Rate Your Research Articles

NCOG-29. HIGHER HYPOTHALAMIC RADIATION DOSE AND FEMALE GENDER ARE RELATED TO HIGHER SELF-REPORTED FATIGUE

Abstract BACKGROUND Fatigue is among the most common symptoms managed by patients with cancer. Hypothalamic pituitary axis dysfunction has an established role in a subset of patients with fatigue. Our primary aim was to longitudinally assess the impact of hypothalamic radiation exposure to patient self-reported fatigue. METHODS We included a sample of patients who received radiation therapy treated at a single institution from 2014-2024. The PROMIS-10 questionnaire (“How would you rate your fatigue on average,” scale 1-5) was used in standard clinical practice, with measures from 6 time points over 2 years. We performed descriptive statistics. Linear mixed models were used to assess the impact of hypothalamic radiation dose on fatigue scores. Mixed models were controlled for gender, age, time, tumor category (CNS vs. non-CNS), and modality (photon vs. proton). Models were fit with random intercepts for each Patient ID. RESULTS 1092 patients (43% female) with a median age of 54 years (range: 18-92) were included. Most patients were treated for CNS cancer (76%), with about 50% each photon and proton. Median hypothalamus radiation dose was 1306 cGy (range: 0.01-6138). Mean baseline fatigue (2.4) increased after treatment (2.7) remaining elevated at 3- and 6-months post-treatment (2.6, 2.5), returning near baseline at 1- and 2-years post-treatment (2.4, 2.3). Higher radiation dose (Estimate (SE): 0.014 (0.006), p=0.0266) and CNS cancer treatment (0.11 (0.051), p=0.0319) were significant predictors of higher fatigue in the mixed model. Male patients (-0.16 (0.042), p=0.0001) and time (-0.003 (0.0016), p=0.0398) were associated with lower fatigue. Age and treatment modality were not significant predictors of fatigue. CONCLUSIONS We found that higher hypothalamic radiation dose was related to more self-reported fatigue, which peaked by 6 months. This effect was seen more prominently in female patients and those treated for CNS disease. Treatment modality and age did not influence fatigue scores.

Comparison of Traditional and Intensive Cardiac Rehabilitation on Dietary Behavior and Clinical Risk Factor Outcomes

Purpose: The objective of this study was to assess differences in dietary behavior and clinical risk factor outcomes and explore predictors of change among patients participating in traditional and Pritikin intensive cardiac rehabilitation (CR). Methods: This secondary analysis of cardiac registry data from 2015 to 2021 included patients participating in traditional CR (n = 420) or Pritikin intensive CR (n = 1005) at a single hospital site. Dietary behavior outcomes included the Rate Your Plate measure, while clinical risk factor outcomes included fasting lipids, blood pressure, anthropometrics, functional outcomes, and psychosocial assessment. Analysis of covariance examined a difference in Rate Your Plate scores between CR groups. Multivariate analysis of covariance was used to determine differences in clinical risk factor variables between CR groups. Predictors of change in dietary behavior and clinical risk factors were determined through multiple bivariate linear regression models within each CR group. Results: Both CR programs led to significant improvements though more change was observed among Pritikin intensive CR participants in dietary behavior, anthropometrics, and fasting lipids. Status as a current or recent smoker was not a significant predictor of dietary behavior. Male sex, status as a current or recent smoker, beta-blockers, and angiotensin-converting enzyme inhibitors prescribed were not significant predictors of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or non–high-density lipoprotein cholesterol for traditional and Pritikin intensive CR groups. There were not significant predictors of blood pressure, body mass, or waist circumference. Conclusion: Although participation in either CR program yielded cardiometabolic benefits, Pritikin intensive CR patients exhibited significantly greater improvements in dietary behavior and clinical risk factors.

How Union Organizers Rate Your Place of Business: Part 2

Last month, we began a discussion of how a union organizer might assess employers they wish to target. We addressed issues such as how the employer handles overtime policies and overnight shifts, as well as housekeeping, seniority, and grievance procedures. This month, to help employers prioritize the most significant flags that could draw the attention of an organizer, we discuss additional criteria frequently used by union organizers to target employers.

