Postal Mail Research Articles

Parent-Reported Outcomes of Early Childhood Selective Dorsal Rhizotomy for the Treatment of Spastic Diplegia.

BackgroundA selective dorsal rhizotomy (SDR) is employed to treat spastic cerebral palsy. The surgical techniques and patient care protocols vary among hospitals. One of the variations is the age cut-off for SDR. We have been advocating SDR to be performed early - especially at ages 2 and 3. With this study, we are reporting the feasibility and parent-reported surgical outcomes of receiving SDR at an early age for the treatment of spastic diplegia.ObjectivesOur aim is to examine the safety and benefits of receiving SDR at the ages of 2 and 3 for the treatment of spastic diplegia.MethodsThe Institutional Review Board (IRB) of Washington University School of Medicine approved this retrospective quality of life survey and chart review (approval #202009056). The subjects of this study were children and teens (ages: 3.9-18.1) with spastic diplegic cerebral palsy who underwent SDR at ages 2 or 3 between years 2005 and 2019 at St. Louis Children’s Hospital. Only domestic patients that were minors at the time of the study were selected to be participants in compliance with IRB regulations to protect patient health information that could potentially be breached by sending information to an incorrect or dated email. Thus, all contact was made through postal mail. The study included 141 patients from a total of 362 eligible patients. Parents of eligible patients were sent the research survey via postal mail. Only patients who responded to the survey were included in this study. The survey included questions on demographic information, quality of life, health perception, motor and ambulatory functions, braces and orthotics, pain issues, side effects of SDR, and post-SDR treatment.ResultsThe study included 141 diplegic patients. Of all patients at the time of the study, 91% reported an improvement in walking, 92% in standing, and 89% in sitting. In daily life activities, 87% of patients became more independent after SDR. 65% of patients were able to walk without a walking aid and about 4% were not able to walk. 11% of all patients relied mostly on a wheelchair. Moreover, 43% of patients were able to run independently. Regarding post-SDR orthopedic surgery, 48% of patients received at least one type of orthopedic surgery, with Achilles tendon lengthening, hamstring lengthening, and calf muscle release being the most common types. ConclusionsSDR performed at an early age through a single-level laminectomy was proved feasible and safe. A follow-up until the adult age (18 years) showed improvements in walking and other motor functions. The results support the implementation of early-age SDR for the treatment of spastic diplegia.

COVID-19 Pandemic Restrictions Affecting Older Adults’ Social Interactions and Communication

ObjectivesDue to increased risk of social isolation caused by COVID-19, this study was conducted to understand changes in health behaviors among older adults, particularly concerning means of social interaction.MethodsCommunity dwelling adults ages 60 and older completed qualitative individual interviews via Zoom and a 24 item online survey, the Questionnaire for Assessing the Impact of the COVID-19 Pandemic in Older Adults. Data were analyzed using directed content analysis and descriptive statistics.ResultsA total of 23 participants completed interviews and 25 completed online surveys. Participants were mainly female (72%), white (96%), with a mean age of 71.96 years. Nineteen (76%) participants were very concerned by the pandemic, and only one participant was not at all concerned. Participants frequently reported more interactions with their immediate family. Only five (20%) reported communicating withclose friends and family less often than before the pandemic began. Seven (28%) reported communicating with friends and family more often than before and about half (52%) reported that their frequency of communication was “about the same” as pre-pandemic. Twenty-one (84%) participants communicated with others daily or at least several times per week. However, participants reported less face-to-face interaction and increased use of technology, such as virtual happy hours. All participants stayed in touch with others by phone calls (100%). Other often used means of communication were texting (92%), video calls (68%), email (68%), social media (52%), and postal mail (48%). Participants also reported some social gatherings with individuals bringing their own food and social distancing maintained. Despite this, 16 participants (64%) reported feeling isolated from others sometimes or often.ConclusionsAlthough many older adults have adjusted their usual behaviors to stay in contact with others during the pandemic, this study found that most still felt isolated. Long-term feelings of isolation and lack of social support may compromise nutrition for this population. Therefore, it is crucial that nutrition professionals incorporate aspects of social support when working with these individuals.Funding SourcesJulie O'Sullivan Maillet Research Grant Award funded by the Academy of Nutrition and Dietetics Foundation (ANDF).

