Open-ended Questions Research Articles

Leadership in intellectual disability practice: design, development, and evaluation of a programme to support practice

BackgroundIntellectual disability services have and continue to experience changes in service provision. This has an implication for leadership in practice as the quality of leadership has a direct influence on staff practice and care provided.AimTo design, deliver, and evaluate a leadership programme for nurse and social care managers in Ireland.DesignAn accredited programme was designed based on evidence from literature, practice, and national expertise. A cross-sectional survey was used to collect information on the attitudes and behaviour of participants before commencing and after completing the programme. Data from the questionnaires were analysed using SPSS and open-ended questions were analysed using content analysis.SettingIntellectual disability services.Participants102 participants completed the programme and survey.MethodsPre-post survey and reported using the CROSS guidelines.ResultsParticipants’ expectations were rated highly, and all items scored higher in the post-survey. Qualitative data was overall positive regarding opportunities for more time to work through each aspect of the programme. The key learning was through the forum day where participants shared their group projects.ConclusionsOverall, the programme was positively evaluated and through engaging with the programme participants’ perceptions moved from seeing leadership as mostly task-oriented to realising that qualities such as good communication, person-centredness, advocacy, supporting, role modelling, and empowering are key to leadership.

Fostering Social Connectedness in First Year Seminar Students: A Pilot Study

University First Year Seminar (FYS) programs are diverse in their content and pedagogy. Yet all seek to assist first-year students in the difficult college transition. The purpose of this pilot study was to evaluate if grouping similar academic majors into the existing First Year Seminar (FYS) courses would improve social connectedness, use of academic resources, and engagement on campus. A subset of first year students were assigned to either the control group (CON) of normal mixed major sections, or to the experimental course (EXP) with only related majors. Thirteen EXP and 36 CON students completed the data collection, including an 18-question social support survey administered at the beginning and end of the course. Additionally, two open-ended qualitative analysis questions were asked related to student expectations and perceived course outcomes. Lastly, the three instructors of the EXP and CON courses studied were interviewed using phenomenological methods approximately one week after the end of the semester. Between-groups analysis of the 18 quantitative survey questions identified that the CON group reported more personal conversations with peers and attendance of campus activities while the EXP group reported more faculty interactions. At the beginning of the course, 77% of the EXP group expected to create social connections as a primary course outcome, while only 19% of the CON group did. Academic skills were a higher expectation among the CON group than the EXP group. When asked more directly, both groups expected to make social connections in the class (86%). However, by the end of the study, the reported outcomes were equivocal. Interviews with FYS professors uncovered their own valuable perceptions of connectedness to the university and recommendations for instructor support were made.

“That does not apply”: graduate students’ (mis)perceptions of the racial climate in STEMM

Purpose This study aims to explore how science, technology, engineering, mathematics and medicine (STEMM) graduate students’ experiences with and conceptualizations of racism can more clearly expose the current racial climate across multiple academic institutions. Design/methodology/approach A mixed-method approach using a single online questionnaire consisting of open-ended and Likert scale questions about their perceptions of the racial climate in their department was completed by 34 graduate students of different races and STEMM disciplines. Findings Results from this study suggested that graduate students, regardless of race, consistently perceive STEMM as colorblind. The results also suggest that experiencing or witnessing racial discrimination is potentially predictive of perceptions of negative social support. Furthermore, multiracial and international graduate students often face different experiences of discrimination than do other graduate students. Originality/value By better understanding STEMM academic climates, higher education institutions can begin to reflect on the social barriers that may limit minoritized students from matriculating in academic STEMM spaces and affect retention.

A Qualitative Study on Digital Citizenship Education in Primary Schools

In recent years, the number of studies related to digital citizenship has increased amidst the intense use of digital media. The literature, rich in theoretical and empirical examples related to this topic, provides a clear picture of contemporary society. There is little empirical research on digital citizenship education in the early school years. Thus, through this investigation, we aimed to collect qualitative data on the development of specific digital competencies and digital citizenship in primary school students. Therefore, the authors considered it appropriate to use the observation method in its participatory version. Over a year, a group of 29 pupils, aged between 6 and 7, formed the sample to identify how they would develop digital competencies and digital citizenship in the context of formal and non-formal learning experiences. To collect the necessary information, we used the observation protocol, conducted in the form of open-ended questions described by Gay, Mills & Airasian (2006). The results of the study showed that parental educational attainment, family structure, time spent online, and the type of device have an important impact on the development of digital competencies and digital citizenship in young learners.

