Online Survey Research Articles

Public acceptability and anticipated uptake of risk-stratified bowel cancer screening in the UK: An online survey

ObjectiveThis study aimed to quantify public acceptability and anticipated uptake with risk stratification incorporated at three points on the bowel cancer screening pathway, compared with current screening in England. MethodsWe conducted an online population-based survey of 1,203 UK adults. The main outcome measures were overall acceptability of three strategies where risk stratification is introduced at 1) the point of eligibility, 2) the referral threshold and 3) the screening interval, compared with the current programme (screening as usual), and the acceptability of high- and low-risk screening practices at each point. Other outcomes included anticipated uptake of screening and the acceptability of data collection methods. ResultsAcceptability of risk-stratified eligibility and referral thresholds was significantly greater than for screening as usual (p < 0.001). There was no difference for stratified intervals. At all three points, more intense screening for those at high-risk was more acceptable and less intense screening for those at low-risk less acceptable when compared with screening as usual (p < 0.0001). The anticipated likelihood of taking up screening was also significantly higher if at high-risk and significantly lower if at low-risk, compared with screening as usual for all strategies (p < 0.0001). ConclusionsParticipants expressed strong acceptability for risk-stratified bowel cancer screening, particularly for risk-stratified eligibility and thresholds for referral. However, acceptability for less intense screening for those at low-risk was lower than for the current programme and may negatively impact uptake. This suggests that the design and framing of risk groups requires careful consideration and communication with the public. Patient and public contributionThree members of the public contributed through online correspondence to the development of the survey and participant-facing documents.

Real-world experience with glucagon-like peptide 2 analogues in patients with short bowel syndrome and chronic intestinal failure: results from an international survey in expert intestinal failure centers.

Background and AimsGlucagon-like peptide 2 (GLP-2) analogues are the first available disease-modifying treatments for patients with intestinal failure (IF) due to short bowel syndrome (SBS). Efficacy in terms of reduction of parenteral support (PS) has been demonstrated in multiple studies and real-world reports. However, it remains unclear how many patients are eligible to receive the treatment, when treatment is started after intestinal resection, how treatment efficacy is assessed outside of clinical trials, and how the treatment is modified in case of non-response or adverse events. The aim of this study was to investigate the real-world management of patients treated with GLP-2 analogues in expert centers around the world. MethodsA survey questionnaire was developed by a multidisciplinary working group consisting of 52 questions related to various aspects of multidisciplinary care of SBS-IF patients. The 17 questions related to the use of GLP-2 analogues in clinical practice were analyzed for this study. The online survey was sent to 33 participating centers in a phase 3 study of a long-acting GLP-2 analogue. Only responses from countries with access to commercially available GLP-2 analogues were included in the study. A descriptive analysis was performed for each question. Results are presented as median (interquartile range). ResultsThe responses from the 19 expert IF centers with access to GLP-2 analogues indicated that 10 (10-20) % of patients with SBS-IF were treated with a GLP-2 analogue, which was less than the number of eligible patients (30 (25-40) %). In most centers (10 centers, 53%), GLP-2 therapy was started 6-12 months after the last intestinal resection, with 5 centers (26%) starting later (12-24 months). Multiple parameters were used in combination to determine the response to GLP-2 analogues of which the three most common were >20% decrease in PS (95%), at least 1 day of PS reduction per week (84%) and increased urinary output (68%). In non-responders GLP-2 therapy was stopped within the first year by 67% of the centers. Finally, strategies in case of significant adverse events include stopping the GLP-2 analogue (used by 79% of experts), dose reduction (67%) and temporary treatment interruption (62%). ConclusionThe results of this survey completed by expert IF centers show the real-life use of GLP-2 analogues in clinical practice. Key learning points identified include the accounting for a period of intestinal adaptation before starting GLP-2 analogues and not stopping the treatment too early in case of non-response. The best strategy in case of adverse effects should be studied further.

Elucidating Diurnal Patterns in Touch Desire Using Social Media Data Toward Design of Haptic Applications and Displays.

