Significant Differences In Marital Status Research Articles

The impact of digital technologies on public life: a critical examination of perspectives from spatial design experts

ABSTRACT This study explores the influence of digital technologies on public life and evaluates spatial design professionals’ perceptions of these impacts. The research involved surveying architects, urban planners, and landscape architects to comprehend the ramifications of digital technology on public life. In total, 356 spatial design experts participated in the study. The analysis utilised descriptive statistical methods, t-tests and ANOVA tests for independent samples. The findings reveal that social isolation was rated highest among the spatial design experts’ scale, whereas social anxiety scored lowest among the elements comprising the spatial design experts’ scale. A comparison between participants’ socio-demographic characteristics and their scores on the impact of digital technologies in public life showed variances in gender, employment status, profession, and daily usage of digital technology, but found no significant differences in marital status, level of education, or professional experience. Consequently, this research sheds light on the repercussions of digital technology usage in public life, offering invaluable insights for all stakeholders, particularly spatial design professionals and social scientists. By understanding these impacts, the study highlights the importance of adopting more informed and conscious approaches to fostering positive social interactions and enhancing community well-being in public life.

Gender disparity in maintenance hemodialysis units in South India: a cross-sectional observational study.

Diseases manifest differently according to gender in many medical specialties. However, sex differences in kidney diseases have not been well explored worldwide, especially in India. These differences could also be attributed to sociocultural factors. Although CKD is more prevalent in women worldwide, most men are initiated on kidney replacement therapy (KRT). This study aimed to examine sex disparities in patients on maintenance hemodialysis. A cross-sectional observational study was conducted in two maintenance hemodialysis units at the Institute of Nephrourology, a tertiary care referral government center in Bengaluru, India. Demographic characteristics and laboratory parameters were also recorded. In total, 374 adult patients (aged >18 years) were included in the study. Most patients (72.7%) were men. Mean age in men was 46.95 ± 12.65 years, and women was 46.63 ± 13.66 years. There was no significant difference in marital status and the availability of caretakers between the groups. Spouses were the predominant caretakers for both sexes (64% men and 51% women, P = 0.14). Sons cared more for patients with mother than fathers (19.6% vs 8.8%, P = 0.074). Diabetic nephropathy was the most common cause of ESKD in both groups (33.1% vs 31.3%, P = 0.92). Men had a significantly longer duration of HTN and received more HD sessions per week than women. Mean hemoglobin (9.9 ± 1.79 vs 9.46 ± 1.47 g%) and mean serum creatinine (7.76 ± 2.65 vs 6.41 ± 2.27 mg/dl) were higher in men compared to women (P <0.002). Intradialytic complications, such as hypotension and cramps, were significantly more common in women than in men (P = 0.004). Most men (47.1%) were planning a kidney transplant (and were waitlisted) compared with fewer women (43%). There was no significant difference in the average number of hospitalizations per month or HD vintage. Women tend to initiate dialysis later, and a lesser number are waitlisted for kidney transplantation, which might be partly related to varying access to or delivery of health care services. Factors such as lack of education, insufficient identification of and strategies to address cultural obstacles to healthcare, and a shortage of financial means to afford medical care are potentially correctable elements that might explain this discrepancy.

Salivary Interleukin 1-Beta Concentration Associates With Sleep Quality in Older Individuals.

