Nationwide Survey Study Research Articles

Investigation into the effects of COVID-19 on the Mobility Preferences and Challenges amongst Senior U.S. Citizens: Insights from a Nationwide Survey Study

Seniors’ mobility decreases as they age as a result of deteriorating health and restricted travel alternatives. Consequently, it is imperative that their transportation needs be met, particularly when they are at risk because of pandemics like COVID-19. This study aims to examine older U.S. citizens’ (65 years and older) travel behavior and challenges before and during COVID-19 through conducting a nationwide online survey that collected responses from 1,507 senior U.S. citizens. The McNemar-Bowker test and Ordered Probit Modeling were employed to assess the differences in their travel behavior and factors determining their mobility satisfaction during COVID-19. The findings indicate that there was a considerable reduction in the frequency of work-related, shopping, medical, leisure, and social/religious trips during COVID-19. In addition, the frequency of all travel modes usages declined significantly except for paratransit and motorcycle. Senior U.S. citizens’ travel choices during COVID-19 were largely influenced by their safety and security, virus infection concern, and comfort and convenience. Seniors mostly preferred to use their private vehicles during COVID-19. Accessibility, reliability, and flexibility were the greatest concerns of seniors about using public transit. Moreover, seniors’ satisfaction with their mobility depended on their physical mobility challenges, family size, subregional locations, length of driving, decline in their driving skills and abilities as they aged, preference to use private cars as the most affordable and reliable modes, and extra expenditure they made on their travels during COVID-19. Finally, several actionable countermeasures have been suggested in this study to improve the mobility of seniors.

Relationship between serum neurofilament light chain protein and depression: A nationwide survey and Mendelian randomization study

BackgroundInvestigating the link between serum neurofilament protein (sNfL) levels and depression remains an area of limited understanding. This study explores the correlation in US adults and employs Mendelian randomization (MR) to ascertain causality. MethodsOur cross-sectional study analyzed data from participants aged 20 and above in the National Health and Nutrition Examination Survey (2013–2014). We employed a weighted multiple logistic regression model to examine the relationship between ln (sNfL) and depression. Restricted cubic splines (RCS) were used to visualize non-linear relationships. Stratified analyses examined associations between ln(sNfL) and depression in different subgroups. Subsequently, we conducted a two-sample bidirectional Mendelian randomization (MR) to assess the causal relationship between sNfL and depression. The inverse variance-weighted (IVW) method was utilized as the primary analysis. ResultsAmong 1765 participants (mean age 45.19 years; 49.37 % male), 166 had depression with a Patient Health Questionnaire (PHQ-9) score ≥ 10. After adjusting for covariates, a positive correlation remained between sNfL and depression (OR 1.511, 95 % CI: 1.050–2.175). RCS curves indicated a non-linear association, with a turning point at 2.76 pg/ml. Stratified analyses revealed positive correlations in specific subgroups, with interactions involving age, race, family income, recreational activity, and ln(sNfL). MR using IVW found no significant causal relationship between sNfL and depression genetically (OR = 0.956, 95 % CI: 0.878–1.042), with reverse analysis yielding similar results (OR = 0.897, 95 % CI: 0.756–1.065). ConclusionsThis cross-sectional study highlights a significant correlation between ln(sNfL) and depression. However, MR results indicate no causal relationship between sNfL and depression.

Over-the-Counter Hearing Aids: A Nationwide Survey Study to Understand Perspectives in Primary Care.