Advances in haptic technology have led researchers and engineers to seek out killer applications in which users can enjoy an experience of touch in AR/VR spaces. Such applications will respond appropriately to human desire for haptic experiences (i.e., touch desire) and thus it is essential for researchers and engineers to understand the nature of people's touch desires as they arise in the course of daily life. In this study, we employed Twitter data analysis to investigate a diurnal pattern in touch desire. Our results showed that touch desire identified in and extracted from Twitter texts did reveal a diurnal pattern. Touch desire tended to be at its lowest in the morning and increased as the day progressed. The time at which it peaked varied with the specific target of touch desire. Touch desire in relation to other people and objects reached its peak at night, but touch desire in relation to animals reached its peak at noon. These results were confirmed not only by our Twitter text analysis but also by data from other social media and an online survey. In addition, we found that the diurnal pattern of touch desire for each target shows a strong correlation with that of visual desire for the same target. This suggests that the diurnal pattern of touch desire is not limited to the sense of touch but is common to other sensory desires for each target. Our findings suggest that researchers need to take the time of day into account when investigating touch desire. Our findings also offer valuable insights for developers into the design of haptic applications and displays that takes into account the timing of daily peaks in touch desire.

Impact of flexible work arrangements on job resignation after cancer diagnosis among Japanese young adult cancer survivors.

Many workers had flexible work arrangements during the COVID-19 pandemic. This study aimed to identify the association between flextime and remote working and job resignation among Japanese young adult cancer survivors after diagnosis. This cross-sectional observational study was conducted using an online survey with 401 Japanese young adult cancer survivors diagnosed with adult-onset cancer and aged 20-39years at the time of the survey in January 2022. A multivariable Cox regression analysis was performed to analyze the impact of flextime and remote working on job resignation. In the sample, 264 participants (65.8%) were female, and 185 (46.1%) had been diagnosed with cancer between 1 and 5years ago. After adjusting for potential confounders, the multivariable Cox regression analysis revealed that young adult cancer survivors using remote working only (HR 0.44, 95% CI 0.21-0.96, p = 0.04) and both flextime and remote working (HR 0.37, 95% CI 0.21-0.64, p < 0.01) experienced a lower risk of job resignation after cancer diagnosis compared to those who did not use flextime and remote working. Young adult cancer survivors who used remote working only or remote working combined with flextime could reduce their risk of job resignation after a cancer diagnosis. This study showed that having the option of remote working can be important for young adult cancer survivors' continuing employment. Furthermore, social welfare systems need to promote a workplace culture and climate that allows remote working.

Self-compassion and psychological well-being of radiographers at work

ABSTRACTObjectivesThe aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work.MethodsAn online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion.ResultsA total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive.ConclusionParticular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

A mixed-methods study among adolescents and teachers in Bogotá, Colombia: adapting the OurFutures Alcohol Program.

Early onset of alcohol consumption among Colombian adolescents highlights the need for effective and accessible preventive interventions. This project aimed to conduct formative work to inform the adaptation of an effective eHealth alcohol use prevention program originally developed in Australia, the OurFutures Alcohol Module, to the Bogotá context. Twenty-six adolescents and 10 teachers in Bogotá participated in the study. We used a mixed-methods approach comprising interviews, surveys and semi-structured discussions to evaluate the acceptability of OurFutures. Study materials were translated into Spanish before conducting three 1.5-hour focus groups with adolescents (aged 11-15; n = 26), and 1-hour interviews or online surveys with teachers to assess attitudes towards alcohol use and the acceptability of one lesson from the OurFutures Alcohol Module in the Bogotá context. Qualitative data were analysed thematically, and descriptive analyses of quantitative data reported percentage agreement for survey questions. Overall, 96% of students and 89% of teachers expressed strong satisfaction with the OurFutures Alcohol Module lesson. Most students (96%) liked its storyline and character portrayal, and most teachers (80%) said they would use OurFutures with their students. Participants provided feedback for improving program relatability, including adapting scenarios, character names, clothing and language to align with the Bogotá context and resonate with Colombian adolescents. This study marks the first step in informing the adaptation of the OurFutures Alcohol Module to the Bogotá context and highlights key considerations for cultural adaptations of other substance use prevention interventions. This research underscores the importance of place-based end-user involvement in co-designing adolescent prevention interventions.

