Nationwide Survey Research Articles

PHSOR05 Presentation Time: 9:20 AM: Practice Patterns and Physics Staffing for HDR Brachytherapy: Results of an IROC Nationwide Survey of Medical Physicists

PHSOR05 Presentation Time: 9:20 AM: Practice Patterns and Physics Staffing for HDR Brachytherapy: Results of an IROC Nationwide Survey of Medical Physicists

Association of socioeconomic status with unintended pregnancy and induced abortion in married couples: An analysis of the 2021 national survey data in Japan

BackgroundAn association of the major indicators of socioeconomic status with unintended pregnancy and induced abortion in married couples has not been investigated in Japan, and we investigated it using recent nationwide survey data in Japan. MethodsData from the National Fertility Survey in 2021 in Japan, which evaluated the outcomes and intentions of previous pregnancies in married couples, were used. Number of unintended pregnancies, induced abortions, and unintended pregnancies ending in induced abortion were used as outcomes, and the number of unintended pregnancies ending in induced abortion was analyzed among couples who experienced an unintended pregnancy. Associations with current educational attainment, employment status, and household income were investigated using Poisson regression analysis. A complete-case analysis was conducted for dealing with missing data, as well as an analysis using multiple imputation. ResultsAverage number of unintended pregnancy and induced abortion per pregnancy of junior high school graduates was the highest among educational attainments of wives and husbands. The adjusted regression analysis showed that junior high school graduate in husbands was significantly associated with higher number of unintended pregnancies and induced abortions, regardless of the missing data analysis methods. In addition, high school or training school graduate in husbands was significantly associated with higher number of induced abortions. A significant association between socioeconomic status and the unintended pregnancy ending in induced abortion was not observed. ConclusionThis study showed that a lower educational attainment in husband was associated with higher number of unintended pregnancies and induced abortions in Japan.

Effect of Local Fire Risks and Preventive Measures on the Installation of Residential Firefighting Systems in Detached House

This study analyzes the major factors affecting the installation of residential firefighting systems in detached houses. In particular, it investigates the dependence of local fire risk and local government prevention efforts, along with housing and household characteristics, on the type of installation. This study used data from the 2020 Population and Housing Census, the first nationwide survey on residential firefighter system installation, and employed multinomial logistic regression analysis. The analysis results revealed that less than half of households had installed all firefighting systems, where the installation rate differed significantly by region. Housing and household characteristics also influenced the installation type. Local fire risk as well as the local government’s fire prevention policies positively affect the installation of residential firefighting systems.

Practice patterns for eosinophilic esophagitis vary widely among Canadian gastroenterologists: a nationwide survey

Abstract Introduction Eosinophilic esophagitis (EoE) is a chronic allergic, type 2, immune-mediated condition of the oesophagus, resulting in dysmotility and oesophageal stricturing. This study aims to identify practice variation among Canadian gastroenterologists treating adults with EoE. Methods A cross-sectional, web-based survey was distributed to Canadian gastroenterologists through the Canadian Association of Gastroenterology and administrations of Canadian universities. Results Seventy gastroenterologists completed the survey, with 59% working in academic practice or research. Overall, 90% of gastroenterologists require histological evidence of EoE to establish a diagnosis of EoE, while 50% require clinical symptoms of oesophageal dysfunction; 39% of gastroenterologists take less than 5 biopsies when assessing for EoE, with variability in biopsy location. Only 51% of respondents took biopsies in every case presenting with acute food bolus. Proton pump inhibitors were the initial therapy of 70% of gastroenterologists, with 11% using topical steroids. The preferred dietary approach was the 6-food elimination diet in 36%, followed by the 2-food elimination diet in 26%. Overall, 27% of participants did not use histologic improvement and 63% did not use endoscopic improvement to evaluate treatment response. Use of EoE Endoscopic Reference Score (EREFS) is low, with 56% being either unaware of what EREFS is or never using it. Most respondents feel Canadian guidelines would be helpful in their practice. Conclusions Eosinophilic esophagitis practice patterns among Canadian gastroenterologists are variable and differ from consensus guidelines. The development of Canadian guidelines and continuing medical education content can be considered to improve the management of EoE in Canada.

State Full Practice Authority Regulations and Nurse Practitioner Practice Autonomy: Evidence From the 2018 National Sample Survey of Registered Nurses.