Potential for optimizing the perioperative care in robotic prostatectomy patients by adoption of enhanced recovery after surgery principles.

Several benefits have been reported after applying the principles of enhanced recovery after surgery (ERAS) into the perioperative care of patients undergoing robot-assisted radical prostatectomy (RARP). Nevertheless, there are still barriers. We aimed to identify the key areas by systematically surveying urology departments in Germany and Austria. A 27-question survey on the adoption of ERAS principles for the perioperative care of RARP patients was designed, in compliance with the guidelines on good practice in conducting and reporting of survey research. After positive testing for face and content validity, the survey was distributed via postal mail to 82 departments performing RARP. In total, 39 departments responded to our survey (response rate 48%). The ERAS adoption rates ranged from 21 to 97%, with nine ERAS principles being widely adopted (72-92% of the departments). The lowest adoption rates and, subsequently, the largest potential for optimization were detected for the preoperative nutrition counselling (21%), preoperative pelvic floor physiotherapy (54%), postoperative early initiation of nutrition (44%) and postoperative patient audit for further quality improvement (36%). High-volume centers performed more frequently a perioperative nutrition counselling (8/27; 30%) than low-volume centers (0/12; 0%; p = 0.036). The implementation of the ERAS principles into the perioperative care algorithm were medium-to-high, yet not optimal. Our real-world data assessment revealed four key areas showing low adoption rates (nutrition counselling, preoperative pelvic floor physiotherapy, early initiation of nutrition and patient audit), implying a great potential for further optimization.

Patient Recruitment Into a Multicenter Clinical Cohort Linking Electronic Health Records From 5 Health Systems: Cross-sectional Analysis

BackgroundThere is growing interest in identifying and recruiting research participants from health systems using electronic health records (EHRs). However, few studies have described the practical aspects of the recruitment process or compared electronic recruitment methods to in-person recruitment, particularly across health systems.ObjectiveThe objective of this study was to describe the steps and efficiency of the recruitment process and participant characteristics by recruitment strategy.MethodsEHR-based eligibility criteria included being an adult patient engaged in outpatient primary or bariatric surgery care at one of 5 health systems in the PaTH Clinical Research Network and having ≥2 weight measurements and 1 height measurement recorded in their EHR within the last 5 years. Recruitment strategies varied by site and included one or more of the following methods: (1) in-person recruitment by study staff from clinical sites, (2) US postal mail recruitment letters, (3) secure email, and (4) direct EHR recruitment through secure patient web portals. We used descriptive statistics to evaluate participant characteristics and proportion of patients recruited (ie, efficiency) by modality.ResultsThe total number of eligible patients from the 5 health systems was 5,051,187. Of these, 40,048 (0.8%) were invited to enter an EHR-based cohort study and 1085 were enrolled. Recruitment efficiency was highest for in-person recruitment (33.5%), followed by electronic messaging (2.9%), including email (2.9%) and EHR patient portal messages (2.9%). Overall, 779 (65.7%) patients were enrolled through electronic messaging, which also showed greater rates of recruitment of Black patients compared with the other strategies.ConclusionsWe recruited a total of 1085 patients from primary care and bariatric surgery settings using 4 recruitment strategies. The recruitment efficiency was 2.9% for email and EHR patient portals, with the majority of participants recruited electronically. This study can inform the design of future research studies using EHR-based recruitment.

Provision of Care by "Real World" Telemental Health Providers.

Despite its effectiveness, limited research has examined the provision of telemental health (TMH) and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy (CBT) in their remote practice. The most commonly used in-session and between-session (i.e., homework) exercises included coping and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine.