How the public understands and reacts to the term “climate anxiety”

The term climate anxiety has increasingly appeared in the academic literature and popular discourse since 2019, typically when discussing young people's negative emotional responses to climate change. This paper reports results from a nationally representative survey of the Norwegian public (N = 2040) that investigated whether people respond differently to descriptions of young people “having climate anxiety”, compared with being “concerned” or “worried” about climate change. Results from the survey experiment showed stronger support for politicians taking young people's climate concern or climate worry into consideration when designing new climate policy as compared with young people's climate anxiety. Analyses of an open-ended question asking what people think of when they hear or read the term “climate anxiety” showed that most respondents (52%) provided neutral descriptions (e.g., worry about climate change impacts), 27% viewed climate anxiety as unfounded, irrational, or excessive, and equal proportions of respondents critiqued the term specifically for contributing to such negative associations (6%) or referred to climate anxiety as a reasonable and rational reaction (6%). These findings indicate that among some audiences, using the term climate anxiety may provoke reactance and be perceived as distracting from political actions to mitigate climate change. Our results give important insights into the potential consequences of the terms we use when reporting on climate distress.

Detecting lies in investigative interviews through the analysis of response latencies and error rates to unexpected questions

In this study, we propose an approach to detect deception during investigative interviews by integrating response latency and error analysis with the unexpected question technique. Sixty participants were assigned to an honest (n = 30) or deceptive group (n = 30). The deceptive group was instructed to memorize the false biographical details of a fictitious identity. Throughout the interviews, participants were presented with a randomized sequence of control, expected, and unexpected open-ended questions about identity. Responses were audio recorded for detailed examination. Our findings indicate that deceptive participants showed markedly longer latencies and higher error rates when answering expected (requiring deception) and unexpected questions (for which premeditated deception was not possible). Longer response latencies were also observed in participants attempting deception when answering control questions (which necessitated truthful answers). Moreover, a within-subject analysis highlighted that responding to unexpected questions significantly impaired individuals’ performance compared to answering control and expected questions. Leveraging machine-learning algorithms, our approach attained a classification accuracy of 98% in distinguishing deceptive and honest participants. Additionally, a classification analysis on single response levels was conducted. Our findings underscore the effectiveness of merging response latency metrics and error rates with unexpected questioning as a robust method for identity deception detection in investigative interviews. We also discuss significant implications for enhancing interview strategies.

Promotion of a social prescribing pathway to general practitioners in a rural area (a feasibility study protocol)

PurposePsychosocial problems, including social isolation and loneliness, are prevalent in rural communities and can impact the use of health services and health outcomes. Current approaches to managing patients with predominantly psychosocial issues may not be the most appropriate. Social prescribing (SP) is a relatively new way of linking patients with sources of non-medical support within the community. Emerging literature suggests that community-based, non-medical activities are an effective and preferred approach to managing psychosocial problems. However, there is little evidence describing the attitudes of general practitioners (GPs) towards formal SP pathways.Design/methodology/approachThis research will occur in a general practice in a rural area of Tasmania, Australia. The project will deliver an education module to rural GPs to highlight the benefits of SP and provide a streamlined pathway for referring patients to community support hubs. Existing community organisations will act as “link workers” to connect patients with suitable community activities. GPs will complete a baseline and follow-up survey to measure their perception of SP and the acceptability, feasibility and appropriateness of such an intervention.FindingsThe acceptability, feasibility and appropriateness of the pathway will be assessed using published measures. Free-text responses to open-ended questions will be used to complement the quantitative data. A hybrid effectiveness-implementation method will be used to gather information about the rate of uptake and quality of the SP referral process and identify barriers and facilitators of the process in a real-world setting.Research limitations/implicationsWhile qualitative data for SP programmes is predominantly positive, quantitative data is lacking. Although the planned project is relatively short, it will provide a basis for future SP programme implementation and guide the approach to data collection and implementation assessment.Social implicationsThe barriers to and facilitators of introducing a SP programme in a rural general practice setting may be used to guide the development and implementation of future large-scale SP interventions. This research is both timely and relevant as the problem of social isolation and loneliness, especially in rural areas of Australia, is becoming more well-recognised as a driver of poor health and unnecessary health service usage.Originality/valueUsing SP to address psychosocial risks may reduce healthcare burden and costs. Few SP programmes have been delivered and formally assessed in Australia, and the best way to implement SP locally remains unclear. By delivering a SP intervention in a rural setting and assessing GPs’ responses, future SP projects will be better able to design and integrate social and medical care services.