State full practice authority (FPA) laws are designed to permit NPs to practice autonomously from physicians. Little is known regarding how FPA laws affect NPs' practice autonomy in daily practice. This study used nationwide survey data from 20,830 NPs to estimate how NPs' practice autonomy differs between NPs in FPA and non-FPA states. NPs in states with FPA laws were more than twice as likely as NPs in non-FPA states to practice in clinic settings with no onsite physicians and were twice as likely to not have a physician collaborator. Associations between FPA laws and four other indicators of practice autonomy were positive but smaller in magnitude. States with FPA laws more than 10 years experienced larger changes in nurse practitioner (NP) autonomy compared with states with FPA laws in effect less than 10 years. FPA laws may promote the development of autonomous NP practice sites, thereby expanding access in underserved populations.

Factors Influencing Quality of Life in the Disabled: Focus on Household Members Mental Health

Abstract Background Household members of the disabled experience various difficulties such as social isolation and the burden of caregiving. These difficulties can lead to mental health problems, which in turn affect the quality of life(QoL) of the disabled. Research on the QoL of the disabled is ongoing, but there are few studies addressing the mental health of household members. We aimed to investigate the impact of household members’ mental health on the QoL of the disabled. Methods We used data from the 2021 Disability and Life Dynamics Panel(nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of household members’ mental health on the QoL of the disabled by using correlation analysis and multiple regression analysis adjusted for gender, age, income level, employment status, education level, activities of daily living, participation in social activities, type and severity of disability, presence of multiple disabilities, and health status. Results The level of depression(r=-.316, p<.0001) and self-esteem(r=.248, p<.0001) of household members were found to be significantly correlated with the QoL of the disabled. The level of depression of household members had a significant negative impact on the QoL of the disabled(β=-.153, p<.0001), while self-esteem had a significant positive impact(β=.144, p<.0001). It was found that the level of depression had a greater impact on QoL than self-esteem. Conclusions Lower levels of depression and higher levels of self-esteem of household members are associated with higher QoL for the disabled. Improving the mental health of household members is crucial in improving the QoL of the disabled, enabling them to interact more positively with society. Additionally, as 27% of household members experience depressive issues, enhancing their mental health positively impacts on the overall well-being of families with disabilities. Efforts to enhance household members’ mental health are crucial. Key messages • Household members’ mental health significantly influences the quality of life of the disabled. • To improve the quality of life of the disabled, strengthening programs for promoting the mental health of household members and policy improvements are necessary.

Depression and its risk factors in a conflict-affected population: findings from a nationwide survey

Abstract Introduction The impact of armed conflict and war on mental health is well documented, with limited data on populations living in unrecognized states. In this study, we examined the prevalence and risk factors of symptoms of depression among the Nagorno-Karabakh population during a ceasefire period, prior to a blockade, full-scale military attack, and their forced displacement. Methods A total of 1023 women, aged 18-49 years, from all regions of Nagorno-Karabakh, participated in a population-based household survey in 2022, which included the Center for Epidemiologic Studies-Depression (CES-D) 16-item scale to assess their depression symptoms. Simple and multivariable linear regression analyses explored the socio-demographic factors associated with CES-D score. Results The mean CES-D score was 8.90 (SD = 8.93), and 13.1% of the respondents had a score >18 (presence of depressive symptoms). The adjusted linear regression showed that CES-D score was higher among divorced (2.66, SE = 1.15, p-value=0.021) or widowed (3.09, SE = 1.57, p-value=0.049) vs. married, and among those having war-related deaths in the household in the previous 2 years (8.60, SE = 1.65, p-value<0.001) vs. not having. Conversely, a vocational/university level (-2.33, SE = 0.70, p-value=0.001) or post-graduate education (-3.81, SE = 1.72, p-value=0.027) vs less than secondary/secondary level, and 3-5 members in the household (-2.71, SE = 1.16, p-value=0.020) vs.1-2 members were significantly associated with lower CES-D score. Conclusions Our findings suggest that depression symptoms are highly prevalent among women in conflict-affected areas, with specific socio-demographic factors increasing the risk of depression symptoms. These results highlight the importance of providing mental health support and interventions for women in conflict-affected areas, particularly for those who experienced loss in the family due to war, are divorced or widowed, live in small households, and have lower education. Key messages • Depression symptoms are highly prevalent among women of reproductive age in areas affected by armed conflict and war. • Mental health intervention is recommended for women in conflict-affected areas who experienced loss due to war, are divorced or widowed, live in small households and/or have lower education.