Current Status of the clinical role in Spanish interventional radiology: An online survey among the Spanish Society of Vascular and Interventional Radiology (SERVEI) members

PurposeThis work aims to provide an overview of the current reality of clinical practice in interventional radiology in Spain, evaluating clinical activity, interventional radiologists’ opinion on the importance of playing a proactive clinical role, and the barriers they encounter in doing so. Materials and MethodsThe study was based on an 18-question survey divided into four categories: general aspects, clinical activity, opinion on a proactive clinical role, and barriers. The questionnaire, validated by the Spanish Society of Vascular and Interventional Radiology (SERVEI), was distributed to all members (n = 483) via email. A descriptive statistical analysis was performed. ResultsThe response rate was 26.5% (128/483). A total of 44.5% (57/128) had admitting privileges, 70.3% (90/128) had consultations, 32.8% (42/128) did ward rounds, and 94.5% (121/128) participated in multidisciplinary committees. Most spent just 0%–10% of their workday on clinical activity. A total of 43.7% (56/128) reported providing longitudinal care for their patients. On a Likert scale from 1 to 10, the importance of performing pre-procedural consultations was rated a mean of 8.3 (IQR: 10–8), post-procedural consultations 8.1 (IQR: 10–7), and care during hospitalization 7.7 (IQR: 10–6). The main obstacles were a lack of time/excessive workload and inadequate professional resources. ConclusionsSpanish interventional radiologists demonstrated a clear awareness of the importance of providing longitudinal patient care. However, they reported only partially taking on the clinical responsibilities for the patients they treated.

Obstetric healthcare experiences and information needs of Dutch women in relation to their vegan diet during pregnancy

ObjectivesThe prevalence of a vegan (strict plant-based) diet is increasing. Adequate access to nutritional information for pregnant women on a vegan diet is vital, as optimal maternal nutrition is important in order to prevent maternal and fetal complications. This study evaluated the obstetric healthcare experiences and information needs of pregnant women following a vegan diet in the Netherlands. MethodsAn online survey examined women’s experiences with obstetric healthcare in relation to their vegan diet during pregnancy. In total, 195 women, all of whom followed a vegan diet during their pregnancy and gave birth between January 2018 and April 2020, completed an online survey about their experiences. Descriptive statistics were used to present the data. ResultsIn total, 36.5% of participants reported that an obstetric healthcare provider had inquired about their diet in general during the first prenatal consultation, and an additional 43.1% of participants proactively informed their healthcare provider about their diet. Only 19.0% of all participants received specific information about their vegan diet during pregnancy, and 25.2% reported having had extra checks, mostly blood tests, during their pregnancy. Of all participants, 35.9% would have preferred to receive additional information regarding their diet. ConclusionsOur data shows that only a minority of pregnant women following a vegan diet received information and recommendations about their diet from their healthcare providers. It is our recommendation that healthcare providers inquire about pregnant women’s diets, and refer those following a vegan diet to reliable sources of dietary information or to a specialized dietitian.

Clinical and lifestyle predictors of loneliness: a two-year longitudinal study

BackgroundWhile loneliness is a global public health problem, the literature lacks studies assessing loneliness predictors in low- and middle-income countries. Therefore, we aimed to analyze clinical and lifestyle predictors of loneliness. MethodsWe conducted a 2-year longitudinal study in Brazil based on a snowball sample and online surveys (baseline: May 6 to June 6, 2020). We assessed clinical and lifestyle predictors of loneliness using multiple regression models. The analyses were adjusted for several sociodemographic variables and weighted for attrition and sampling procedures. ResultsThe study included a nationwide sample of 473 participants (18-75 years; 87.1% females). After adjusting for sociodemographic factors, we identified as risk factors: depressive symptoms (RR: 1.214; 95%CI: 1.08-1.36; p=0.001), anxiety symptoms (RR:1.191; 95%CI: 1.04- 1.35; p=0.007), alcohol abuse (RR: 1.579; 95%CI: 1.32- 1.88; p<0.001), and cannabis use (RR: 1.750; 95%CI: 1.25- 2.39; p<0.001). More than 150 min/week of physical activity (RR: 0.177; 95%CI: 0.07- 0.34; p<0.001) and good/excellent quality of family relationships (RR: 0.73; 95%CI: 0.60- 0.87; p<0.001) and sleep (RR: 0.483; 95%CI: 0.39- 0.59; p<0.001) were protective factors. ConclusionSeveral clinical factors (depression, anxiety, alcohol, and cannabis) have been identified as risk factors for loneliness, while lifestyle factors (physical activity, better quality of sleep, and family relationships) have been associated with a lower incidence of loneliness. Addressing clinical and lifestyle factors may therefore be essential to preventing loneliness.

