ResultsThe Response Rate Research Articles

Survey to assess present practice and address challenges in gynaecological brachytherapy in Australia and New Zealand

AbstractIntroductionThis survey assessed gynaecological brachytherapy caseloads, local training requirements and quality assurance processes across Australia and New Zealand.MethodsThe survey was developed by the Gynaecological Oncology Radiation Oncology Collaboration (GOROC) and emailed to all centres offering gynaecological brachytherapy across Australia and New Zealand. It covered 9 areas including caseloads per centre and per radiation oncologist, techniques practised, local training requirements and quality assurance processes over a 2‐year period – 2019 and 2020.ResultsThe response rate was 18 out of 25 centres. All centres offered vaginal vault brachytherapy and 89% treated an average of at least 10 patients per annum. Intracavitary and/or interstitial brachytherapy was offered at 89% of centres of which 31% treated less than an average of 10 patients per annum and 23% of radiation oncologists did less than an average of 5 or more insertions per annum as recommended in the GOROC guidelines. Most centres required only Fellowship from the Royal Australian and New Zealand College of Radiologist to practice gynaecological brachytherapy. Peer review of volumes and dosimetry was routinely performed in 28% and 17% of centres, respectively.ConclusionThis survey adds to the limited literature available regarding practice patterns of brachytherapy worldwide. Ensuring adequate training and robust quality assurance processes with volume and dosimetry review may support all centres and clinicians to continue to safely offer this complex technique.

The association between personality traits and transphobia among university students: a cross-sectional study in northwestern Iran

BackgroundIndividuals with GD may suffer from limited access to healthcare services because of negative attitudes from the healthcare providers. Therefore, to promote medical service it is of great importance to address negative attitudes among healthcare providers. The present study aimed to estimate the prevalence of transphobia as well as to assess the association between personality traits and transphobia among students of the University of Medical Sciences, who will hold key positions within the healthcare system.MethodsThis cross-sectional study was conducted on 418 students at Tabriz in northwestern Iran in 2024. Convenience sampling method was utilized. Data were gathered through standard self-reported questioners; Genderism and Transphobia Scale (GTS), and Big Five Inventory scale (BFI-44). Linear regression analysis was conducted to estimate standard coefficient with 95% Confidence Intervals (CIs).ResultsThe response rate was calculated as 98.35% in which 204 (48.8%) out of the participants were female. The mean (SD) age was 23.73 (2.01) years. The adjusted multiple linear regression coefficients indicated that the agreeableness (β = 0.16, p = 0.001), neuroticism (β = 0.11, p = 0.02), and openness (β = -0.27, p = 0.001) were able to effectively explain the variance in transphobia scores. However, conscientiousness (β = 0.06, p = 0.18) and extroversion (β = 0.06, p = 0.05) did not significantly contribute to explaining the variance in transphobia scores.ConclusionsPersonality traits may significantly influence attitudes toward transgender individuals, suggesting that interventions designed to reduce transphobia should consider these foundational personality characteristics.Clinical trial numberNot applicable.

Managing anxiety in men undergoing surveillance in the NHS abdominal aortic aneurysm screening programme: A survey of screening staff in England

BackgroundAAA is an enlargement in the aorta that can increase in size and rupture. In England, the National Health Service (NHS) AAA Screening Programme offers screening to all men aged 65 to identify those with an AAA. Men with small or medium sized aneurysm enter surveillance where they receive ultrasound scans annually or every three months respectively. Due to concerns about mortality from AAA rupture, anxiety levels may be high for men and their families and impact on their quality of life. AimTo obtain the views of staff providing Abdominal Aortic Aneurysm (AAA) screening on how best to help men in surveillance to manage AAA-related anxiety. MethodsA cross-sectional online survey of the 38 AAA regional screening services in England was conducted. Four staff with different roles from each service (doctor, nurse, manager and scanning technician) were asked to complete an online questionnaire. ResultsThe response rate was 71 % (27/38) for regional AAA screening services and 65 % (99/152) for the staff approached. 93 % (79/84) of respondents strongly or somewhat agreed that men in surveillance may need help to manage anxiety. The size of the aneurysm was rated as the factor most likely to cause anxiety. 63 % (51/81) considered AAA Programme Nurses to be the best people to deliver an intervention. Staff suggested that improved information about AAA and associated risks, group support/networking sessions, and more contact with the screening service were ways of helping with management of anxiety. ConclusionStaff providing AAA screening recognised that being in surveillance can cause anxiety for men and their families, and identified that potential interventions, such as organised support groups and improved provision of information, might help manage anxiety. Programme Nurses were considered the ideal healthcare professional to help men in surveillance manage AAA-related anxiety.