Needs and Challenges Cattle Producers Face in Adapting Preconditioning Programs

Abstract Identifying the producer’s needs and challenges is the first step to understanding what types of programs will benefit producers the greatest. In the cattle industry, participation in calf preconditioning programs have slowly increased over the last two decades as more sellers and buyers recognize the economic benefits. However, for a seller to receive maximum benefit when marketing their cattle requires planning and an understanding of the components that go into a preconditioning program. Surveys are a practical way to gain useful information to develop programming to educate on developing preconditioning protocols that best fits their operation. Following the 2019 Oklahoma Quality Beef Network (OQBN) VAC45 fall certified sales, a survey was distributed electronically and by postal mail to participating cattle producers. The survey examined a number of aspects associated with preconditioning calves, management practices, operation size, demographics, and obstacles producers face when preconditioning calves. Participation rate was approximately 56% out of the 126 OQBN producers surveyed. Of the respondents, 52% did so electronically. Program ear tags moved to online sales in 2019 and 98% of respondents found ordering online convenient. These results would indicate that the use of technology is an increasing component in the cattle industry by producers and leading the way to the development of more tech related tools. Smaller operations marketing 50 or fewer head (72%) are utilizing preconditioning programs the greatest. Still, the biggest challenge reported by producers preconditioning calves was the expense (59%) associated followed by availability of labor (22%) and facilities (13.5%). Thirty-two percent of respondents indicated 5% or less morbidity rate, and 13% of respondents experienced 10% or less mortality rate. Thirty-three percent of producers estimated 1lb. or less ADG. Developing resources concerning the costliest components of preconditioning may be most crucial and beneficial to the producer to achieve a successful program.

Individual disaster recovery: A framework in the long-term recovery process after the Great East Japan Earthquake

In the aftermath of a disaster, individual recovery processes differ depending on the conditions of the victims. Improving the living conditions of individual victims is crucial in disaster recovery process. This study illustrates the trajectories and relationships of victims’ recovery perceptions in the long-term recovery process. The analyses also focus on the differences among the characteristics of victims. The target sites are tsunami inundation areas in Ofunato City, Iwate Prefecture, and Kesennuma City, Miyagi Prefecture, Japan, where a large number of people were affected, and many buildings collapsed after the Great East Japan Earthquake. Using data from a long-term panel survey, we examine the relationships among recovery perceptions, degrees of recovery perceptions, attributes, and time points. This study used three survey waves: in March 2012, January to February 2015, and February to March 2018. The survey was conducted by postal mail. To understand the relationships, multiple correspondence analyses were performed. In the relationships among all the recovery perceptions and attributes of respondents, we found five stages in the individual recovery process: securing basic subsistence, accessing public services, ensuring and improving stable housing life, re-shaping economic and social activities, and re-building communication activities. As living conditions are improved, communication opportunities and activities became essential in individual disaster recovery. The results also reveal a distortion in the distribution of recovery perception items, which was presumably accompanied by problems related to the decrease in work, income, and communication activities.

Preferences for Communication About End-of-Life Care in Atypical Parkinsonism.

Studies on preferences regarding discussions on end-of-life care (EOLC), advance care planning (ACP), medical assistance in dying (MAiD), and brain donation have not yet been conducted in patients with atypical parkinsonism (AP). The aim of this study was to know the preferences of patients with AP regarding discussions on EOLC, ACP, MAiD, and brain donation. This cross-sectional study was conducted in patients clinically diagnosed with AP. An adapted questionnaire that assessed various potential factors that affect patients' preferences regarding EOLC and ACP was sent through postal mail to 278 patients. A total of 90 completed questionnaires were returned. Most patients preferred to discuss at the time of diagnosis information about the disease, its natural course, treatment options, and prognosis. In contrast, they preferred that EOLC and ACP be discussed when the disease has progressed. No demographic or disease-related factors were found to be predictors of the patient's preferences. Notably, most patients (63.3%) had previous actual discussions on these issues. Less than a third of patients were open to discussions about MAiD and brain donation; older age and the importance of spirituality and religion decreased the odds of discussing these. Our study demonstrates that patients with AP have preferences regarding the timing of the discussion of the different themes surrounding EOLC and ACP. A needs-based approach in initiating and conducting timely discussions on these difficult but essential issues is proposed. A thorough explanation and recognition of a patient's beliefs are recommended when initiating conversations about MAiD and brain donation. © 2021 International Parkinson and Movement Disorder Society.

