Results Of Survey Research Articles

Utility of a Neuromuscular Activation Exercise Protocol on Surgeon Posture.

Surgeons are at risk for musculoskeletal disorders from ergonomic strain in the operating room. These deficits may stem from neuromuscular control deficits. Neuromuscular activation exercises (NMEs) may strengthen the brain-muscle connection. This study aimed to assess the utility of a surgeon-oriented NME protocol on posture. Surgeons, operating room staff, and medical students completed a professionally established NME routine. An electronic application, PostureScreen®, assessed participants' posture. A long-term cohort was assessed before and after a 2 to 6-week routine. A short-term cohort was assessed immediately before and after completion. All participants additionally completed a postintervention survey. After intervention, the short-term cohort (n = 47) had significantly reduced frontal and sagittal postural deviation (P < 0.05). A significant decrease in effective head weight was additionally demonstrated with decreased neck flexion and increased cerebral-cervical symmetry (P < 0.05).The long-term cohort (n = 6) showed a significant postintervention decrease in lateral and anterior shoulder translation (P < 0.05). Total anterior translational deviations demonstrated trend-level decrease (P = 0.078). This demonstrates that after intervention, participants' shoulders were more centered with the spine as opposed to shifted right or left. Survey results showed participants favored exercises that immediately brought relief of tension. A decrease in postural deviations associated with NME in both cohorts demonstrates NME as a potential mechanism to protect surgeon musculoskeletal health and improve well-being. Survey results demonstrate areas of refinement for NME protocol design.

Development of a decision support system for client acceptance in independent audit process

Intelligent Information Technology (IIT) applications are crucial in the audit process, enhancing quality, effectiveness, and efficiency. The client acceptance process (CAP), one of the critical audit steps, involves subjective evaluations where business managers' claims intersect with independent audit firm managers' expectations. This subjective nature introduces the potential for errors or misjudgments, impacting audit time and costs. In this paper, therefore, we propose a decision support system considering both auditors' subjective judgments and financial data variations for accepting or rejecting a client enterprise. The decision support system consisting of the Fuzzy Analytic Hierarchy Process (AHP), the logistic regression model, and the fuzzy inference system comprises four phases. In the first phase, a logistic regression model is developed using financial ratios to determine the client's probability of being in a close monitoring market (CMM) which represents publicly traded firms that are struggling to meet specific financial indicators or that are exposed to certain risks. In the second phase, the evaluation criteria used by the audit firm to measure the market reputation of the client enterprise are defined, and the weights of the evaluation criteria are obtained by using Fuzzy AHP. In the third phase, the Client Acceptance Score (CAS) representing market reputation of the client is calculated by incorporating the results of a reputation survey and applying the weights assigned to the evaluation criteria obtained in the second phase. Finally, client acceptance risk level (CARL) is obtained by using a fuzzy inference system and a rule-based defined by auditors. The CMM probability value and CAS score obtained in previous phases are used as input values of the fuzzy inference system. The CARL score guides the audit firm in deciding whether to engage with the client. To illustrate the applicability of the proposed model, a case study has been given in the paper.

Improving recycling of medical nutrition packaging in primary and secondary care: follow-up survey results and next steps

Improving recycling of medical nutrition packaging in primary and secondary care: follow-up survey results and next steps

Подходы к построению трейсера бизнес-циклов на примере обрабатывающей промышленности России

The importance of studying business cycles is determined by the scale of their impact on the economy and society, which leads to the need to develop methods to counteract their negative impact. Given the complexity of the topic and the many theories and debates in the field, there is a need for a simple tool to present business cycle information in an intuitive way for a wide audience. Such a tool is a business cycle tracer. This article is devoted to testing the possibility of using three approaches for its construction: the first (trend approach) is based on information whether the cycle is above or below the long-term trend, and whether it is increasing or decreasing; the second (growth rate approach) is whether the growth rates are above zero, and they are growing or decreasing compared to the neighboring time period; the third (fact-expectation approach) is whether estimates of the current situation and expectations are above or below zero (trend, long–term average, etc.). The work used data on the dynamics of output, the volume of future orders and the results of surveys of the manufacturing industry. The article shows that the first approach works best and allows you to clearly define the phases and turning points of the business cycle. The second approach makes it possible to identify phases of the business cycle, but has some disadvantages: jumps in the series from one quadrant to another and back near the boundary values occur, which complicates the analysis. The third approach is not acceptable for constructing a tracer, since it does not allow us to fully identify all phases of the business cycle and may have dynamics that do not correspond to the general logic of business cycles. The article also demonstrates the high relationship between the business cycles of the manufacturing industry and the business climate indicator of the Bank of Russia (data from business surveys of enterprises), indicating a change in the dynamics of the business cycle with 1-3 months ahead of statistics. Given the faster publication of survey results than statistical data, it can be used as a leading indicator.