Student perspectives on learning transfer from online postgraduate sonography courses to traineeships: A pilot survey

AbstractIntroductionThis survey aims to understand how postgraduate sonography students perceive to apply knowledge from online coursework to traineeships. It also explores the impact of students' age, gender, traineeship duration and geographic location on learning transfer. The ability to apply learnt knowledge is a key factor for student success in higher education and the workplace, yet it is an under‐researched topic.MethodThe Human Research Ethics Committee of an Australian university granted ethical approval. A pilot online survey was sent to 279 medical sonography students enrolled in an online postgraduate program. These students had an industry traineeship as a corequisite to online coursework. The survey was sent via email on Microsoft Forms from October to December 2023. Descriptive, Likert scale and free‐text data were analysed using Microsoft Excel, IBM SPSS Statistics (version 29) and Lumivero NVivo (version 14).ResultsThe response rate was 38% (n = 106). Most respondents agreed that they developed transfer skills from online courses. Practice questions, lectures and interactive sessions emerged as the key online learning activities that helped to facilitate knowledge transfer. With summative assessments, case studies enhanced knowledge transfer. No significant difference was seen in the transfer ability based on geographical location, age and gender.ConclusionIt is challenging for online educators to foster transfer skills to prepare safe, competent, job‐ready graduates. Our study has provided initial insights on enablers of online learning transfer to online educators on students' perspectives of how they see the relevance and how they apply knowledge from online courses to traineeships.

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

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

Human Papillomavirus Vaccination Awareness and Uptake among Healthcare Students in Japan

BackgroundThe vaccination rate for HPV (Human Papillomavirus) has remained significantly low in Japan because of the administrative suspension of active recommendation. This study investigates the awareness and uptake of the HPV vaccine among healthcare students in Japan following the reinstatement of active recommendation for young women in April 2022. MethodsA web-based survey was administered to 2,567 healthcare students from Okayama and Shujitsu Universities in Japan in July 2023. The survey assessed participants' backgrounds, immunization status, awareness of vaccine recommendations, and knowledge of cervical cancer across various demographics, including sex, academic year, and department (Medicine, Health Science, Pharmaceutical, and Dentistry). ResultsThe response rate was 36.3% (933 students; 181 male, 739 female, and 13 unspecified gender). The overall immunization rate among female students was 55.6%, with higher rates observed in medical (73.8%) and dental (63.0%) students. Awareness of the government's change in vaccine recommendation was notably high among female and senior male students. Over half of the female students (54.7%) reported receiving vaccinations based on their parents' advice. Among those unvaccinated but interested in future immunization, concerns about adverse reactions (47.4%) and challenges in scheduling vaccinations (29.1%) were predominant. ConclusionHealthcare students exhibited a higher HPV vaccination rate than the general population. Ongoing education to improve vaccine literacy is crucial for augmenting HPV vaccination rates in Japan.

The construction of the index system for nurses' innovation competence evaluation in China: A Delphi study

BackgroundScientific and technological innovation has become the "key variable" of national social and economic development. Nurses' innovation ability can improve the quality of patient care, thus shorten the hospital stay, reduce the medical costs, and promote the rapid development of the nursing industry. Nowadays nurses have gradually involved in various innovation, but less concerns are focus on the evaluation of nurse’s innovation competence. ObjectiveTo develop evaluation index system for nurse's innovation competence. ParticipantsEleven experts with innovation experience from different regions in China. MethodsLiterature review and qualitative interview were used to establish first version of index system. Then, a two-round Delphi expert consultation was conducted to collect opinions from 11 experts. Then the final version of nurses' innovation competence evaluation index was used in one tertiary hospital for preliminary application. ResultsThe response rate of the two rounds was more than 90%, the expert familiarity coefficient was 0.818, the judgment coefficient was 0.918, and the authority coefficient was 0.868. The two rounds of expert coordination coefficient test showed P < 0.05. The evaluation index system of nurses' innovation competence includes 4 first-level indicators, 9 second-level indicators and 36 third-level indicators. The scores of innovation production and innovation subject were the lowest among all the first-level indicators when use this index for preliminary application. ConclusionThe constructed evaluation index system of nurses' innovation competence are scientific, reliable and practical, and can be used to promote nurse's innovation competence and innovation conversion competence in clinical practice. Hospital managers should pay more attention on cultivate nurse’s innovation competence and provide resources and multi-form platforms to support the nurses with innovative ideas and willingness.