Background: Poor sleep quality is prevalent in older people and impairs their quality of life. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines. The cytokine IL-1β has been shown to display both somnogenic and insomnia-promoting effects in experimental animals. Objectives: to evaluate the relationship between insomnia and salivary IL-1β concentration and the role of associated factors such as the symptoms of depression, use of hypnotics, intake of caffeinated beverages, smoking, and alcohol use in older individuals. An analytical, cross-sectional, observational research was carried out with a population of community-dwelling individuals over 60years of age in Valencia (Spain). Sleep quality was measured with the Athens insomnia scale (AIS) and depressive symptoms with Geriatric Depression Scale (GDS). Results: 287 individuals participated in the study (mean age 74.08years (76.7% women). 41.5% of the participants had insomnia, 36.9% took drugs for sleep problems, and 32.4% had relevant depressive symptoms. There was a significant inverse correlation between the IL-1β and total AIS score (rho = -0.302, p < 0.001), the sleep difficulty subdomain (rho = -0.259, p < 0.001), and the daytime sleepiness subdomain (rho = -0.322, p < 0.001). No significant correlation was observed between GDS and salivary IL-1β concentration. The IL-1β concentration was significantly lower in individuals taking drugs for sleeping compared with those not taking those drugs (1.11 ± 0.09 and 1.48 ± 0.08, respectively; p = 0.001). Regarding the AIS score, there was no significant difference in marital status, smoking, or the number of cups of tea or cola drinks, but there was a significant association with alcohol intake (p = 0.019) and in the number of daily intakes of coffee (p = 0.030). The receiver operating characteristic (ROC) curve analysis of IL-1β for diagnosis of moderate-severe insomnia showed an area under the curve (AUC) value of 0.78 (95% confidence interval 0.71-0.85). At the cut-off of 0.83 pg/µL of Il-1β, it had a sensitivity of 70.3% and a specificity of 69.8%.

A population-based cross-sectional study on the situation of cervical cancer screening in Liaoning, China

BackgroundCervical cancer (CC) screening is currently recognized as an effective intervention for CC. Previous studies found that the proportion of screening was low in China, especially in Liaoning. Therefore, we performed a population-based cross-sectional survey to investigate the situation of cervical cancer screening and analyze their related factors for providing a decision-making basis for sustainable and effective development of cervical cancer screening.MethodsThis population-based cross-sectional study involved aged 30 to 69 years in nine counties/districts in Liaoning from 2018 to 2019. Data were collected using the quantitative data collection methods, and analyzed in SPSS version 22.0.ResultsOverall, only 22.37% of 5334 respondents reported having ever been screened for cervical cancer in past 3 years, and 38.41% of respondents reported having the willingness for cervical cancer screening in next 3 years. In the rate of CC screening, multilevel analysis indicated that age, marital status, education level, type of occupation, medical insurance, family income, place of residence and regional economic level had a significant impact on proportion of screening. In the rate of CC screening willingness, multilevel analysis indicated that age, family income, health status, place of residence, regional economic level and CC screening still had a significant impact, but marital status, education level and medical insurance type had no significant impact. There was no significant difference in marital status, education level and medical insurance type after the factors of CC screening were added in the model.ConclusionOur study found both proportion of screening and willingness were at a low level, and age, economic and regional factors were the main factors for implementation of CC screening in China. In the future, targeted policies should be formulated according to the characteristics of different groups of people, and reduce the gap in the current health service capacity between different regions.

Vaginal misoprostol vs intramuscular carboprost in first trimester abortion

Background: A number of conditions demands first trimester abortions including medical and social causes. This study was mainly undertaken in order to compare the oral misoprostol with the intramuscular carboprost for cervical ripening in suction evacuation for medical termination of pregnancy up to 12 weeks of gestation. Material and methods: A randomized controlled trial was undertaken to determine the safety and efficacy of misoprostol over carboprost in first trimester abortions for cervical ripening. A total 120 pregnant women were randomized in to two equal groups where one group received oral misoprostol and another group received intramuscular carboprost. Two groups were studied and compared for the baseline characteristics, induction abortion interval, cervical dilation, blood loss and complications. Results: The mean age of misoprostol group was 26.2 years and carboprost group was 25.8 years. There was no statistically significant difference in marital status, gravidity, parity and gestational age in this study. Incomplete abortion was the common cause of abortion in both the groups. The induction abortion interval was 195.2 minutes in misoprostol group and 89.9 minutes in carboprost group. The mean cervical dilation was 8.35 minutes in misoprostol group and 9.31 minutes in carboprost group.

Analysis of Clinical Characteristics and Influencing Factors for H-Type Hypertension Complicated with Other Chronic Diseases in a Community in Beijing.

