Survey-based Assessment Research Articles

Survey-based assessment of hematopoietic stem cell graft manipulation (minimal) by cell therapy labs supporting hematopoietic stem cell transplants in India

Background aimsHematopoietic stem cell transplants (HSCTs) are increasingly being offered to patients in India for various conditions. The Indian Stem Cell Transplant Registry shows that a total of 2533 transplants were done in India in 2019. MethodsAn epidemiological descriptive cross-sectional survey (55 questions) of centers providing HSCT in India was planned to analyze variations in policies and practices regarding HSCT graft manipulation (i.e., plasma reduction, red blood cell [RBC] depletion and cryopreservation). A total of 63 of 102 centers responded to the survey (response rate, 61.7%), mostly from the northern part of India (27 of 63 [42.8%]). ResultsThe majority of responding centers reported performing >50 HSCTs annually (n = 24 [38%]), and 92% (58 of 63) performed stem cell collections from a pediatric donor/patient (age <18 years). A total of 56 of 63 responding centers indicated that they did product manipulations involving cryopreservation (n = 45), plasma reduction (n = 42) and RBC depletion (n = 28). Cryopreservation was primarily done by blood centers (27 of 45 [60%]), with dimethyl sulfoxide (DMSO) being the primary constituent, used most commonly at a concentration of 5–10% (28 of 45 centers). Dump freezing was most commonly used (27 of 45) with a –80°C deep freezer. A 7-aminoactinomycin D based viability assessment was also most commonly used (30 of 45). Thawing of the product was done mainly at the bedside (30 of 45) using a wet-type thawer (36 of 45), and washing of DMSO was done by a few centers (seven of 45). Plasma reduction and RBC depletion were primarily done for ABO incompatibility at blood centers. ConclusionsThis survey demonstrates the lack of standardization and uniformity in the minimal manipulation of hematopoietic stem cell grafts in centers supporting HSCT in India. This work also highlights the need for more studies and country-specific recommendations to establish best practices.

A survey-based assessment of internet and social media use by oncology patients and their caregivers for health-related education.

321 Background: Oncology patients are increasingly utilizing the internet and social media (SM) as sources of health-related information. Contemporary information on oncology patient use patterns for health-related education is not well understood. To address this gap, we surveyed adult oncology patients on active treatment seen in a community-based oncology clinic about their use of the internet and SM around cancer-specific content. Methods: We conducted a qualitative, cross-sectional anonymous survey to understand the range of values, perspectives, and behaviors that patients and caregivers have around their use of internet and SM resources. We also assessed patient beliefs regarding the quality of education provided by their oncologists and how this may relate their patterns of use of these resources. Results: Of the 40 patients surveyed: 55% were male, 64% identified as Caucasian, 22% Latino, 14% were of other races, and 81% spoke English as their primary language. The group represented a diverse age range and education level and a variety of solid and hematologic malignancies. Most participants (89%) reported receiving written educational materials by their oncologist and 58% reported receiving links to electronic/internet resources for disease education.The vast majority of patients (95%) had a positive opinion of in-person education provided by their oncologist and 75% were satisfied with the quality of written or online resources provided. The majority of patients (85%) reported using the internet to learn about their diagnosis and treatment. A smaller proportion (43%) of patients used SM platforms. Of internet information sources used, the patient’s own health system website was the most popular choice (41.7%). Interestingly, 87% found resources without specific guidance from their oncologist. Notably, 11% of patients were instructed by their oncologist to avoid researching their diagnosis online. Conclusions: Our research shows that internet and SM use among patients with cancer is ubiquitous, and independent of the educational interventions provided by their oncologists. Importantly, 66% of participants felt that online research helped them feel more prepared for discussions with their oncologists. A quarter (25%) of patients agreed that they only use online resources recommended by their oncologist’s office, suggesting that the majority of patients will pursue their own research in a self-guided fashion. Encouragingly, the majority of patients (86%) reported that they feel comfortable discussing information they find online with their care provider. Improved understanding in this area will help oncologists better guide their patients to reliable resources and engage more directly in the patient or caregiver’s process of seeking cancer-specific information from outside sources.

