Short Survey Research Articles

Social media quality in undergraduate medical education: A reconceptualisation and taxonomy.

Social Media (SoMe) as a learning tool, though ubiquitous in society and popular within medical education, is often criticised as superficial. Its limitless output has been blamed for encouraging shorter attention spans and shirking in-depth reflection. The evidence base is itself superficial and lacking rigour or meaning. We aimed to consider a theoretical basis for how 'quality' learning may happen on such platforms. Our findings then informed the construction of a taxonomy for SoMe learning. We conducted a qualitative interview study of United Kingdom (UK) medical students using a theory-informed inductive study design. The research question was: 'How do medical students conceptualise quality of learning on social media?'. We purposively sampled participants from responses to a short survey collecting demographic and SoMe usage data. Interview data were analysed using framework analysis and informed by Blooms taxonomy, connectivism and communities of practice (CoP) theories. We received survey responses from 118 medical students across 25 UK medical schools. From these, 13 participants were recruited to individual semi-structured interviews. We constructed three themes through framework analysis of interview data: cognitive hacking, professional identity reflection and safety, control and capital. Quality SoMe learning may be conceptualised as a socially connected process, built upon constantly evolving networks but inexorably influenced by fluctuating hierarchy within learner-centric CoP. Educators and institutions may support high-quality learning for students through engagement which promotes community development, and safe, listening environments which foster professional identity formation.

Challenges in institutional ethical review process and approval for international multicenter clinical studies in lower and middle-income countries: the case of PARITY study

BackgroundOne of the greatest challenges to conducting multicenter research studies in low and middle-income countries (LMICs) is the heterogeneity in regulatory processes across sites. Previous studies have reported variations in requirements with a lack of standardization in the Institutional Review Board (IRB) processes between centers, imposing barriers for approval, participation, and development of multicenter research.ObjectivesTo describe the regulatory process, variability and challenges faced by pediatric researchers in LMICs during the IRB process of an international multicenter observational point prevalence study (Global PARITY).DesignA 16-question multiple-choice online survey was sent to site principal investigators (PIs) at PARITY study participating centers to explore characteristics of the IRB process, costs, and barriers to research approval. A shorter survey was employed for sites that expressed interest in participating in Global PARITY and started the approval process, but ultimately did not participate in data collection (non-participating sites) to assess IRB characteristics.ResultsOf the 91 sites that sought IRB approval, 46 were successful in obtaining approval and finishing the data collection process. The survey was completed by 46 (100%) participating centers and 21 (47%) non-participating centers. There was a significant difference between participating and non-participating sites in IRB approval of a waiver consent and in the requirement for a legal review of the protocol. The greatest challenge to research identified by non-participating sites was a lack of research time and the lack of institutional support.ConclusionsGlobal collaborative research is crucial to increase our understanding of pediatric critical care conditions in hospitals of all resource-levels and IRBs are required to ensure that this research complies with ethical standards. Critical barriers restrict research activities in some resource limiting countries. Increasing the efficiency and accessibility of local IRB review could greatly impact participation of resource limited sites and enrollment of vulnerable populations.

Parshin’s method and the geometric Bombieri-Lang conjecture

In this short survey, we explain Parshin’s proof of the geometric Bombieri–Lang conjecture, and show that it can be used to give an alternative proof of Xie–Yuan’s recent resolution of the geometric Bombieri–Lang conjecture for projective varieties with empty special locus and admitting a finite morphism to a traceless abelian variety.

On Complexity Classes of Envy-Free Pricing Problems: A Short Survey

On Complexity Classes of Envy-Free Pricing Problems: A Short Survey

Confusion of extragalactic sources in the far-infrared: A baseline assessment of the performance of PRIMAger in intensity and polarization