Objective The aim of the study is to analyze the clinical characteristics of patients with H-type hypertension complicated with other chronic diseases in a community in Beijing and to explore the influencing factors related to the occurrence of the disease by means of a case-control study. Methods A questionnaire was designed. 362 residents with H-type hypertension in a community in Beijing were randomly enrolled from January 2020 to December 2021. The general data and clinical indexes of the patients were collected and their clinical characteristics were analyzed. According to the complications of other chronic diseases, they were divided into the simple hypertension group (n = 65) and the other chronic disease group (n = 297). Univariate and multivariate analyses were used to analyze the influencing factors for H-type hypertension patients with other chronic diseases. Results Among the 362 H-type hypertension patients, 21 cases were aged 35–45 years, 35 cases were aged 45–55 years, and 127 cases were aged 55–65 years. The number of patients aged ≥65 years was 179, and the number of patients aged ≥55 years accounted for the highest proportion with a constituent ratio of 85.00%. Only 65 patients were patients with simple hypertension. The remaining 297 patients were complicated with different kinds of chronic diseases. The types of chronic diseases include malignant tumors, diabetes, rheumatoid arthritis, coronary heart disease, asthma, chronic obstructive pulmonary disease, systemic lupus erythematosus, and stroke. The proportion of H-type hypertension complicated with coronary heart disease, diabetes, and stroke is higher. Among the 297 patients, most of them were local, resident, and nonagricultural patients with a constituent ratio of 89.90%, 95.96%, and 98.98%, respectively. The prevalence rate of the male was 59.60% higher than that of the female at 40.40%. The blood types B and AB were more common. 90.57% of patients were married and the proportion of body mass index (BMI) was 45.79%. 60.61% of patients had a history of smoking, 55.56% had a history of drinking, 35.02% had a regular physical examination, 14.81% had regular exercise, and 37.71% had a light diet. There were significant differences in marital status, smoking, alcohol consumption, regular exercise, and light diet between the simple hypertension group and the chronic disease group (P < 0.05). The results of the logistic regression analysis showed that smoking, drinking, little exercise, and not eating lightly were the independent risk factors for other chronic diseases (P < 0.05). Conclusion The incidence of H-type hypertension is higher in people ≥55 years old. Most of them are accompanied by three other chronic diseases: smoking, drinking, little exercise, and no light diet are also risk factors for chronic diseases.

Assessment of Anxiety and Depression in Patients with Acne Vulgaris in Medina: A Case-Control Study.

PurposeAcne vulgaris is a common dermatological disease in adolescents that show high prevalence rates of anxiety and depression that may lead to consequences that affect quality of life. This study aimed to assess and compare anxiety and depression in patients with acne and a control group and to determine their correlation with other demographic data.Patients and MethodsThis was a case-control study conducted in 2019 for 3 months at the derma-tology department of Ohud Hospital and two other private clinics in the Medina region of Saudi Arabia. For this study, 296 consecutive patients in the age group of 12 to 60 years who were diagnosed as having acne vulgaris were enrolled and matched with a control group. Data were collected through a self-administered questionnaire, including sociodemographic data and Hospital Anxiety and Depression Scale scores.ResultsWe found no significant differences between the two groups regarding sex, age group, nationality, and educational level, but found a significant difference in marital status (p < 0.001). Most (62.5%) of the acne cases were moderate in severity. The overall anxiety score in the acne group was 7.68 ± 4.90, with a significant difference with the control group (p = 0.031), whereas the anxiety level and depression score showed no significant difference (p = 0.082 and p = 0.656, respectively). Moreover, a strong correlation was found between anxiety and depression in the acne group (r = 0.732, p < 0.001).ConclusionA positive correlation was found between the anxiety and depression scores in the patients with acne, which was not related to age group or educational level. However, the anxiety scores of the patients with acne showed a significant relationship with sex.

Burnout en docentes de un instituto tecnológico agronómico

INTRODUCCIÓN. El estrés en docentes puede causar afectaciones físicas y conductuales que inciden en la calidad de educación. Para atenuar este riesgo se determinó la presencia del Síndrome de Burnout. OBJETIVO. Analizar presencia Síndrome de Burnout en profesores de una institución de educación superior agronómica y su relación con aspectos psicosociales. MÉTODO. Es un estudio descriptivo-transversal con aplicación del Cuestionario Maslach Burnout Inventory (MBI) para medir la presencia de Síndrome de Burnout y su relación con aspectos psicosociales de los docentes. RESULTADOS. Siete docentes (24,14%) presentan el Síndrome de Burnout, mientras que 21 (72,41%) se encuentran en riesgo y un docente (3,45%) ausenta este síndrome. DISCUSIÓN Y CONCLUSIONES. Únicamente, en la dimensión Despersonalización hubo diferencia estadísticamente significativa en estado civil y campo profesional.