The expansion of over-the-counter (OTC) hearing aids has raised inquiries regarding primary care physicians' (PCP) knowledge, perspective, and perceived roles. We aimed to understand PCP perspectives on OTC hearing aids via nationwide online surveys. RedCap survey was distributed to PCPs via online forums and public mailing lists. Outcomes included PCPs' attitudes toward, perceived role surrounding, confidence managing, and knowledge of OTC hearing aids. Regression analyses were performed to identify associated factors including demographics and practice characteristics. Cohort included 111 PCPs primarily working in non-rural (83.8%) outpatient academic medical centers (47.5%), with a mean (SD) of 16.9 (11.6) years practicing. Most reported unfamiliarity (61.3%) with OTC hearing aids but viewed them positively (91.9%). They often perceived themselves as poor sources of OTC hearing aid information (63.1%) but desired involvement (90.1%) and believed associated knowledge is important (98.2%). Rural practice environment was associated with less familiarity toward OTC hearing aids (β = -0.72, [95% CI -1.40 to -0.04]). Respondents answered 5.0 (2.4) of 10 OTC hearing aid knowledge questions correctly. Using 5-point Likert scale, participants reported most confidence recognizing signs/symptoms of hearing loss 3.71 (0.84), but less confidence educating 1.68 (0.96) about and determining candidacy 1.72 (1.05) for OTC hearing aids. Participants reported continuing medical education courses and published guidelines would effectively improve their OTC hearing aid knowledge. PCPs displayed positive attitudes toward OTC hearing aids and valued involvement. Addressing unfamiliarity/knowledge gaps surrounding OTC hearing aids through courses and published guidelines may help clarify misconceptions and promote hearing health care. NA Laryngoscope, 2024.

Prävalenz ausgewählter Erkrankungen bei prähospitalen Rettungskräften in Deutschland

Prevalence of selected diseases among pre-hospital emergency services personnel in Germany – results of the EMS Health Study 2023 Objective: The health of pre-hospital emergency medical services (EMS) staff is crucial for the provision of high-quality medical care. However, currently only limited data on the health monitoring of German EMS staff is available. The aim of the study was therefore to analyse the 12-month prevalence of selected diseases and symptoms among German EMS staff. Methods: A nationwide survey study was conducted. Questions from the GEDA2019/2020 study were used to collect information on the health status of EMS staff. Subsequently, 12-month prevalences were calculated with the corresponding 95 % confidence intervals (95 % CI). Results: In the end, 1,171 active German EMS staff (67.9 % male/31.9 % female) with a median age of 32.0 years were included in the analysis. The results indicate that excess weight and obesity are common health problems among EMS staff, with men (68.4 % [95 % CI: 64.8 %; 71.4 %]) being more affected than women (45.0 % [95 % CI: 39.9 %; 50.2 %]). The highest 12-month prevalence was calculated for lower back pain (51.8 % [95 % CI: 48.9 %; 54.7 %]), followed by pain in the cervical spine (41.9 % [95 % CI: 39.1 %; 44.8 %]), allergies (34.1 % [95 % CI: 31.4 %; 36.9 %]), hypertension (19.1 % [95 % CI: 16.9 %; 21.5 %]) and depression (16.2 % [95 % CI: 14.2 %; 18.5 %]). Compared to the German general population, the 12-month prevalence of obesity, asthma, COPD, hypertension, elevated blood lipid levels, arthritis, depression and obesity was higher for certain gender and age groups of emergency workers. Conclusion: The result of this study indicate a poor health state among German pre-hospital EMS staff and the need for preventive measures. Keywords: 12-month prevalence – emergency medical services – health – obesity – epidemiology

Management of Stress Urinary Incontinence by Obstetricians and Gynecologists in Jordan: A Nationwide Survey Study.