Because of their limited angular resolution, far-infrared telescopes are usually affected by the confusion phenomenon. Since several galaxies can be located in the same instrumental beam, only the brightest objects emerge from the fluctuations caused by fainter sources. The PRobe far-Infrared Mission for Astrophysics imager (PRIMAger) will observe the mid- and far-infrared (25--235\,mu m) sky both in intensity and polarization. We aim to provide predictions of the confusion level and its consequences for future surveys. We produced simulated PRIMAger maps affected only by the confusion noise using the simulated infrared extragalactic sky (SIDES) semi-empirical simulation. We then estimated the confusion limit in these maps and extracted the sources using a basic blind extractor. By comparing the input galaxy catalog and the extracted source catalog, we derived various performance metrics as completeness, purity, and the accuracy of various measurements (e.g., the flux density in intensity and polarization or the polarization angle). In intensity maps, we predict that the confusion limit increases rapidly with increasing wavelength (from 21\,mu Jy at 25\,mu m to 46\,mJy at 235\,mu m). The confusion limit in polarization maps is more than two orders of magnitude lower (from 0.03\,mJy at 96\,mu m to 0.25\,mJy at 235\,mu m). Both in intensity and polarization maps, the measured (polarized) flux density is dominated by the brightest galaxy in the beam, but other objects also contribute in intensity maps at longer wavelengths (sim 30\,<!PCT!> at 235\,mu m). We also show that galaxy clustering has a mild impact on confusion in intensity maps (up to 25\,<!PCT!>), while it is negligible in polarization maps. In intensity maps, a basic blind extraction will be sufficient to detect galaxies at the knee of the luminosity function up to zsim 3 and 1011\,M$_ main-sequence galaxies up to zsim 5. In polarization for the most conservative sensitivity forecast (payload requirements), sim 200 galaxies can be detected up to z=1.5 in two 1\,500\,h surveys covering 1\,deg$^2$ and 10\,deg$^2$. For a conservative sensitivity estimate, we expect sim 8\,000 detections up to z=2.5, opening a totally new window on the high-z dust polarization. Finally, we show that intensity surveys at short wavelengths and polarization surveys at long wavelengths tend to reach confusion at similar depth. There is thus a strong synergy between them.

Self-Reported Difficulty with and Assistance Needed by People with Spinal Cord Injury to Prepare Meals at Home

Individuals with spinal cord injury (SCI) experience an increased risk for obesity and cardiometabolic disease. Recommendations to prevent and treat obesity for those with SCI follow those of the US Department of Agriculture to adopt a healthy eating pattern that includes eating a variety of fruits, vegetables, grains, dairy, and protein, plus limiting added sugars, saturated fats, and sodium. Yet, people with SCI eat too many calories, fat, and carbohydrates and too few fruits, vegetables, and whole grains. The study is based on secondary analyses of SCI participants (n = 122) who enrolled in a weight loss study to determine how SCI may impact their ability to prepare food at home. We hypothesize those with higher-level spinal injuries (specifically, those with cervical versus those with thoracic or lumbar/sacral injuries) experience significantly greater difficulty and are more likely to rely on others’ assistance to perform meal preparation tasks. Physiologic (weight, BMI, blood pressure, hemoglobin A1c) and self-reported data (demographic plus responses to the Life Habits Short Survey and meal prep items) were collected at baseline and qualitative data were obtained from a subsample after the intervention during phone interviews. Participants’ average age was 50 ± 14.7 years old, they lived with SCI for an average of 13.0 ± 13.1 years, and their average BMI was 32.0 ± 6.5. Participants were predominantly white (76.1%) men (54.1%) who had some college education (76.3%), though only 28.8% worked. A substantial proportion of respondents (30% to 68%) reported difficulty across the 13 tasks related to purchasing and preparing meals, with a proxy reported as the most common assistance type used across all tasks (17% to 42%). Forty-nine percent reported difficulty preparing simple meals, with 29% reporting a proxy does the task. More than half reported difficulty using the oven and stove, though between 60% to 70% reported no difficulty using other kitchen appliances (e.g., coffee machine, food processor, can opener), the refrigerator, or microwave. There was a significant difference in kitchen function by injury level. Those living with cervical-level injuries had significantly greater limitations than those with thoracic-level injuries. Spouses, other family members, and caregivers were most likely to serve as proxies and these individuals exerted both positive and negative influences on respondents’ dietary intake, based on qualitative data obtained during interviews. The results suggest that many people living with SCI experience functional and environmental barriers that impact their ability to prepare food and use kitchen appliances. Future research should examine how SCI-related functional limitations, transportation access, accessibility of the kitchen, ability to use appliances, availability of financial resources, and assistance by others to prepare foods impact people’s ability to follow a healthy eating pattern.