Comparison of a Single Assessment Numeric Evaluation Method and the Banff Patella Instability Instrument 2.0 for Patients With Patellofemoral Instability.

The concept of Single Assessment Numeric Evaluation (SANE) has been introduced for several clinical entities; however, a validated SANE focusing on patients with patellofemoral instability has not been described. The purpose of this study was to investigate the expressiveness of SANE questions (SQs) for the assessment of patients experiencing patellofemoral instability. It was hypothesized that the complexity of patellofemoral instability cannot be demonstrated by a single question. Cohort study (diagnosis); Level of evidence, 2. Between October 2022 and March 2023, 120 consecutive patients (male/female, 50/70; mean age, 23.9 ± 8.0 years; mean body mass index, 25.3 ± 5.1 kg/m2) with patellofemoral instability were assessed with the Banff Patella Instability Instrument 2.0 (BPII 2.0). Patients were randomized into 3 groups (40 patients each) and asked to answer 1 of 3 SQs: "How do you rate your knee joint if a completely stable kneecap means 100%?" (SQ 1), "How do you rate your knee joint if complete satisfaction means 100%?" (SQ 2), and "How do you rate your knee joint if complete normal function means 100%?" (SQ 3). Means ± standard deviations were compared using 1-way analysis of variance, the correlation between BPII 2.0 and each SQ was assessed by Pearson correlation, and Bland-Altmann analysis was performed to investigate biases of each SQ in comparison with BPII 2.0. The mean BPII 2.0 score was 40.5 ± 16.8 points, and the mean results of SQ 1, SQ 2, and SQ 3 were 44.2% ± 26.0%, 42.6% ± 25.4%, and 44.2% ± 18.9%, respectively, without significant differences between the groups (all P > .05). The correlations between BPII 2.0 and SQ 1, SQ 2, and SQ 3 were high (r = 0.75; 95% CI, 0.58 to 0.86; P < .0001), low (r = 0.35; 95% CI, -0.05 to 0.6; P = .02), and low (r = 0.31; 95% CI, -0.002 to 0.56; P = .051), respectively. Bland-Altman analysis between BPII 2.0 and SQ 1, SQ 2, and SQ 3 revealed biases of -0.12 (SD, 17.1), -1.45 (SD, 24.4), and -8.0 (SD, 19.4), respectively. The SQ "How do you rate your knee joint if a completely stable kneecap means 100%?" demonstrated concurrent validity with the BPII 2.0 and may serve as a helpful tool to quickly assess patients with recurrent patellofemoral instability in a preoperative setting.

Implementation of a patient-centered phone line to address non-medical cancer support needs in an integrated health system.

208 Background: From the moment cancer is suspected, patients and their caregivers may feel overwhelmed and not know where to seek help for non-medical questions. Social risks, including financial instability, housing and food insecurity can lead to poor cancer outcomes, and 39% of Kaiser Permanente (KP) cancer patients screened positive for at least one social risk. KP implemented the Cancer Support Line to provide patients and caregivers with a single point of contact to address non-medical concerns, including financial navigation, social health needs, and general cancer information. Methods: Kaiser Permanente partnered with patients, clinicians, and health plan functions supporting member services, social health, and quality to co-design and implement a phone number for cancer members in the KP Northwest market. The Cancer Support Line (‘Line’) is an inbound phone number staffed by Cancer Support Specialists (‘Specialists’), a dedicated team of health plan member services, trained in cancer support skills. Specialists use four co-designed pathways to navigate callers to resources for financial questions, social needs, and general cancer information and support. If clinically appropriate questions arise, Specialists use existing operational channels to connect patients back to their care teams. Results: During the pilot, there were 1,057 interactions with members, patients, and caregivers from March 12 th to May 17 th . Financial questions about payment assistance and insurance benefits/eligibility emerged as the highest call driver. The top call outcomes by volume are shown in the included table. A high majority of calls (94%, n=992) were addressed by the Cancer Support Specialists themselves. Post-call survey results revealed that 96% of callers (n=26) rated their call experience high when asked “How would you rate your overall call experience today?” Conclusions: Effective collaboration across KP’s project teams was a critical driver of the pilot’s success. Workflows were built with all partner teams and departments, Specialist training was designed internally with consultation from the American Cancer Society, team communications were open and consistent, call reporting was robust and adaptable. Furthermore, the Line addresses a critical gap in the cancer patient experience: navigating non-medical needs that busy care teams are unable to address on their own. Though positive, these pilot results are preliminary and focused on one KP market. To evaluate the pilot for scalability, the team will assess process metrics and outcomes on caller, frontline staff, and Specialist experience on an ongoing basis to capture the Line’s broader operational impact. Call transfer destination. Transfer Destination # of calls % No Transfer 992 93.9% KP Community Support Hub Transfer 45 4.3% Clinical Transfer 17 1.6% KP Community Support Hub + Clinic Transfer 3 0.3%