Nutritional knowledge, attitudes and behaviours in rugby league; influences of age, body composition and ancestry.

Rugby league is a physically demanding sport that necessitates considerable nutritional intake, focusing on quality and type, in order to optimize training and competition demands. However, rugby league athletes are reported to have inadequate nutrition intake to match these demands. Some factors that may determine an athlete's nutrition intake have been reported in other sports, including (but not limited to, knowledge, time, cooking skills, food costs, income, belief in the importance of nutrition, body composition goals, and family/cultural support). However, these potential factors are relatively unexplored in rugby league, where a range of personal (age, body composition) or social (ancestry) influences could affect nutritional intake. Further exploration of these factors is warranted to understand the knowledge, attitudes and behavior underlying rugby league athletes' nutritional intake that can provide practitioners with a more detailed understanding of how to approach nutrition behaviors and attitudes in rugby league athletes. The primary aim was to describe the nutrition behaviors and knowledge of rugby league athletes. A secondary aim was to compare nutrition knowledge and behavior based on age, body composition and self-identified ancestry. Fifty professional rugby league athletes anonymously completed a seventy-six-question online survey. The survey consisted of three sections : 1) sports nutrition knowledge, 2) attitudes toward nutrition on performance , and 3) nutrition behaviors. All participants completed the online survey without assistance using their own personal device, with data entered via REDCap during pre-season. Nutrition knowledge was compared based on age (years), body composition (body fat percentage (%)) and ancestral groups (Pasifika, Aboriginal and/or Torres Strait Islander (ATSI) and Anglo- European).Pearson correlation was used for the relationship between nutrition knowledge, age and body composition. An Analysis of Covariance (ANCOVA) was used to determine nutrition knowledge differences between ancestral groups with age and body composition as covariates. Attitudes and behaviors were compared based on age groups (<20, 20-24 and >25 y), ancestry and body composition. Attitudes and behaviors were analyzed by Pearson correlation for body composition, one-way ANOVA for age groups and ANCOVA for ancestry with covariates age and body composition. Overall athletes' nutrition knowledge score was reported as 40 ± 12% (overall rating "poor"). Nutritional behaviors were significant for body composition, as those with lower body fat percentage had higher intakes of vegetables and dairy products (p = 0.046, p = 0.009), and ate more in the afternoon (lunch p = 0.048, afternoon snack p = 0.036). For ancestry, after adjustment for both age and body composition, Pasifika athletes were more inclined to miss breakfast and lunch compared to their Anglo-European (p = 0.037, p = 0.012) and ATSI (p = 0.022, p = 0.006) counterparts and ate more fruit than Anglo-Europeans (p = 0.006, p = 0.016). After adjustment for body composition, ATSI athletes also viewed the impact of nutrition on mental health and well-being significantly lower than Pasifika (p = 0.044). These findings suggest differences exist within rugby league athletes based on ancestral backgrounds and body composition for nutrition attitudes, behaviors and knowledge. Such outcomes could be used when designing nutrition education interventions, with consideration given to these factors to optimize long-term positive behavior change.

Radiographers’ perspectives on immobilisation and restraint mechanisms in paediatric radiography

IntroductionThe utilisation of immobilisation or restraint during paediatric radiography is a multifactorial issue with associated legal and ethical considerations. Current practice regularly presents challenges for radiographers, with a notable absence of any professional best-practice guidance. This study investigated radiographers’ perspectives in Ireland on the use of immobilisation or restraint methods and the factors influencing these choices and aimed to fill the 20-year gap in European radiographers’ perspectives gaining an up-to-date understanding and contribute to the global conversation in this regard. MethodsAn anonymous online survey design was constructed using the Google Forms platform and distributed to hospital radiology departments across the Southern region of Ireland. Additionally, a short survey was send to the head of the nine radiology departments to audit the existing availability of immobilisation and/or restraint devices for paediatric radiography. Descriptive statistics (frequencies and percentages) were undertaken. Bar charts were utilised where appropriate to display trends. ResultsOne hundered and three responses were received. The majority of radiographers reported using immobilisation (95 %) or restraint (89 %) techniques during paediatric radiography, although 70 % acknowledged the lack of training regarding restraint techniques. However, 93 % reported trying alternative techniques such as distraction and negotiation to avoid immobilisation or restraint. A desire for further guidance and training was reported, with 80 % of respondents noting training as essential or potentially beneficial. ConclusionsAmbiguity remains surrounding the distinction between the terms “restraint” and “immobilisation” in paediatric radiography. Radiographers' use of restraint and immobilisation during paediatric radiography is influenced by the child's age, distress level, radiation protection and safety, and the ability of the child to understand instructions. Appropriate up-to-date guidelines and training would be recommended to clarify terminology and promote the safe practice of restraint and immobilisation during paediatric radiography.