Stress urinary incontinence (SUI) is a common condition that can significantly impact a patient's quality of life. Although multiple diagnostic and treatment options exist, significant variability in SUI management exists between countries. Since women's SUI prevalence in Jordan is high, and Jordan is a lower-middle-income country, this study aimed to investigate how obstetricians and gynecologists (OBGYNs) across Jordan manage and treat women with SUI. A Google Forms survey was prepared and sent out to Jordanian OBGYNs via WhatsApp. The results were collected and arranged in Microsoft Excel and then transferred to SPSS for statistical analysis. Out of the 804 Jordanian registered OBGYNs, 497 could be reached, 240 conduct gynecological surgeries, and 94 completed the survey, providing a response rate of 39.2%. Most of the respondents were females between 41 and 55 years old. More than 70% of the OBGYNs worked in the private sector, and 88.3% operated in the capital of Jordan. Most of the respondents favored lifestyle and behavior therapy (43.6%) or pelvic floor physiotherapy (40.4%) as the first-line management for SUI. The transobturator mid-urethral sling (MUS) was the most common initial surgical treatment option. The physicians preferred two-staged procedures for the repair of pelvic organ prolapse alongside concomitant SUI. In the case of recurrent SUI following surgery, 77% of the respondents chose to refer to a urologist or urogynecologist. The Jordanian OBGYNs preferred using lifestyle/behavioral therapy and pelvic floor muscle physiotherapy as the first-line treatment to manage SUI. Secondly, the MUS would be the most frequently preferred surgical choice. To effectively manage SUI, adequate training in urogynecology and referral resources are essential in lower-middle-income countries.

Trend analysis of pharmacist involvement in cancer care in Japan from 2015 to 2020: A nationwide survey study on hospital pharmacy practice.

Pharmacists are needed as members of oncology teams. The Japanese Society of Hospital Pharmacists (JSHP) conducts a nationwide survey annually to analyze the actual situation and generate fundamental information about hospital pharmacy practice in Japan. Using data from this large-scale survey, we described pharmacists' involvement in cancer chemotherapy. We explored the factors related to the acceleration of pharmacists' tasks or involvement in clinical practice, primarily in oncology. Data were obtained from annual surveys conducted by JSHP from 2015 to 2020. All variables were expressed as categorical variables and tabulated. The Chi-square and Fisher's exact tests were used to compare the categorical variables. The Cochran-Armitage trend test was used to identify significant trends. From 2015 to 2020, 22,362 responses were recorded. After applying the exclusion criteria, 20,906 were analyzed. The proportion of hospitals enrolling pharmacists with oncology-related certifications significantly increased in all hospitals providing cancer care. Multivariable logistic regression analysis indicated that a smaller number of beds per pharmacist significantly correlated with additional fees for outpatient pharmacy services (p = 0.0002 for trend). Hospitals charging increased fees for outpatient oncology pharmacy services were associated with a smaller number of beds per pharmacist, regardless of hospital size. A balance between the number of beds and pharmacists, particularly certified oncology pharmacists, is crucial for safe and high-quality cancer treatment.

Offering extended use of the contraceptive implant via an implementation science framework: a qualitative study of clinicians’ perceived barriers and facilitators

BackgroundThe etonogestrel contraceptive implant is currently approved by the United States Food and Drug Administration (FDA) for the prevention of pregnancy up to 3 years. However, studies that suggest efficacy up to 5 years. There is little information on the prevalence of extended use and the factors that influence clinicians in offering extended use. We investigated clinician perspectives on the barriers and facilitators to offering extended use of the contraceptive implant.MethodsUsing the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured qualitative interviews. Participants were recruited from a nationwide survey study of reproductive health clinicians on their knowledge and perspective of extended use of the contraceptive implant. To optimize the diversity of perspectives, we purposefully sampled participants from this study. We used content analysis and consensual qualitative research methods to inform our coding and data analysis. Themes arose deductively and inductively.ResultsWe interviewed 20 clinicians including advance practice clinicians, family medicine physicians, obstetrician/gynecologist and complex family planning sub-specialists. Themes regarding barriers and facilitators to extended use of the contraceptive implant emerged. Barriers included the FDA approval for 3 years and clinician concern about liability in the context of off-label use of the contraceptive implant. Educational materials and a champion of extended use were facilitators.ConclusionsThere is opportunity to expand access to extended use of the contraceptive implant by developing educational materials for clinicians and patients, identifying a champion of extended use, and providing information on extended use prior to replacement appointments at 3 years.