Recruiting a Probability-Based Online Panel via Postal Mail: Experimental Evidence

Once recruited, probability-based online panels have proven to enable high-quality and high-frequency data collection. In ever faster-paced societies and, recently, in times of pandemic lockdowns, such online survey infrastructures are invaluable to social research. In absence of email sampling frames, one way of recruiting such a panel is via postal mail. However, few studies have examined how to best approach and then transition sample members from the initial postal mail contact to the online panel registration. To fill this gap, we implemented a large-scale experiment in the recruitment of the 2018 sample of the German Internet Panel (GIP) varying panel recruitment designs in four experimental conditions: online-only, concurrent mode, online-first, and paper-first. Our results show that the online-only design delivers higher online panel registration rates than the other recruitment designs. In addition, all experimental conditions led to similarly representative samples on key socio-demographic characteristics.

System Architecture for "Support Through Mobile Messaging and Digital Health Technology for Diabetes" (SuMMiT-D): Design and Performance in Pilot and Randomized Controlled Feasibility Studies.

BackgroundDiabetes is a highly prevalent long-term condition with high morbidity and mortality rates. People with diabetes commonly worry about their diabetes medicines and do not always take them regularly as prescribed. This can lead to poor diabetes control. The Support Through Mobile Messaging and Digital Health Technology for Diabetes (SuMMiT-D) study aims to deliver brief messages as tailored interventions to support people with type 2 diabetes in better use of their diabetes medicines and to improve treatment adherence and health outcomes.ObjectiveThis paper describes the overall architecture of a tailored intervention delivery system used in the pilot and randomized controlled feasibility studies of SuMMiT-D and reports its performance.MethodsThe SuMMiT-D system includes several platforms and resources to recruit participants and deliver messages as tailored interventions. Its core component is called the clinical system and is responsible for interacting with the participants by receiving and sending SMS text messages from and to them. The personalization and tailoring of brief messages for each participant is based on a list of built-in commands that they can use.ResultsFor the pilot study, a total of 48 participants were recruited; they had a median age of 64 years (first quartile, third quartile [Q1, Q3: 54.5, 69]). For the feasibility study, a total of 209 participants were recruited and randomly assigned to either the control or intervention group; they had a median age of 65 years (Q1, Q3: 56, 71), with 41.1% (86/209) being female. The participants used the SuMMiT-D system for up to 6 months (26 weeks) and had a wide range of different interactions with the SuMMiT-D system while tailored interventions were being delivered. For both studies, we had low withdrawal rates: only 4.2% and 5.3% for the pilot and feasibility studies, respectively.ConclusionsA system was developed to successfully deliver brief messages as tailored health interventions to more than 250 people with type 2 diabetes via SMS text messages. On the basis of the low withdrawal rates and positive feedback received, it can be inferred that the SuMMiT-D system is robust, user-friendly, useful, and positive for most participants. From the two studies, we found that online recruitment was more efficient than recruitment via postal mail; a regular SMS text reminder (eg, every 4 weeks) can potentially increase the participants’ interactions with the system.Trial RegistrationISRCTN Registry ISRCTN13404264; http://www.isrctn.com/ISRCTN13404264

Information, switching costs, and consumer choice: Evidence from two randomised field experiments in Swedish primary health care

Consumer choice policies may improve the matching of consumers and providers, and may spur competition over quality dimensions relevant to consumers. However, the gains from choice may fail to materialise in markets characterised by information frictions and switching costs. We use two large-scale randomised field experiments in primary health care to examine if individuals reconsider their provider choice when receiving leaflets with comparative information and pre-paid choice forms by postal mail. The first experiment targeted a representative subset of the 1.3 million residents in a Swedish region. The second targeted new residents in the same region, a group expected to have less prior information and lower switching costs than the general population. The propensity to switch providers increased after the interventions in both the population-representative sample (by 0.6–0.8 percentage points, 10–14%) and among new residents (2.3 percentage points, 26%). The results demonstrate that there are demand side frictions in the primary care market. Exploratory analyses indicate that the effects on switching were larger in urban markets and that the interventions had heterogeneous effects on the type of providers chosen, and on health care and drug consumption.