Key Factors Influencing Quality of Life in the Disabled Based on Multifaceted Life Satisfaction

Abstract Background Healthy life of the disabled is considered a global social issue, and enhancing the quality of life (QoL) of the disabled is an important task. The disabled have lower multifaceted life satisfaction due to various daily restrictions, which negatively affects their QoL. Research on the QoL of the disabled is ongoing, but there are few comprehensive studies addressing multifaceted life satisfaction. To enhance the QoL of the disabled, it is essential to understand their multifaceted life satisfaction and investigate key factors influencing their QoL. Methods We used data from the 2021 Disability and Life Dynamics Panel (nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of multifaceted life satisfaction of the disabled on their QoL by using multiple regression analysis adjusted for gender, age, education level, daily living activities, type and severity of disability, and presence of multiple disabilities. Results The satisfaction with social relationships(β=.535, p<.0001), income(β=.146, p<.0001), housing environment(β=.132, p<.0001), occupation(β=.130, p<.0001), and health(β=.111, p<.0001) was found to have a significant positive impact on the QoL of the disabled. Particularly, satisfaction with social relationships exerted the greatest impact on their QoL. Conclusions Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. These findings can support the government in prioritizing health policy development for the disabled and contribute to improving the QoL for the disabled through a comprehensive and integrated approach. The government should develop health policies to enhance social connections and support networks for the disabled, while also considering aspects for improving income, housing environment, occupation, and health. Key messages • Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. • The government should prioritize developing health policies aimed at enhancing social relations for the disabled, while also considering income, housing environment, occupation, and health.

Digital services as alternative for in-person visits among clients with long-term illnesses

Abstract Background For individuals managing long-term illnesses and often requiring complex care across health and social care sectors, the transition to digital platforms holds considerable potential to facilitate management of one’s health. This study examined factors among people with long-term illnesses associated with their perception that digital services had replaced in-person visits in health and social care. Methods A total of 11,012 Finnish residents with long-term illnesses necessitating regular care (56% female, mean age 56.9, SE .23) responded to a nationwide population survey between September 2022 and March 2023. The Inverse Probability Weighting method was used to correct for bias. Complex samples binary logistic regression was used to examine whether factors related to self-rated health, distress, digital skills and perceived benefits of digital services were associated with the replacement of in-person visits by digital services. The model was adjusted for age, gender, education, and urbanicity. Results Approximately one third (35.8%) of the respondents indicated that the use of digital services had replaced in-person visits within the past 12 months. Respondents in poor or moderate health (OR 1.17, 95% CI 1.02-1.34) had greater odds of reporting the replacement compared to those in good health. Those with proficient digital skills (OR 1.84, 1.57-2.14) and those perceiving more benefits in digital services (OR 1.56, 1.47-1.74) had greater odds of reporting of the replacement compared to their counterparts. Conclusions Transition to digital services could facilitate access to care for individuals with long-term illnesses perceiving their health poorer. Promoting digital skills and perceptions of benefits of digital services can significantly increase the use of digital services as substitutes of in-person visits and contribute to more efficient allocation of health and social care resources. Key messages • Especially those reporting poorer health seem to use digital services as replacements of in-person visits, offering the potential to optimize resource utilization in health and social services. • Promotion of digital skills and perceptions of the benefits of digital services could increase the use of digital services as replacements for traditional visits with health and social professionals.

Health symptoms in individuals with and without post-covid in the Dutch general population

