and 12 indicating not having foundation doctors. Whilst about 50 % of respondents ranked the competencies of foundation year doctors as similar to that of the former senior house officer grade, the ratings were down in areas specific to obstetrics and gynaecology, such as seeing new patients in antenatal clinic, and up in general terms such as communication. General comments highlighted differences in ability and role and suggested longer attachments and less frequent changes in training structure. The study highlighted the need to focus on teaching generic skills in shorter durations and reflection on whole-patient management, which are relevant to all specialities. It underlined the impact of more frequent change of doctors on service delivery and recommended having a further look at foundation training programme before making any future changes.

A cross-sectional national questionnaire survey assessing the clinical attitudes of members of the British Menopause Society to the management of women with premature ovarian insufficiency.

To explore the current clinical attitudes of members of the British Menopause Society to the management of premature ovarian insufficiency. An electronic cross-sectional questionnaire survey. Members of the British Menopause Society. All members of the British Menopause Society with a valid email address. Completion of an electronic survey. Investigations and treatment options and preferences for the management of women with premature ovarian insufficiency. A total of 130 questionnaires were returned and analysed. The majority of responses were from Hospital Consultants (n = 55/130; 42.3%). A total of 53/124 (42.7%) clinicians routinely performed a bone density scan. A total of 73/130 (56.2%) clinicians would prescribe hormone replacement therapy in preference to combined ethinyl estradiol and progesterone (COC; 27/130, 20.8%). A total of 44/108 (40.7%) routinely prescribed oral estradiol in preference to transdermal administration (62/108, 57.4%). A total of 26/128 (20.3%) prescribed oral micronised progesterone, 31/128 (24.2%) oral progestogens, while 42/128 (32.8%) preferred the intra-uterine system. Fertility concerns remain an important aspect of care, with 33.9% (n = 39/115) of clinicians indicating that more than 50% of their patients had a concern regarding their fertility. The majority of clinicians indicated a preference for hormone replacement therapy instead of the COC as their choice of hormone replacement in women with premature ovarian insufficiency. However, there was a significant variation in practices. This information can be useful in counselling women and in guiding clinical practitioners. The results highlight the need for further research to determine the optimal regimens for the management of women with premature ovarian insufficiency.

Nursing doctoral faculty perceptions of factors that affect their continued scholarship.

This focus group study was undertaken as part of a larger investigation of how the demand for increased production of nurses with doctorates affects doctoral faculty's scholarly productivity. This study provided a basis for development of the national survey questionnaire. Two focus groups that included 29 faculty teaching in doctor of philosophy and/or doctor of nursing practice programs took place at one of two national conferences. The focus group interviews were transcribed and content analyzed for the identification of themes; all members of the research team reached consensus. The three major themes were the demands of teaching, the importance of institutional structure and climate, and the sustainability of one's self, the institution, and the discipline. Participants identified strategies for enhancing scholarly productivity. Findings are limited by the small sample size and the voluntary participation of conference attendees. The strength of emotion that participants revealed underscores the need for nursing leaders to address the increasing academic expectations for faculty. If the profession does not address the needs of its current and future faculty, goals explicated by the Institute of Medicine in The Future of Nursing cannot be achieved, and the health of the nation will suffer.

Compliance with Guidelines Recommending the Use of Simulation for Neonatal and Infant Resuscitation Training in Austria

Current international resuscitation guidelines recommend simulation for the training of neonatal and infant resuscitation. We aimed at assessing compliance rates with these recommendations in Austria. We performed a national questionnaire survey among 31 neonatal institutions in Austria. 25 questionnaires (80.6%) were analyzed. 22/25 institutions (88%) used simulation as an instructional modality. 8 institutions (32%) had access to medical simulation centers, with 6/8 being used for neonatal and infant resuscitation training. Simulation equipment was available at 17/25 institutions (68%), with a median of 1 part-task trainer (0-2), 2 low-fidelity resuscitation mannequins (0-10), and 0 high-fidelity patient simulators (0-7). Resuscitation training frequency varied widely, ranging from one training per month to one training per year. 5 simulation centers utilized interdisciplinary resuscitation training with other medical specialties and team training including physicians and nursing staff. Of the 17 institutions with simulation equipment at their disposal, 8 (47.1%) carried out interdisciplinary training and 13 (76.5%) performed team-oriented training sessions. The majority of surveyed institutions adopted simulation for neonatal and infant resuscitation training according to current guidelines and had simulation equipment at their disposal. However, educational practice varied widely, especially in regard to training frequency. Therefore, we suggest a national consensus agreement on best practices in simulation-based neonatal and infant resuscitation training.