Differences in Prevalence and Psychosocial Characteristics of Irritable Bowel Syndrome According to Rome III and Rome IV Criteria in Medical and Nursing Students.

In Korea, changes in the prevalence of irritable bowel syndrome (IBS) after the Rome IV update have not been extensively studied. The aim of this study is to compare the prevalence and psychosocial risk factors of IBS according to Rome III and Rome IV criteria in medical and nursing students. From August 13, 2021 to October 22, 2021, participants were enrolled and surveyed online. The survey includes general and specific questions for disease diagnosis and regarding participants' social and psychological characteristics using the 36-item short form survey, the Brief Encounter Psychosocial Instrument-Korean version, and the Hospital Anxiety and Depression Scale. In total, 338 medical students and 102 nursing students completed the survey. IBS was diagnosed in 78 students (17.7%) using Rome III criteria and in 51 students (11.6%) using Rome IV criteria. Significant differences in physical functioning score and severity score were observed between patients diagnosed using Rome IV criteria and patients diagnosed using Rome III criteria. Multiple logistic regression revealed that severity score (adjusted odds ratio = 1.01; 95% confidence interval: 1.00-1.21; P = 0.022) is the only predictor of IBS that differentiates Rome IV criteria from Rome III criteria. Even after updating the Rome IV diagnostic criteria, the prevalence of IBS in medical and nursing students in Korea remained high. Patients who met the Rome IV criteria had more severe symptoms and lower quality of life than patients who met the Rome III criteria.

Determinants of quality of life and emotional well-being in a bariatric surgery seeking cohort of 1501 multi-ethnic Asian patients.

The relationship between ethnicity, obesity and health-related quality of life outcomes in a multi-ethnic population remains poorly understood. We aim to investigate the relationship between ethnicity, body mass index (BMI), obesity-associated diseases, as well as determinants of quality of life (QoL) in Southeast Asian patients with obesity. We aim to develop and validate a simple objective score to identify patients with obesity at high risk for major depression. Associations between ethnicity, obesity-associated diseases, BMI and determinants of QoL (Patient Health Questionnaire-9 and 36-Item Short Form Survey) were analysed using multivariate logistic regression in a prospective cohort of 1501 patients with obesity. Multivariate regression and receiver operating characteristics curves were used to develop and validate a novel scoring system to identify patients at risk of major depression. Patients of Chinese, Malay and Indian ethnicity had increased risk of hypertension (odds ratio [OR]: 1.51 [95% confidence interval [CI]: 1.19-1.92, p < .001]), BMI Class 4 (OR: 17.89 [95% CI: 9.53-33.60, p < .001]) and major depression (OR: 1.71 [95% CI: 1.23-2.39, p = .002]), respectively. Factors associated with major depression (gender, ethnicity, age, obstructive sleep apnoea, Physical Component Score and Mental Component Score scores) were used to create and validate a novel scoring system with an area under curve of 0.812 (95% CI: 0.787-0.837). A cutoff of 4 of 7 points was identified with a sensitivity of 70%, specificity of 81%, positive predictive of 53% and negative predictive value of 90%. The prevalence of metabolic complications from obesity significantly varies with ethnicity. We developed a novel and simple scoring tool combining objective demographic and patient-reported outcomes to screen and triage patients at risk of major depression.

Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum’s role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Methods: Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. Results: After 4 weeks of treatment, both groups showed statistically significant (p &lt; 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. Conclusions: The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

The economics of gender norms

AbstractAn important dimension of social norms in any society are rules that describe and regulate the expected behavior, appearance, and demeanor of men and women. In this paper, I offer a short survey of how gender norms have been introduced and used in economics, what we know about how they are formed and transmitted and how they persist or change, and then consider how we might incorporate norms into economists’ perennial concerns about policy.