Forest practitioners’ requirements for remote sensing-based canopy height, wood-volume, tree species, and disturbance products

Abstract Despite decades of development, the uptake of remote sensing-based information products in the forestry sector is still lagging behind in central and southern Europe. This may partly relate to a mismatch of the developed remote sensing products and the requirements of potential users. Here, we present the results of a questionnaire survey in which we questioned 355 forest practitioners from eight central and southern European countries. We aimed to learn about forest practitioners' technical requirements for four remote sensing-based information products, including information on tree species, canopy height, wood volume/biomass, and forest disturbances. We asked for practitioners’ preferences with respect to thematic and spatial detail as well as the maximal acceptable error and the temporal frequency with which the information layers would be needed. We then examined whether the education, age, and professional background affect the requirements. Preferences with respect to spatial and thematic detail were comparably diverse while more homogenous patterns could be observed for demands with respect to errors and temporal frequency. Our results indicate that for some information products such as canopy height maps, existing remote sensing technology, and workflows can match all demands of practitioners. Remotely sensed information on forest disturbances partly fulfils the demands of the practitioners while for products related to tree species and wood volume/biomass the level of thematic detail and the accuracy of the products demanded by practitioners in central and southern Europe is not yet fully matched. We found no statistically significant differences between the demographic groups examined. The findings of this study improve our understanding of matches and mismatches of the technical requirements of practitioners for remote sensing-based information products.

Use of Risk Management to Support Business Sustainability in the Automotive Industry

Today’s companies operate in a dynamic, constantly evolving, and highly competitive environment. The globalization of markets has significantly changed the economy, where companies operate within increasingly complex supply chains. The ever-increasing expectations of customers and company stakeholders, as well as the need to incorporate a comprehensive approach to the life cycle of manufactured products in corporate strategies, expose companies to a whole range of risks. The research was based on the need of organizations operating in the (automotive) industry to manage the dynamics of the business environment. This was accomplished using an appropriate model that, through its universality, would help to ensure the effective risk management in a holistic approach, protecting their performance and meeting the needs of the relevant stakeholders. The main idea of the research was to create and implement a dynamic model of risk management in the environment of a production organization based on the use of available methods such as SWOT, PESTLE, brainstorming, affinity diagrams, risk matrix, SIPOC diagram, risk, and the results of questionnaire surveys. The research was conducted in two directions: (1) designing the structure of the dynamic risk management model for the strategic management process; and (2) verifying the effectiveness of the proposed model in specific cases and evaluating the technical and economic benefits. To support the dynamics of the model, three basic management tools have been proposed: process review, internal audit, and management review, enriched with features that support the concept of risk-based thinking.

Not Only Social Networks: Channels of Dissemination of Fake News in the Views of the Population

This article presents an analysis of the problem of the spread of fake news in modern society. The dissemination of fictitious, unreliable information harms public trust, leading to uncontrollable consequences. The purpose of this work is to study the channels of media consumption and to identify the most problematic of them in the context of the spread of fake news. It is based on the results of a mass representative sociological survey of the population of the Republic of Mordovia—a typical representative of the Middle Volga region. During the research, it was found that fake news has penetrated quite firmly into the structures of everyday interaction between people: three out of ten respondents encountered fake news at least several times a month, and two out of ten shared it with others. The key channel for their distribution is social networks, internet publications, television, and Telegram channels. At the same time, these are some of the most popular sources of information. The results obtained can be useful for constructing mathematical models of the spread of fake news, developing measures to counter this kind of content, and developing mechanisms for regulating deliberately false and unreliable data.