Self-Reported Health and Associated Factors among Nepalese Older Adults

Background: Self-reported health (SRH) is a subjective measurement tool for overall health status that integrates biological, social, mental, and functional aspects of individuals. Objectives: The purpose of this article is to assess the SRH and its correlates among community-living older adults. Methods: This study is a secondary analysis of structured interview data collected by the Central Department of Population Studies at Tribhuvan University (TU) via a cross-sectional survey of community-dwelling persons aged 60+ in the Pharping area of Kathmandu. For this study, there were 1320 valid responses. A simple and direct question was used “In general, how do you rate your general health?” Its answer was recorded on the 5-point Likert scale ranging from “Very Good to Very Bad”. Results: The mean age of the participants was 69.92 years. Of the participants, 19.2% reported poor SRH. Results show mental health problems, total number of children still alive, age of respondent, literacy status, physical health problem now, satisfaction with current living arrangements, walking efficiency, adequate income sources, marital status and currently working were correlated with SRH. However, linear regression shows that significant factors of SRH are walking efficiency (β= 0.324, 95% CI= 0.240 to 0.323), physical health problems (β = -0.258, 95% CI= -0.493 to -0.346), currently working (β: 0.197, 95% CI=0.223 to 0.373), having enough income to meet basic needs (β: 0.065, 95% CI= -0.136 to -0.021) and satisfied with living arrangements (β= 0.065, 95% CI= 0.018 to 0.116). Conclusion: Nepal is aging rapidly, and the proportion of older people will increase in the coming days. Walking efficiency, physical health, currently working and having sufficient income are important factors related to SRH. Identifying these determinants through self-rated status can support the planning of actions aimed at improving the health of the community living older adults.

How Union Organizers Rate Your Place of Business: Part 1

How Union Organizers Rate Your Place of Business: Part 1

Factors Associated with Self-Reported Health (SRH) among Nepalese Older Men

Background: Self-reported health (SRH) is a subjective measurement tool of overall health status. It integrates with the biological, social, mental, and functional aspects of individuals. The aim of this article is to assess the SRH and its correlates among community-living older men from Nepal. Methods: This study uses the secondary data collected by the Central Department of Population Studies at Tribhuvan University (TU). This study includes community-dwelling male elderly aged 60+ in the Pharping area of Kathmandu. For this study, there were 657 valid responses. A simple and direct question was used “In general, how do you rate your general health?” Its answer was recorded on the 5-point Likert scale “Very Good to Very Bad”. Results: The mean age of the participants was 69.51 years. The majority of respondents (75.9%) live with family members. People who reported poor SRH were 17.0%. Many of them have physical health problems (73.2%) and mental health problems (57.2%). Mental health problems, age of respondents, physical health problems, satisfaction with current living arrangements, walking efficiency, adequate income sources, Insecurity feelings, Income sufficient to fulfill the basic needs, and current working were correlated with SRH. However, linear regression shows that satisfaction with walking efficiency, physical health, and working situation, were significant predictors of SRH. Conclusion: This analysis suggests that working, walking ability, physical health problems, and financial adequacy are significantly associated with self-rated health. Identifying these variables through self-rated status can support the planning of actions aimed at improving the health of the community living older adult men in Nepal.