Exploring the Features of Mobile Language Learning Apps (MELLAs) for Improving English Language Skills in College Level Students

This study investigated the features of mobile language learning apps (MELLAs) that college students prefer for improving their English skills. The research surveyed 40 students from two government colleges in Khairpur. The researcher employed a mixed-methods approach, analyzing quantitative data in MS-Excel (likely survey responses agree, strongly agree, neutral, disagree, strongly disagree) in tables first, followed by qualitative data (potentially open-ended questions through face-to-face interviews) presented in graphs based on the quantitative findings. The study suggests that using MELLAs for self-directed learning is an effective way for college students to improve their English, favoring this approach over traditional methods in which students use themselves. It is said to be self-directed language learning that saves time. Further, this study recommends improving language learning apps and learning strategies. It aims to provide a foundation for future studies in this area, potentially benefiting learners, teachers, parents, and others interested in mobile language learning.

Factors that influence the scope of practice of the chiropractic profession in Australia: a thematic analysis.

Scope of practice has been defined as the activities that an individual health care practitioner is allowed to undertake within a specific profession. The chiropractic profession in Australia does not currently have a documented scope of practice. Informed discussions around scope of practice are hampered by a paucity of literature in this area. Acknowledging this void in the literature, we chose to investigate the factors that influence scope of practice of the chiropractic profession. A knowledge of the factors will facilitate discussion on the topic and help the profession to work towards establishing a scope of practice.Aim The aim of this study was to identify the factors that influence scope of practice of chiropractic in Australia from the perspective of 4 stakeholder groups within the profession.Methods This study employed semi-structured, online-interviews. Open-ended questions, guided by a flexible interview protocol, and augmented by supplemental questions, probes and comments, were used to gather data on the research question. Data were analysed using reflexive thematic analysis.Results Six factors that influenced scope of practice of chiropractic were identified in this study: education, evidence (research-derived and practice-based), political influence, community expectations, entrepreneurial business models, and geographical location.Conclusion Knowledge of the factors that influence scope of practice of chiropractic in Australia is important for establishing a scope of practice for the profession. This knowledge is also of value to a range of stakeholders including patients, health care providers (within and outside the profession), professional associations, and policymakers.

Knowledge, attitudes and practices of using Indocyanine Green (ICG) fluorescence in emergency surgery: an international web-based survey in the ARtificial Intelligence in Emergency and trauma Surgery (ARIES)-WSES project.

Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency settings. Between March 08, 2023 and April 10, 2023, a questionnaire composed of 27 multiple choice and open-ended questions was sent to 200 emergency surgeons who had previously joined the ARtificial Intelligence in Emergency and trauma Surgery (ARIES) project promoted by the WSES. The questionnaire was developed by an emergency surgeon with an interest in advanced technologiesand artificial intelligence. The response rate was 96% (192/200). Responders affirmed that ICG fluorescence can support the performance of difficult surgical procedures in the emergency setting, particularly in the presence of severe inflammation and in evaluating bowel viability. Nevertheless, there were concerns regarding accessibility and availability of fluorescence imaging in emergency settings. Eighty-seven out of 192 (45.3%) respondents have a fluorescence imaging system of vision for both elective and emergency surgical procedures; 32.3% of respondents have this system solely for elective procedures; 21.4% of respondents do not have this system, 15% do not have experience with it, and 38% do not use this imaging in emergency surgery. Less than 1% (2/192) affirmed that ICG fluorescence changed always their intraoperative decision-making. Precision surgery effectively tailors surgical interventions to individual patient characteristics using advanced technology, data analysis and artificial intelligence. ICG fluorescence can serve as a valid and safe tool to guide emergency surgery in different scenarios, such as intestinal ischemia and severe acute cholecystitis. Due to the lack of high-level evidence within this field, a consensus of expert emergency surgeons is needed to encourage stakeholders to increase the availability of fluorescence imaging systems and to support emergency surgeons in implementing ICG fluorescence in their daily practice.

