Supplementary Questions Research Articles

Emotional State of Chinese Healthcare Workers During COVID-19 Pandemic

ObjectiveAnti-epidemic work against coronavirus disease (COVID) has become routine work in China. Our study was intended to investigate the emotional and psychological state of healthcare workers and look for the association between sociodemographic factors/profession-related condition and emotional state.MethodsA cross-sectional survey was conducted online among healthcare workers from various backgrounds. Symptoms of anxiety and depression were assessed by the Chinese versions of the seven-item Generalized Anxiety Disorder (GAD-7) and the nine-item Patient Health Questionnaire (PHQ-9), respectively. Supplementary questions (Supplementary Material) were recorded to describe the participants’ information about workplace violence, profession, and attitude related to the COVID pandemic. Wherever suitable, independent t-test, and one-way ANOVA were performed to detect group differences of GAD-7 and PHQ-9 total scores after grouping by sociodemographic variables, respectively, such as age, gender, marital status, educational level, after-tax income, department category, job title, experience of workplace violence, and anti-epidemic participation. Multiple linear regression analyses (stepwise method) were utilized in order to look for the potential associated factors of GAD-7 and PHQ-9 total scores.ResultsA total of 2,139 questionnaires with valid response were completed. Approximately 86.44% of participants had minimal symptoms of anxiety, 11.08% mild, 1.59% moderate, and 0.89% severe. Meanwhile, 81.34% had minimal symptoms of depression, 14.07% mild, 2.90% moderate, 1.17% moderately severe, and 0.51% severe. Student’s t-test showed that participants with female gender, with experience of workplace violence scored higher on both GAD-7 and PHQ-9, and participants with experience of anti-epidemic front-line work during pandemic scored lower on both GAD-7 and PHQ-9. ANOVA showed that participants aging from 31 to 40, with higher educational level, with middle level of annual after-tax income, with department of internal medicine or surgery, or with middle level of job title scored higher on both GAD-7 and PHQ-9. Regression analyses showed that female gender, high job title, and the experience of workplace violence positively were associated with anxiety or depression. Doctoral education, department (other vs. psychiatry), job enthusiasm, and professional self-identity were negatively associated with anxiety or depression. Additionally, psychological support was negatively associated with depression.ConclusionAs the epidemic prevention and control against COVID-19 become normalized in China, emotional state of healthcare workers deserves extensive attention. Our study revealed that gender, educational level, department category, job title, the experience of workplace violence, job enthusiasm, and professional self-identity are the most important influencing factors of physician’s anxiety and depression. Self-tailored psychological intervention should be based on the predisposing factors above to mentally prepare healthcare workers for this long-lasting battle against COVID-19.

Evaluation of expert views and considerations to develop rehabilitation sports public services for persons with disabilities in Republic of Korea: a Delphi study

BackgroundPhysical activity is required to maintain health; however, resources needed for physical activity (e.g. facilities, instructors, and programmes) are scarce for persons with disabilities (PWD), particularly those who require rehabilitation following hospital discharge and those with severe disabilities. The Republic of Korea presently lacks a legal and administrative framework that supports the implementation of health services for PWD. Therefore, it is necessary to develop such a framework based on the perspectives of PWD, medical and physical education experts, facility managers, and government organisations. Thus, this study aimed to establish expert consensus on the development of rehabilitation sports public services (RSPS) in the Republic of Korea by reviewing previous studies and expert statements.MethodsUsing the Delphi method, we reviewed the literature to identify the critical roles and factors required for planning efficient RSPS programmes, including coordinators, physicians, facility managers, rehabilitation exercise and physical education instructors, and integrated information systems for facilities, instructors, and programmes. We developed a Delphi questionnaire with closed-ended questions, based on the factors derived from the literature review and supplementary open-ended questions, which was administered to a panel of 26 experts.ResultsThe panel reached a consensus on most factors (i.e. coordinators, physicians, facility managers, rehabilitation exercise and physical education instructors, and integrated information systems for facilities, instructors, and programmes). However, no consensus was reached regarding ‘when an applicant can continue/discontinue an RSPS programme’, ‘establishing information systems to manage physical fitness of PWD’, and ‘joint operation of the to-be-established system by the Ministry of Health and Welfare and Ministry of Culture, Sports, and Tourism’, leaving room for further debate.ConclusionsBy identifying the factors and roles necessary for RSPS, this study is expected to offer valuable information for state-led pilot projects and contribute to promoting physical activity and quality of life among PWD.