The feasibility and effectiveness of remote cognitive training on cognitive function and work performance in workers.

We aimed to determine whether remote cognitive training (CT) is feasible and has the potential to improve cognitive function and work performance in Japanese workers. From June to September 2020, this intervention time series study enrolled workers aged 18-65 years from 10 companies located in a metropolitan area of Japan. Cognitive function tests and self-administered questionnaires were completed by the participants three times: at baseline, after 12 weeks of CT, and after a further 12 weeks following cessation. We measured work performance with the question: "How would you rate your performance (compared with your optimum performance) over the past 4 weeks?" Responses were made via a visual analog scale (0-100). Cognitive function was assessed using the THINC-integrated tool, which is a brief, objective computerized cognitive assessment battery. For our computerized remote CT intervention, BrainHQ was used on the basis of our scientific rationale and the empirical literature. We recommended three 20-min sessions of BrainHQ per week and sent participants three reminders. In total, 119 participants were recruited to this study. Only 22.7% of the subjects achieved the recommended training time of 720 min over 12 weeks. The median training time was used to divide participants into long and short- training groups. The long-training group showed a greater improvement in attention and executive function than the short-training group but there was no significant improvement in work performance after CT compared to baseline. Our results suggest that although remote CT was not feasible enough, the effects on cognitive function can be expected by increasing training time and motivation.

Developing Disability Advocates Through Deliberate Interprofessional Conversations Regarding Quality of Life After Stroke

ObjectiveStroke can result in significant mental and physical impairment. Training health care professionals on effective strategies for mitigating stroke-related quality-of-life issues is crucial in facilitating comprehensive stroke management. This study aimed to evaluate the impact of an interprofessional education (IPE) experience on students’ attitudes regarding poststroke disability. MethodsIn this pre-post interventional study, pharmacy and medical students received an electronic patient chart and a store-and-forward video depicting physical and cognitive impairment in a patient with stroke. Students were instructed to discuss the acute management and postdischarge needs of the patient from an advocacy perspective. After the IPE experience, students completed the Student Perceptions of Interprofessional Clinical Education-Revised, version 2 and an unvalidated disability attitudes survey. The surveys were analyzed using a paired t test. In addition, students reflected on the prompt, “What are some things you had NOT considered prior to this IPE?” ResultsA total of 708 students completed the surveys. After IPE, there was a significant improvement in all domains of the Student Perceptions of Interprofessional Clinical Education-Revised, version 2. On the disability survey, there was significant improvement on all statements, including “rate your comfort with…”: “discussing the expected disabilities associated with new-onset stroke” and “discussing strategies for improving the quality of life of a patient who has long-term disabilities.” On the self-reflections, 31.7% (n = 211) had not considered the need for poststroke care services before this IPE. ConclusionThis IPE experience was instrumental in improving student perspectives regarding poststroke disability.

Poster 161: Rotator Cuff Repair and Minimum Clinically Important Difference: Does Number of Tendons Involved Affect the Minimum Clinically Important Difference Value?