Dentists' perspectives, practices, and factors associated with informed consent process for fixed prosthodontic treatment: a cross-sectional study of kampala metropolitan area, Uganda.

Dentists have a legal and ethical obligation to obtain informed consent from patients before carrying out treatment. In Uganda, the process of obtaining informed consent in dentistry is not well documented. The aim of the present study was to determine dentists' perspectives and practices regarding informed consent to fixed prosthodontic treatment (FPT) in Kampala Metropolitan, Uganda. A quantitative cross-sectional study was conducted among 153 dentists from July to September 2023. Data were collected using a semi-structured self-administered questionnaire that included both closed- and open-ended questions. The questionnaire included items on participants' sociodemographic information, perspectives, and practices about informed consent for FPT. Perspectives were rated using ten items on a five-point Likert scale. The minimum possible total score was 10, and the maximum possible score was 50. Descriptive statistics and Poisson regression were used to summarize and analyze the quantitative data, and the significance level was set at p < 0.05. Open-ended items were analyzed using content analysis. The majority (83.9%) of the participants were general dentists with working experience ranging from 1 to 38 years and a median of 8 years. The majority were familiar with the concept of informed consent and had positive perspectives regarding its use for FPT. The mean score for perspectives was 39.27 (SD, 5.42). However, there were variations in the practices of the dentists. More than three-quarters (87.6%) reported that they always obtained the patient's informed consent before FPT. Less than a third (29.4%) obtained written consent for FPT. About half of the dentists provided information regarding the procedure, benefits, and risks of treatment during the consent process. Bivariate analysis showed that the use of written consent for FPT was significantly (p < 0.05) associated with having a work experience of more than 10 years and having had training involving informed consent after undergraduate studies. The present study provides baseline data regarding perspectives and practices regarding informed consent for FPT among dentists in Uganda. It is recommended that regular training courses be developed to highlight the importance of improved informed consent practices for patient protection and to instruct dentists about obtaining valid informed consent. There is a need for future research to streamline guidelines for the informed consent process in dental care in Uganda.

Enhancing Cardiac Arrest Skills: Exploring Student Nurses’ Journey through Mental Simulation to Self-efficacy

Objective: This study explores mental simulation (MS) as a potential tool for enhancing skill acquisition and readiness among student nurses in life-saving procedures, particularly in high-stress, time-sensitive situations like cardiac arrest. It aims to investigate the impact of MS on learning life support skills and creating self-officious students in nursing education. Methods: The study combines a theoretical framework grounded in social constructionism with qualitative research methods. We utilize a qualitative reflexive thematic analysis approach. Eleven pre-registration student nurses participated in interview-based investigations after engaging in a 4-week MS program. Data collection utilized open-ended questions, allowing participants to express their experiences and perceptions regarding MS for life support skill acquisition. Results: The research identified six key themes and sub-themes: “Motivation to learn”, “emulating reality”, “emulating real-world intensity”, “emotional resonance”, “harmonizing reflective practice”, and “empowering confidence”. Participants reported using MS to address self-efficacy challenges, creating vivid simulated experiences, inducing real-world intensity, personalizing visualizations, fostering reflective practice, enhancing team understanding, and demystifying cardiac arrest skills, ultimately empowering confidence in employing their cardiac arrest skills. Conclusion: The findings underscore MS’s potential as a valuable training tool in nursing education. MS not only bridges knowledge gaps but also prepares student nurses for real-life scenarios, demystifying cardiac arrests and enhancing self-efficacy. The study advocates for the integration of MS alongside traditional training methods to enhance preparedness and confidence among student nurses in critical life support situations. Further research could explore the broader implications of MS across various healthcare contexts.