Abstract P1-02-02: Examination of low Her2 expression in breast cancer

Abstract Introduction: Antibody-drug conjugates (ADC) are designed to effectively deliver cytotoxic agents directly to malignant cells. Trastuzumab deruxtecan (Tdx), an ADC of trastuzumab, an enzyme-cleavable linker, and a cytotoxic topoisomerase I inhibitor, has been shown to have antitumor activity in patients with breast cancer with low levels of HER2. However, current companion diagnostic tests for HER2-targetting therapies, immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH), were optimized for high (gene amplified) levels of HER2. We hypothesize that the current common assays used in clinic do not efficiently differentiate between patients whose cancers have “0” HER2 expression and “1+” HER2 expression and thus could miss patients who would benefit from treatment with this drug. Methods: Here, we evaluated two years of HER2 surveys from the College of American Pathologists’ (CAP) Proficiency Testing Surveys for HER2 expression in breast cancer from 2019 and 2020. Participating laboratories received two tissue microarrays (TMAs) of 10 breast cancer cores, each Laboratories stained for HER2 using the standard IHC assay used in their labs. The scores were returned to the CAP as part of their quality assessment program. Each survey dataset covers the scores from around 1400 labs of 20 cores each as well as supplemental questions regarding the methodology used. We summarized the relative frequency and distribution of each score given to every core. A second independent analytic dataset was selected from the archives of the Department of Pathology at Yale, from breast biopsies in 2018. The set, enriched in HER2 2+ and 3+ cases, was read by eighteen board-certified pathologists, most with over 5 years’ experience, participating in an interobserver variability study. Hematoxylin and eosin (H&E) and HER2 IHC digitally scanned images of 170 independent cases were provided. Pathologists scored the cases as 0,1, 2, or 3+. Fisher’s exact test was used to compare the 0/1+ concordant cases to 2+/3+ cases. All tests were two-sided at a significant level 0.05. Statistical analysis was performed using Graphpad Prism Version 9.0.1 and the dplyr package in R Version 1.0.143. This study was approved by Yale Human Investigation IRB protocol ID 9505008219. Results: We found that 65% of the 80 cores evaluated in the CAP survey (52/80) had a concordance rate ≥90%. This high concordance was limited to scores of 0 and 3+. The lowest concordance was found between 0 versus 1+. Of the 80 cores, 56 were considered negative (HER2 score of 0 or 1). In 25% of those cores there was < 70% concordance (n=15; 6 in 2019 and 9 in 2020). Analytic concordance was assessed in the independent, Yale cohort where we found that of the 170 cases, 92 were read as 0 by at least one pathologist. Of these 92, 24 were concordant (26%), defined as a ≥90% agreement. In comparison, 45/170 were read as 3+ by at least one pathologist. Again,. using a 90%definition of concordance, 26 of 45 cases (58%) were concordant. Comparison of 0/1+ concordant cases versus 2+/3+ concordant cases showed a significant difference (χ2 = 12.07, p<0.0005). Conclusions: Assessment of laboratory performance of around 1400 CAP labs using common current HER2 assays on CAP survey specimens, there is significant discordance in the evaluation of 0 vs. 1+ cases. In a separate selected breast biopsy cohort examined by 18 breast pathologists, we showed that discordance between scores of 0 vs 1+ is significantly larger than that between 2+ and 3+. Given the efficacy of T-DXd, we believe patients may be mis-assigned for treatment or no treatment if the decision depends on performance of the standard current HER2 assays. Citation Format: Aileen I Fernandez, Matthew Liu, Andrew Bellizzi, Jane Brock, Oluwole Fadare, Krisztina Hanley, Malini Harigopal, Julie M. Jorns, M. Gabriela Kuba, Amy Ly, Mirna Podoll, Kimmie Rabe, Mary Ann Sanders, Kamaljeet Singh, Olivia L Snir, Rinda Soong, Shi Wei, Hannah Wen, Serena Wong, Esther Yoon, Lajos Pusztai, Emily Reisenbichler, David L. Rimm. Examination of low Her2 expression in breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-02-02.