A future scenario earthquake and ground motion hazards for Kathmandu, Nepal

Since Nepal is an earthquake-prone country due to the collision of the Indian and Eurasian plates, it is crucial for its capital of Kathmandu to evaluate ground motion hazards from a future large earthquake. For this purpose, we constructed a realistic scenario earthquake with realistic rupture parameters in a likely location. To obtain the location, a new distribution of the rupture zones of large historical earthquakes along the Main Himalayan Thrust (MHT) was obtained by integrating the distribution from a previous study and the results of trench surveys. Global Navigation Satellite System observations indicated that the plate boundary is strongly coupled from the southern boundary of the MHT to a depth of approximately 10 km and there is almost no lateral change in the coupling. This implies that all regions along the MHT have similar rates of strain increase. Therefore, it is most probable that the rupture zone of the oldest previous event will rupture as a scenario earthquake. In the new distribution, the 1255 earthquake is the oldest. However, large earthquakes occurred in 1934 and 2015 within its rupture zone. Thus, we adopted the area obtained by removing the 1934 and 2015 rupture zones from the western part of the 1255 rupture zone. The relationship between the rupture area size and seismic moment of the 2015 earthquake lies between the scaling formulas for crustal earthquakes and plate-boundary earthquakes, but is closer to the former. Therefore, using this and the scheme for characterized source models, we determined realistic rupture parameters. We then simulated broadband ground motions in Kathmandu using these rupture parameters, our 3-D velocity structure models, and a hybrid method combining the finite-difference method and the stochastic Green’s function method. We obtained the peak ground accelerations (PGAs) of simulated ground motions, and calculated the seismic intensities in the Modified Mercalli intensity scale from the PGAs as indexes of hazards for Kathmandu. Intensities IX coincide with the center of the Kathmandu Valley, and intensities VIII and VII are found in the area surrounded by the sedimentary boundary and the southernmost part of the valley.Graphical abstract

The impact of processes of long duration on the cultural potential for economic development in the peripheries of the European Union

The factors of cultural potential for economic development are: elite exclusion, management style, confidence, and conservatism. This study focuses on two research questions: (1) Do cultural factors affect economic development?; (2) Do cultural factors of significance to economic development derive from long-duration processes or from current adaptations within an international distribution of labour? The study compares countries where capitalism originated (United Kingdom, Netherlands) and historical manorial economies (Czech Republic, Poland, Slovakia, Hungary). A country’s position in the international distribution of labour is indicated by its business service sector, industry, and agriculture. Economic development is measured based on productivity and GDP per capita. The study is based on data from the European Social Survey (ESS Round 6–8), OECD, and Eurostat. Cultural factors correlate with economic development; a regression analysis demonstrates that in terms of development, history matters more for cultural potential than does the current position in the international distribution of labour. Survey results indicate that the core-periphery model is one-sided, overemphasising the influence the core has on the underdevelopment of the peripheries.

At-sea distribution of marine predators around South Georgia during austral winter, with implications for fisheries management

AbstractThe sub-Antarctic island of South Georgia is surrounded by highly productive waters, supporting dense aggregations of Antarctic krill (Euphausia superba), a vital food source for globally important seabird and marine mammal populations. These waters also support a commercial fishery for Antarctic krill. Regular monitoring of key krill predator species is undertaken at South Georgia to detect any changes in the ecosystem in response to harvesting activities. This monitoring provides essential data but is focused on land-breeding animals during the austral summer, whilst the krill fishery operates exclusively in winter. Here, we report the results of at-sea surveys to investigate abundance and distribution of krill-dependent predators from winter 2010 and 2011, which represented a “poor” krill year and “good” krill year, respectively. Correspondingly in 2011 higher numbers of krill predators were observed; notably Antarctic fur seals (Arctocephalus gazella) across the northern shelf. Spatial overlap between fur seals and the krill fishery occurred mainly within the krill fishery hotspot to the north-east, highlighting the potential for locally high levels of competition. Cetaceans were observed during both survey years, but in low numbers compared to recent studies. Gentoo penguins (Pygoscelis papua) were the most frequently observed penguin species, showing an inshore distribution and almost no overlap with the krill fishery. Diving-petrels (Pelecanoides spp.) were the most abundant flying seabirds, observed across all transects, with particularly high densities to the south in early winter 2010. In conclusion, this survey provides valuable baseline data on the distribution of South Georgia’s predators during the winter months.

Predictive value of Cmmi-MHR combined with thromboelastography parameters in acute cerebral infarction.