Objectives: The minimum clinically important difference (MCID) is a commonly used measure to aid in determining significant improvements for patient-reported outcomes (PROs). As MCID and PROs continue to be implemented in shoulder procedures, MCID can greatly differ depending upon the specific patient population, follow-up time, and methodology. In the setting of rotator cuff repair (RCR), there are few studies that discuss the effect of tendon involvement on MCID achievement. Other orthopaedic conditions have calculated separate MCIDs depending on the severity of the fracture or pathology. The purpose of this study was to calculate an MCID for one-, two-, and three-tendon RCR. They hypothesis was that MICD values would be lower for larger repairs compared to smaller repairs. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included evaluating what patient and surgical characteristics affect MCID achievement for each MCID. Methods: A prospectively collected PRO database was queried for patients who underwent primary RCR from 2018 to 2022. Revision procedures, patients with a history of prior shoulder surgery, or patients lacking PROs at any time point were excluded. Demographic and surgery characteristics were extracted through chart review. The primary outcome was the ASES score. ASES is a validated instrument scored on a 100-point scale with 0 indicating the” worst outcome” and 100 being the “best outcome.” MCID was calculated using the anchor-based method as has been done in previous works. The anchor question from PROMIS-10 asks, “In general, how would you rate your physical health?” scored on a 5-point Likert scale. An increase of one point was deemed to be a significant improvement in the anchor to calculate the MCID. An MCID was calculated for the three sizes of RCRs in this sample. Statistical analysis included descriptive statistics, as well as independent sample t-tests, chi-square tests, and fisher exact tests. Results: A total of 799 patients met inclusion criteria. Most patients were male (n=474, 59.3%) and were 61.2 years old. There were 61.5% of patients who had their dominant shoulder treated with RCR. Patients typically presented with at least one tendon that had a full thickness tear (n=643, 80.5%). Many underwent various concomitant procedures including subacromial decompression (83.9%), biceps tendon procedures (tenotomy or tenodesis) (59.0%), distal clavicle excision (24.2%), and arthroscopic debridement (24.0%). The average case length was 130.1 minutes. There were 36 symptomatic retears (4.5%), 10 revisions (1.3%), and 14 other reoperations (1.8%) within one year. ASES scores at baseline and one-year were 48.1 and 84.6, respectively, with an average one-year change of +36.6. MCIDs by number of tendons involved were 40.5, 36.3, and 39.3 for single-, two-, and three-tendon repairs. The number of patients that achieved MCID by tendon size did not statistically differ between groups (Single: 51.0%; Two: 53.0%; Three: 50.0%, p&gt;0.610, respectively). MCID achievement and biceps tendon procedures trended towards significance for the single-tendon cohort (p=0.085), while patient sex trended towards significance in the two-tendon cohort (p=0.055). More acute tears compared to chronic tears met MCID in the three-tendon cohort although this only trended towards significance (p=0.074). MCID achievement was affected by symptomatic retears in the two-tendon RCR group (p&lt;0.001). While reoperation trended towards significance in the single-tendon RCR group (p=0.058). Conclusions: This study found that MCID value varied by the number of tendons involved in RCR, with two-tendon repairs having the lowest MCID (36.3). The number of patients that met MCID in each cohort was similar. Single-tendon tears appear to be more affected by biceps tendon procedures and reoperations, although both of these findings only trended towards significance. Patients with two-tendon tears were shown to be affected by symptomatic retear (p&lt;0.001), and patient sex, although the later finding was not statistically significant (p=0.055). MCID achievement in three-tendon RCRs appear to be influenced by tear chronicity with those with an acute tear being more likely to attain MCID, although this finding was not significant (p=0.074). Surgeons should consider the size of a cuff repair and what corresponding surgical and patient factors may be more pertinent to each patient to help maximize patient outcomes.

A balance focused biometric does not predict rehabilitation needs and outcomes following total knee arthroplasty