The burden and management competency of cardiomyopathies in China: a nationwide survey study

The public health burden of cardiomyopathies and competency in their management by health agencies in China are not well understood. This study adopted a multi-stage sampling method for hospital selection. In the first stage, nationwide tertiary hospital recruitment was performed. As a result, 88 hospitals with the consent of the director of cardiology and access to an established electronic medical records system, were recruited. In the second stage, we sampled 66 hospitals within each geographic-economic stratification through a random sampling process. Data on (1) the outpatient and inpatient visits for cardiomyopathies between 2017 and 2021 and (2) the competency in the management of patients with cardiomyopathies, were collected. The competency of a hospital to provide cardiomyopathy care was evaluated using a specifically devised scale. The outpatient and inpatient visits for cardiomyopathies increased between 2017 and 2021by 38.6% and 33.0%, respectively. Most hospitals had basic facilities for cardiomyopathy assessment. However, access to more complex procedures was limited, and the integrated management pathway needs improvement. Only 4 (6.1%) of the 66 participating hospitals met the criteria for being designated as a comprehensive cardiomyopathy center, and only 29 (43.9%) could be classified as a primary cardiomyopathy center. There were significant variations in competency between hospitals with different administrative and economic levels. The health burden of cardiomyopathies has increased significantly between 2017 and 2021 in China. Although most tertiary hospitals in China can offer basic cardiomyopathy care, more advanced facilities are not yet universally available. Moreover, inconsistencies in the management of cardiomyopathies across hospitals due to differing administrative and economic levels warrants a review of the nation allocation of medical resources. This work was supported by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (2023-I2M-1-001) and the National High Level Hospital Clinical Research Funding (2022-GSP-GG-17).

Significance of definitive concurrent chemoradiotherapy for vulvar cancer: a Japanese Gynecologic Oncology Group nationwide survey study

ObjectiveThis study aimed to show the results of radical radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) for vulvar cancer (VC) based on data from a Japanese nationwide survey.Materials and methodsWe collected data from 108 institutions on cases of VC diagnosed between January 2001 and December 2010. Patients with histologically proven squamous cell carcinoma and adenocarcinoma with curative intent were selected, and 172 patients with VC were included in this study. The collected data were analyzed for overall survival (OS) using the Kaplan–Meier method. Univariate and multivariate analyses were performed to examine the prognostic factors for patients with VC.ResultsThe median follow-up period was 16.8 (range; 3.2–154.8) months. Fifty-five patients received CCRT, and 117 patients received RT alone. The 2-year OS rates (95% confidence interval [CI]) for stages I, II, III, and IV were 77.9% (55.8–100.0), 71.9% (53.8–89.9), 55.4% (42.5–68.3), and 41.5% (27.3–55.7) respectively. Univariate analyses showed that the FIGO stage (p = 0.001), tumor diameter (p = 0.005), and lymph node (LN) status (p = 0.001) were associated with OS. The concurrent use of chemotherapy resulted in a significantly longer OS in Stage III (p = 0.013). Multivariate analysis showed that the hazard ratios (95% CI) for tumor diameter, positivity for LN metastasis, and RT alone (no concurrent chemotherapy) were 1.502 (1.116–2.021), 1.801 (1.287–2.521), and 1.936 (1.187–3.159), respectively.ConclusionsOur analysis revealed that CCRT should be recommended, especially for Stage III VC patients. Further studies are warranted to determine who benefits from CCRT, considering primary tumor size and LN status.The study was registered at the University Hospital Medical Information Network (protocol number: UMIN000017080) on April 8th, 2015.

A Nationwide Survey Study of Recovery Community Centers Supporting People in Recovery From Substance Use Disorder.