An exploration of spirituality and spiritual care with rehabilitation inpatients

Purpose The aim of this study was to explore spirituality in inpatient rehabilitation care from the patient’s perspective. Materials and methods Participants were recruited from three inpatient rehabilitation services in Sydney, Australia. A qualitative research design was adopted. Demographic data collected included religious affiliation, age and gender. Participants completed a short survey, where they indicated the level of acceptability for 14 items which could be used in a spiritual history. This was followed by a semi-structured interview where participants discussed how they would like to be asked about spirituality, and by whom. Results Eighteen participants were recruited (10 females, 8 males; mean age 68.8 years) and were undertaking either general rehabilitation (n = 9) or neurorehabilitation (spinal cord injury n = 6, traumatic brain injury n = 3). The impact of loss and existential struggle was evident for participants with long-lasting injuries. These participants could identify sources of spiritual strength which helped them engage with hardship and described how staff could facilitate access to these sources of strength. Conclusions Rehabilitation inpatients are willing to explore issues around spirituality. Staff can support inpatients to access sources of spiritual strength by creating a safe and trusting environment and finding out what is most meaningful to the patient.

Building the OAChangeMap to improve the service delivery of the New South Wales Osteoarthritis Chronic Care Program: a worked example of using a co-design framework.

The Osteoarthritis Chronic Care Program (OACCP) has been implemented in Australian public hospitals to deliver best-evidence OA care. It is important to ensure that the OACCP continues to deliver evidence-based OA care as intended. We aimed to identify barriers and enablers to delivering the OACCP, prioritise the barriers, and generate strategies to address them. This study provides a worked example of a seven-step theory-informed co-design framework. We invited OACCP coordinators to participate in semi-structured interviews (analysed thematically) and complete a questionnaire to identify barriers and enablers to delivery of the OACCP. We then invited a broader group of stakeholders (OACCP coordinators, health managers, policy makers, consumers, researchers) to prioritise the barriers via a short survey (survey 2). We held five co-design workshops where we mapped the priority barriers to the Theoretical Domains Framework and developed strategies to address them. Sixteen coordinators were interviewed and the main barriers identified were: 1. patients often have beliefs that are inconsistent with best-evidence care; 2. there are aspects of clinical care that are not delivered optimally; and 3. system level factors are a barrier to optimal patient care and sustainability of the OACCP. We co-designed a plan for action with patient educational materials, shared decision-making tools, and health professional education and training. Our worked example of co-design used a theory-based, data driven approach with key stakeholders, identified and prioritised barriers to the delivery of the OACCP, acknowledged enablers, and generated a plan for feasible strategies to improve the program.

Does perceived usability of a multi-component mobile device intervention improve health-related quality of life?

Abstract Background Good health-related quality of life (HRQL) is essential to healthy aging. Prior studies have demonstrated that mobile device technologies can promote HRQL in older adults. However, evidence of technology acceptance in older adults is often inconsistent and poorly understood. Purpose This study aims to 1) describe technology acceptance using efficiency, learnability, user experience (i.e., acceptability), and perceived control from the USABILITY survey of a multi-component mobile device intervention consisting of a wearable activity tracker (Fitbit Versa), access to Lose It app, and text messages (for experimental group only) in older adults at risk for cardiovascular disease, and 2) examine the correlation between technology acceptance and changes in HRQL before and after using each component of the digital intervention. Methods Data were collected using a purpose-built technology usability survey, and HRQL was assessed using the 12-Item Short Form Survey (SF-12), which measured perceived physical and mental health. Correlations were used to identify associations between technology acceptance and HRQL. Results The mean age of participants (n=54) was 65.4 ± 6.0 years; a majority were females (60%), married (53%), Hispanic (66%), and had a high school education or higher (76%). Table 1 shows that the experimental group had considerably higher HRQL at three months, but no differences in technology acceptance were noted. Fitbit technology adoption was found to be correlated with physical HRQL (r=304, p=0.027). The Lose It app showed no correlation with HRQL. Despite receiving higher usability ratings, SMS messages were not correlated with physical or mental HRQL. Conclusion Our findings demonstrate that older persons at risk for cardiovascular disease find mobile device intervention components acceptable. However, each component affected physical and mental health differently. These findings inform more complete technology acceptance models for older individuals' technology design, education, and deployment. Older persons prefer personalized communication, such as customized text messages, as the most favored aspect of the multi-component mobile device intervention. It warrants a larger clinical trial to determine its efficacy on HRQL.