No Journal is an Island: The John Donne Journal and the Possibilities of Open Access

This paper examines the possibilities for moving a print journal to Diamond Open Access electronic publication. It uses a case study of a mature academic publication, the John Donne Journal, to explore options for a transition that retains a print version of the journal—and thus its institutional and individual subscribers—while at the same time establishing a fully Open Access electronic version. Informed by a survey-based assessment of the interests and values of the membership of the John Donne Society (the journal's issuing body) and by a brief survey of the state of Open Access journal publication in Renaissance Studies, this paper then examines the means by which other journals have achieved electronic publication and the remaining options for sustainable (i.e. funded) Open Access journal publication. It ends by proposing an independent ('hipster') model for the John Donne Journal that leverages the print form as an asset and basis for approaching subscribing libraries to join the journal as continuing subscribers and partners in Open Access publication.

An International Survey-Based Assessment of Minimally Invasive Mitral Valve Surgery.

Minimally invasive mitral valve surgery (MIMVS) has been shown to be safe and feasible however its adoption has lagged globally. The international consortium is lacking a set of guidelines that are specific to MIMVS. The aim of this study was to capture the practices of MIMVS in different centres. A survey was constructed containing 52 multiple-choice and open-ended questions about various aspects of MIMVS. The survey was sent to centers that routinely and frequently perform MIMVS. All surgeons provided informed consent for participating in the survey and publication of data. The survey was sent to 75 known surgeons from whom 32 (42%) completed the survey. All survey responders performed more than 25 MIMVS cases annually. Twenty (68%) of the surgeons thought that simulation training, MIMVS fellowship, and proctorship are all essential prior to commencing a MIMVS program. Eleven (34%) of the surgeons stated that 50-100 MIMVS cases are required to overcome the learning curve, followed by 6 (18%) who said 21-30 cases should suffice. Eighteen (62%) of the surgeons had adopted a fully endoscopic approach for their MIMVS, followed by 15 (51%) surgeons who had performed cases via endoscopic-assisted strategies, 5 (17%) surgeons had conducted the operation under direct visualization, and 6 (20%) surgeons had used a robot for their MIMVS. The study highlights a marked variability on training and approach to MIMVS. Consensus guidelines should be established to allow standardisation of MIMVS.

The Impact of Infectious Disease Syndromes on Activities During Military Travel.

We evaluated the impact of infectious disease (ID) syndromes on US active duty (AD) servicemembers returning from overseas deployment (DEP), military training exercises (EXR), or short-term military travel (eg, temporary assignment of duty [TDY]). We conducted a survey-based assessment of US AD servicemembers returning from DEP, EXR, or TDY between 2015 and 2019. Subjects completed a post-travel survey capturing symptoms of travelers' diarrhea (TD), influenza-like illness (ILI), and febrile illness (FI). Risk factors associated with any ID syndrome (ie, either TD, ILI, or FI) that impacted daily activities were assessed using a logistic regression model with backward selection. One-third of servicemembers (654/1822) experienced an ID syndrome, and 26% (471/1822) reported a ≥50% reduction in activity level due to an ID syndrome (median duration, 3 days). TD was the most common ID syndrome experienced and accounted for 73% (346/471) of ID syndromes impacting daily activities. The greatest impact of ID syndromes was observed in servicemembers on DEP. Compared with servicemembers on EXR or TDY, those on DEP had a longer duration of travel and a delayed period of risk for ID syndromes. Multivariate analysis identified high-risk exposures (ie, environmental exposures, close contact with locals, consuming food from street vendors) and behaviors (ie, inability to sanitize hands before meals) that could be used to inform mitigation strategies. ID syndromes result in a significant loss of productivity during military travel. Addressing modifiable risk factors and access to TD self-treatment in high-risk settings may help mitigate the impact of ID threats during military travel.