BackgroundBoth length of hospital stay and discharge to a skilled nursing facility are key drivers of total knee arthroplasty (TKA)-associated spending. Identifying patients who require increased postoperative care may improve expectation setting, discharge planning, and cost reduction. Balance deficits affect patients undergoing TKA and are critical to recovery. We aimed to assess whether a device that measures preoperative balance predicts patients’ rehabilitation needs and outcomes after TKA.Methods40 patients indicated for primary TKA were prospectively enrolled and followed for 12 months. Demographics, KOOS-JR, and PROMIS data were collected at baseline, 3-months, and 12-months. Single-leg balance and sway velocity were assessed preoperatively with a force plate (Sparta Science, Menlo Park, CA). The primary outcome was patients’ discharge facility (home versus skilled nursing facility). Secondary outcomes included length of hospital stay, KOOS-JR scores, and PROMIS scores.ResultsThe mean preoperative sway velocity for the operative leg was 5.7 ± 2.7 cm/s, which did not differ from that of the non-operative leg (5.7 ± 2.6 cm/s, p = 1.00). Five patients (13%) were discharged to a skilled nursing facility and the mean length of hospital stay was 2.8 ± 1.5 days. Sway velocity was not associated with discharge to a skilled nursing facility (odds ratio, OR = 0.82, 95% CI = 0.27–2.11, p = 0.690) or longer length of hospital stay (b = -0.03, SE = 0.10, p = 0.738). An increased sway velocity was associated with change in PROMIS items from baseline to 3 months for global07 (“How would you rate your pain on average?” b = 1.17, SE = 0.46, p = 0.015) and pain21 (“What is your level of pain right now?” b = 0.39, SE = 0.17, p = 0.025) at 3-months.ConclusionPreoperative balance deficits were associated with postoperative improvements in pain and function after TKA, but a balance focused biometric that measured single-leg sway preoperatively did not predict discharge to a skilled nursing facility or length of hospital stay after TKA making their routine measurement cost-ineffective.

Association of healthy eating index and self-rated health in adults living in Tehran: a cross-sectional study

BackgroundSelf-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran.MethodsThis cross-sectional study was carried out among 850 adult men and women aged 20–59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: “In general, how do you rate your health?“. We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH.ResultsThe final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH.ConclusionAccording to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.

The Impact of Loan Apps on Students: Exploring Financial Access, Risks, and Implications

This article explores the influence of loan applications on students, investigating the impact of these apps on their financial behavior, academic performance, and overall well-being. With the rapid proliferation of loan apps in recent years, it is crucial to understand the consequences they may have on student borrowers. The study examines the experiences of students who utilize loan apps, providing insights into the potential advantages and drawbacks associated with these financial tools. By analyzing the data collected from surveys and interviews, the research highlights the significance of responsible borrowing, financial literacy, and regulatory measures in mitigating the negative effects and maximizing the benefits of loan apps. The findings contribute to the existing literature on financial behaviors and offer recommendations for policymakers, educational institutions, and students to navigate this evolving landscape effectively. Loan apps have gained significant popularity among students, offering quick and convenient access to financial resources. These apps provide students with a platform to obtain loans with minimal paperwork and faster processing times compared to traditional lending institutions. While these apps offer benefits such as easy accessibility, they also raise concerns about potential negative consequences. This article aims to delve into the impact of loan apps on students, shedding light on their financial behaviors, academic performance, and overall well-being. The widespread use of loan apps among students has brought forth a variety of issues that warrant examination. Firstly, these apps can influence the financial behaviors of students, shaping their attitudes towards borrowing, spending, and saving. Understanding the impact of loan apps on students is of significant importance for various stakeholders. Firstly, policymakers can benefit from this research by gaining insights into the implications of loan app usage among students. This knowledge can inform the development of regulations and policies to safeguard students' financial well-being and prevent predatory lending practices. It can also aid in implementing initiatives to promote financial literacy and responsible borrowing among students. Educational institutions can utilize the findings to better support their students in managing their finances. By understanding the challenges and potential risks associated with loan apps, institutions can provide targeted resources, workshops, and counseling services to help s. From the result it is seen that Rate your internet accessibility after loan lending entered market got the first rank Rate your internet usage per day where as is the having the lowest rank

Patients With and Without Double Crush Syndrome Achieve Similar Rates of Clinical Improvement Following Carpal Tunnel Release.