Prospective Teachers' Views on Teaching Science Concepts

This study aims to investigate the views of pre-service teachers who have taken the "Science Teaching" course in the undergraduate program of classroom teaching about the teaching of science concepts. In this study, the phenomenology study approach, one of the qualitative research designs, was used. The study group of this research consisted 75 pre-service teachers, 56 female and 19 male, studying in the third year of the undergraduate primary teaching program of a state university. In this study, the views of the pre-service teachers who took the science teaching course about the teaching of science concepts were determined through four open-ended questions followed by face-to-face semi-structured interviews with eight participants. It can be said that the idea that prototype examples should be given about a concept in concept teaching is known by pre-service teachers (82.3%). It was observed that the pre-service teachers were aware of a misconception about force as a science concept (90.7%), but they had difficulty writing the main views of learning theories (48.0%). It is an important detail that the participants did not see the exams as tools to eliminate misconceptions at a high rate (82.7%). Interviews were conducted with eight participants who volunteered and had available time about the answers they wrote for four open-ended questions. It was seen that the participants’ opinions supported the findings of this study. Some suggestions were made based on the findings of the study.

‘Do young legislators face age-based discrimination in parliament? Views from young MPs across the globe'

ABSTRACT There is a growing literature on youth representation in parliament illustrating a stark underrepresentation of adults aged 35 years or under, as well as 40 years or under, in most national legislatures across the globe. However, we know less about the kind of treatment young MPs receive once elected to parliament. Through a survey with structured and open-ended questions, featuring 144 young legislators across the globe, we illustrate that – judging by these perceptions – youths’ obstacles in politics do not stop at the electoral stage. A sizeable number of young MPs from our sample report that they experience ageism in many national legislatures. Most frequently, such perceived ageism is informal. In the view of young MPs, it manifests itself in subtle and not-so-subtle forms of discrimination and belittling treatment. For the broader literature on representation, this implies that the disadvantage youth face during elections might continue once in parliament, with the potential risk that this group of legislators has less influence in parliament than other groups.

'I only eat because I have to-to live': The impacts of dysphagia on quality of life from the perspectives of people with dysphagia, supporters of people with dysphagia and allied health professionals.

A recent literature review identified that past research has described the impacts of dysphagia on quality of life; but there is limited research on these impacts from the perspective of people with dysphagia, their supporters and allied health professionals. Recent qualitative research has provided details about these perspectives, but researchers have also called for verification of these findings with a larger group of participants. To expand upon the findings of the prior qualitative research on the views of people with dysphagia, supporters of people with dysphagia,and allied health professionals on the impacts of dysphagia and texture-modified food on quality of life. An online survey of adults with dysphagia (n = 30), supporters of people with dysphagia (n = 4) and allied health professionals (n = 18) was conducted between November 2021 and February 2022. Categorical questions were analysed descriptively and open-ended questions were analysed for content categories of meaning. Participants with dysphagia reported that dysphagia and texture-modified foods had a greater impact on their physical health than on their choice and control or social engagement. Supporters and allied health professionals viewed that dysphagia impacted the physical health and their choice and control of people with dysphagia. Across groups, participants considered that mealtime enjoyment, participation, and inclusion were influenced by the control the person had over their meals, the accessibility of the mealtime environment, and the attitudes of others. Dysphagia and its interventions negatively impact quality of life for people with dysphagia. People with dysphagia were the most affected by the physical impacts of dysphagia. Their perspectives contrasted with those of supporters and allied health professionals in some domains, highlighting the need for people with dysphagia to be included in research. Future research exploring how these perspectives are integrated into person-centred dysphagia management is warranted. What is already known on the subject Recent qualitative research has provided insights into the impacts of dysphagia on quality of life from the perspective of people with dysphagia, supporters of people with dysphagia, and allied health professionals. However, the small scale of these studies means that further research is needed with a larger group of people with dysphagia, supporters of people with dysphagia, and allied health professionals. What this paper adds to existing knowledge This paper verifies and extends upon the findings of prior qualitive research on the views of people with dysphagia, supporters of people with dysphagia, and allied health professionals on the impacts of dysphagia and its interventions on quality of life, participation, and inclusion. What are the potential or actual clinical implications of this work? This research shows the importance of supporters of people with dysphagia and allied health professionals discussing mealtime quality of life with the person with dysphagia so that their perspectives are considered in the mealtime decision-making process. Furthermore, people with dysphagia should be able to specify strategies they want to trial to enhance their mealtime participation and inclusion.