Anterior Hemi-epiphysiodesis of the Distal Tibia for Residual Equinus Deformity in Children with Clubfeet

Background: Residual equinus deformity in toddlers with a history of clubfoot can be managed with soft tissue release, provided there is no articular incongruity. Distal tibia osteotomy is a reasonable choice in mature patients with a flattened talus provided the growth plate is closed. Anterior distal tibia hemi-epiphysiodesis is an option for children with articular incongruity who have substantial growth remaining. The aim of this study is to evaluate radiographic and clinical outcomes of this method. Methods: Fourteen clubfoot patients (20 ankles) with residual equinus deformity were treated between 2010-2015 with anterior distal tibial hemi-epiphysiodesis utilizing size appropriate modular plate and screw constructs. Patients were evaluated clinically and radiographically. Oxford Ankle Foot Questionnaire for Children (and caregivers) with supplemental questions were requested at most recent follow-up. Results: There were 12 males and 2 females, mean age 10 years at surgery (50-152 months), with the minimum 18 months of radiographic follow-up (Mean 34 months). Pre-surgical mean radiographic anterior distal tibial angle (ADTA) was 87.8 degrees (79-100) and mean maximum dorsiflexion was -5.7 degrees (-40-7). At follow-up, mean improvement of radiologic ADTA was 18 degrees and mean clinical dorsiflexion improvement was 8.4 degrees. On the Oxford Ankle Foot Questionnaire, children reported a mean functional score of 47% in the “Physical” domain, 71% in “School and Play”, 70% in “Emotional”, and 38% in footwear. Parents reported mean scores of 45% in Physical, 69% in School and Play, 56% in Emotional, and 28% in footwear. Sixty percent of parents reported increased foot flexibility, 80% noted improvement in their child’s walking, and 100% would choose this surgery again. Conclusions: Anterior distal tibial hemi-epiphysiodesis is a viable option for treatment of residual equinus in children with a clubfoot history and open growth plates. Radiographic improvement was at least 2x greater than the clinically measured improvements of dorsiflexion; yet each family would undergo the surgery again as they perceived an improvement in function.

Validation of the Swedish Watson Dysphagia Scale for adult patients with eosinophilic esophagitis.

SUMMARY Background: The Swedish Watson Dysphagia Scale (S-WDS) has been used to assess dysphagia in patients with eosinophilic esophagitis (EoE) but has not been validated for this patient group. The aim of this study was to validate the S-WDS for adult patients with EoE. Methods: Ninety-seven Swedish adult patients with EoE and 97 controls without dysphagia filled out the S-WDS, the Swedish Eosinophilic Esophagitis Activity Index (S-EEsAI) and a set of supplementary questions. The reliability of the S-WDS was evaluated using Cronbach’s alpha, Pearson correlation of items and total score, and test–retest analysis (n = 29). Validity was investigated using Spearman correlations of the S-WDS items, S-EEsAI domains and a self-assessment score, and by investigating floor and ceiling effects. Results: The Cronbach’s alpha of the S-WDS was 0.77 and all items demonstrated moderate to strong correlation to the S-WDS score (r = 0.40–0.81) indicative of sufficient reliability of the instrument. In addition, the test–retest results reflected excellent reliability with an intraclass correlation coefficient of 0.85 for the S-WDS score. Adequate validity of the instrument was demonstrated, the S-WDS score correlated moderately with the self-assessment score and with 4/6 S-EEsAI domains, and strongly with the remaining two domains. Floor effects were more common for liquids and soft-textured foods and ceiling effects increased with increasing food consistency. The S-WDS scores of the patient group were significantly different from those of the nondysphagia control group (P < 0.001). Conclusion: The S-WDS instrument is an appropriate and valid instrument for assessment of dysphagia in patients with EoE.