Development of a Brand Value Measurement Model with a Corporate Social Responsibility Perspective. A Comparative Analysis of Consumer Perception of Energy Providers in Spain and Colombia

Sustainable development of companies and their products involves the integration of multiple dimensions, including economic, ethical, social, and environmental considerations, all of which are increasingly important to consumers. The present study identified key variables that define brand value in the context of Corporate Social-Environmental Responsibility (CSR), comparing two companies in the energy sector in Spain and Colombia (Naturgy and Ecopetrol S.A.). Among the factors that contribute to brand success, this study evaluated three variables: Visibility, Loyalty and Experience as perceived by consumers. Data measuring brand value were collected through an online survey of 640 respondents in Spain and Colombia, assessing their response to company logos and corporate messaging regarding environmental sustainability of their operations. Structural equation models (SEM) were then used to measure brand value based on latent variables and compared to survey data. Our results show that company visibility had a positive impact on brand loyalty and consumer experience, which ultimately increases brand value. Conversely, an improved consumer experience can also enhance brand loyalty and visibility. Our findings represent a framework to quantify brand value within the energy sector that is based on integrating multiple indicators of brand equity (BE) using the analysis of company logos, while simultaneously considering CSR, greenwashing and other forms of company messaging. This integration is a significant departure from traditional approaches and offers a new and novel perspective when developing a comprehensive corporate model. Our study suggests that implicit and explicit allusion to corporate environmental-social responsibility has a profound influence on brand recognition and brand acceptance by customers, due to the positive responses it elicits. The current study's findings support incorporating references to CSR in sustainable branding in its broadest spectrum and definition and offer a procedure to quantify and measure brand value, which can help company managers make effective branding decisions.

Perceptions and understanding of family pediatricians regarding the new Italian Type 1 Diabetes screening program

AimsItaly is the first country to implement a nationwide Type 1 Diabetes (T1D) screening program aimed at reducing cases of diabetic ketoacidosis and potentially delaying disease progression through early interventions. This study assesses the knowledge, perceptions, and willingness of family pediatricians (FPs) to participate in this program. MethodsAn anonymous online survey was conducted among 113 FPs in the Friuli Venezia Giulia region, an area not included in the initial pilot study. The survey evaluated their knowledge, readiness, and concerns regarding the screening program. ResultsOf the 62 respondents (55% response rate), 84% expressed a willingness to participate in the screening program, although most reported limited knowledge about it. The key concerns included family anxiety, identifying individuals at risk of diabetes, and uncertainty regarding follow-up procedures. While FPs acknowledged the potential benefits of reducing ketoacidosis, 75% emphasized the need for more training and support. ConclusionsWhile FPs are largely willing to participate in the T1D screening program, significant gaps in knowledge and preparedness remain. Addressing these gaps through comprehensive education and clear follow-up protocols is crucial for the successful nationwide implementation of the program in 2025.

Cross-culture adaptation and validation of Indonesian language version of Pittsburgh Sleep Quality Index

Hemodialysis (HD) patients have a high rate of poor sleep. The Pittsburgh Sleep Quality Index (PSQI) is the most popular self-reported instrument to measure sleep quality. No study has tested the psychometric efficiency of the Bahasa (Indonesian language) PSQI in hemodialysis (HD) patients, and no cross-cultural adaptation has been done. The purpose of this research was to translate the PSQI into Bahasa and improve its psychometric properties for use in evaluating HD patients in Indonesia. This study used instrument translation, cultural adaptation, content validation, and equivalence to crossculturally validate and adapt an instrument. The hemodialysis center at a West Java medical facility served as a source of potential HD patients throughout the period of October 2022 to February 2023. A content validity index (CVI) was calculated for each item and the entire scale. The factor structure of the Bahasa PSQI has been evaluated by confirmatory factor analysis and internal consistency was calculated using Cronbach's alpha. The online survey received a response rate of 62.8% from a total of 220 patient with HD (about ten responders each item). The level of language clarity was 87.8%, and the level of cultural relevance was 84.5%. The CVI varied from 0.92 to 1.00. Each factor had factor loading ranging from 0.51 to 0.62. that Cronbach alpha for total score was 0.803, and the subscale ranged from 0.771 to 0.863. Our research provides preliminary evidence of the validity and reliability of the translated and adapted tool using data from HD patients in Indonesian hospitals.