Sustainability performance measurement framework for PFI projects in the UK

Purpose – The relationship between sustainable development and private finance initiative (PFI) procurement systems is clarified, and the current debate on the effectiveness of PFI in the UK and the benefits of PFI to deliver sustainable construction is reviewed. The study develops a sustainability assessment framework encompassing environmental, economic, social and technical aspects through the life cycle of the procurement process. The paper aims to discuss these issues. Design/methodology/approach – A comprehensive literature review develops a conceptual sustainability performance indicators framework. A national questionnaire survey measures existing PFI projects' sustainability performance level. Findings – The study provides empirical insights about key performance indicators of sustainable PFI project development and a benchmarking for existing PFI project performance measurement. It suggests that successful sustainable PFI projects should integrate technical aspects into the traditional three dimensions sustainability model and achieve a balance between social and economic performance. Research limitations/implications – Because of the chosen research approach, the research results may lack in-depth analysis of individual projects. Therefore, researchers are encouraged to test the framework further. Practical implications – The sustainability indicator framework proposed in this paper is readily applicable in PFI projects, as well as other types of PPP projects. Originality/value – This paper fulfils an identified need to study how the sustainability performance levels achieved could be effectively measured within PFI/PPP projects; while contributing to the debate on benchmarking and measuring sustainability performance in construction.

Utilization and impact on fellowship training of non-physician advanced practice providers in intensive care units of academic medical centers: a survey of critical care program directors

BackgroundNon-physician advanced practice providers (APPs) such as nurse practitioners and physician assistants are being increasingly utilized as critical care providers in the United States. The objectives of this study were to determine the utilization of APPs in the intensive care units (ICU)s of academic medical centers (AMCs) and to assess the perceptions of critical care fellowship program directors (PDs) regarding the impact of these APPs on fellowship training. MethodsA cross-sectional national survey questionnaire was distributed to program directors of 331 adult Accreditation Council for Graduate Medical Education-approved critical care fellowship training programs (internal medicine, anesthesiology and surgery) in US AMCs. ResultsWe received 124 (37.5%) PD responses. Of these, 81 (65%) respondents indicated that an APP was part of the care team in either the primary ICU or any ICU in which the fellow trained. The majority of respondents reported that patient care was positively affected by APPs with nearly two-thirds of PDs reporting that fellowship training was also positively impacted. ConclusionsOur survey revealed that APPs are utilized in a large number of US AMCs with critical care training programs. Program director respondents believed that patient care and fellowship training were positively impacted by APPs.

Gender, ethnicity and graduate status, and junior doctors’ self-reported preparedness for clinical practice: national questionnaire surveys

Medical schools need to ensure that graduates feel well prepared for their first medical job. Our objective was to report on differences in junior doctors' self-reported preparedness for work according to gender, ethnicity and graduate status. Postal and electronic questionnaires. UK. Medical graduates of 2008 and 2009, from all UK medical schools, one year after graduation. The main outcome measure was the doctors' level of agreement with the statement that 'My experience at medical school prepared me well for the jobs I have undertaken so far', to which respondents were asked to reply on a scale from 'strongly agree' to 'strongly disagree'. Women were slightly less likely than men to agree that they felt well prepared for work (50% of women agreed or strongly agreed vs. 54% of men), independently of medical school, ethnicity, graduate entry status and intercalated degree status, although they were no more likely than men to regard lack of preparedness as having been a problem for them. Adjusting for the other subgroup differences, non-white respondents were less likely to report feeling well prepared than white (44% vs. 54%), and were more likely to indicate that lack of preparedness was a problem (30% non-white vs. 24% white). There were also some gender and ethnic differences in preparedness for specific areas of work. The identified gender and ethnic differences need to be further explored to determine whether they are due to differences in self-confidence or in actual preparedness.

Why do nursing students not want to work in geriatric care? A national questionnaire survey

BackgroundGiven the severe shortage of nurses in geriatric care in Israel and the planned expansion of their role in the care of older people, the Israel Ministry of Health's Nursing Division decided to investigate the readiness of current students to work in geriatrics. ObjectivesTo gather last-year student nurses’ views on geriatric nursing as a career choice and identify the factors behind those views. DesignA cross-sectional questionnaire study was designed. Settings and participants486 students (70% of the total last-year student nurse population) across the whole range of study settings completed the questionnaire in 2011. MethodsOn the basis of extensive data collection from focus groups of student nurses and working geriatric nurses a structured, self-administered questionnaire was compiled. The researchers distributed and collected the questionnaire in the students’ classrooms. Results61% of the 486 respondents had no intention of working in geriatrics while 12% considered the prospect favourably. 27% of the respondents were prepared to consider geriatric nursing as a career choice only after advanced specialist training in that field. 69% said that the planned expansion of the powers of geriatric nurses would incline them more favourably to work in geriatrics.A relatively high proportion of those interested in working in geriatrics were men. The students’ appraisal of the content of their training programme and of the current state of geriatrics in Israel appeared not to influence career choice. Multiple regression analysis found that the factors most predictive of geriatric care as a career choice were a generally favourable attitude to older people, the expansion of nurse powers in the sector and previous experience in older people care. Studying on an academic programme as opposed to a diploma programme was a negative predictor. ConclusionsThe non-influence of training programme content/design is the key finding. The chief recruitment effort should be invested in making the domain of geriatric nursing more attractive to nurses by improving its pay structure and expanding the powers of geriatric nurses to the level of Clinical Nurse Specialist, which would provide an attractive promotion track.