Beyond the Business Climate: Regular and Supplementary Questions in the ifo Business Survey

Beyond the Business Climate: Regular and Supplementary Questions in the ifo Business Survey

The negative impact of interface design, customizability, inefficiency, malfunctions, and information retrieval on user experience: A national usability survey of ICU clinical information systems in Finland

IntroductionClinical information systems (CISs) used in intensive care units (ICU) integrate large amounts of patient data every minute, and from multiple systems and devices. Intensive care requires efficient use of information technology to acquire, synchronize, integrate, and analyze data in order to make quick decisions and implement interventions in a timely manner. ObjectivesTo identify factors affecting poor user experience (UX) of CISs used in ICUs in Finland. MethodsData from national Electronic Health Record (EHR) and user experience survey was undertaken in 2017. Those, who used the ICU CIS on a daily or weekly basis were asked supplementary questions and, therefore, comprise a subset of the responses reported in this article. ResultsOn a 4–10 scale (i.e., “Fail” to “Excellent”), the mean ‘grade’ for the principally used ICU CIS was 6.9 (SD 1.3) points. Of the respondents, 119 (57%) were categorized as having good UX. The factors identified as affecting poor UX of the ICU CISs related to poor interface design (OR 7.8; 95% CIs 12.5–24.1; p = 0.001), insufficient customizability (OR 7.2; 95% CIs 1.7–30.6; p = 0.008), the inefficiency of performing routine tasks (OR 4.3; 95% CIs 1.0–18.2; p = 0.044), malfunctions (OR 3.5; 95% CIs 1.2–9.6; p = 0.019), and difficulties in information retrieval (OR 3.0; 95% CIs 1.0–8.8; p = 0.044). The most commonly reported usability problems with the main EHR system and ICU CISs were also identified. ConclusionsOverall satisfaction with the principally used ICU CIS was moderate. However, the overall grades varied significantly. Poor interface design, insufficient customizability, inefficiency, malfunctions, and difficulties in information retrieval all affect poor UX.

Development of the Rheumatoid Arthritis Distress Scale (RADS): a new tool to identify disease-specific distress in patients with Rheumatoid Arthritis

BackgroundPatients with Rheumatoid Arthritis (RA) may experience psychological distress (depression, anxiety) in addition to their physical symptoms. People with RA may also experience disease-specific distress (DSD), related to the specific burden of living with their life-long condition. DSD is a patient reported outcome in several long-term conditions, including type 1 and 2 diabetes. The aims of this study were to determine whether DSD is experienced by people with RA, and if so, develop a Patient Reported Outcome Measure (PROM) to assess for DSD in people with RA.MethodsA five-phased qualitative study was conducted which consisted of a secondary data analysis of 61 interviews of people with rheumatological disease (Phase 1), validation of findings via a Patient and Public Involvement (PPI) group of people with RA (n = 4) (Phase 2), item generation for a PROM (Phase 3) and establishing face and content validity of the PROM via PPI group (n = 4) and individual cognitive interviews (n = 9) of people with RA respectively (Phase 4 and 5). The final PROM was presented at a Patient Education Evening for patients with long-term rheumatological conditions, including RA, and carers.ResultsFive themes of rheumatological disease distress emerged from Phase 1, which were validated in the Phase 2 PPI group. After Phases 3–5, the Rheumatoid Arthritis Distress Scale (RADS) was formed of 39 items and 3 supplementary questions. Overall participants reported the content of the RADS to be clear and relevant, and that DSD is a valid concept in RA, distinct from other entities like clinical depression or anxiety.ConclusionsDSD appears to be an important concept in RA. The 39-item RADS demonstrates acceptable face and content validity in this patient group. Further psychometric testing is needed. The RADS may be a useful tool for healthcare professionals to identify RA distress.

Role of Corporate Social Marketing Campaigns in Employer Branding: A Study of Campus Engagement Initiatives