Cerebral infarction is a common neurological disease with high rates of morbidity, mortality, and recurrence, posing a great threat to human life and health. Cerebral infarction is the second leading cause of death in the world and the leading cause of long-term disability in humans. The results of the third national retrospective sampling survey on causes of death in 2008 showed that cerebral infarction has become the leading cause of death in China and its mortality rate is 4-5 times that of European and American countries. Therefore, this article proposed a study on the predictive value of Cmmi-MHR combined with thromboelastography parameters that was performed for acute cerebral infarction. This paper mainly proposed a high frame rate imaging technology and analyzed its algorithm. In this article, in the experimental part, an in-depth analysis of the predictive value of the Monocyte-to-high-density lipoprotein cholesterol ratio (MHR) combined with thromboelastography parameters was performed for acute cerebral infarction. The final experimental results showed that HDL (OR = 1.695%, P-trend = 0.049) had a probability of death within 90days of hospitalization (OR = 0.81, 95% CI = 1.06-3.11, P-trend = 0.523). There were no significant differences in mortality rate after 90days. Regardless of adjusting for confounders such as age, gender, and NIHSS score, there was no significant difference in the risk of MHR or monocyte count within 90days of hospitalization. The conclusion indicates that the combination of Cmmi-MHR and thromboelastography parameters provides a new perspective and method for the diagnosis and treatment of cerebral infarction, and provides important support for personalized treatment and management of cerebral infarction.

Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic treatment versus Invisalign: a randomised clinical trial

BackgroundWe evaluated anxiety, pain, and oral-health-related quality of life in individuals treated with conventional fixed appliances (Group A) and clear aligners (Group B) for moderate malocclusion during the initial phase of orthodontic treatment.MethodsSixty individuals, separated into Group A (n = 30) and Group B (n = 30), were included in the study. They completed the Anxiety Levels, Oral Health Impact Profile-14, and Oral Health Related Quality of Life - United Kingdom/Surveys after the application of attachments on days 0 (T1), 10 (T10), and 20 (T20). Their pain levels were evaluated with the Visual Analogue Scale on days 0, 2, and 6 in the 2nd and 6th hours and on the 1st, 3rd, 7th, 14th, and 21st days.ResultsPer the VAS questionnaire, pain levels in the 2nd hour, 6th hour, 1st day, and 3rd day were significantly lower in Group B than in Group A. In the OHIP-14 survey results, the comparison between Group A and Group B showed a significant difference only on the 1st day. The STAI and OHRQoL-UK survey results did not differ significantly between the groups.ConclusionsWe found no significant difference between the two groups in terms of anxiety levels, and pain among individuals in Group A was higher than in Group B only at the beginning of the treatment. No significant differences were observed in terms of individuals’ quality of life.Trial registrationNCT06133296 (retrospectively registered)- Registration Date:15/11/2023.

Buprenorphine Prescribing and Challenges Faced Among National Health Service Corps Clinicians