Can a large language model create acceptable dental board-style examination questions? A cross-sectional prospective study

Background/purposeNumerous studies have shown that large language models (LLMs) can score above the passing grade on various board examinations. Therefore, this study aimed to evaluate national dental board-style examination questions created by an LLM versus those created by human experts using item analysis. Materials and methodsThis study was conducted in June 2024 and included senior dental students (n = 30) who participated voluntarily. An LLM, ChatGPT 4o, was used to generate 44 national dental board-style examination questions based on textbook content. Twenty questions for the LLM set were randomly selected after removing false questions. Two experts created another set of 20 questions based on the same content and in the same style as the LLM. Participating students simultaneously answered a total of 40 questions divided into two sets using Google Forms in the classroom. The responses were analyzed to assess difficulty, discrimination index, and distractor efficiency. Statistical comparisons were performed using the Wilcoxon signed rank test or linear-by-linear association test, with a confidence level of 95%. ResultsThe response rate was 100%. The median difficulty indices of the LLM and human set were 55.00% and 50.00%, both within the range of “excellent” range. The median discrimination indices were 0.29 for the LLM set and 0.14 for the human set. Both sets had a median distractor efficiency of 80.00%. The differences in all criteria were not statistically significant (P > 0.050). ConclusionThe LLM can create national board-style examination questions of equivalent quality to those created by human experts.

Tobacco use, secondhand exposure and knowledge of secondhand and third-hand smoke among medical college students in Western Nepal: a cross-sectional study

ObjectivesThis study was conducted to assess the prevalence of tobacco use, secondhand smoke (SHS) exposure and knowledge about SHS and third-hand smoke (THS) exposure among students in a medical college...

Relationship of different left bundle branch pacing sites and clinical outcomes in patients with heart failure

BackgroundLeft bundle branch pacing (LBBP) is a novel physiological pacing modality. However, whether it delivers comparable efficacy with different capture sites in patients with heart failure remains unclear. ObjectiveThis study aimed to assess the association between different pacing sites and the response of LBBP. MethodsForty-three consecutive patients with heart failure, referred for successful LBBP implantation, were prospectively recruited in this study. Patients were assigned to 3 subgroups according to the paced QRS complex morphology (left bundle branch trunk pacing [LBTP], left posterior fascicular pacing, or left anterior fascicular pacing groups). Echocardiograms and electrocardiograms were recorded and analyzed at baseline and 6-month follow-up. ResultsThe response rate was 95.0%, 88.2%, and 83.3% in LBTP, left posterior fascicular pacing, and left anterior fascicular pacing groups, respectively. All subgroups were efficient in narrowing the QRS complex (QRS complex narrowing: 38.1 ± 10.8 ms, 36.4 ± 12.6 ms, and 40.8 ± 10.8 ms) and improving cardiac function (LVEF improvement： 25.7% ± 8.1%, 15.3% ± 8.1%, and 18.8% ± 4.4%). Compared with left fascicular pacing, LBTP resulted in longer peak left ventricular activation time (76.5 ± 10.2 ms vs 82.3 ± 6.5 ms; P = .037) and shorter duration from intrinsicoid deflection in V1 or V2 to QRS end (128.0 ± 6.0 ms vs 113.3 ± 5.2 ms; P＜.0001), along with better improvement in septal systolic longitudinal strain (P = .007) and lateral-septal myocardial loading inhomogeneity (P = .036). Linear regression analysis further revealed that left bundle branch capture sites were strongly associated with the improvement in peak strain dispersion (model R2 = 0.586; P = .042) and LVEF (model R2 = 0.425; P < .0001). ConclusionDifferent left bundle branch capture sites led to a subtle difference in mechanical synchrony, which may, in turn, affect LVEF improvement in patients with heart failure.