Background Corporate social marketing (CSM), as a type of corporate social initiative, is considered to be the most effective tool for creating social good through behavioural change. However, the relevance and benefits of CSM in the business context are largely unknown. The understanding of ‘the business case’ of CSM initiatives can provide useful insights to practitioners in this field. In this paper, we study the boundary spanning benefits of CSM in the area of employer branding. Research Questions This research aims to answer one major question: Do CSM campaigns play any role in building an organization’s employer brand? If yes, then how? Further, two associated supplementary questions include (i) how do managers perceive the use of CSM campaigns during campus engagement initiatives? (ii) how do job seekers perceive the use of CSM campaigns in campus engagement initiatives? Methods We use a qualitative research approach to answer the above questions. Using a purposive sampling method, we interviewed 6 managers who manage and 13 management students who attended campus engagement initiatives. The research was carried out in an emerging economy context, namely India, which has had several successful CSM campaigns and is home to the youngest working population, particularly millennials. Results The study shows that CSM leads to three major employer branding outcomes – increasing employer awareness, enhancing employer attractiveness and differentiating an employer from other competing organizations. Students prefer employers who provide them opportunities to work for society and are even willing to accept a lower pay in such organizations. Managers revealed the importance of showcasing CSMs during campus presentations and confirmed the relevance of social causes in employer branding initiatives. Recommendations for Practice The study offers useful insights to human resource managers on the role of CSM campaigns in creating employer awareness and attracting talent during campus engagement. We recommend that CSM campaigns be leveraged during campus engagement sessions for achieving differentiation in a competitive talent market. Lesser-known employers can use CSM campaigns for increasing employer awareness among potential student recruits. Organizations may proactively design and implement CSM campaigns, consistent with their values and mission, for the positive spill-over effects it can yield for their employer brand. The study aims to contribute to the CSM literature by studying the boundary spanning role of CSM in employer branding.

Questionnaire Survey of Burnout Amongst Dentists in Singapore

BackgroundBurnout results from ongoing, unsuccessfully managed workplace stress, resulting in feelings of exhaustion, increased mental distance from one's job, and reduced professional efficacy.MethodThis research used a cross-sectional questionnaire survey design. Graduated dentists in Singapore completed an online questionnaire comprising 5 sections: (a) demographics (3 items); (b) working conditions and experience (12 items); (c) the Copenhagen Burnout Inventory (CBI) (19 items); (d) supplementary questions assessing causes and outcomes of stress and burnout (15 items); and (e) other outcomes (3 items).ResultsOverall, low to moderate levels of burnout were reported by the 210 survey respondents. Average CBI scale scores (out of 100) were as follows: personal burnout = 49.14, work-related burnout = 46.41, and patient-related burnout = 37.72. High to severe levels of burnout were self-reported by 24 individuals (11.3%) for personal burnout, 17 individuals (8.0%) for work-related burnout, and 9 individuals (4.2%) for patient-related burnout.ConclusionsLevels of burnout were generally low to moderate in this sample, with a small proportion of dentists experiencing high levels of burnout. Further research is required to gain clarity on stress and burnout levels across different occupational designations and dentistry settings in Singapore.

Racial and ethnic differences in perception of provider cultural competence among patients with depression and anxiety symptoms: a retrospective, population-based, cross-sectional analysis