A survey of the involvement of primary care doctors in HIV prevention and care in a low-prevalence, high-income setting

BackgroundIn high-income countries with a low HIV prevalence, primary care doctors are likely the first point of medical contact for people at high risk of HIV. One of the key factors for successful implementation of preventive measures is the cooperation of primary healthcare providers. Hong Kong’s population mostly seek primary care in the private sectors. Our study evaluated the involvement of private primary healthcare providers in HIV prevention and care.MethodsA cross-sectional postal structured questionnaire was administered to 1102 private primary care doctors in Hong Kong in December 2017. Responses were received via postal mail, fax or online. Non-respondents received a phone-call reminder to complete the survey. Descriptive analyses were performed for all the question items. Chi-square test was used to assess the association between participants’ level of involvement in HIV prevention and care and their demographics and medical practice characteristics.ResultsThe response rate was 17.9% (197/1102). Most of the respondents were Chinese (95%) and have obtained their primary medical qualifications in Hong Kong (72%). More than half of the doctors have practiced in the private sector for more than 20 years (54%). Six aspects were used to evaluate practices or involvements in HIV prevention or care: Most of the responding doctors had offered advice (61%) and/or HIV test (76%) to patients with high-risk behaviors. However, fewer doctors had diagnosed HIV (27%), provided care for HIV positive patients (21%), reported HIV cases (19%) or prescribed antiretrovirals (4%). Nine (4.5%) did not answer all six questions on their practices or involvements in HIV prevention or care. The remaining respondents were then categorized into no/low involvement group and high involvement group. Overall,71% had no/low involvement (133/188) compared to 29% who had high involvement (55/188). Factors associated with high involvement included being in the 50–59 age group (OR: 2.48, 95% CI: 1.12–5.5), and belonging to a large practice (OR: 3.16, 95% CI: 1.4–7.12).ConclusionsOverall, most private primary care doctors in Hong Kong have no or low involvement in HIV prevention and care. However, most were willing and experienced in providing general preventive services, such as HIV testing and advice.

The Long-Term Impact of Different Offline Population Inclusion Strategies in Probability-Based Online Panels: Evidence From the German Internet Panel and the GESIS Panel

While online panels offer numerous advantages, they are often criticized for excluding the offline population. Therefore, some probability-based online panels have developed offline population inclusion strategies. Two dominant approaches prevail: providing internet equipment and offering an alternative survey participation mode. We investigate the impact of these approaches on two probability-based online panels in Germany: the German Internet Panel, which provides members of the offline population with internet equipment, and the GESIS Panel, which offers members of the offline population to participate via postal mail surveys. In addition, we explore the impact of offering an alternative mode only to non-internet users versus also offering the alternative mode to internet users who are unwilling to provide survey data online. Albeit lower recruitment and/or panel wave participation probabilities among offliners than onliners, we find that including the offline population has a positive long-term impact on sample accuracy in both panels. In the GESIS Panel, the positive impact is particularly strong when offering the alternative participation mode to non-internet users and internet users who are unwilling to provide survey data online.

Anal Intercourse among Heterosexual Young Adults: A Population-Based Survey in Switzerland

ABSTRACT Anal intercourse (AI) among heterosexuals is an understudied and taboo subject. This 2017 Swiss national study aimed to describe the characteristics and motivations of heterosexual young adults practicing AI. Participants with any same-sex experience, same-sex attraction or non-heterosexual identity were excluded. The Federal Statistical Office provided the initial sample and potential participants were recruited through postal mail inviting them to an online survey (response rate 15.1%). The sample comprised 3892 participants (52% males; 54% of the overall sample, mean age 26.3 years). Overall, 55% of women and 56% of men had never experienced AI, 17% and 12% had done it once and 28% and 32% more than once, respectively. We found that participants engaging in AI had higher odds of practicing intercourse while intoxicated, being younger at first sexual experience, not using a condom at last intercourse and reporting a history of sexual transmitted infections. The main reason reported by both genders for engaging in their first AI was being curious followed by being in love. In conclusion, AI is a widespread practice among heterosexual young adults and health professionals should be especially attentive to it.