The purpose of this study is to compare outcomes of carpal tunnel release (CTR) in patients with and without double crush syndrome (DCS), defined as concurrent carpal tunnel syndrome (CTS) and cervical radiculopathy at C5-T1 on preoperative nerve conduction studies. Patients with preoperative nerve conduction studies who underwent unilateral, isolated CTR were retrospectively identified. All patients completed preoperative and 3-month postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) and pain interference (PI), and Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaires, and responded to the anchor question: "Since your treatment, how would you rate your overall function?" (much worse, worse, slightly worse, no change, slightly improved, improved, much improved). Preoperative, postoperative, and changes in scores for UE, PI, and QuickDASH were compared, as were the anchor question responses and rates of achieving the minimal clinically important difference (MCID). Sixty-three patients with DCS and 115 patients with CTS only were included. At 3- to 4-month follow-up, absolute and change in UE, PI, and QuickDASH scores were not statistically different between patients with DCS and CTS. Rates of anchor question response and MCID achievement were comparable for patients with CTS only and DCS on each questionnaire. The MCID achievement ranged from 48.4% to 68.8% in the unmatched cohort and 48.4% to 60% in the matched group. At 3 to 4 months, patients with DCS experience similar patient-reported symptomatic and functional improvement, and achieve MCID of outcome measures at comparable rates to patients with CTS only. For patients with nerve compression at the carpal tunnel and cervical spine, CTR is a reasonable first step prior to proceeding with cervical spine decompression.

Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75.

Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup. Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors. Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58). Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.

Effectiveness of Multidisciplinary Post-Acute Kidney Injury Clinic on Awareness and Knowledge in Acute Kidney Injury Survivors

Introduction: Acute kidney injury (AKI) awareness and knowledge among survivors is poor, leading to suboptimal self-management and follow-up care. The purpose of the study was to evaluate the impact of a multidisciplinary post-AKI clinic on AKI awareness and knowledge among survivors. Methods: We conducted a quasi-experimental study among stage 2-3 AKI survivors who were followed in the multidisciplinary post-AKI clinic, comprising nephrologists, renal nurses, pharmacists, and dietitians. Patients were evaluated before and after entering the clinic during a 3-month follow-up period, using a three-component questionnaire including the following: (1) Do you know of your AKI diagnosis during hospitalization? (yes/no), (2) how do you rate your AKI knowledge? (ranging from 1 or “very low” to 5 or “excellent”), and (3) 25-item objective AKI knowledge survey instrument that covered general knowledge of AKI, nutrition, medication, and symptoms of renal failure. Results: A total of 108 AKI survivors were enrolled, with 37.0%, 41.7%, and 21.3% being stage 2 AKI, stage 3 AKI, and stage 3-dialysis AKI, respectively. Before entering the clinic, 50% of patients were unaware of their AKI during hospitalization. After receiving education from the multidisciplinary post-AKI clinic, all patients became aware they had experienced AKI. The mean perceived knowledge and objective knowledge scores were significantly increased over the 3-month period from 1.6 (0.7) to 3.9 (0.7) out of 5 and 15.4 (3.5) to 21.4 (2.0) out of 25, respectively (p < 0.001 for both). Additionally, reverse transformation of the Likert scale to a percentage format also revealed a significant improvement in mean perceived AKI knowledge scores, transitioning from 13.8 ± 16.8 to 73.0 ± 17.6, p < 0.001. Conclusion: The multidisciplinary post-AKI clinic effectively enhanced AKI awareness and knowledge among survivors. These findings highlight the importance of follow-up care and the benefits of a multidisciplinary approach. Further studies are needed to determine the long-term outcomes associated with increased knowledge.

Rate your coach: exploring ratings of coaching skills throughout teacher induction

ABSTRACT This quantitative study explores novice teacher and coach ratings on coaching skills. Annual surveys were collected from respondents throughout a two-year programme to learn more about their induction experiences. We run a series of t-tests to identify differences between respondent groups and over time as well as multiple linear regressions to predict for characteristics that are associated with respondent ratings of coaching skills. Results from this study indicate that novice teachers’ belief that they were well matched with their coaches as well as coaches’ beliefs about induction complimenting surrounding support separately predicted for higher ratings of coaching skills. Additionally, novice teachers rated their coaches’ skills higher than the coaches did and all ratings increased over time. The findings have implications for creating more nuanced induction programme curricula to better support coaching interactions for novice teacher development.