Incidence of and risk factors for hepatocellular carcinoma in primary biliary cirrhosis: National data from Japan

Primary biliary cirrhosis (PBC) primarily affects females and is rarely complicated by hepatocellular carcinoma (HCC). Although the HCC incidence in PBC patients is low, several characteristics and risk factors associated with its development have been reported. In this study, national data concerning the current status of carcinogenesis in PBC patients in Japan are reviewed. Using data from two national questionnaire surveys, we investigated the clinicopathological findings associated with HCC in PBC patients. According to the data of all reviewed PBC patients, the HCC incidence was 2.4% (71/2946). The HCC incidence by gender was 5.1% (19/370) in males and 2.0% (52/2576) in females, and the proportion of males was 26.7%. Prognosis was significantly poorer in the PBC patients with HCC than in those without. Multivariate analysis of risk factors associated with HCC by gender revealed histological stage at the time of PBC diagnosis as an independent risk factor associated with the development of HCC in females, but not in males. Furthermore, data from another national survey of 178 PBC patients with HCC (male/female = 49/129; proportion of males 27.5%) revealed that the duration between the diagnosis of PBC and that of HCC was significantly shorter in males than in females. In addition, histological stage at the time of HCC diagnosis was an independent risk factor for HCC in females, whereas no risk factors were identified in males. these data indicate that males are at risk of developing HCC at any histological stage of PBC. Therefore, male PBC patients in particular should be carefully screened for HCC from the early stages of PBC.

On the Budgetary Supervision of Local People’s Congress in China

Strengthening the budgetary supervision of the local People’s Congress is essential not merely to the deepening of budgetary reform but also to the improvement of the People’s Congress system and socialist democracy. Budgetary supervision by the People’s Congress comprises three elements: information, dialogue and enforcement. A national questionnaire survey based on these three elements shows that with the deepening of budgetary reform, the budgetary supervision of the People’s Congress has undergone a shift from procedural to substantive oversight. Nevertheless, it still faces a number of challenges at local level. In the forthcoming reforms, budgetary supervision by the People’s Congress should be strengthened to make local governments more accountable to the people.

Selection of medicines in Chilean public hospitals: an exploratory study

BackgroundThere is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD.MethodsA combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees). Interviews were conducted with key actors in the selection of medicines in large urban public hospitals.ResultsThe national survey had an overall response rate of 42% (83 out of 196), whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties.The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used.ConclusionsThere is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical needs of doctors, training members in the analysis of scientific evidence beyond their own specialities. An influential PTC can take the appropriate measures and design workable policies to enforce a cost effective-use of resources.

Total prohibition of smoking but not partial restriction effectively reduced exposure to tobacco smoke among restaurant workers in Finland

To assess work-related exposure to tobacco smoke in Finnish restaurants, a series of nationwide questionnaire surveys were conducted among restaurant workers and the levels of indoor air nicotine concentrations were measured in restaurants. The survey aimed to evaluate the impact of the smoke-free legislation in general and in particular after the total smoking ban launched in 2007. In 2003-2010, four national questionnaire surveys were conducted among restaurant workers and the concentration of nicotine in indoor air was measured in different types of restaurants, bars and nightclubs. Between 2003 and 2010, the proportion of restaurant workers reporting occupational exposure to tobacco smoke dropped from 59% to 11%. Among pub workers, the decrease was from 97% to 18% and in workers of dining restaurants from 49% to 10%, respectively. The median concentration of nicotine in indoor air of all restaurants decreased from 11.7 μg/m(3) to 0.1 μg/m(3). The most significant decrease was detected in pubs where the decrease was from 16.1 μg/m(3) to 0.1 μg/m(3). Among all restaurant workers, in 2003-2010 the prevalence of daily smokers was reduced from 39% to 31% in men and from 35% to 25% in women. Total prohibition of smoking but not partial restriction in restaurants was effective in reducing work-related exposure to tobacco smoke. Strict tobacco legislation may partly be associated with the significant decrease of daily smoking prevalence among restaurant workers.

P84 Utility Values For COPD Patients Based on the EQ-5D Questionnaire from Three Indacaterol Phase III Studies

Introduction and ObjectivesChronic obstructive pulmonary disease (COPD) is characterised by airflow limitation that is not fully reversible and disabling symptoms such as breathlessness and COPD exacerbations, which have a negative...