Impact and determinants of depression in cardiac hospitalized patients

Abstract Depression increases cardiovascular risk and involves worse clinical outcomes. Little attention is paid to it in hospitalized patients. We studied prevalence and determinants of depression in this group, in order to select patients for further specific management. Methods Consecutive patients admitted to Cardiology wards were included. Cardiovascular risk factors, clinical and psychosocial data were collected. Self perceived mental and physical health quality were assesed by 12-item Short Form survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) questionnaires were administered. Statistical analysis was performed using Spearman´s correlation, Mann-Whitney and Fisher tests, and Mantel-Cox, linear and logistic regression analyses. Results 170 consecutive patients, median age 74.5 (67.2-81.1), 59.4% male, were included. Most common pathologies were heart failure (44.7%) and coronary syndroms (28.8%). According to HADS results, depression was probable (score &amp;gt;10) in 10%, and at least possible (score &amp;gt; 8) in 27.1%. Both increased duration of hospitalization (Median 14 vs 7 days;p=0.016 and 11 vs 7 days;p=0.005 respectively). Anxiety was present in 16.5 % for probable case and 34.1% for possible case, with no significant change in median duration of hospitalization. 22.9% of patients were under antidepressant treatment, and 24% under anxiolytics, but they were added to treatment only in 1% and 7% respectively. No other not pharmacological measure was initiated. Self perceived mental health was diminished in probable depression (mean difference 14.9%;95%IC 9.7-20.2;p&amp;lt;0.001). Self perceived physical health was also lower (mean difference 6.4%;95%CI:1.1-11.8;p=0.016). Patients with depression were a mean of 5.6 years older (95%CI 1.4-9.8;p=0.032). Less than primary education (OR 5.69 (p 0.021), and Previous hospital admission OR 3.2 (1.0-10.3;p=0.034) increased the risk of depression in univariate analysis. By multivariate analysis, determinants of depression were anxiety (OR 22.5;95%CI 5.9-85.6;p&amp;lt;0.0001), need for surgery (OR 12.3;95%IC 2.1-73.2;p=0.009), need for intensive care unit surveillance (OR 4.2;95%CI 1.1-15.8;p=0.039), and age (OR 1.1;95%IC 1.0-1.2;p=0.001. AUC was 0.89;95%CI 0.81-0.96;p&amp;lt;0.0001. There was no difference in civil status, gender, income level, living accompanied, number of comorbidities, cardiovascular risk factor or reason for hospital admission. Conclusions Depression was prevalent in our hospitalized cardiac patients,in spite of previous pharmacological treatment. It prolongs duration of stay and impacts negatively in self perceived mental and physical health. Risk is increased in older people requiring intensive care surveillance or surgery, and specially by anxiety. These patients could benefit from a preventive multifactorial approach. Attention should also be paid to patients with a previous hospitalization and low educational level.ROC curve for multivariate model

Food insecurity impacts diet quality and adherence to the gluten-free diet in youth with celiac disease.

Celiac disease (CD) is an autoimmune gastrointestinal disorder that requires a strict lifelong gluten-free diet (GFD). Gluten-free (GF) foods are more expensive and less readily accessible than gluten-containing foods, contributing to an increased risk for food insecurity (FI). The study aimed to determine associations between GF-FI, sociodemographic risk factors and child dietary adherence and diet quality (DQ). A 26-item, cross-country online survey was administered through social media to parents of children with CD on the GFD. The survey elicited household and CD child sociodemographic and clinical characteristics (e.g., duration of CD), measures of household FI, child DQ and GFD adherence, and parents' concerns related to GF food. Household GF-FI was evaluated using the validated Hunger Vital Sign™ and the US Department of Agriculture Six-Item Short Form Household Food Security Survey Module. GF-FI occurred in 47% of households with children with CD with >30% reporting low to very low food security. Sociodemographic risk factors identified included lower income, renters, rural residency, single-parental households, and having children with additional dietary restrictions (p < 0.001). Regardless of FI status, a majority of households reported experiencing significantly higher GF food expenditure. GF-FI was associated with reduced adherence to the GFD, increased consumption of processed GF food, and lower intakes of fresh fruits and vegetables and GF grains among children with CD (p < 0.05). GF-FI is prevalent in this multiethnic cohort of households with CD children and is associated with worsening DQ and GFD adherence. Policy interventions are urgently needed to address GF-FI.