A cross-sectional assessment of health-related quality of life among healthcare providers in Alkharj, Saudi Arabia

Purpose: To determine the current level of health-related quality of life (HRQoL), and evaluate factors influencing it among health-care providers (HCPs) in Alkharj, Saudi Arabia.Methods: A prospective cross-sectional study was conducted among HCPs in Alkharj, Saudi Arabia, using the standardized research tool, BREF-WHOQOL. A self-administered questionnaire was distributed in hospitals, in the medical colleges of Prince Sattam Bin Abdulaziz University, andcommunity pharmacies in Alkharj, Saudi Arabia. Descriptive, comparative, and inferential statistics were performed using SPSS.Results: A total of 289 HCPs agreed to participate in the study, 52 % of whom were female. Most participants were married (69 %), and most had fewer than 10 years of experience (58 %). Statistically significant differences in marital status, education level, income, and year of practice were found that correlated with HCPs’ HRQoL (p ≤ 0.05). Overall, respondents reported an above-average score for all survey items.Conclusion: The results indicate that HCPs see their general quality of life as good - a particularly important consideration in view of the demanding nature of their job. This study will help the concerned authorities to exactly know the current level of HRQoL among HCPs in Alkharj, Saudi Arabia, as well as help in designing better healthcare policies in Saudi Arabia.&#x0D; Keywords: Healthcare providers (HCP), Health-related quality of life (HRQoL), Healthcare policies, Occupational stress

ATTRIBUTION ERROR TO THE VICTIM IN DOMESTIC VIOLENCE: A CONTEMPLATION OF DOMESTIC VIOLENCE OBSERVER

This study aims to determine the attitudes toward the violence, conducted by a husband to wife, focus on victim-blaming. In this study, the effect of demographic factors on the violence and victim-blaming was also analyzed. The respondents of this study were 458 college students aged 18 to 32 years. Two measuring instruments were used, namely: IBWB (Inventory of Beliefs about Wife Beating) and DVBS (Domestic Violence Blame Scale). The data was analyzed using stepwise regression, and the result shows a relationship between attitudes about violence against wife and victim-blaming (r=-.41, p&lt;.001). Independent t-test of ANOVA shows the higher level of bias of gender role on the male as female. ANOVA and independent t test show that men have a higher level of gender role bias, but there is no significant difference in marital status or religion in blaming the victim. Stepwise regression analysis showed R2 = .03 for the gender variable, and R2 = .20. The R2 = .20 is a contribution from two variables, namely husband’s violent attitude to wife and gender. This can lead to the victim blaming in a domestic violence case. The implications of the findings are also discussed.

Partial penectomy or total penectomy for T1 and T2 squamous cell carcinoma of the penis?

BackgroundTo assess prognostic factors and survival outcomes for partial penectomy (PP) and total penectomy (TP) patients with T1 and T2 squamous cell carcinoma of the penis.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was used to identify 708 penile cancer patients. Among these, 607 underwent PP and 101 underwent TP. Kaplan-Meier analysis was used to compare survival outcomes between PP and TP patients. Univariate and multivariate Cox proportional hazards regression models were used to determine prognostic factors.ResultsThere were significant differences in marital status and regional lymph node removal between patients of the PP and TP groups. Multivariate regression analysis demonstrated that age [odds ratio (OR) =1.045; 95% confidence interval (CI): 1.034–1.057; P<0.0001], T2 carcinoma (OR =1.388; 95% CI: 1.077–1.788; P=0.0114), node stage N1–3 (OR =3.351; 95% CI: 2.317–4.847; P<0.0001), and ≥4 regional lymph nodes removed (OR =0.498; 95% CI: 0.255–0.972; P=0.0411) were independent predictors of overall survival (OS). Age (OR =1.019; 95% CI: 1.005–1.033; P=0.0065), stage N1–3 (OR =5.127; 95% CI: 3.213–8.181; P<0.0001), and ≥4 regional lymph nodes removed (OR =0.452; 95% CI: 0.219–0.932; P=0.0315) were independent predictors of cancer specific survival (CSS). However, there was no significant difference between PP and TP in terms of OS and CSS.ConclusionsThere was no significant difference in terms of OS and CSS between patients treated by PP or TP. T2 was associated with shorter OS, while age and N1–3 were associated with shorter OS and CSS. Removal of ≥4 regional lymph nodes was associated with longer OS and CSS.