Racial and ethnic minorities face disparities in access to health care. Culturally competent care might lessen these disparities. Few studies have studied the patients' view of providers' cultural competence, especially in psychiatric care. We aimed to examine the associations of race, ethnicity, and mental health status with patient-reported importance of provider cultural competence. Our retrospective, population-based, cross-sectional study used data extracted from self-reported questionnaires of adults aged at least 18 years who participated in the US National Health Interview Survey (NHIS; 2017 cycle). We included data on all respondents who answered supplementary cultural competence questions and the Adult Functioning and Disability survey within the NHIS. We classified participants as having anxiety or depression if they reported symptoms at least once a week or more often, and responded that the last time they had symptoms the intensity was "somewhere between a little and a lot" or "a lot." Participant answers to cultural competency survey questions (participant desire for providers to understand or share their culture, and frequency of access to providers who share their culture) were the outcome variables. Multivariable ordinal logistic regressions were used to estimate adjusted odds ratios (aORs) for the outcome variables in relation to sociodemographic characteristics (including race and ethnicity), self-reported health status, and presence of symptoms of depression, anxiety, or both. 3910 people had available data for analysis. Mean age was 52 years (IQR 36-64). 1422 (39·2%, sample weight adjusted) of the participants were men and 2488 (60·9%) were women. 3290 (82·7%) were White, 346 (9·1%) were Black or African American, 31 (0·8%) were American Indian or Alaskan Native, 144 (4·8%) were Asian American, and 99 (2·6%) were Mixed Race. 380 (12·5%) identified as Hispanic ethnicity and 3530 (87·5%) as non-Hispanic. Groups who were more likely to express a desire for their providers to share or understand their culture included participants who had depression symptoms (vs those without depression or anxiety symptoms, aOR 1·57 [95% CI 1·13-2·19], p=0·008) and participants who were of a racial minority group (Black vs White, aOR 2·54 [1·86-3·48], p=0·008; Asian American vs White, aOR 2·57 [1·66-3·99], p<0·001; and Mixed Race vs White, aOR 1·69 [1·01-2·82], p=0·045) or ethnic minority group (Hispanic vs non-Hispanic, aOR 2·69 [2·02-3·60], p<0·001); these groups were less likely to report frequently being able to see providers who shared their culture (patients with depression symptoms vs those without depression or anxiety symptoms, aOR 0·63 (0·41-0·96); p=0·030; Black vs White, aOR 0·56 [0·38-0·84], p=0·005; Asian American vs White, aOR 0·38 [0·20-0·72], p=0·003; Mixed Race vs White, aOR 0·35 [0·19-0·64], p=0·001; Hispanic vs non-Hispanic, aOR 0·61 [0·42-0·89], p=0·010). On subgroup analysis of participants reporting depression symptoms, patients who identified their race as Black or African American, or American Indian or Alaskan Native, and those who identified as Hispanic ethnicity, were more likely to report a desire for provider cultural competence. Racial and ethnic disparities exist in how patients perceive their providers' cultural competence, and disparities are pronounced in patients with depression. Developing a culturally competent and humble approach to care is crucial for mental health providers. None.

Doplňující otázky k rozhovoru Ulysse Lojkina a Frédérica Wormse (přel. E. Fulínová)

Supplemental questions to the interview of Ulysse Lojkine and Frédéric Worms.

Institutional factors associated with hospital partnerships for population health: A pooled cross-sectional analysis.

Hospitals are increasingly engaging in partnerships to address population health in response to national policies, such as value-based payment models. However, little is known about how institutional factors influence hospital partnerships for population health. Guided by institutional theory, we examine the association between institutional pressures (coercive, normative, and mimetic isomorphism) and hospital partnerships for population health. A pooled cross-sectional analysis used an unbalanced panel of 10,777 hospital-year observations representing respondents to a supplemental question of the American Hospital Association's annual survey (2015-2017). The analysis included descriptive and bivariate statistics, and regression models that adjusted for repeated observations to examine the relationship between key independent variables and partnerships over time. In regression analyses, we found the most support for measures of coercive (e.g., regulatory factors) isomorphism, with nonprofit status, participation in accountable care organizations, and acceptance of bundled payments, all being consistently and significantly associated with partnerships across all organization types. Modest increases were observed from 2015 to 2017 for hospital partnerships with public health organizations (+2.8% points, p < .001), governmental organizations (+2.0% points, p = .009), schools (+4.1% points, p < .001), and businesses (+2.2% points, p = .007). Our results suggest that institutional factors, particularly those related to regulatory policies and programs, may influence hospital partnerships to support population health. Findings from this study can assist hospital leaders in assessing the factors that can support or impede the creation of partnerships to support their population health efforts.

Витамины и микроэлементы в профилактике инфекционных заболеваний у женщин репродуктивного возраста