Results of a Diagnostic Procedure Based on Multiplex Technology on Dried Blood Spots and Buccal Swabs for Subjects With Suspected Alpha1 Antitrypsin Deficiency

IntroductionThe objective of this analysis was the evaluation of a new national circuit used for diagnosing alpha1 antitrypsin deficiency (AATD) based on multiplex technology using online registration and mail posted samples from dried blood spots (DBS) and buccal swabs. MethodsThis is an observational, ongoing study conducted in Spain since March 2018. Samples are coded on a web platform and sent by postal mail to the central laboratory. Allele-specific genotyping for the 14 most common mutations was done with the Luminex 200 Instrument System. Gene sequencing was done if none of the mutations were found and the AAT serum level was <60mg/dl, or by request from the clinician in charge. ResultsAt the time of the present report, 5803 (92.9%) samples were processed, 4984 (85.9%) from buccal swab and 819 (14.1%) from DBS. The prevalence of the frequent allele combinations were: MS 19.0%, MZ 14.4%, SS 2.9%, SZ 3.7%, and ZZ: 1.4%. Globally, Z carriers represented 20.0% and S carriers 26.6% of this population, with differences seen between regions. 209 (3.6%) were identified carrying rare alleles, 12 (0.2%) carrying null alleles and 14 (0.3%) new mutations were described. Respiratory diseases other than COPD, including poorly controlled asthma or bronchiectasis, also presented AATD mutations. ConclusionsThe availability of a diagnostic system based on the simultaneous testing of 14 genetic variants from buccal swabs or DBS sent by postal mail and with web registration has proven to be useful, and the system can improve the timely diagnosis of AATD.

Are residents receiving the training needed within their residency programs to optimally manage patients with diabetes?

ABSTRACT Objective: Diabetes is a prevalent and growing problem in the United States (U.S.); primary care physicians need to be prepared to initiate and progressively advance treatment. The objective of this study was to understand how diabetes management is taught in U.S. Family Medicine (FM) and Internal Medicine (IM) residency programs. Methods: Invitations to complete an online survey were sent via postal mail to U.S. FM and IM residency programs in 2019. Results: Directors/associate directors from 68 FM residencies and 66 IM residencies completed the online survey out of 645 (10.5%) and 505 (13.1%) programs, respectively. Most respondents rated cardiovascular disease and risk management in diabetes as ‘very important’ (90%), but only about half (47%) did so for newer generation insulin analogs and 27% for digital health technologies. About two-thirds of programs cover non-insulin options for type 2 diabetes (66%) and types of insulin (63%) to a great extent, but only about one-third of programs cover social determinants of health (36%) and pre-diabetes (35%) to this degree. Many programs report plans to expand training on cardiovascular disease and diabetes (59%), but only 32% plan to expand training on digital technology for diabetes care. Lack of faculty time and competing priorities are cited as being the biggest barriers to expanding diabetes training. Conclusions: Our study found that the current U.S. FM and IM residency program diabetes curricula are dominantly oriented toward cardiovascular disease and ‘traditional’ insulins. A variety of training materials and resources could help overcome some of the current barriers to curriculum expansion of other important components of diabetes care that may help future physicians successfully manage diabetes with newer generation insulin and glucose monitoring technologies. Abbreviations: U.S: United States; PCP: Primary Care Physician; FM: Family Medicine; IM: Internal Medicine; CGM: Continuous Glucose Monitor; AAFP: American Academy of Family Physicians; ACGME: Accreditation Council for Graduate Medical Education; U/mL: units per milliliter; CME: Continuing Medical Education.

Post-traumatic stress disorder symptoms in non-muscle-invasive bladder cancer survivors: A population-based study

ObjectiveThis cross-sectional study examined the prevalence of post-traumatic stress disorder (PTSD) and identified the predictive factors associated with PTSD symptoms in a population of non-muscle-invasive bladder cancer (NMIBC) survivors. MethodsA random sample of 2,000 NMIBC survivors, identified through the North Carolina Central Cancer Registry, were sent postal mail survey. PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). Descriptive statistics and hierarchical multiple linear regression were used to examine the prevalence of PTSD and to identify the factors associated with PTSD. ResultsA total of 376 participants were included in the analysis. The average PCL-5 score was 7.1 (standard deviation [SD] = 10.9, range: 0–66), where higher scores represent higher levels of PTSD symptoms. The prevalence of the provisional PTSD diagnosis was 5.3% or 6.9% (after adjusting for nonresponse). In addition, 28.7% of participants met criteria for at least one PTSD symptom cluster. After controlling for other variables, participants who were younger, had active disease or unsure of status, had more comorbidities, had lower social support, and had higher cognitive concerns reported significantly higher PTSD symptoms. ConclusionMore than one-fourth of NMIBC survivors had PTSD symptoms. Thus, healthcare providers should assess PTSD symptoms and provide supportive care for NMIBC survivors in the survivorship phase of care.