Participant-reported neurological events following immunization in the Canadian National Vaccine Safety Network-COVID-19 vaccine (CANVAS-COVID) study

IntroductionThe Canadian National Vaccine Safety Network (CANVAS) conducted active participant-based surveillance for adverse events following immunization during the COVID-19 vaccine campaign. This study evaluated the association between COVID-19 vaccination and neurological adverse events. MethodsParticipants were invited to complete online surveys to report health events that prevented daily activities and/or required medical attention within 7 days after COVID-19 vaccination or 7 days prior to the survey (unvaccinated controls); follow-up surveys were sent 7 months later. Neurological events were health events where the most severe symptom reported was ≥1 of: numbness/tingling, loss of taste or smell, vision loss, facial weakness/paralysis, seizure, weakness/paralysis of arms or legs, confusion, change in personality or behavior, or difficulty with urination or defecation. Data were extracted from the CANVAS-COVID database for analysis. ResultsCompleted survey responses were received from 15,273 unvaccinated controls, 758,619 dose 1 recipients, 406,884 dose 2 recipients, and 126,586 dose 3 recipients. Rates of neurological events ranged from 15.9 (95 % CI 13.6–18.4) per 10,000 dose 1 ChAdOx1 recipients to 8.4 (6.5–10.8) and 7.9 (5.7–11.0) per 10,000 dose 3 mRNA-1273 and BNT162b2 recipients, respectively. Multivariable regression adjusted for age, sex, previous SARS-CoV-2 infection, and baseline health status showed an increased risk of neurological event among ChAdOx1 dose 1 recipients versus controls (adjusted OR 2.3, 95 % CI 1.2–4.3), but not among mRNA vaccine recipients after any dose. Risk of anaesthesia/paresthesia were increased following ChAdOx1 dose 1 (aOR 4.7, 1.7–13.1), and consistently but not statistically significantly higher following any dose of either mRNA vaccine. Risk of loss of smell/taste was decreased among recipients of any dose of either mRNA vaccine versus controls. ConclusionsThe results support the safety of COVID-19 vaccines while confirming reported associations between ChAdOx1 dose 1 and neurological events. Participant-based AEFI surveillance is a useful component of post-market surveillance programs.

Food insecurity and substance use among young adults in the United States

PurposeThe purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18–25 in the U.S. MethodsA cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January–April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination. ResultsNearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors. ConclusionFood insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.

South African Chiropractic Students’ Intentions, Motivations, and Considerations for Emigration: A Cross-Sectional Study

ObjectiveThe purpose of this study was to investigate the emigration intentions of South African senior chiropractic students upon graduation, emphasizing motivations and considerations guiding migration decisions. MethodsA cross-sectional, quantitative, and exploratory approach was employed, utilizing an anonymous and adapted online survey administered to chiropractic students at 2 South African institutions (n = 177) between March 15 and May 19, 2021. Data were analyzed using frequencies, descriptions, and cross-tabulations to identify trends and interrelationships related to students’ intentions to emigrate postqualification. ResultsFindings indicate that 75.5% of South African chiropractic senior students intend to emigrate. Motivations for emigration include improved quality of life and seeking of opportunities. Economic instability in South Africa (SA) (82.7%) and concern for the National Health Insurance implementation (57.7%) serve as a significant push factor, whereas economic stability abroad (85.7%) emerged as a key pull factor. Preferred emigration destinations are primarily developed countries with established chiropractic communities. ConclusionHigh emigration intentions among students were driven by diverse push factors in SA, including economic decline, socio-political climates, and safety concerns, contrasting with pull factors abroad, such as better opportunities, living conditions, and economic stability. Concerns regarding healthcare reforms, particularly the National Health Insurance, are also highlighted. Destinations in order of preference such as the United Kingdom, Canada, and Australia offer valuable insights for policy interventions. Understanding these dynamics is crucial for developing effective retention strategies and addressing socio-economic challenges.