How do Children Rate Their Health? An Investigation of Considered Health Dimensions, Health Factors, and Assessment Strategies

AbstractIn large-scale surveys of both children and adults, self-rated health (SRH) based on questions such as “In general, how would you rate your health?” is a widely used measurement to assess individuals’ health status. However, while a large number of studies have investigated the health aspects people consider for their responses, and some studies show deeper insights into the assessment strategies in answering this question for adults, it is largely unknown how children assess their health based on those questions. Therefore, this study examines how children rate their health according to this question in a sample of 54 9- to 12-year-olds. By using techniques of cognitive interviewing and qualitative and quantitative content analysis, we investigate the health dimensions, health factors as well as different assessment strategies that children refer to in their self-assessment of general health. Our results indicate that children in this age group mostly refer to their physical health and daily functioning or consider health more non-specifically. They also show that children take into account a wide range of specific health aspects, with some minor differences between subgroups, especially by gender. Additionally, our study highlights that children use several assessment strategies. Finally, our results indicate that the majority of children assess their health only using one health dimension, but a substantial share of children reflect on several health factors and combine different assessment strategies. We conclude that children refer to comparable health dimensions and health factors, but use somewhat different assessment strategies compared with studies focusing on adults.

E23 Pediatric rheumatology in primary care in Tunisia

Abstract Background Primary care medicine is the first line of defence in the management of all diseases, and pediatric rheumatology is no exception to this rule. The aim of our work was to assess the management of rheumatological manifestations in the pediatric population, particularly in cases of suspected juvenile idiopathic arthritis (JIA). Methods A self-administered survey via google forms, was conducted among Tunisian primary care practitioners, during the month of February 2023. They were asked about their usual practice when children with articular symptoms consulted them. Results Our work included 33 practitioners, 25 of whom were women and eight men, with a female to male ratio of 3:1 and a mean age of 26 years [25–57]. Eighty-eight percent were family medicine residents (n = 29), nine percent were public health physicians (n = 3) and three percent were private physicians (n = 1). The average number of years in practice was three years [1–26]. Fifty-eight percent (n = 19) practiced in a university hospital, 18% (n = 6) in a regional hospital, 21% (n = 7) in a local dispensary, and three percent (n = 1) in a private practice. Regarding the number of pediatric-aged consultations per week, 70% (n = 23) reported seeing less than five patients and 21% more than ten per week (n = 7). A rheumatological reason for these patients was found in less than five consultations per week according to 94% of practitioners (n = 31). Forty-eight per cent (n = 16) of participants expressed anxiety when asked how they felt about managing a rheumatological case in this population, nine per cent (n = 3) were confident, 21% felt fearful (n = 7), 27% (n = 8) were indifferent and three per cent (n = 1) were alert. Forty-two per cent (n = 14) suspected JIA in a patient. In 77% of cases, the patients were seen repeatedly for polyarthralgia, 47% for arthritis, 18% for spinal pain, and 47% for systemic manifestations. 79% believe that early management of JIA brings a benefit in terms of health costs. When asked about their sources of training in JIA, 76% said it was through clinical courses and nine per cent through medical days, six per cent webinars and workshops and three per cent felt they had not received any training. As for sources of information, 31% through peer groups, 49% on medical websites, 27% through medical journals and 49% through medical school courses. To the question ‘On a scale of 0–5, how would you rate your training in the management of rheumatological manifestations in children and adolescents’ the answers were 0 in 21% of cases, 1 in 42% of cases, 2 in 12% and 3 in 24%. When faced with a suspicion of JIA, 49% of practitioners referred patients to pediatrics, 64% to rheumatology, 55% initiated a biological and imaging work-up and 18% prescribed symptomatic treatment. For the treatment, 67% prescribed paracetamol, 58% NSAIDs, 15% corticosteroids, 9% did not prescribe any treatment and three percent admitted not knowing what to prescribe in this situation. Conclusion JIA may affect functional and even vital prognosis of young patients. The detection and early management of the disease depend on the reinforcement of training and awareness for primary care physicians.