The National Health Service Corps (NHSC) Loan Repayment Program (LRP) expansion in fiscal year (FY) 2019 intended to improve access to medication for opioid use disorder (MOUD) by adding more clinicians who could prescribe buprenorphine. However, some clinicians still face barriers to prescribing, which may vary between rural and nonrural areas. To examine the growth in buprenorphine prescribing by NHSC clinicians for Medicaid beneficiaries during the NHSC LRP expansion and describe the challenges to prescribing that persist in rural and nonrural areas. This cross-sectional study analyzed preexpansion and postexpansion Medicaid claims data to evaluate the percentage of prescriptions of buprenorphine filled during FY 2017 through 2021. This study also analyzed challenges and barriers to prescribing MOUD between rural and urban areas, using results from annual surveys conducted with NHSC clinicians and sites from FY 2019 through FY 2021. Prescribing of buprenorphine by NHSC clinicians. The main outcomes were the percentage and number of Medicaid beneficiaries with opioid use disorder (OUD) who filled a prescription for buprenorphine before and after the LRP expansion and the challenges NHSC clinicians and sites faced in providing substance use disorder and OUD services. Survey results were analyzed using descriptive statistics. During FYs 2017 through 2021, 7828 NHSC clinicians prescribed buprenorphine (standard LRP: mean [SD] age, 38.1 [8.4] years and 4807 females [78.9%]; expansion LRPs: mean [SD] age, 39.4 [8.1] years and 1307 females [75.0%]). A total of 3297 NHSC clinicians and 4732 NHSC sites responded to at least 1 survey question to the 3 surveys. The overall percentage of Medicaid beneficiaries with OUD who filled a prescription for buprenorphine during the first 2.5 years post expansion increased significantly from 18.9% before to 43.7% after expansion (an increase of 123 422 beneficiaries; P < .001). The percentage more than doubled among beneficiaries living in areas with a high Social Vulnerability Index score (from 17.0% to 36.7%; an increase of 31 964) and among beneficiaries living in rural areas (from 20.8% to 55.7%; an increase of 45 523). However, 773 of 2140 clinicians (36.1%; 95% CI, 33.6%-38.6%) reported a lack of mental health services to complement medication for OUD treatment, and 290 of 1032 clinicians (28.1%; 95% CI, 24.7%-31.7%) reported that they did not prescribe buprenorphine due to a lack of supervision, mentorship, or peer consultation. These findings suggest that although the X-waiver requirement has been removed and Substance Abuse and Mental Health Services Administration guidelines encourage all eligible clinicians to screen and offer patients with OUD buprenorphine, as permissible by state law, more trained health care workers and improved care coordination for counseling and referral services are needed to support comprehensive OUD treatment.

Greening the hospitality industry: examining institutional influences and perceived benefits of EMS in Malaysian SME hotels

PurposeThe majority of Malaysian firms are small and medium-sized enterprises (SMEs), and the hospitality industry is no exception. However, a study on environmental management systems (EMS) reveals that relatively few studies have observed EMS implementation in small and medium-sized enterprises hotels (SMEHs). Hence, this study aims to determine the link between institutional influences and mediating effects of top managers' perceived benefits toward EMS implementation by Malaysian SMEHs.Design/methodology/approachThe results of a questionnaire survey of 252 SMEHs managerial-level professionals using Smart-PLS software provide some explanation for the marginal action taken by these SMEHs to improve their environmental performance.FindingsBased on the findings, five variables might stimulate the implementation of an EMS: regulatory influences, customer influences, competitor influences, employee influences and manager attributes influences.Research limitations/implicationsThis study significantly advances understanding of EMS and SMEHs, offering a replicable research framework applicable across industries and countries. Scholars can leverage the framework for further exploration, while managers should recognize institutional influences on EMS implementation.Originality/valueGiven that this study is one of the few that investigates the institutional influences and perceived benefits of EMS implementation, it may provide valuable information for future research on the hospitality industry and the SMEHs among researchers and practitioners.

Individual Understanding and Importance of Business Agility in the 21st Century

Objective: In an era of rapid technological development, unpredictable global events and ever-changing customer expectations, new competences have become more valuable for economic operators. Those who can adapt best to change are those who can be flexible, changeable and fast at the same time. These can be collectively referred to as agility and its economic counterpart as business agility. Business agility is not just a buzzword, it is a fundamental change in the way organisations operate and respond to the dynamic challenges of the modern marketplace. The pace of change has accelerated exponentially, driven by technological breakthroughs, market disruptions and unforeseen global events such as the COVID-19 pandemic or international war conflicts. Businesses must adapt to change and have the flexibility to adapt their strategies, products and services accordingly. Moreover, competition is no longer confined to traditional industry boundaries. New players can appear on the market overnight and can pose very significant risks to any business. The ability to adapt, innovate and react quickly to changing circumstances is a core competence that can determine the survival and prosperity of a company. The paper focuses on the understanding and importance of business agility. Method: The paper aims to introduce the subject under study through a secondary research based on a literature review. Following the secondary research, the results of the questionnaire survey will be presented. The questionnaire assessed aspects of agility and agile operations along closed, scaled questions. The results were analysed using descriptive statistics and analysis of variance. Results and conclusion: In this study we wanted to present an individual interpretation of agility. We were interested in the extent to which previous participation in economic and agile education influences the perception of agile criteria. The four cardinal domain statements presented in the survey and the impact of agility on them are not yet adequately assessed by the respondents. Due to the novelty of agility and misconceptions about it, it is not yet possible to clearly demonstrate the positive impact of this approach in Hungary, which is something that needs to change in the future. Research implications: The study can provide a good basis for understanding individual interpretations of agility. The results show that the concept itself is not yet embedded in everyday business thinking, which means that important steps are still to be taken, at least in the case of Hungary. Complex programmes to broaden our understanding would be important and necessary, challenging future education and providing a good basis for further research. Originality/value: The originality of the research lies in the fact that there have been no comprehensive studies and research on agility, on the human side of agile thinking. In this field, the study aims to serve as a thought-provoking tool, establishing the importance of the topic and the need for further research, which is particularly relevant for organisations and individuals in the rapidly changing and challenging world of the 21st century.