Career trajectories in a technology management-HRD programme

ABSTRACT This ‘perspectives on research’ paper presents the first stage of an innovative in-progress study aimed at understanding the career trajectories of graduates of a technology management undergraduate program with a strong integration of a human resource development component. The program is housed in the College of Education at an American University and started graduating students in 2008. The scope of work is limited to obtaining critical information to the institution on the career trajectories of its graduates and to provide perspectives on research to the HRD community through an online survey instrument (first stage of the study). The total amount of alumni, approximately 500, were invited via postal mail and phone calls and 75 responded to the survey, a simple 4 open-ended questionnaire that included demographic information. This online survey, first stage of the study, provided participants’ responses that were qualitatively analysed. The results are presented here in the form of strengths and weakness of the program. Some of the findings include females’ perception of their gender as a factor affecting their careers and an almost generalized petition for courses more focused on technology content. Also, aspects of career development from classic HRD literature are discussed and presented here.

Targeting mailed nicotine patch distribution interventions to rural regions of Canada: protocol for a randomized controlled trial

BackgroundQuitting smoking is the most effective way of reducing the risk of cancer among smokers. One way of helping people stop smoking is to provide them with free Nicotine Replacement Therapy (NRT), such as when NRT is sent to people by postal mail as part of a mass distribution initiative. Our previous research indicated that there may be a substantial impact on increasing quit rates of a mailed NRT intervention in rural areas. The current research seeks to confirm this finding and to understand the social determinants of health driving these anticipated large effects.Methods/designTelephone numbers will be randomly selected from across rural regions of Canada in order to recruit adult smokers interested in completing a smoking survey and willing to be interviewed again in 6 months. The survey will ask participants about their smoking history, demographic characteristics, and a hypothetical question: would they be interested in receiving nicotine patches if they were provided to them free of charge? Half of the smokers interested in receiving nicotine patches will be selected by chance and offered the NRT package. The other half of smokers will not be offered the nicotine patches. In addition, the municipality where each participant lives will be identified and, once the relevant general population data becomes available, attempts will be made to link participant data to relevant municipal characteristics (e.g., smoking rates, availability of health services). Characteristics of the participants and the municipalities in which they live will be used to explain why the nicotine patch intervention may have a larger impact in some rural regions compared to others.DiscussionThe findings from the proposed RCT are timely and of high relevance as the distribution of nicotine patches has substantial potential to combat the public health problem of cigarette related cancer, other diseases, and premature death from tobacco use. Targeting such tobacco cessation initiatives to rural regions may substantially increase the impact of this intervention, helping to optimize the use of limited prevention resources while aiming to save the maximum number of lives.Clinical trials registrationClinicalTrials.govNCT04606797, October, 27, 2020.

THE ROLE OF FINANCIAL LITERATION IN MODERATING THE RELATIONSHIP BETWEEN ACCESS TO FINANCIAL AND THE GROWTH OF MSMES IN WEST KALIMANTAN PROVINCE – INDONESIA

The low rate of financial literacy in West Kalimantan has triggered a study to explore the role of this variable, can it moderate the relationship between financial access and the growth of MSMEs in West Kalimantan Province?. This research uses a descriptive method with an associative research design and 390 MSMEs respondents. The distribution of the questionnaires used postal services, electronic mail, and social media. The results of this study are financial literacy can moderate the relationship between financial access and the growth of MSMEs and financial literacy has a positive and significant effect on the growth of MSMEs. An interesting finding from this research is access to finance has a negative and significant effect on the growth of MSMEs, this result is due to the lack of knowledge of MSMEs about how to manage money obtained from bank loans.