Abstract Background Health symptoms, often non-specific in nature such as headache and sleep problems, are more prevalent in the aftermath of disasters. Relatively little research focused on non-specific symptoms in the context of the COVID-19 pandemic, including those with post-covid conditions. The aim of this study was to assess the symptomatic profile of people with post-covid conditions, and to assess differences in health symptoms between non-infected individuals, infected individuals, and individuals with post-covid. Methods A nation-wide cross-sectional health survey performed in 2022 was combined with routine primary care electronic health records (EHRs). Prevalence of individual symptoms was analyzed, as well as symptom scores for number, duration, and severity of symptoms. The total survey sample consisted of 315,586 individuals. The EHR sample consisted of 29,797 individuals with matched survey data. Both samples were divided into three groups: non-infected, infected, and post-covid. Results Survey participants with post-covid experienced significantly (CI 99%) more (incidence risk ratio (IRR) 1.55), longer lasting (IRR 1.87), and more severe self-reported symptoms (IRR 1.95) compared to non-infected individuals. For infected compared to non-infected survey participants, there were hardly differences in symptom scores. The most distinct differences in individual symptoms were observed for loss of smell or taste, fatigue, and respiratory problems. Based on EHR data, the post-covid group is at significantly higher risk of experiencing fatigue, shortness of breath, headache, sleep problems, and dizziness. Conclusions Individuals suffering from post-covid are at the highest risk of experiencing health symptoms, both based on self-reported symptoms as well as based on EHRs. The infected group generally experienced more self-reported symptoms than the non-infected, but on average, they experienced them at a shorter duration, and they also reported them to be less severe. Key messages • Health symptom prevalence is higher in individuals with post-covid in the Netherlands. • This effect is confirmed in self-reported health surveys as well as in primary care registries.

Associations between diabesity and mortality over 7 years: a Maltese population-level case study

Abstract Introduction Diabesity presents a growing global epidemic. Demographic and socioeconomic associations have been documented, yet, the literature on mortality risk associated with diabesity is scarce. The aim of this study was to assess whether diabetes and/or diabesity increas the risk of all-cause mortality across a period of 7 years at a population level. Methods A nation-wide health examination survey in Malta was conducted between 2014 and 2016. This collected sociodemographic information, bio-anthropometric measurements (waist circumference, body mass index [BMI], body adiposity index [BAI]) and blood samples. Mortality information was acquired in 2021 by cross-referencing with the national mortality register. Statistical analysis was conducted using chi-square tests and Cox proportional hazard models. Results A mortality rate of 1.67% was observed (n = 3947), with diabetes and obesity being responsible for 6.06% and 3.03% of deaths, respectively. Examining the deceased individuals alongside their baseline characteristics (2014-2015) revealed that 25.76% (CI95%: 16.75 - 37.44) had diabetes, and 30.30% (CI95%: 20.55 - 42.22) were obese. Diabetes was associated with significant mortality risk (HR: 2.65 CI95%: 1.20 - 5.85; p = 0.02), while diabesity showed borderline significance (p = 0.06). After adjustment for potential confounding factors the mortality risk linked to diabetes remained significant and BAI was the only anthropometric measurement positively associated with mortality. Conclusions These findings emphasise the urgency for comprehensive public health policies targeting the concurrent prevention and management of diabetes and obesity at a population level. Our results also indicate that incorporating body adiposity index (BAI) into risk assessment protocols may provide valuable insights into mortality risk prediction and inform tailored interventions. Key messages • Diabetes and a high BAI score were significantly associated with mortality in the Maltese population, while diabesity had moderate significance, emphasising the urgency of tackling this epidemic. • These findings call for broad health policies to address diabesity at a population level and suggest integrating BAI into risk assessment for better mortality prediction and tailored interventions.

Future proof competencies for nurses working in primary care; a mixed methods study

Abstract Background Healthcare services, also those provided by nurses, are challenged by the increasing care demands of an ageing population and people with chronic conditions. To improve care efficiency and quality, now and in the future, nurses must have competencies regarding self-management support of patients, electronic communication, preventive care, and engaging relatives in care. This study aimed to assess primary care registered nurses’ (RNs) time allocation to these competencies and their perceived needs for further development of these competencies. Methods A mixed methods design was used, involving a nationwide survey (n = 303) and focus groups (12 participants), both with RNs working in community care services or general practitioners (GPs) practices. Survey data were analysed descriptively, and focus group transcripts underwent qualitative thematic analysis. Results The majority of RNs invest significant time in client self-management support (90%), preventive care (82%), and involving relatives in care (74%). RNs also recognized an increasing demand for these competencies in the future and the need to motivate patients and relatives to self-manage their health. Furthermore, RNs reported that competencies regarding electronic communication skills will become extra important in the future, yet currently only 37% dedicate substantial time to this. RNs face challenges in effectively utilizing electronic communication with patients and thus need opportunities to improve digital skills. Additionally, RNs desire enhanced collaboration with other healthcare professionals, such as GPs and medical specialists. Conclusions RNs’ limited time allocation and perceived inadequacy in electronic patient communication, underscore the importance of targeted training in this area, and prioritizing this by healthcare organizations. In addition, fostering collaboration between nursing staff and other healthcare professionals could support future proof nursing in primary care. Key messages • Nurses demonstrate resilience in addressing healthcare challenges, emphasizing client care, prevention and family engagement. • Training nurses in competencies for electronic communication with patients is essential to meet the anticipated increase in demand for this aspect in their practice.