Cash Rules Everything around Me: Investigating Craft Beer Drinkers Purchase Decisions during Inflationary Period

Since March 2020, there have been multiple outside influences negatively impacting the U.S. craft beer industry from COVID-19 to inflation all leading up to increased prices for consumers. However, to date, research has not investigated consumer sentiment toward increased prices and their willingness to continue paying increased prices for beer from various outlets. The current study provides an initial assessment of craft beer consumers’ purchase behaviors for on(own)- and off-premise consumption given the impacts of COVID-19 and the recent economic situation. Past research has indicated that increased prices tend to lead to decreased purchases of beer (and alcohol in general). Results of the current online survey of craft beer drinkers mostly align with past findings, as nearly half of the 350 participants in this study indicated that they had decreased their consumption of craft beer away from home. Relatedly, respondents indicated a relatively low willingness to pay price increases for craft beer consumed on-premise (own-premise) or off-premise.

How Ohio public library systems respond to opioid-related substance use: a descriptive analysis of survey results

BackgroundPublic libraries in the United States have experienced increases in opioid-related substance use in their communities and on their premises. This includes fatal and non-fatal overdose events. Some libraries have adopted response measures in their branches to deter substance use or prevent overdose. A small number of libraries around the nation have decided to stock the opioid antagonist naloxone (Narcan) for staff to administer to patrons who experience overdose. This response measure has generated extensive media attention. Although Ohio ranks fourth in age-adjusted drug mortality rate in the United States, there has been no investigation of whether Ohio libraries are observing opioid-related transactions, consumption, and/or overdose events, or which measures they have adopted in response to these activities. We conducted a multimethod survey with Ohio public library directors to identify the response measures they have adopted. We present descriptive findings from the quantitative and qualitative items in our survey.MethodsWe conducted a cross-sectional 54-item multimethod survey of public library system directors (one per system) in Ohio. Directors of each of Ohio’s public library systems were invited to participate via email.ResultsOf 251 library systems, 56 responded (22.3% response rate), with 34 respondents (60.7%) indicating awareness of opioid-related transactions, consumption, and/or overdose on their premises. Most (n = 43, 76.8%) did not stock naloxone in their buildings. Over half (n = 34, 60.7%) reported implementing one or more non-naloxone response measures. These measures focus on improving security for staff and patrons, deterring opioid-related transactions (purchases and exchanges) and consumption, and providing educational events on substance use. Nearly half (n = 25, 47.2%) partner with community organizations to provide opioid response measures. A similar proportion reported adequate funding to respond to opioid-related substance use (n = 23, 45.1%), and most (n = 38, 74.5%) reported adequate support from their boards and communities. Few respondents have implemented evaluations of their response measures.ConclusionsOhio public libraries are responding to evidence of opioid-related transactions, consumption, and/or overdose on their premises with a range of measures that focus on substance use prevention and deterrence. Most Ohio library systems do not stock naloxone. Respondents indicated they prefer to call 911 and let first responders handle overdose events. The majority of respondents indicated their library systems have political capacity to respond to evidence of opioid-related substance use on their premises, but have limited operational and functional capacity. Findings suggest the need to revisit assumptions that public libraries are willing to stock naloxone to respond to overdose events, and that libraries have the resources to respond robustly to opioid-related transactions, consumption, and/or overdose on their premises.

Time to diagnosis and determinants of diagnostic delays of people living with a rare disease: results of a Rare Barometer retrospective patient survey.