Awareness and perceptions of artificial intelligence in dentistry: A cross-sectional survey among Indian dental professionals

Introduction Artificial intelligence (AI) is inevitably going to impact healthcare including dentistry and will become an essential tool in medical diagnosis and decision-making. Dental professionals must be familiar with growing trends in dentistry such as AI and its future scope. Despite the positive developments in AI research, there are divergent perspectives on its benefits and risks among stakeholders. We intended to understand the knowledge, awareness, and perceptions of dental professionals towards AI and its applications in dentistry. Methods and Material A semi-structured, 25-item Google form questionnaire consisting of closed and open-ended questions was made and the link to answer the survey was circulated among postgraduate students, dental academicians, and practitioners across India in an online mode, and the responses were collected and analyzed. Results 83.3% of participants were aware of AI and its applications. Most of the participants understood the attributes, advantages, and disadvantages of AI. Interestingly 72% of participants agreed that they have witnessed AI being used in clinical practice and 92.7% agreed to use AI for diagnosis. 65.3% expressed concern over unemployment due to AI and 85% agreed that AI has ethical issues. Over 85% of participants agreed AI should be a part of the postgraduate dental curriculum. Conclusions We found that dental professionals are updated with AI technology and showed a willingness to adopt AI into dental practice. The participants lacked a deeper understanding of AI and concerned about the potential risk of unemployment resulting from AI and trusting AI alone in dental diagnosis. Keywords: Artificial intelligence, Cross-sectional survey, Dentist, Knowledge, Perceptions.

Unveiling the clinical incapabilities: a benchmarking study of GPT-4V(ision) for ophthalmic multimodal image analysis

PurposeTo evaluate the capabilities and incapabilities of a GPT-4V(ision)-based chatbot in interpreting ocular multimodal images.MethodsWe developed a digital ophthalmologist app using GPT-4V and evaluated its performance with a dataset (60...

Intaka Workshop: Innovation, Research, Interdisciplinarity, And Interculturality With The Taptana Cañari - A Novel Approach to Education

Objective: This article To analyze the relevance of the INTAKA Workshop in strengthening cultural identity and preparing students for the challenges of the 21st century. Theoretical Framework: The Ecuadorian Curriculum of 2016 seeks to integrate interculturality, innovation, and ancestral knowledge into education. However, traditional approaches still predominate. Method: An instrumental case study was applied to the 44 participants of the workshop. A qualitative questionnaire with open-ended questions was applied, and a content analysis was carried out. Results and Discussion: The results showed that the INTAKA Workshop promotes interdisciplinary and intercultural learning through practical activities with the Taptana Cañari, an ancestral mathematical tool. It fosters critical thinking and social responsibility. Participants positively evaluated the experience and highlighted its impact on learning and cultural identity. In the discussion, the results supported the relevance of the INTAKA Workshop as an innovative alternative to overcome the challenges of current education. Implications of the Research: It’s interdisciplinary, intercultural, and value-oriented approach has the potential to strengthen cultural identity, promote meaningful learning, and prepare students for the 21st century. Originality/Value: This study contributes to the educational literature by presenting the INTAKA Workshop as an unprecedented pedagogical initiative that integrates Cañari cultural richness with interdisciplinary learning. This study presents an innovative proposal to strengthen cultural identity and prepare 21st-century students, using the Taptana Cañari as a teaching tool and promoting vlues such as solidarity.