Gastrointestinal manifestations of Rett syndrome: An updated analysis using the Gastrointestinal Health Questionnaire.

We conducted a nationwide survey using a validated Gastrointestinal Health Questionnaire (GHQ) for Rett syndrome (RTT) to provide an updated and accurate baseline assessment of the prevalence of common gastrointestinal (GI) issues in RTT, based on parental reporting. Parents and caregivers of females with RTT or normally developing, unaffected, age-matched controls completed the GHQ survey. The prevalence of GI symptoms and personality and mood symptoms due to stomach or intestinal problems, as well as GI medication usage and surgical interventions, were assessed in females with RTT and unaffected controls. The relation between GI symptoms and medication usage, surgical status, age, and genetic mutation were analyzed. Parents of 118 females with RTT and 27 unaffected females completed the GHQ. GI symptoms were common in females with RTT, including constipation (81%), gas and bloating (70%), issues with eating, chewing and swallowing (73%), and irritability because of stomach or intestinal problems (53%). Females with RTT commonly used proton pump inhibitors (52%) and laxatives (64%). Medication usage was associated with significantly higher GHQ symptom scores. Parents of individuals with RTT reported a significantly higher prevalence of GI symptoms affecting their daughters in all symptom categories compared with unaffected females. GI problems are common in RTT and pose a significant medical burden to caregivers. The GHQ is a useful tool to assess GI issues in individuals with RTT. Improved recognition of these issues may allow for improved treatment and enhanced quality of life for girls and women affected by RTT.

Digital health literacy of adults with low reading and writing skills: A mixed-methods study

Abstract Background Around 12% of the adult population living in Germany have low reading and writing skills. Little is known about their digital health literacy and use of digital health technologies. The objectives of the Liter@te study were to assess the digital health literacy of adults with low reading and writing skills and to explore which digital tools they used in everyday life. Methods A cross-sectional survey (n = 96) and five focus groups (n = 39) were conducted with adults aged 18-64 years with low reading and writing skills. Digital health literacy was measured using the eHEALS scale and compared with results from a nationwide sample. Focus group participants completed a task course on digital health information and then discussed their experiences. Survey data were analyzed using descriptive statistics and logistic regression. Qualitative content analysis was applied to analyze the focus group data. Results Survey participants were on average 44 years old, 72% were female and 92% were not born in Germany. Compared to the nationwide survey, use of digital health technologies and digital health literacy were lower. In addition, use of digital health technologies was associated with higher digital health literacy. Lack of technical skills, language problems, and searching and finding health information online were most challenging for focus group participants (mean age 43 years, 87% female). Focus group participants reported that they prefer videos when searching for health information online and seek support from family members or local organizations if they cannot find a solution to their health issue. Conclusions Adults with low reading and writing skills search for health information online, but have difficulties to find the appropriate information. Interventions to promote digital health literacy are needed to ensure that persons with low reading and writing skills are not further left behind. Key messages • Adults with low language skills have a low digital health literacy. • Reading and writing requirements and lack of technical skills make it difficult for them to search health information online.

Empowering health literacy: Turkiye’s Health Literacy Action Plan 2022-2026

Abstract Issue/Problem The ‘Health Literacy Action Plan 2022-2026’ of the Turkish Ministry of Health addresses the critical public health issue of limited health literacy, leading to increased hospital admissions, inappropriate emergency department use, and poor health outcomes. This underscores a significant challenge in individual health self-management and higher healthcare expenditure within the country. Description of the Problem The Health Literacy Action Plan aims to tackle disparities in health literacy levels among people. It employs customized teaching schemes, digital communication, and inclusive healthcare practices to reach every demographic group. The plan seeks to enhance health knowledge and empowerment among Turkish people by increasing access to medical information, simplifying clinician instructions, and promoting closer communication between patients and healthcare professionals. Results Comparative evaluation of nationwide surveys conducted in 2017 and 2023 with 15,000 participants shows remarkable improvements. Despite delays due to the pandemic, the action plan led to a notable increase in adequate health literacy levels from 31.9% in 2017 to 46.1% in 2023. Additionally, significant improvements were observed in ailment prevention and health promotion, with health literacy levels in disease prevention increasing from 28.4% to 45.7%. Lessons The Health Literacy Action Plan plays a crucial role in developing and implementing multifaceted public health strategies based on data and stakeholder participation. These interventions, requiring continuous monitoring and adjustment, are essential steps toward achieving high-level health literacy. Key messages • Strategic health literacy interventions are essential for improving health outcomes and optimizing the use of public resources. • Evidence-based interventions and ongoing evaluation are key to promoting health literacy.