The issue of increasing nonspecific immunity is becoming particularly relevant in the context of the spread of a new coronavirus infection SARS-CoV-2. Thus, there is question of supplementation with vitamins and micronutrients, especially in reproductive-aged women planning pregnancy, due to socio-economic aspects, geographical latitude, dietary habits, and increased needs associated with the epidemiological situation. The deficiency of certain micronutrients in the diet has been found to impair the chemical, structural and regulatory processes in the body, which can negatively affect the state of the immune system. Certain associations have been identified between sufficiency of micronutrients, the severity of the course and development of complications of COVID-19. Severe course of infection is associated with severe deficiency of vitamin D (<10 ng/ml). Vitamin D contributes to changing the macrophage phenotype from pro-inflammatory Th1 to anti-inflammatory Th2, which may reduce the risk of a cytokine storm. There was a statistically significant decrease in the level of inflammatory markers, including ferritin and D-dimer, a decrease in the risks of multiple organ failure, a tendency to reduce the need for ventilation, vascular damage in patients with acute respiratory distress syndrome with parenteral use of high doses of ascorbic acid. The experimental studies have shown that cations Zn2+ inhibit the activity of SARS-coronavirus RNA polymerase by reducing its replication;this fact opens up prospects for the use of Zn2+ as an antiviral agent in the treatment of COVID-19. Vitamin E and selenium have effects that reduce the risk of infection: they increase the number of T cells, enhance the responses of mitogenic lymphocytes, increase the secretion of IL-2 cytokines, and stimulate the activity of natural killer cells. The causative agent influences beta-carotene which accelerates the immune response of the body by increasing the activity of macrophages. Conclusion. The strategies for the prevention of COVID-19 provide for the intake of vitamin and mineral complexes containing vitamins D, A, E, zinc, selenium. The optimal intake of micronutrients largely determines the protection of a person from the effects of negative environmental factors including biological agents, namely microbes and viruses. © A group of authors, 2021.

Social Support and Dietary Habits as Anxiety Level Predictors of Students during the COVID-19 Pandemic.

The COVID-19 pandemic is a public health emergency concern and a challenge to students’ mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst men and women who are studying during the pandemic in terms of the relations towards their sense of social support and their nutritional behaviors. A State–Trait Anxiety Inventory was used to measure anxiety level, alongside supplementary questions such as the feeling of support from close ones, concentration of attention on nutrition during the pandemic and externally derived factors (university, specialization). Analysis of the regression was applied to the examination of the dependency between the anxiety level (in both forms of its occurrence—as state-anxiety and as trait-anxiety). We observed that the pandemic situation affected a level of state-anxiety above average (mean value of 46–48 points) even when students felt social support. Nutrition habits and chosen education type are associated with trait-anxiety level, which was also elevated (mean values of 49–50 points). Chosen factors had a partial influence on the anxiety level of students, therefore their mental health should concern shaping positive nutrition habits and social support.

Determinants of Early Retirement in the UAE

Abstract The purpose of this paper is to analyze the retirement behavior of UAE nationals by understanding the socio-economic characteristics of early retirees and identifying the main determinants of early retirement. Accordingly, a survey study is created and deployed for current employees and retirees affiliated with Abu Dhabi Retirement and Pension Benefit Fund (ADRPBF). The survey was designed to reach 100 retirees and 200 currently active workers from those registered at the ADRPBF. The survey was conducted by employing the online survey method and face-to-face interviews. The total number of respondents is around 244, with a total response rate of 81.33%. Some factors related to the psychosocial work environment play a significant role in the early retirement decision of Emiratis. These factors are stress level, autonomy level and authority level at work. In addition to these, the level of work environment comfortability and life-work balance seem to also affect the early retirement decision. In general, the results indicate that higher the stress level, lower the level of autonomy and authority; higher the early retirement decision within the Emirati workforce. Last but not least, the likelihood of early retirement increases significantly if employees face a work-related health problem. Initiatives at the government and company level to adjust the working conditions for the capacity of elderly people shall be considered. Healthy living campaigns and sport programs might be launched to reduce work-related health problems and consequently early retirement. Our work is the first comprehensive study exploring the early retirement decision of the UAE nationals. One limitation of our study is the limited number of participants in the survey. Future work that will include a higher number of participants and supplementary questions to cover more job features (physical workload, other psychosocial factors) might be helpful.

Patient Reported Sexual Function Outcomes in Male Patients Following Open Radical Cystoprostatectomy and Urinary Diversion