Psychometric Properties of the Credibility/Expectancy Questionnaire in Individuals with Opioid Use Disorder

ABSTRACT Credibility and expectancy are important aspects of therapy/treatment processes. We aimed to perform cross-cultural validation and examine the psychometric properties of the Credibility/Expectancy Questionnaire (CEQ). Ninety-one patients with opioid use disorder from Tobacco, Alcohol, and Drug Addiction Treatment Program were included in the study. Sociodemographic data form, CEQ, Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), and Attitudes Toward Seeking Psychological Professional Help Scale-Short Form (ATSPPHS-SF) were filled out by participants. Confirmatory factor analyses showed that CEQ has two factors in our sample, similar to the original version. Reliability analyses showed that CEQ has a high internal consistency and test-retest reliability. Regarding convergent validity results, CEQ was correlated with ATSPPHS-SF. No significant correlation was found between CEQ and BDI and STAI regarding discriminant validity results. In conclusion, the Turkish version of CEQ is a valid, reliable scale and could be used in patients with opioid use disorder. In patients with opioid use disorder, we contributed to the addiction literature by adapting a short and effective survey that measures trust and expectation.

How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?

Uncomplicated joint replacement improves pain and other patient-reported outcome measures (PROMs) such as joint function scores and quality-of-life measures. However, the overall impact of periprosthetic joint infection (PJI) and its successful treatment on PROMs is poorly defined. In this study, we describe quality-of-life scores using the 12-item Short Form survey, version 2 (SF-12v2), collected as part of a large, prospective, observational study of PJI. (1) Do patients with newly diagnosed PJI have lower quality-of-life scores than the general age-matched population? (2) Are lower quality-of-life scores for patients with PJI sustained for ≥ 12 months? (3) What factors are associated with a good functional outcome at 12 months, defined by achieving a physical component summary (PCS) score of > 50 on the SF-12v2 (that is, above the age-adjusted population mean) or an increase of > 8.9 or more from baseline? The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort was a prospective, longitudinal, multicenter cohort study of 783 patients with newly diagnosed PJI recruited across 27 centers between July 2014 and December 2017. All participants were followed for 2 years. SF-12v2 scores were collected at diagnosis (baseline) and 3, 12, and 24 months after diagnosis. Treatment success was defined as being alive with no clinical or microbiological evidence of infection and no ongoing use of antibiotics for the index joint. After exclusion of 6.6% (52) who had died, 4.2% (33) with PJI of joints other than hips and knees, and those with incomplete data sets (200 [25.5%]), 498 patients had complete SF-12v2 data sets available. At baseline, the median (IQR) PCS score was 37 (30 to 46), which increased to 41 (34 to 49; p < 0.001) at 12 months. Both measures were lower than those for the general age-matched population norm. There was no further improvement in PCS scores between 12 and 24 months. By contrast, the median (IQR) mental component summary score of the SF-12v2 was similar to age-adjusted population norms (48 [37 to 57]) at baseline. Only 40% of patients with PJI achieved a good functional outcome at 12 months. After adjustment for other factors, treatment success of PJI increased the odds of a good functional outcome by 67% (95% CI 11% to 154%; p = 0.02). PJIs have a large effect on the PCS score of the SF-12v2 quality-of-life measure at baseline, which is sustained for at least 2 years. Successful treatment of PJI increases the likelihood of a good functional outcome. These data can be used to set expectations for patients presenting with PJI and can be used to inform future clinical studies in which quality-of-life measures are incorporated into clinical endpoints. Level II, therapeutic study.