The medical community has become aware of its role in contributing to the opioid epidemic and must be part of its resolution. Recovery community centers (RCCs) represent a new underused component of recovery support. This study performed an online national survey of all RCCs identified in the United States, and used US Census ZIP code tabulation area data to describe the communities they serve. Residents of areas with RCCs were more likely to be Black (16.5% vs 12.6% nationally, P = 0.005) and less likely to be Asian (4.7% vs 5.7%, P = 0.005), American Indian, or Alaskan Native (0.6% vs 0.8%, P = 0.03), or live rurally (8.5% vs 14.0%, P < 0.0001). More than half of RCCs began operations within the past 5 years. Recovery community centers were operated, on average, by 8.8 paid and 10.2 volunteer staff; each RCC served a median of 125 individuals per month (4-1,500). Recovery community centers successfully engaged racial/ethnic minority groups (20.8% Hispanic, 22.5% Black) and young adults (23.5% younger than 25 years). Recovery community centers provide addiction-specific support (eg, mutual help, recovery coaching) and assistance with basic needs, social services, technology access, and health behaviors. Regarding medications for opioid use disorder (MOUDs), RCC staff engaged members in conversations about MOUDs (85.2%) and provided direct support for taking MOUD (77.0%). One third (36.1%) of RCCs reported seeking closer collaboration with prescribers. Recovery community centers are welcoming environments for people who take MOUDs. Closer collaboration between the medical community and community-based peer-led RCCs may lead to significantly improved reach of efforts to end the opioid epidemic.

An exploration of the quality of graduates of Philippine teacher education institutions

The study evaluated the quality of graduates of Philippine Teacher Education Institutions (TEIs) through the performance of the graduates in the Board Licensure Examination for Professional Teachers (BLEPT) and the teaching performance of the beginning teachers in their first three years of teaching. A nationwide survey study employing a descriptive cross-sectional design was conducted to 2,680 respondents from 16 regions in the country, selected using a multi-stage approach. Results revealed an increasing trend in the beginning teachers’ performance in the licensure examinations from 2017 to 2019. These teachers were also consistently averaging a rating of Very Satisfactory from 2019 to 2021 in their teaching performance. Furthermore, socio-economic status, grade point average in college, and grade level taught were other factors found to be significant in relation to teaching performance. As a result, a graduate’s score on the teacher licensure exam has an impact on their success during their first three years of teaching. The dimensions of teacher quality in the country are anchored on the alignment of the outcomes and competencies in the written and tested curricula, effective program delivery, and qualified faculty which contribute to the high probability of passing the BLEPT that ultimately results in better teaching performance of beginning teachers. By focusing on these aspects, institutions can play a pivotal role in nurturing highly competent educators who make a lasting impact on the education system. The findings of this study serve as a valuable guide for educational policymakers and institutions striving to elevate the standard of teacher education across the country.

Prevalence and clinical profiles of anti-myelin-associated glycoprotein neuropathy in Japan: A nationwide survey study of 133 patients.

The aim of this study was to determine the prevalence of anti-myelin-associated glycoprotein (MAG) neuropathy and the current status of such patients in Japan. We conducted a nationwide survey in 2021 using established epidemiological methods. Questionnaires were sent to all neurology and pediatric neurology departments throughout Japan to identify patients with anti-MAG neuropathy. An initial questionnaire was used to determine the number of patients, with a second one used to collect detailed clinical information. The estimated number of patients with anti-MAG neuropathy was 353, with a prevalence of 0.28 per 100,000 and an incidence of 0.05 per 100,000. The detailed clinical profiles of 133 patients were available. The median (range) age of onset was 67 (30-87) years, with a prominent peak in the age range 66-70 years, and the male-to-female ratio was 3.6. Most patients had distal sensory-predominant polyneuropathy, and neuropathic pain (50%), or sensory ataxia (42%), while 18% had Waldenström's macroglobulinemia or multiple myeloma. Intravenous immunoglobulin was the most frequently used treatment (65%), but the response rate was <50%, whereas rituximab was given in 32% of patients, and 64% of these showed improvement. At the last visit, 27% of patients could not walk independently. This study on anti-MAG neuropathy provides updated insights into the epidemiology of this disease, clinical profiles, and treatment approaches in Japan. Rituximab therapy, used for only one-third of the patients, demonstrated efficacy. During the final visit, a quarter of the patients were unable to walk independently. Further studies are warranted to determine the optimal management of this rare and intractable disorder.