Prevalence and correlates of probable rapid eye movement sleep behavior disorder among middle-aged and older adults in a psychiatric outpatient clinic: A cross-sectional survey

ObjectiveRapid eye movement sleep behavior disorder (RBD) is often underdiagnosed among people living with mental disorders. The present study aimed to investigate the prevalence of probable RBD (pRBD) and its associated factors among middle-aged and older adults in a psychiatric outpatient clinic. MethodsWe conducted a cross-sectional survey among 2907 people aged 45–80 years who visited the outpatient clinic between March 1 and August 31, 2022 in a psychiatric hospital. A cutoff score ≥5 on the RBD Screening Questionnaire (RBDSQ) was used to indicate the presence of probable RBD (pRBD). Potential factors associated with pRBD were also assessed with a structured checklist. The association between these factors and the presence of pRBD was examined with logistic regression. ResultsThe response rate was 64.3 %. Among 1868 respondents [age 58.5 ± 9.6 years, male n = 738 (39.5 %), female n = 1130 (60.5 %)], 15.9 % (95 % CI 14.2–17.6 %) screened positive for pRBD. Occupational exposure to chemicals; positive family history of psychotic disorders; a late start of mental health care; a medical history of autonomic dysfunction; mood problems; and use of antidepressants, hypnotics, and acetylcholinesterase inhibitors were associated with an increased likelihood of having pRBD (P < 0.05 for all). ConclusionpRBD is common among outpatients with mental disorders, especially in mental disorders due to neurological diseases and physical conditions, mood disorders and anxiety or somatoform disorders. The findings highlight the importance of identifying sleep behavior disorders among people living with mental disorders in clinical practice.

Training of Tutors in Problem Based Learning: Feedback of Participants

Background The faculty members should have knowledge on PBL process and must be familiar with the changing role of teacher to facilitator to adopt PBL as a teaching/learning strategy. The transition from the role of teacher to tutor is critical for the success of PBL. The objective of this study was to describe the process of proceedings of training workshop at the outset of introduction of PBL in Gandaki Medical College Nepal and assess the feedback of the tutors towards PBL training workshop.MethodsTwo one-day training workshops were organized at GMC; first on November 28, 2021, and second on October 16, 2022. Feedback of the participants was taken on valid semi-structured self-administered questionnaire at the end of proceedings of training workshops. Data was analyzed for frequency and central tendency. ResultsThe response rate was 100% (Total number of participants =37). The training workshops were rated for usefulness (7.89±0.90), content (7.83±0.76), relevance (7.83±0.98), facilitation (7.91±1.11) and overall process (8.13±0.82) using scale 1-10(1=Poor, 10= Excellent). Most of the participants found the sessions moderately important ("PBL Process" 70.3%, "Role of Tutor" 75.7%, "Designing PBL problem package" 48.6%, and “Conducting PBL" 70.3%). The majority of the participants recommended increasing the duration of workshop, allocate adequate time for the practice session and arrange other types of training workshops in medical education. Conclusions The significance of PBL trainings was recognized by the participants. Overall, their feedback on training workshops were positive.

The Society of Black Academic Surgeons membership survey: Insights on demographics, engagement, and opportunities for improvement

BackgroundThe Society of Black Academic Surgeons (SBAS) sought to understand who constitutes its membership and obtain feedback to improve the organization. MethodsSBAS conducted a 25-question survey amongst members. ResultsThe response rate was 19 ​% (n ​= ​132/685) with an even gender breakdown (male n ​= ​64, female n ​= ​68). The majority identified as Black or African American (85 ​%), followed by White (12 ​%). Fifty-two percent identified as trainees, while the rest were practicing surgeons specializing in burn/trauma/critical care (19 ​%), oncology (19 ​%), and general surgery (13 ​%). Half joined SBAS within the last 3 years. Satisfaction was reported at a mean of 3.7/5. Lack of awareness (41 ​%), time (13 ​%), or interest (5 ​%) limited committee participation. Networking (83 ​%), mentorship/sponsorship/allyship (71 ​%), and leadership development (46 ​%) were most valued benefits with job boards, webinars, and grants least valuable. ConclusionSBAS is a unique organization uniting both new and lifetime members and opportunities exist to enhance current membership and improve participation.

Navigating the Neurosurgery Match Process: Insights from the National Resident Matching Program – Program Director Surveys

ObjectiveNeurosurgery is one of the most competitive specialties and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program (NRMP) Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties. MethodsWe evaluated seven surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all seven surveys included data about the program director (PD)’s attitude towards USMLE test scores. ResultsThe response rate of PDs decreased over the years. The most cited for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews. ConclusionOur analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis towards the USMLE step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews.