Timely diagnosis is one of the most serious challenges faced by people living with a rare disease (PLWRD), and this study estimates that in Europe, the average total diagnosis time (TDT) is close to 5 years. We investigated the duration of the TDT for PLWRD in Europe, the difficulties associated with their diagnosis odyssey and the main determinants of diagnosis delays for all rare diseases (RD). We conducted a survey of PLWRD and their families using Rare Barometer, the survey initiative of EURORDIS-Rare Diseases Europe. In geographical Europe, we surveyed 6507 people living with 1675 RD in 41 countries. We then performed a descriptive analysis and ordinal logistic regressions to identify the main determinants of diagnosis delays. Average TDT is 4.7 years. 56% of respondents were diagnosed more than 6 months after a first medical contact. The main determinants of diagnosis delays are symptom onset before 30 years of age, especially during childhood (OR = 3.11; 95% CI: 2.4-4.0) and adolescence (OR = 4.79; 95% CI: 3.7-6.2), being a woman (OR = 1.22; 95% CI:1.1-1.4), living in Northern Europe (OR = 2.15; 95% CI:1.8-2.6) or Western Europe (OR = 1.96; 95% CI:1.6-2.3), the number of healthcare professionals consulted (OR = 5.15; 95% CI:4.1-6.4), misdiagnosis (OR = 2.48; 95% CI:2.1-2.9), referral to a centre of expertise (OR = 1.17; 95% CI:1.0-1.3), unmet needs for psychological support (OR = 1.34; 95% CI:1.2-1.5) and financial support (OR = 1.16; 95% CI:1.0-1.3), having a genetic disease (OR = 1.33; 95% CI:1.1-1.5) and a family history of an RD (OR = 1.36; 95% CI:1.1-1.6). These determinants can inform policies and actions to improve access to diagnosis for all PLWRD.

Correlation of the technical subjects teachers burnout syndrome incidence level on the geographical teacher action in a specific region of Slovakia

The presented paper discusses the incidence of burnout syndrome among secondary school teachers of technical subjects. Teachers experience burnout syndrome to an increased extent, especially with certain variables. The main goal of the paper is to map the level of burnout syndrome, specifically of emotional exhaustion, depersonalization and personal satisfaction among teachers of technical subjects. Specifically, we analysed the incidence of burnout among technical subjects in the context of all self-governing regions of Slovakia. The research sample consisted of 213 technical subject teachers working at secondary vocational schools of primarily technical orientation in various self-governing regions of Slovakia. Data collection was carried out using the MBI-ES online questionnaire. Statistical analyses were used to evaluate the results of the questionnaire survey. The results show that teachers of technical subjects experience burnout to a moderate degree, statistical significance is observed in the degree of burnout, specifically in the factor of personal satisfaction, in connection with teachers acting in different self-governing regions of Slovakia.

Leveraging Project ECHO to Implement a Suite of Substance Use Learning Communities for Statewide Impact.

Overdoses and alcohol consumption rose during the pandemic. However, uptake of practices which reduce mortality (eg, medications for opioid use disorder, harm reduction practices) remains insufficient. Provider training and telementoring is needed to ensure sufficient capacity for treating substance use disorders (SUDs) with evidence-based practices. The Project ECHO (Extension for Community Healthcare Outcomes) model involves the use of web technologies to deliver didactic and case-based learning through a panel of experts to build such competency in a community of learners. Project ECHO was leveraged to implement a statewide telementoring center of addictions-focused ECHO programs, including programming in prescribing, harm reduction, recovery support services, collaborations with first responders, and systems-level challenges. Participants represented health and behavioral health disciplines practicing across the state of Texas in metropolitan and rural areas. Learners were administered: (1) an online registration form that inquired about basic demographics, (2) a post-session survey at the conclusion of each session capturing satisfaction and likelihood to implement, and (3) annual surveys measuring changes in knowledge and self-efficacy. Attendance and other learner data were stored and extracted from the partner relationship management database: iECHO. Training programs were attended by 968 learners, with an average of 48 learners per session. Geographic reach included 47 Texas cities. Post-training survey results indicated high rates of learner satisfaction, with an average rating of 4.68 on a 5-point Likert-like scale. Annual surveys indicated improvements in provider knowledge and self-confidence across all programs. Early results indicate robust uptake, wide geographic reach, high learner satisfaction, and provider knowledge and confidence gains. This preliminary evidence supports the use of the ECHO model as a potential tool for scaling comprehensive SUD telementoring centers to meet workforce development needs over large geographic areas.