Early mobilization of patients with subarachnoid haemorrhage: a national survey of french intensive care units.

To describe French intensive care unit practices regarding the mobilization of patients with subarachnoid haemorrhage. A cross-sectional nationwide survey study. Intensivists and physiotherapists or nurses from French intensive care units managing patients with subarachnoid haemorrhage. An online questionnaire survey was distributed through the Neurocritical Care and Neuro Anesthesiology French Speaking Society. The response rate was 89%. Of these, 90% did not have a mobilization protocol for patients with subarachnoid haemorrhage. Sixteen percent of departments prohibited all forms of motor physiotherapy for a predefined period. Nineteen percent systematically prohibited out-of-bed mobilization, regardless of the severity of subarachnoid haemorrhage and in the absence of any complication, for a predefined period. The main factors that would delay or interrupt physiotherapy prescription were intracranial hypertension (79%), currently treated vasospasm (59%), and suspicion of vasospasm (44%). Ninety-one percent of the centres identified at least one complication that could be associated with standing upright. These mainly included decreased cerebral perfusion (71%), dislodged external ventricular or lumbar derivations (68%), and haemodynamic instability (65%). Mobilization of patients with subarachnoid haemorrhage is heterogeneous among French neuro-intensive care units and several barriers preclude improvement of mobilization practices. Interventional studies assessing mobilization practices, as well as education and training of staff, are crucial to ensure the proper management of patients with subarachnoid haemorrhage and to improve outcomes.

Risk Factors for Infertility in Korean Women.

Female infertility is a crucial problem with significant implications for individuals and society. In this study, we explore risk factors for infertility in Korean women. A total of 986 female patients who visited six major infertility clinics in Korea were recruited from April to December 2014. Fertile age-matched controls were selected from two nationwide survey study participants. Conditional logistic regression after age-matching was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of each risk factor for infertility. Women with a body mass index (BMI) < 18.5 kg/m² had 1.35 times higher odds of infertility (OR, 1.35; 95% CI, 1.03-1.77), while those with a BMI ≥ 25.0 kg/m² had even higher odds (OR, 2.06; 95% CI, 1.61-2.64) compared to women with a normal BMI (18.5 kg/m² ≤ BMI < 25 kg/m²). Ever-smokers exhibited 4.94 times higher odds of infertility compared to never-smokers (95% CI, 3.45-8.85). Concerning alcohol consumption, women who consumed ≥ 7 glasses at a time showed 3.13 times significantly higher odds of infertility than those who consumed ≤ 4 glasses at a time (95% CI, 1.79-5.48). Lastly, women with thyroid disease demonstrated 1.44 times higher odds of infertility compared to women without thyroid disease (95% CI, 1.00-2.08). Female infertility in Korea was associated with underweight, obesity, smoking, alcohol consumption, and thyroid disease.

An analysis of attitudes, knowledge, and willingness of Thai pharmacists as vaccinators: A nationwide survey study