English

Crop mapping and its health monitoring are of key importance for a country like Pakistan where a considerable share of the GDP originates from agricultural production. Currently, extensive capital and human resource are utilized to record the crop types and monitor crop health due to variations in crop pattern and intercropping practices being observed in many parts of the country. Satellite Remote Sensing, however, can be utilized very efficiently to identify crop types and estimate acreage by using unique phenological cycles derived from NDVI thresholds. In this research, we proposed a semi-automated, efficient and cost-effective state-of-the-art technique for crop classification using satellite remote sensing datasets and GIS techniques to replace outdated conventional survey-based crop estimations procedures. This research was conducted in Sahiwal district, Pakistan to categorise several crop types using two major inputs: satellite (Sentinel-2, 10m) imagery and local crop calendar. The research adopted a semi-automatic approach to find the main crops of Rabi (winter) and Kharif (summer) using orthorectified and atmospherically corrected Level-1C images to extract phenological information based on Normalized Difference Vegetation Index (NDVI). The complete phenological life cycle of crops including sowing, growing, and harvesting stages were deeply analyzed with the help of crop calendar and NDVI profiles. Then this information passed through iterative selforganizing (ISO Data Model) of unsupervised classification technique in the form of temporal stacked images. The NDVI profiles of each crop were synchronized with the crop calendar of the study area to develop the crop categorization procedure. The results were validated with the statistics of the agriculture department Lahore and field samples gave about 85% and 88% accuracy for Rabi and Kharif cropping seasons respectively. It is concluded from the research that the tested methodology is capable of providing a fast, cost-efficient, and reliable solution for crop mapping instead of conventional survey-based crop area assessment techniques (conventional Girdawri) which requires a vast number of resources and time, and it can be replicated in different areas with minor changes

Economic impact of urinary incontinence and pelvic organ prolapse in women in Belize

Introduction: Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent in low-income and middle-income countries (LMIC). Although the significant clinical and social impacts of UI/POP are well-described, less is known regarding their microeconomic impacts. This study aimed to assess the microeconomic impact of UI/POP in the LMIC country of Belize. Methods: The authors performed a prospective survey-based assessment of patients with urologic disease during surgical trips to Belize in 2019–2021 by the charity Global Surgical Expedition. This study is a post-hoc analysis focused on a subset with urogynecologic disorders. Patients completed a 17-item survey focused on disease impact on work, caretaker responsibilities, and finances. The primary study outcome was income loss resulting from work impairment or absence related to UI/POP, calculated using the validated work productivity and activity impairment questionnaire. Results: Forty-nine women with UI (n=15) and POP (n=34) completed surveys. The majority (73% UI; 88% POP) reported their condition negatively impacted their lives. In the analysis of 21 patients able to provide financial data, 6 (29%) patients reported missing work and 10 (48%) reported impairment at work due to UI/POP. This resulted in a loss of 6.7% (UI) and 8.5% (POP) in total income per capita. When also accounting for direct treatment costs, the total cost attributable to UI/POP was 28% (2%, 51%) of weekly income. Conclusions: In Belize, UI and POP significantly impair work and caretaking responsibilities, resulting in considerable lost income and cost. Efforts are thus necessary to provide surgical care for UI/POP in LMIC to address not only the quality of life but also the financial health of individuals and families.

Coping Mechanisms for Financial Toxicity Among Patients With Metastatic Prostate Cancer: A Survey-based Assessment.

Assessments of financial toxicity among patients with metastatic prostate cancer are lacking. Using patient surveys, we sought to identify coping mechanisms and assess characteristics associated with lower financial toxicity. Surveys were administered to all patients seen at a single center's Advanced Prostate Cancer Clinic over a 3-month period. Surveys included the COST-FACIT (COmprehensive Score for Financial Toxicity) and coping mechanism questionnaires. Patients with metastatic disease (lymph nodes, bone, visceral) were included for analysis. Coping mechanisms were compared between patients experiencing low (COST-FACIT >24) vs high (COST-FACIT ≤24) financial toxicity using Fisher's exact test. Multivariable linear regression was used to evaluate characteristics associated with lower financial toxicity. Overall, 281 patients met inclusion criteria of which 79 reported high financial toxicity. In multivariable analysis, characteristics associated with lower financial toxicity included older age (estimate: 0.36, 95%CI: 0.21-0.52), applying for patient assistance programs (estimate: 4.42, 95%CI: 1.72-7.11), and an annual income of at least $100,000 (estimate: 7.81, 95%CI: 0.97, 14.66). Patients with high financial toxicity were more likely to decrease spending on basic goods (35% vs 2.5%, P < .001) and leisure activities (59% vs 15%, P > .001), as well as use savings (62% vs 17%, P < .001) to pay for their treatment. In this cross-sectional study, patients with metastatic prostate cancer and high financial toxicity were more likely to decrease spending on basic goods and leisure activities and use savings to pay for care. Understanding the impact of financial toxicity on patients' lives is crucial to inform shared decision-making and interventions designed to mitigate financial toxicity in this population.