Effectiveness of Social Skills Training on Quality of Life and Functional Performance in Patients with Schizophrenia

The study aims to determine the effectiveness of social skills coaching on quality of life and functional performance in patients with schizophrenia. Methods: A quasi-experimental study design was chosen and sixty participants (N=60) aged 18 to 55 years were recruited using a convenience sampling approach. The participants were divided into two groups viz. experimental (n = 30) and control (n = 30). Participants in the experimental group received social skills coaching for eight weeks, while participants in the control group received traditional occupational therapy interventions. Two outcome measures, consisting of the Canadian Activity Performance Index (COPM) and a 36-item short survey (SF-36), were used to measure quality of life and functional performance. Results: There was a statistically significant difference between the pre- and post-test scores of the COPM and SF-36 survey in both the experimental and control groups. In addition, the quality of life and functional performance of the patients in the experimental group improved significantly compared to those in the control group. Conclusion: In schizophrenia patients, a social skills training intervention was more successful in improving quality of life and functional performance. Through social skills training exercises, participants' engagement increased, they showed more enthusiasm in completing their everyday tasks, and their role identity and integration into the community also improved.

Thinking beyond the closure assumption: Designing surveys for estimating biological truth with occupancy models

Abstract Occupancy models estimate distributions of imperfectly detected species, but violations of the closure assumption can bias results. However, researchers working with mobile animals may find it impossible to eliminate such violations. Here, we tested the hypothesis that occupancy models fit to realistic sampling data can generate unbiased occupancy estimates for an itinerant Wood Thrush (Hylocichla mustelina) population. In 2013 and 2014, we tracked movements of 41 breeding Wood Thrush males. We modelled territory shift probabilities using logistic exposure models and within‐territory movements using continuous‐time stochastic process models. We then constructed an individual‐based model, simulated (1000 iterations) spatiotemporal locations for individuals and simulated sampling these populations using 162 different point count protocols with variable spatial (sampling radius and point placement method), and temporal (survey length, between‐survey intervals and number of surveys) characteristics. We compared occupancy estimates with true values of instantaneous, daily and seasonal occupancy from the simulations. We parameterized continuous time stochastic process models based on movements within 34 unique territories and estimated a daily territory shift probability of 0.0099 (95% CI: 0.0060, 0.0152). Simulated data indicated that estimates of occupancy ranged from 0.18 (0.06, 1.00) to 0.80 (0.71, 0.89) depending on protocol characteristics. Occupancy estimates increased with increasing survey radius, survey length and between‐survey interval. Protocols using shorter surveys and between‐survey intervals were good estimators for instantaneous occupancy (low bias and mean‐squared error) but poor estimators for daily and seasonal occupancy; longer surveys and intervals generated unbiased estimators of daily occupancy but underestimated seasonal occupancy. Logistic regression models that ignored imperfect detection outperformed occupancy models for estimating instantaneous occupancy but not daily or seasonal occupancy. For mobile animals, occupancy of sampling sites changes in space and time. Consequently, the spatial and temporal aspects of a sampling protocol have strong, but predictable, effects on occupancy model parameter estimates. Our results demonstrate that how these factors interact is critical for designing surveys that produce occupancy estimates representative of the biological process of interest to a researcher.

Stigma, support, and messaging for people recently diagnosed with HIV: a qualitative study.

Background Despite advances in antiretroviral treatment and the message of undetectable equals untransmittable (U=U), there remain challenges related to stigma and quality of life for people living with HIV. This study aimed to understand the experiences of people recently diagnosed with HIV at a clinical service, to guide insights into how to improve care and support in the contemporary treatment era. Methods This qualitative study involved semi-structured interviews with individuals diagnosed with HIV between 2016 and 2021 at RPA Sexual Health service (a sexual health clinic in Sydney, Australia), or who were referred to the clinic directly after diagnosis. Participants were recruited through a short survey questionnaire between May 2022 and May 2023, and interviews were transcribed and analysed thematically. Results Fourteen participants were interviewed for the study, eight of whom were born outside of Australian or Aotearoa New Zealand. We found that diagnosis was still a shocking event requiring careful support; that there was ongoing stigma, shame, and reduced sexual confidence following diagnosis; and that beyond initial diagnosis, some people would benefit from ongoing support and education about key concepts regarding HIV treatment. Conclusion Our study suggests that HIV diagnosis remains disruptive, and sexual stigma is a key issue negatively impacting quality of life. Health providers can mitigate these issues by supporting the ongoing psychosocial needs of people with HIV in the early period of adjusting to HIV diagnosis, and referring to peer-based and other services. Initiating conversations about sex and dating and checking understandings of key health messages over time may promote improved care.