AbstractIntroductionDespite the diverse roles of pharmacists in immunization, the vaccinator role remains uncharted for Thai pharmacists. This survey assesses pharmacist attitudes, knowledge, and willingness as vaccinators, providing insights to enhance their pivotal contribution to vaccination outcomes in Thailand.MethodsThe survey encompassed three sections: respondent characteristics, attitudes toward the vaccinator role, and vaccination knowledge. Disseminated via the Pharmacy Council of Thailand (PCT)'s email system, it received 400 valid responses. Descriptive and inferential statistics were employed, including logistic regression to identify factors affecting willingness to become vaccinators (p &lt; 0.05).ResultsThe survey was conducted between January 19, 2023, and February 28, 2023. The respondents, with an average age of 39.8 ± 10.25 years, were predominantly female (54.5%) with bachelor's degrees (68%). Hospital (45%) and community (20.7%) pharmacists were prominent, primarily in the central region (51%). Notably, 12.3% received vaccination training from PCT. Of the respondents, 169 (42.25%) were willing to become vaccinators, while 231 (57.75%) were uncertain or uninterested. Factors driving willingness differed; knowledge and skills for vaccine administration (72.59%) were crucial for those not willing to become vaccinators, while public benefits (73.91%) influenced vaccinators. In multivariate analysis, longer experience (10–19 years) (odds ratio [OR] 2.317; p = 0.009) and vaccination training (OR = 1.926; p = 0.047) were significant factors supporting the decision to become vaccinators. Average vaccination knowledge scores were 5.68 ± 2.63 out of 12 points, slightly higher in the vaccinator group (6 ± 2.3) compared to non‐vaccinators (5.4 ± 2.8) with a significant difference (p = 0.034). Post‐vaccination counseling knowledge was high, but questions related to adverse events following immunization (AEFI) had low correct response rates (12.5%).ConclusionThe study underscores substantial willingness among Thai pharmacists to assume the vaccinator role, revealing influential factors and knowledge gaps. This insight can guide training enhancements and implementation strategies to seamlessly expand pharmacist contributions to vaccination efforts.

Perioperative nutritional practices and attitudes among gastrointestinal oncologic surgeons in Korea: a nation-wide survey study

Perioperative nutritional practices and attitudes among gastrointestinal oncologic surgeons in Korea: a nation-wide survey study

Pregnancy in Medical Training: A Survey of Physician Moms on Their Experiences During Residency and Fellowship

Resident physicians undergo physically and emotionally rigorous training; this is particularly difficult for the pregnant resident and affects their unborn child. This study aims to elucidate pregnant residents' perspectives regarding their prenatal and postnatal experiences, across all specialties, with a focus on pregnancy complications, postpartum health, and policy execution. This is a nationwide cross-sectional survey study developed to characterize resident and fellow perceptions about work schedules while pregnant, perceived discrimination, complications during pregnancy, lactation and lactation support, marital distress, parental leave policy, and overall satisfaction with the parental leave period. Descriptive statistics were used to characterize survey responses. The experiences of physician mothers in online Facebook support groups: Physician Mom Group, Surgeon Mom Group, and Dr Mothers Interested in Lactation Knowledge, were queried by an electronic survey distributed using Qualtrics XM. Physicians who had children during their U.S. residency training were eligible to participate and 1,690 physician mothers from all specialties completed the survey. One thousand six hundred and ninety responses from members of the Facebook support groups were analyzed. Most surveyed physicians (1353/1519, 89.1%) were required to work until delivery and 63.6% (993/1561) of women took in-house calls during the last month of pregnancy. Half (820/1560, 52.6%) thought that the physical demands of their jobs compromised their own health and safety, or that of their child, and 1259 complications were reported among 1690 respondents, an average of three complications for every four respondents. Twenty-nine percent (442/1519, 29.1%) of physician mothers suffered from postpartum depression. Ninety-two percent (1479/1602, 92.3%) of respondents breastfed, but only one-third (483/1456, 33.2%) breastfed for more than 12 months and 52.7% (769/1458) would have liked to breastfeed longer. Marital distress was reported by nearly half (756/1650, 45.8%) of respondents during pregnancy and/or the first year of their child's life due to parental leave policies. The majority (957/1688, 56.7%) did not have a parental leave policy at their institution. Nearly two-thirds (946/1518, 62.3%) of respondents took 6 or fewer weeks off, and 79.7% (1211/1520) felt their duration of time off was inadequate. Nearly 30% (457/1593, 28.7%) stated they would recommend against a female medical student going into their field of medicine based upon their own experiences during pregnancy. Many mothers experienced discrimination from colleagues and worked until delivery despite concerns about the health and safety of themselves or their unborn children, and many reported experiencing a pregnancy-related complication. Most did not have a parental leave policy, which likely contributed to the disproportionately higher rates of postpartum depression among physician mothers compared to the general public. Residency training parental leave policies should be more accommodating to improve mental health, career satisfaction, and retention of the next generation of physician mothers.