Interconnected mental health symptoms: network analysis of depression, anxiety, stress, and burnout among psychiatric nurses in the context of the COVID-19 pandemic

BackgroundMental health symptoms such as anxiety, depression, stress, and burnout are common among healthcare workers. However, the interconnections among them remain under-explored. This study aimed to address the interrelationships among these symptoms in psychiatric nurses.MethodsWe conducted a nationwide survey in the early stage of the COVID-19 pandemic (January to March 2021) to investigate the interconnectedness of depression, anxiety, stress, and burnout among psychiatric nurses. Using network analysis, we identified central symptoms, important bridge symptoms, and the correlations among these central symptoms.ResultsOf the 9,224 psychiatric nurses (79.2% female) included in the statistical analyses, 27.6% reported clinically significant depression, 31.2% anxiety, 14.5% stress, and 23.8% burnout. Network analysis revealed that stress had the highest expected influence (EI) value (0.920) and the highest strength among all nodes. The node for depression scored the highest in both closeness and betweenness. Emotional exhaustion (EE) had the highest bridge expected influence (BEI) of 0.340, with the strongest intergroup association between EE and depression. No significant differences were found in gender or frontline work experience (all p > 0.05).ConclusionsBurnout, depression, anxiety, and stress are relatively common among psychiatric nurses in the context of the COVID-19 pandemic. While anxiety was the most prevalent, stress emerged as the core symptom, and depression as an important bridging node. Interventions targeting the core symptoms and bridging nodes may improve the mental health of psychiatric nurses.

Patient safety and quality improvement education in dermatology residency programs: a nationwide survey of program directors.

Patient Safety and Quality Improvement (PSQI) are key components of graduate medical training, as detailed by the Accreditation Council for Graduate Medical Education (ACGME), with specific requirements that residents participate in experiential learning in PSQI during residency training. This study aimed to analyze the breadth of available and required PSQI educational experiences across dermatology residency programs in the United States. The objective of this study was to characterize the scope of PSQI educational experiences across dermatology residency programs. We electronically surveyed program directors of all ACGME-accredited dermatology residency programs from September 2023 to March 2024. Responses to the survey were anonymously collected with Research Electronic Data Capture (REDCap). Of the 145 dermatology programs surveyed, 37 program directors responded (25.5%). 89.2% of programs reported requiring residents to participate in PSQI educational experiences, with the most common being participation in a resident-led QI project (70.3%), which was also the most commonly available experience (91.2%). The least common required experience was observed simulated patient safety events and analyses. 83.8% of programs reported formal mechanisms to assess residents' competency in QI. This study highlights variation in PSQI experiences within dermatology residency programs across the United States. More than 10% of surveyed programs reported no required QI experiences during residency training despite ACGME program requirements. Additional gaps include variation in assessment of resident PSQI competencies. This study provides insight on the current landscape of PSQI education across dermatology residency programs and identifies opportunities to strengthen dermatology programs' PSQI educational offerings.

Artificial intelligence in rheumatology: perspectives and insights from a nationwide survey of U.S. rheumatology fellows.