Cultural Variables Underlying Obesity in Latino Men: Design, Rationale and Participant Characteristics from the Latino Men's Health Initiative.

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans (p < .0001) and there were significant differences in marital status (p < .05), country of birth (p < .05), smoking (p < .05) and work status (p < .001). There were no significant differences in religion, education, health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men.

Societal reintegration following cadaveric orthotopic liver transplantation.

Studies on patients' societal reintegration following orthotopic liver transplantation (OLT) are scarce. Between September 2006 and January 2008, all adults who were alive after 3 years post OLT were included in this prospective cohort study. Validated questionnaires were administered to all candidates with the primary aim of investigating the rate of their social re-integration following OLT and potential barriers they might have encountered. Among 157 eligible patients 110 (70%) participated. Mean participants' age was 57 years (SD 11.4) and 43% were females. Prior to OLT, 75% of patients were married and 6% were divorced. Following OLT there was no significant difference in marital status. Employment rate fell from 72% to 30% post-OLT. Patients who had been employed in either low-skill or advanced-skill jobs were less likely to return to work. After OLT, personal income fell an average of 4,363 Canadian dollars (CAN$) (SD 20,733) (P=0.03) but the majority of recipients (80%) reported high levels of satisfaction for their role in society. Although patients' satisfaction post-OLT is high, employment status is likely to be negatively affected for individuals who are not self-employed. Strategies to assist recipients in returning to their pre-OLT jobs should be developed to improve patients' economical status and societal ability to recoup resources committed for OLT.

Assessment of Lifestyle Risk Factors in Female Citizens of Saudi-Arabia with Type 2 Diabetes: Dietary Factors and Physical Activity

Type 2 diabetes mellitus (T2DM) is a major public health problem worldwide. The kingdom of Saudi Arabia is one of the top 10 countries for the development of this non-communicable disease. The aim of this study was to identify critical lifestyle risk factors in female Saudi citizens with and without type 2 diabetes mellitus (T2DM) by assessing dietary habits, physical activity patterns, sedentary behaviors and health-related quality of life. This cross-sectional case-control study was carried out in Jeddah city. A total of 100 Saudi females clinically diagnosed with T2DM aged between 30 to 65 years and another 100 gender- and age - matched non-diabetic controls were recruited. Data was collected through face-to-face interviews using a dietary habits questionnaire, the short-form of the International Physical Activity questionnaire (IPAQ) and the EuroQol instrument. Comparison of both groups revealed statistically significant differences in marital status, educationallevel, professional status and household income between diabetic and non-diabetic subjects. Obesity was more common in diabetic participants (64%) compared with non-diabetic (44%, P<0.05). The majority of the diabetic subjects showed unhealthy dietary behaviors and did not meet the daily recommended intake from food groups and macronutrients compared with the control group. Physical activity assessment revealed that 20% of both diabetic subjects and controls were physically inactive with no significant differences in physical activity patterns or sedentary behavior between the groups. In conclusion, dietary habits, PA and sedentary behavior may act as powerful promoters of T2DM in Saudi females.