Pre-medication Attitudes of Anesthesiologists: A Nationwide Survey Study from Turkey

Objective: This study presents a comprehensive investigation of the demographic data, institutional affiliations, pre-operative evaluations, pre-medication preferences, and induction practices of anesthesiologists in Turkey. This study aimed to examine the implementation of these elements and how they reflect on the attitudes and behaviors of Turkish anesthesiologists, particularly in relation to pre-medication. Methods: This study, conducted between 16.06.2012 and 16.06.2013, utilized an electronic questionnaire distributed to practising anesthesiologists nationwide after approval from the Çanakkale 18 Mart University Clinical Research Ethics Committee. The questionnaire was divided into five sections, encompassing 26 questions addressing demographics, institutional information, pre-anaesthetic assessment data, pre-medication data, and induction data. Results: The survey gathered responses from 419 anesthesiologists across Turkey. Our findings indicated that pre-anaesthetic evaluations were predominantly conducted 2-7 days before elective surgery. There were significant variations in the pre-operative evaluations based on the type of institution, with private sector hospitals being less likely to have a dedicated room for pre-anaesthetic evaluation. The study also revealed differences in pre-medication preferences based on sex and age groups, with midazolam, ketamine, and atropine being the most preferred agents. Interestingly, the location of pre-medication administration varied significantly between private and university hospitals. The predominant motivation for pre-medication was a reduction in patient anxiety. Pediatric anesthesia induction was primarily conducted without the presence of family members, and volatile anesthetic agents were the preferred option. The route of pre-medication administration varied with age, with oral pre-medication being more common in pediatric patients, and intravenous administration being preferred in adults. Concerns about respiratory depression were prevalent after pre-medication. Conclusion: This study emphasizes that pre-operative evaluation and pre-medication are routinely carried out by anesthesiologists in Turkey, although with variations among different types of hospitals. Given the patient safety implications and importance of standardization, this study underscores the need for regular similar surveys to monitor trends and inform practice guidelines.

Current status of vulvar cancer in Japan: analysis of the Japanese Gynecologic Oncology Group nationwide survey study.

This review provides an overview of the current status of vulvar cancer in Japan, focusing specifically on the findings from the Japanese Gynecologic Oncology Group nationwide survey study. The author offers a comprehensive summary of the current status of vulvar cancer in Japan, along with an exploration of the molecular mechanisms underlying the disease. Notably, the review highlights the concerning upward trend of vulvar cancer in older age groups and advanced stages in Japan. The author concludes that addressing these challenges may require the centralization of resources and expertise. By bridging knowledge gaps and identifying areas for improvement, this review contributes to enhancing the understanding and management of vulvar cancer in Japan.

Typology of Dementia-Specific Care Units: A Nationwide Survey Study in Germany.

Dementia-specific care units vary in their organizational characteristics and are difficult to compare in empirical studies. Based on a representative sample of care units in German nursing homes, we present a typology of organizational characteristics focusing on dementia-specific care structures. We also examine the relationships between organizational types and the provision of nonpharmacological interventions for people with dementia. Data were collected in a Germany-wide survey of a stratified randomized sample of 134 care units using a standardized questionnaire administered during telephone interviews with nursing home administrators or their representatives. The typology was developed based on a factor analysis of mixed data and a hierarchical cluster analysis. We identified 4 types of care units: Dementia Care Units (DCUs; n = 40), Dementia Special Care Units (DSCUs; n = 17), Usual Separated Care Units (n = 58), and Usual Incorporated Care Units (n = 19). All care unit types clearly differed in their organizational characteristics. The specialization of DSCUs was agreed upon with cost bearers and included admission criteria, higher costs, and better staff conditions. Dementia Care Units without specialization did not have these characteristics. Three of seven nonpharmacological interventions were associated with the DSCUs and two with DCUs, but not with the other care unit types. Researchers can use the typology to define and describe care units in empirical studies and improve the understanding and comparability of the context. A clear definition of care units also improves international comparisons.