Early symptom improvement and other clinical predictors of response to repetitive transcranial magnetic stimulation for depression

BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a rapidly emerging treatment for depression, but outcome prediction is still a challenge. This study aimed to identify predictors of response to rTMS among baseline clinical factors and early symptomatic improvements. MethodsThis cohort study comprised 136 patients with a unipolar or bipolar depressive episode referred for clinical intermittent theta-burst stimulation or right-sided 1 Hz rTMS at the Uppsala Brain Stimulation Unit. The co-primary outcomes used for logistic regression were response, defined as ≥50 % reduction of Montgomery and Åsberg Depression Rating Scale Self-assessment (MADRS-S) total score, and 1–2 points on the Clinical Global Impression Improvement (CGI-I) scale. Early improvement was defined as ≥20 % reduction in the MADRS-S total score, or ≥ 1 point reduction in each MADRS-S item, after two weeks of treatment. ResultsThe response rates were 21 % for MADRS-S and 45 % for CGI-I. A depressive episode >24 months had lower odds for MADRS-S response compared to ≤12 months. Early improvement of the MADRS-S total score predicted CGI-I response (95 % CI = 1.35–9.47, p = 0.011), Initiative6 predicted MADRS-S response (95 % CI = 1.08–9.05, p = 0.035), and Emotional involvement7 predicted CGI-I response (95 % CI = 1.03–8.66, p = 0.044). LimitationsNo adjustment for concurrent medication. ConclusionsA depressive episode ≤12 months and early improvement in overall depressive symptoms, as well as the individual items, Initiative6 and Emotional involvement7, predicted subsequent rTMS response in a naturalistic sample of depressed patients. This could facilitate the early identification of patients who will benefit from further rTMS sessions.

Association of Physical Fitness With the Work Ability of Aging Workers With Physically Demanding Jobs in a University Hospital in Thailand

BackgroundA decrease in physical fitness with age can impact work ability. Exploring the role of physical fitness is important for identifying interventions to enhance work ability among aging workers. We sought to determine the association between physical fitness and physically demanding work ability in aging workers. MethodsWe recruited workers aged 45–65 years from eight departments of a university hospital in Bangkok, Thailand. Work ability was assessed using the work ability index (WAI), and physical fitness components were evaluated through various tests. Associations between work ability and physical fitness were examined using a multivariable regression analysis. ResultsThe response rate was 46.4% (n = 216). The mean WAI score was 41.6. Participants with an overweight or obese body mass index (BMI) had 1.8 (95% CI –3.1, –0.4) points lower WAI scores than did those within a healthy BMI range. A handgrip strength test revealed that participants in the good/very good group had 2.5 (95% CI: 0.6, 4.3) higher WAI scores than did those in the very poor/poor group. For a single-leg stance test, participants in the above-average group had 2.1 (95% CI: 0.7, 3.5) points greater WAI scores than did those in the below-average group. No significant associations were found between work ability and 3-min step, chair stand, or sit-and-reach test scores. ConclusionThe overall work ability of the participants was good. Body composition, muscle strength, and balance were associated with work ability. Promoting physical fitness is a viable strategy for enhancing work ability among aging workers.

Access to Care Considerations for the Endodontic Treatment of Immature Permanent Teeth: A National Survey of Pediatric Dentists and Endodontists

IntroductionThis study aimed to investigate access to care and financial considerations associated with the endodontic treatment of immature permanent teeth. MethodsSurveys were distributed to endodontists (n = 2,457) and pediatric dentists (n = 3,974) in the United States. Data were analyzed using X2 analysis and logistic regression. The level of significance was set to 0.05. ResultsThe response rate was 13% (n = 840). Respondent specialist groups were similar by age and years since specialty residency completion, but significantly different with regard to primary practice setting (eg private practice, Federally Qualified Health Center, hospital), (P = .001). The majority (91%) of respondents reported participation with dental insurance. Pediatric dentists (69%) were significantly more likely than endodontists (17%) to participate with public-payer dental insurance (P < .001). The majority of respondents (82%) indicated that patients reported economic factors (time or money) as a barrier to accessing endodontic treatment. Pediatric dentists were significantly more likely to consider economic factors when planning for treatment (P < .001). Pediatric dentists were more likely than endodontists to have the opinion that endodontic procedures for treatment of necrotic immature permanent teeth should cost less than root canal therapy (apexification, P < .001; regenerative endodontic procedures, P = .002). Pediatric dentists (33%) reported encountering barriers when attempting to refer their patients to an endodontist. Inability to find an endodontist that participates with dental insurance was the most frequently cited barrier. ConclusionsLimited clinician participation with dental insurance and gaps in insurance coverage for endodontic procedures appear to contribute to access to care barriers for pediatric patients.