The Psychometric Properties of the Midlife Women’s Symptom Index

To evaluate the psychometric properties of the Midlife Women's Symptom Index (MSI) among four racial/ethnic groups of midlife women in the United States. A secondary data analysis. Internet communities/groups. A total of 494 midlife women with symptoms of menopause who self-reported using an Internet survey and completed all sections of the MSI questionnaire. Data were collected from January 1, 2008 to December 31, 2010. The psychometric properties of the MSI were evaluated using measures of internal consistency, item-total correlation coefficients, and discriminant validity. There were statistically significant differences in marital status, employment, income, religion, country of birth, level of education, diagnosed disease, and self-reported health status across the four racial/ethnic groups. The Kuder-Richardson Formula 20 (KR-20) coefficients for the three subscales of the MSI prevalence section (i.e., physical, psychological, and psychosomatic) ranged from 0.58 (psychosomatic symptoms in Whites) to 0.91 (psychological symptoms in Asian Americans). The Cronbach's alpha coefficients for the three subscale scores ranged from 0.60 (psychosomatic symptoms in Whites) to 0.93 (psychological symptoms in Asian Americans). The mean scores of the MSI differed significantly by race/ethnicity among midlife women of each menopausal status, except for the prevalence section of the psychosocial symptoms. The MSI has demonstrated an acceptable reliability and appropriate discriminant validity across the four racial/ethnic groups, except in the domain of psychosomatic symptoms. Health care providers as well as researchers could use the MSI to assess the symptoms of menopause of midlife women from diverse racial/ethnic backgrounds.

패션라이프스타일 유형에 따른 SPA 브랜드 인지, 태도 및 구매경험에 관한 연구

The purposes of this study were to classify respondents by their fashion lifestyle and to investigate the differences in cognition, attitude and purchasing experience of SPA brands among fashion lifestyle groups. The convenience sample was drawn from females between the ages of 20 and 39 who lived in Daegu and Gyeongbuk regions from November <TEX>$1^{st}$</TEX> and <TEX>$15^{th}$</TEX> 2012. Descriptive statistics, cluster analysis, ANOVA, Tukey test, and <TEX>${\chi}^2$</TEX> test were applied to analyze data from 255 respondents. Four clusters (fashion-oriented group, fashion indifferent group, conservative individuality-oriented group, conservative practicality-oriented group) were developed by 16 fashion lifestyle items. The attitude toward SPA brand was classified by six factors(fashionability/variety, good location, good quality, diverse promotions, low price, limited number of merchandise, sales person's information). There were significant differences in cognition, five attitude factors (fashionability/variety, good location, good quality, low price, limited number of merchandise) and purchasing experience of SPA brands among types of fashion lifestyle. While the fashion-oriented group had the highest scores of cognition, attitude and purchasing experience of SPA brands, the fashion indifferent group or the conservative practicality-oriented group had the lowest scores. There were significant differences in age and marital status among the four groups while there were no significant differences in marital status, family monthly income, and job.

Development and psychometric evaluation of a sexual health care knowledge scale for oncology nurses

ObjectiveThe purpose of this study was to develop a sexual health care knowledge scale for oncology nurses and to evaluate its psychometric properties using Rasch analysis and the known-groups technique. BackgroundAlthough sexual oncology has become a popular topic and sexual health care is now promoted, there has been a lack of instruments supported by psychometric evaluations to measure nurses’ knowledge of sexual health issues. MethodsThe initial 72 items were compiled to form the Sexual Health Care Scale – Knowledge (SHCS-K) for oncology nurses using a literature review and analysis of existing research tools. After a specialist panel verified content validity, the questionnaire was shortened to 58 items. The data were analyzed using a Rasch model to investigate the items with respect to unidimensionality of fit and difficulty and reliability distribution. Discriminant validity was examined using the known-groups technique. ResultsTwo items did not fit with the Rasch model. Person and item separation-index ratios were 3.33 and 9.45, respectively, which confirmed that the SHCS-K functioned well. The reliability was good, at 0.99. Significant differences in marital status, levels of education, and participation in SHC training were observed between groups. The final version of the questionnaire consisted of 55 items, with a total score range of 0–55. ConclusionsThe SHCS-K was found to be a valid and reliable measure for evaluating levels of sexual health care knowledge among this sample of oncology nurses.