Artificial Intelligence (AI) is poised to revolutionize healthcare by enhancing clinical practice, diagnostics, and patient care. Although AI offers potential benefits through data-driven insights and personalized treatments, challenges related to implementation, barriers, and ethical considerations necessitate further investigation. We conducted a cross-sectional survey using Qualtrics from October to December 2023 to evaluate U.S. rheumatology fellows' perspectives on AI in healthcare. The survey was disseminated via email to program directors, who forwarded it to their fellows. It included multiple-choice, Likert scale, and open-ended questions covering demographics, AI awareness, usage, and perceptions. Statistical analyses were performed using Spearman correlation and Chi-Square tests. The study received IRB approval and adhered to STROBE guidelines. The survey aimed to reach 528 U.S. rheumatology fellows. 95 fellows accessed the survey with response rate to each question varying between 85 and 95 participants. 57.6% were females, 66.3% aged 30-35, and 60.2% in their first fellowship year. There was a positive correlation between AI familiarity and confidence (Spearman's rho = 0.216, p = 0.044). Furthermore, 67.9% supported incorporating AI education into fellowship programs, with a significant relationship (p < 0.005) between AI confidence and support for AI education. Fellows recognized AI's benefits in reducing chart time (86.05%) and automating tasks (73.26%), but expressed concerns about charting errors (67.86%) and over-reliance (61.90%). Most (84.52%) disagreed with the notion of AI replacing them. Rheumatology fellows exhibit enthusiasm for AI integration yet have reservations about its implementation and ethical implications. Addressing these challenges through collaborative efforts can ensure responsible AI integration, prioritizing patient safety and ethical standards in rheumatology and beyond.

A national DREEM: exploring medical and dental students’ perceptions on their learning environment across Hungary

BackgroundHungarian medical schools attract a diverse student body, enrolling numerous international and Hungarian students annually. The learning environment, encompassing all facets of their academic experience, significantly influences the overall educational experience at the medical schools. As the first nationwide survey, this study aimed to assess and compare the perceptions of international and Hungarian medical and dental students regarding their learning environment across the four medical schools in Hungary.MethodsThe Dundee Ready Education Environment Measure (DREEM) tool was used to get a better insight into the perceptions of international and Hungarian medical and dental students on their learning environment (LE). The questionnaire was distributed via social media platforms and the Neptun Educational System across the four medical schools in Hungary. To gain deeper insights into the participants’ perceptions, a qualitative component was also added to the survey, comprising five open-ended questions. The research was carried out between April and October 2022. To analyse quantitative data, IBM SPSS was used, while the transcription and exploration of the qualitative data was performed using the Sketch Engine software.ResultsA total of 1164 valid responses were received. The results illuminate similarities and differences in perceptions of the learning environment between international and Hungarian medical and dental students. As anticipated, international students’ perceptions were somewhat less favourable compared to their domestic counterparts, who are generally more accustomed to the workings of the Hungarian higher educational system (total DREEM score was 118.1 for the former, and 122.6 for the latter student population). Notably, significant differences were observed in perceptions of teachers and the overall atmosphere.ConclusionThe total score of the DREEM questionnaire was interpreted as “more positive than negative” for both international and Hungarian students, consistent with findings from other DREEM surveys, suggesting overall satisfaction with the learning environment. However, regular and ongoing evaluation of the learning environment is recommended in order to identify areas for improvement, ensure high standards of education, and continuously enhance the overall student experience.

The price of pressure: nationwide survey on lifestyle disturbances, occupational burnout and compromised perceived-competency among radiology residents in China

ObjectivesThe competency of radiology directly affects the quality and equity of medical services. Due to their different occupational characteristics compared to other specialists, this study aims to evaluate the impacts of lifestyles on competency and burnout in radiology residents in China.Materials and methodsA nationwide, cross-sectional survey was conducted from December 1, 2020 to April 30, 2021. A total of 12,208 radiology residents during their standardized residency training in China were invited. Multivariate linear regression and logistic regression were conducted to identify perceived competency and burnout associated with lifestyles.ResultsOf the 3,666 participants, 58.02% were female, 82.24% were aged &amp;lt;30 years, 40.53% were from the Eastern region, and 92.06% obtained a bachelor’s degree. The radiology residents with high-level lifestyles had higher competency (β = 0.16, 95% CI = [0.01, 0.32]), particularly in the realms of sleep, physical activity, and alcohol consumption. The correlation was stronger in residents with longer work hours and more night shifts. Residents with insomnia (OR = 7.69, 95% CI = [4.23, 14.67]) and less exercise (OR = 6.24, 95% CI = [1.33, 29.37]) had higher burnout risk, while residents who smoked had a lower risk (OR = 0.60, 95% CI = [0.40, 0.89]). And lifestyle factors had a slightly different impact on emotional exhaustion and depersonalization.ConclusionRadiology residents’ lifestyles can be emphasized, as it may reflect their pressure and wellbeing and influence their concentration, competency, burnout and performance. Policymakers and hospital administrators should incorporate practical and modifiable strategies into work routines to improve the lifestyle quality of residents.