The experiences of patients not conveyed after evaluation by emergency medical services in Southwest Finland – A qualitative survey study

BackgroundThe amount of non-critical Emergency Medical Services missions has been increasing. After examination and treatment, paramedics can decide, based on guidelines, not to convey the patient to a healthcare facility. This study aimed to investigate patients’ experiences in non-conveyance situations in Southwest Finland. Our research questions were: 1) Which patient concerns were not addressed? 2) What key actions improved patient comfort? and 3) What possible enhancements could make the patient experience more positive? MethodsThis was a qualitative survey study. In March 2023, all the patients who met the inclusion criteria (N = 1017) received a survey via mail. The data from three open-ended questions were analyzed using inductive content analysis. ResultsThe response rate was 22.2 % (n = 226). The unaddressed patient concerns were related to inadequate immediate care and guidance and non-clinical factors causing concern. Key actions for improved patient comfort were related to immediate treatment and guidance, as well as non-clinical factors that impact the patient experience. More thorough treatment processes and more attentive encounters would have enhanced the patient experience. ConclusionsPredominantly, patients reported having received excellent services. Utilizing paramedics’ soft skills and keeping the patient as the central focus is key to improving the non-conveyance process and experience.

Knowledge and attitudes of oral health care workers on HIV-associated oral lesions: A study at PHC facilities in Gauteng

Oral health care workers (OHCWs) are critical in providing holistic treatment and preventing the spread of HIV disease. They are uniquely placed to identify, diagnose, manage and treat HIV-related oral lesions.Aim To determine oral health clinicians’ knowledge and attitudes towards HIV-associated oral lesions. Methodology A descriptive cross-sectional survey was conducted at Gauteng’s primary health care (PHC) facilities. Data collection targeted the three categories of OHCWs – dentists, dental therapists and oral hygienists. ResultsThe response rate was 67.5% (n=110), majority of the participants, 76.4% (n=84), were female. Nearly all participants, 91.8% (n=100), agreed that oral lesions are common in people living with HIV and AIDS (PLWHA) and that early diagnosis of HIV/treatment increases PLHIV’s life expectancy. More than three-quarters (80%) reported that they had no problem treating patients diagnosed with HIV. Almost a third, 36.4% (n=40), listed necrotising periodontal conditions and oral candidiasis 34.5% (n=38) as the most common oral manifestations. Most respondents correctly identified oral candidiasis (92.7%), Kaposi sarcoma (84.5%) and necrotising ulcerative periodontal conditions (80.9%).ConclusionAlthough OHCWs had sound knowledge of oral manifestations of HIV, training programmes must be prioritised for knowledge transfer. Dental facilities can be used as a health-promoting platform and a viable location for provider-initiated testing and counselling (PICT) and client-initiated counselling and testing (CICT), also known as voluntary counselling and testing (VCT). The use of HIV rapid testing kits is an option to be explored in the dental facility by OHCWs.

A Survey of Current Approaches to Inguinal Hernia Repair by Pediatric General Surgeons in the United States

IntroductionInguinal hernia repair (IHR) is a common pediatric operation performed via open or laparoscopic approaches. The objective of this survey study was to assess current approaches to IHR in a national sample of pediatric general surgeons. MethodsA REDCap survey was distributed to all pediatric general surgeons at 21 US institutions in 2023. Descriptive statistics were used to analyze responses. ResultsThe response rate was 70.0% (145/207) with median fellowship graduation year of 2011. Respondents reported they were primarily taught either an open (73.1%) or laparoscopic (6.9%) technique in fellowship, while 18.6% reported being taught both techniques equally. Overall, 60.7% of respondents reported currently performing both laparoscopic and open IHR, while 27.6% reported performing only open IHR and 11.7% reported performing only laparoscopic IHR. During unilateral open IHR, 75.8% of respondents check for and repair a contralateral inguinal hernia, most commonly by placing a laparoscope via the hernia sac (76.3%). Selective mesh use in adolescents was similar between laparoscopic and open repair approaches. For recurrent hernias, 37.2% of respondents indicated performing the approach that was not performed previously, while 38.6% and 22.8% indicated they routinely perform a laparoscopic or open approach, respectively, regardless of initial repair approach. ConclusionOver two thirds of surgeons reported incorporating laparoscopic IHR into their practice despite nearly three-quarters of respondents indicating they were primarily taught an open approach in training. Training in laparoscopic IHR has been increasing over time, and respondents reported a wide variety of laparoscopic and open repair techniques. Level of EvidenceIV.