#2168 Lupus nephritis histopathological classification system: a questionnaire-based survey of the Renal Pathology Society (RPS)

Abstract Background and Aims Kidney biopsy is the gold standard for lupus nephritis diagnosis, defining histologic class, disease activity and chronicity in detail and providing guidance for treatment. The updated 2018 ISN/RPS histopathological classification in lupus nephritis is widely used for prognosis and treatment decisions. Given the evolving phenotypes of lupus nephritis and the success of new targeted agents in clinical trials, there is ongoing discussion about the need for updating existing classification systems. A survey to assess the current use of the lupus nephritis histopathological classification systems in everyday practice was conducted on behalf of the RPS. Method An online survey was sent between September 27th and October 24th, 2023 to active members of the RPS. The survey used an internet platform and contained both multiple-choice and open-ended questions; results were analyzed anonymously. Results 185 of 562 RPS members replied to the questionnaire. 179 (97%) were pathologists and the level of expertise in lupus nephritis was good: 120 (65%) participants indicated they encounter more than 20 biopsies with lupus nephritis per year, while only 13% encounter fewer than 10. Almost 90% of responders discuss kidney biopsy results in a multidisciplinary meeting involving both clinicians and pathologists, on a weekly or monthly basis. The 2018 ISN/RPS lupus nephritis classification is used in most cases (92%), while 7% of participants prefer the earlier 2004 version. The average grade on the utility of the 2018 ISN/RPS classification was 8 (IQR 7-9) on a scale from 0 (not useful) to 10 (extremely useful). Almost 90% of the pathologist responders indicated they include the NIH activity/chronicity indices in biopsy reports. Reasons for not adding the activity/chronicity indices were given as responses to open-ended questions: (1) clinicians usually do not ask for activity/chronicity indices—(2) the extra workload outweighs the perceived clinical benefit—(3) a quantitative description of the degree of activity/chronicity is less time-consuming and more understandable than the indices—(4) reproducibility is not guaranteed. The average grade on the utility of the activity/chronicity indices was 7 (IQR 7-9) on a scale from 0 (not useful) to 10 (extremely useful). Pathologists rated treating clinicians' understanding of kidney biopsy reports and lupus classification at light microscopy with an average score of 8 (IQR 7-9) on a scale from 0 (no understanding) to 10 (complete understanding). Suggested improvements of the 2018 ISN/RPS lupus nephritis classification were further standardization and simplicity. Clearer definitions were requested for: class III vs class IV; segmental sclerosis vs fibrotic crescents; the role of globally sclerosed glomeruli; lupus-like entities; and lupus podocytopathy. Furthermore, there was a request on guidelines for new parameters: e.g., focus on extraglomerular involvement, laboratory and clinical features and biomarkers; CD68+ staining to detect endocapillary hypercellularity; and EXT1/2 immunostaining. Conclusion Our survey shows the 2018 ISN/RPS lupus nephritis classification is widely used in everyday practice by pathologists, and well known by clinicians. The results obtained by the RPS survey serve as a starting point for the new Working Group of lupus nephritis classification. We will consider the ideas and suggestions of the international community to evaluate biopsies from extensively phenotyped cohorts, to modify the classification and to facilitate improved targeted treatment decisions—a current unmet need.

The role of bicultural stress and shame on the well-being of South Asian college students in the United States.

South Asian U.S. college students experience socialization from South Asian cultures they grew up with and White culture outside the South Asian community. The present study considers that the ways of navigating two conflicting cultures and experiences of shame are associated with anxiety and life satisfaction among South Asian U.S. college students. An anonymous survey, distributed to 271 South Asian students (mean age = 22, 38.2% male, 59.2% female, 2.3% nonbinary), quantitively assessed how bicultural stress and shame are related to anxiety and life satisfaction. Open-ended questions asked students to describe experiences of bicultural identity stressors and shame. Survey results indicated bicultural stress and shame as predictors of anxiety and lower life satisfaction. Thematic analysis of open-ended question responses revealed experienced stressors related to academics, finances, family expectations, and fitting in. Shame experiences were tied to bicultural stress and family and self-imposed expectations of participants. There is a need to further investigate the relationships found in the present study and explore ways to support South Asian students experiencing bicultural stress and shame. (PsycInfo Database Record (c) 2024 APA, all rights reserved).