To report sexual health outcomes in male patients undergoing open radical cystoprostatectomy using a validated questionnaire. Beginning in 2017, male patients were asked to complete a validated questionnaire during scheduled post-cystectomy clinic visits that assessed sexual function using the 5 item International Index of Erectile Function (IIEF-5) and supplemental questions which evaluated libido, orgasm, partner interest, and adequacy of pre-operative counselling. Baseline data and functional outcomes were compared and multivariable analysis performed. A total of 134 patients who met inclusion criteria completed the questionnaire. Pre-operative IIEF-5 was available in 78 patients with a median score of 16 (IQR:5-23). In those patients, median age at cystectomy was 68.9 years (IQR:60.2-72.4) and median duration of follow-up was 17.3 months (IQR:6.3-28.7). Median IIEF-5 score at time of survey completion was 1 (IQR:1-11). Increasing age, shorter follow-up duration, insufficient counselling, and absence of partner interest were predictive of lower scores. Younger age, pre-operative erectile function, and neurovascular preservation were predictive of a higher IIEF-5 score on univariate and multivariate analysis. Median libido score was 2 "low" (IQR:1-3) and ability to orgasm was reported by 34 (43.6%) patients. Neurovascular preservation (OR:3.03 95% CI:1.10-8.26, P=.03) and sufficient preoperative counselling (OR:3.078 95% CI:1.17-8.098, P=.02) were associated with preserved ability to orgasm. Libido was influenced by partner interest (OR 11.7, 95% CI:3.793-6.14, P <.0001). Sexual dysfunction after radical cystoprostatectomy is prevalent with many contributing factors. As such, establishing appropriate expectations and goals during preoperative counseling, performing neurovascular preservation when appropriate, and readily identifying and treating dysfunction in follow-up may improve sexual recovery.

Prenatal serum screening for Down syndrome and neural tube defects in the United States: Changes in utilization patterns from 2012 to 2020.

To compile current usage of serum-based prenatal screening for Down syndrome in the United States and compare it with results from a similar 2011/2012 survey. The College of American Pathologists maternal screening proficiency testing survey includes a supplemental question on the first of three yearly distributions. Information regarding tests offered and the monthly number of pregnancies tested for US-based laboratories were reviewed. Results were stratified by size of laboratory, tests offered, and pregnancies tested. Findings were compared to an earlier survey. Fifty-six laboratories reported they will have screened 1,131,336 pregnancies in 2020. Of these, 36% are screened by stand-alone first trimester testing, 48% by stand-alone second trimester testing, and 16% using tests that integrate results from both trimesters. Eighty percent of all serum screens were provided by the five laboratories that performed the most screens (at least 50,000). These five performed similar proportions of first or second trimester screens (42.2% and 41.8%, respectively). Compared to eight years earlier, there are now 54% fewer laboratories. Pregnancies screened using the first trimester, second trimester, and integrated protocols were lower by 27%, 69%, and 72%, respectively. The serum screening activity in the US showed a 62% decrease from 2012 levels. During 2012-2020, the number of cell-free DNA tests increased from negligible to 1,492,332. Maternal serum screening for common aneuploidies has changed significantly in eight years with fewer laboratories, a shift toward larger laboratories and a 2.5-fold reduction in pregnancies tested, likely due to the introduction of cell-free DNA screening.

Anxiety and depression in inflammatory eye disease: exploring the potential impact of topical treatment frequency as a putative psychometric item

ObjectiveTo evaluate whether topical therapy is linked to scores related to anxiety, depression and quality of life (QoL) in inflammatory eye disease (IED).Methods and analysisPatients with ocular surface disease (OSD,...

TED talks as resources for the development of listening, speaking and interaction skills in teaching EFL to university students

The article presents a study conducted on 27 university students and 5 of their teachers in the Winter semester 2020/21. The study was conducted because of recommended online teaching at Polish universities and almost four decades after the first TED event, when the TED community has become worldwide and the recordings of the events can be accessed online cost-free by anybody. The popularity of TEDs and the need to teach online prompted the author to incorporate it in teaching practice and review research literature from the areas of SLA (Second Language Acquisition), EFL (English as a Foreign Language) teaching and learning, socio-constructivism and adult learning. Based on this review, a hypothesis was formulated: TED talks support the development of listening, speaking, and interaction skills when used as a supplementary resource in teaching English as a foreign language to university students. Three supplementary questions were formed to test the hypothesis. Data was obtained in an online questionnaire and analysed using the qualitative data analysis framework of Miles and Huberman (1994). The study confirmed the hypothesis. Lessons with TEDs are valued as varied, interesting, inspiring and supporting oral communication skills’ development. Results are discussed, conclusions drawn and further research explored.&#x0D;