수술실 간호사의 피로 예측요인

Purpose: The purpose of this study was to measure the fatigue of operating room nurses and examine factors contributing to their fatigue. Methods: The subjects of this study were 115 nurses who worked in operating rooms of three hospitals. Data were collected from September 15, 2009 to September 30, 2009. Fatigue and job stress were measured by using the Symptom's Fatigue Scale and the job stress measurement tools in operating room nurses. Results: The mean score of fatigue level was <TEX>$3.10{\pm}0.61$</TEX>. We analyzed fatigue according to characteristics of subjects and found that there were significant differences in marital status, number of children and sleeping hours in general characteristics. Career, daily participation hours in the surgery relating to job related characteristics. Significant positive correlations were found between job stress and fatigue(r=.233, p= .012). Three significant variables influencing fatigue of operation rooms nurses were job stress, daily participation hours in the surgery, and sleeping hours (Adj. <TEX>$R^2$</TEX>=0.284, F=4.773, p<.001). Conclusion: An integrative care program that takes job stress, daily participation hours in the surgery and sleeping hours into consideration is essential to reduce fatigue in operating room nurses.

Emergency department visits: Why adults choose the emergency room over a primary care physician visit during regular office hours?

It has been estimated that up to one third of all emergency department (ED) visits may be "inappropriate" or non-emergent. Factors that have been speculated to be associated with non-emergent use have been noted to include low socioeconomic status, lack of access to primary care, lack of insurance, convenience of "on demand care" and the patient's individual perception of their complaint urgency. The objective of this study is to identify the reasons contributing to self-perceived non-emergent adult emergency department visits during primary care physician office hours of operation. This study was a single-center, descriptive study with questionnaire. The questionnaire was collected from patients meeting exclusion/inclusion criteria who were triaged into an acute or fast track part of the emergency department during regular business hours on Monday through Friday, 8:00 am-5:00 pm during the months of July 2011 and August 2011. Questionnaire data were categorical and summarized using counts and percentages. Data collected included patient demographics, information about the patient's primary care provider, and information about the emergency department visit in question. All responses were compared among patients with visits considered to be non-emergent to those considered to be emergent by using individual chi-square tests. There were 262 patients available for the study. The patients were grouped according to their perception of the severity of their complaints. Roughly half of the patients placed themselves into the non-emergent category (n=129), whereas the other half of the patients categorized themselves into the emergent group (n=131). There were statistically significant differences in marital status and employment status between the two groups. It was found that 61.5% of the non-emergent patients were single, while 58.3% of the emergent patients were married. In the non-emergent group, 59.7% were unemployed, but in the emergent group 60.3% were employed (P<0.05). However, no other factors were significantly different. Our study did not identify a statistically significant factor to the reasoning behind why patients choose the emergency department over a primary care physician during regular office hours. The only significant demographic indicating who was more likely to make this choice during the specified time frame was being single and employed with perceived non-emergent complaint. Patients without insurance and/or without a primary care physician were no more likely to visit the emergency department with a self-perceived non-emergent issue than patients with insurance and/or with an established primary care physician.

Quality of Medical Care in Diabetic Women Undergoing Fertility Treatment

OBJECTIVEDiabetic women are at increased risk for adverse pregnancy outcomes that can be improved by preconception care. Our goal was to evaluate the quality of medical care in diabetic women who undergo fertility treatment and compare it with the quality of medical care in diabetic women with spontaneous pregnancies.RESEARCH DESIGN AND METHODSThis retrospective study on reproductive-age women undergoing fertility treatment in Clalit Health Services (CHS) used data on fertility treatments, prescription fillings, HbA1c levels, and demographics extracted from CHS computerized systems. The control group comprised women with spontaneous pregnancy. Three quality measures in the periconception period were evaluated: folic acid prescription fillings, evaluation and level of HbA1c, and use of potentially hazardous drugs.RESULTSThere were 230 fertility treatment cycles in 83 diabetic women, and 30 diabetic women had spontaneous pregnancy. Women in the fertility group were older and had fewer children. There were no significant differences in marital status or ethnicity. Regular folic acid use, HbA1c recording, and the percentage of women with HbA1c <7% was similar between women in fertility treatment and those with spontaneous pregnancy (23.9, 57.8, and 31.3% vs. 20.0, 73.3, and 40.0%, respectively). Several women in both groups continued the use of potentially hazardous medication.CONCLUSIONSThe periconception medical care of diabetic women who undergo fertility treatment is suboptimal and no better than that of diabetic women with spontaneous pregnancies. More intensive and targeted counseling regarding the importance of folic acid and glycemic control is needed to optimize periconception care of these diabetic patients.