Student radiographers’ confidence of adapting practice for autistic patients: A qualitative survey on the role of placement experiences

IntroductionHealthcare services can be inaccessible to autistic people without adaptions to clinical practice and the care provided. Therefore, understanding how radiographer education develops students' confidence in adapting care for autistic patients is crucial. This study aimed to explore how placement experience impacts student radiographer confidence in adapting care for autistic patients. MethodsUK final-year student diagnostic and therapeutic radiographers were invited to complete a qualitative online survey. The survey asked for a description of placement experiences; of observing and/or performing the care of autistic patients and how this impacted confidence in caring for autistic patients. The data was thematically analysed. Results43 responses (of 44 received) were included, from which 5 themes emerged. Those who felt placement experiences developed confidence described opportunities to apply theory learnt at university (theme 1) or drew attention to the benefit of prior (external) experience with autistic people (theme 3). However, the balance of power with the supervising radiographer (theme 2), witnessing autistic patients in distress (theme 4), and the heterogeneous nature of autism (theme 5) disrupted students’ development of confidence. ConclusionSeveral participants in this study found clinical placement developed confidence with autistic patients through applying knowledge and providing an opportunity for reflexive learning. However, various obstacles hindered this development, such as witnessing distressed patients, limited experiences with autistic patients and difficulty navigating relationships with radiographers. Implications for practiceTo improve student radiographers’ confidence of providing care for autistic patients, educators should consider methods, e.g., co-produced simulation, to fill potential gaps in their experience. There is also a pressing need for all radiographers to understand their responsibility in educating students and their impact on student wellbeing.

Determinants of Salary Variation and the Gender Pay Gap: A Survey of the American Association of Hip and Knee Surgeons (AAHKS) Surgeon Member Workforce

BackgroundThe increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives. MethodsAn online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023. Surgeon demographic data, experience, practice geography and type, and annual case volume were solicited. Univariate and multivariate analyses were performed to describe the association of respondent characteristics with reported salary directly from patient care, as well as indirect revenue streams. ResultsA total of 730 AAHKS members responded to the survey. The largest proportion of surgeons performed 251-400 cases annually (36%); 81% (n = 592) and 93% (n = 679) of respondents identified as white and male, respectively. Case volume was the primary determinant for surgeon salary, followed by practice type, years in practice, and gender. After controlling for confounding variables, multivariate analyses revealed the direct salary of women surgeons was 14.4% less than men [95% confidence interval, 0.4%-28.3%]. When considering indirect revenue, the gender pay gap widened. Salary was not associated with reported hours worked per week, geographic location, or ethnicity. ConclusionsSalary is an important but underdiscussed subject that reflects the realities of our culture and value system in medicine. A direct relationship between salary and modifiable variables like case volume is clear. However, after controlling for confounders, women arthroplasty surgeons still earn 86 cents on the dollar compared to their male colleagues from direct surgical revenue.

Emotion recognition and clinical empathy: An observational study of nurses

AimTo explore nurse ability to recognize emotion and its association with clinical empathy. BackgroundEmpathy is elemental to nursing care and positively effects patient and nurse outcomes, yet self-reported clinical empathy has declined over the past decade. One hypothesized contributor to the ability of a nurse to be empathic is whether they can recognize emotion, a phenomenon thus far unstudied among nurses. MethodsThis cross-sectional study used online survey methods to collect data from 166 licensed nurses employed in one of 22 hospitals in Florida, USA. The Geneva Emotion Recognition Test-Short Form (GERT-SF) measured behavioral empathy—the ability to identify 7 positive and 7 negative basic emotions from non-language-based audiovisual clips with actors expressing these emotions. The Jefferson Scale of Empathy-Health Professionals measured self-reported clinical empathy in patient care. Demographic and work-related factors were assessed with investigator-designed items. Descriptive and bivariate statistical analyses were employed. ResultsAlthough nurses self-reported very high clinical empathy, their ability to recognize emotions using the GERT-S tool was fair. Emotion recognition and clinical empathy were weakly correlated (r = 0.175, p = 0.024, 95 % CI = 0.02–0.32). The least recognized emotion for the participants to identify was anxiety. No demographic variables were associated with either emotion recognition or clinical empathy. ConclusionsThese findings expose how nurse perceptions of being empathic may poorly align with the ability to recognize a patient's emotional response. Thus, findings have implications for teaching empathy, as well as for how researchers validly and reliably measure these constructs.