Cyber Hygiene Methodology for Raising Cybersecurity and Data Privacy Awareness in Health Care Organizations: Concept Study.

Cyber threats are increasing across all business sectors, with health care being a prominent domain. In response to the ever-increasing threats, health care organizations (HOs) are enhancing the technical measures with the use of cybersecurity controls and other advanced solutions for further protection. Despite the need for technical controls, humans are evidently the weakest link in the cybersecurity posture of HOs. This suggests that addressing the human aspects of cybersecurity is a key step toward managing cyber-physical risks. In practice, HOs are required to apply general cybersecurity and data privacy guidelines that focus on human factors. However, there is limited literature on the methodologies and procedures that can assist in successfully mapping these guidelines to specific controls (interventions), including awareness activities and training programs, with a measurable impact on personnel. To this end, tools and structured methodologies for assisting higher management in selecting the minimum number of required controls that will be most effective on the health care workforce are highly desirable. This study aimed to introduce a cyber hygiene (CH) methodology that uses a unique survey-based risk assessment approach for raising the cybersecurity and data privacy awareness of different employee groups in HOs. The main objective was to identify the most effective strategy for managing cybersecurity and data privacy risks and recommend targeted human-centric controls that are tailored to organization-specific needs. The CH methodology relied on a cross-sectional, exploratory survey study followed by a proposed risk-based survey data analysis approach. First, survey data were collected from 4 different employee groups across 3 European HOs, covering 7 categories of cybersecurity and data privacy risks. Next, survey data were transcribed and fitted into a proposed risk-based approach matrix that translated risk levels to strategies for managing the risks. A list of human-centric controls and implementation levels was created. These controls were associated with risk categories, mapped to risk strategies for managing the risks related to all employee groups. Our mapping empowered the computation and subsequent recommendation of subsets of human-centric controls to implement the identified strategy for managing the overall risk of the HOs. An indicative example demonstrated the application of the CH methodology in a simple scenario. Finally, by applying the CH methodology in the health care sector, we obtained results in the form of risk markings; identified strategies to manage the risks; and recommended controls for each of the 3 HOs, each employee group, and each risk category. The proposed CH methodology improves the CH perception and behavior of personnel in the health care sector and provides risk strategies together with a list of recommended human-centric controls for managing a wide range of cybersecurity and data privacy risks related to health care employees.

A Survey-Based Assessment of Awareness Regarding Parthenium hysterophorus in a Rural Population of North India.

Background Parthenium hysterophorus is a poisonous weed that has spread across the length and breadth of the Indian subcontinent. It is a common cause of dermatitis similar to other members of the family, such as ragweeds in the United States and chrysanthemums in Europe. Despite the common occurrence of the plant in the environment, the general population does not seem to be aware of its adverse effects. This cross-sectional study was conducted with the aim of assessing the awareness of P. hysterophorus in the local rural population. Methodology A questionnaire was designed by an expert panel consisting of three dermatologists after a bibliological survey and collection of published literature on P. hysterophorus. All adult patients >18 years of age approaching the outpatient department of dermatology at our tertiary health care center were included in a consecutive sampling manner. Patients with an unsound mind or those who refused to provide consent were excluded from the study. Results A total of 250 patients participated in the study, of whom 56.8% were male and 43.2% were female, with ages ranging from 18 to 80 years. The majority of the participants were farmers by occupation. Three-fourths of the participants (187, 74.8%) were able to identify the plant. Maximum participants (144, 57.6%) did not know about the ill effects of Parthenium, and 148 (59.2%) did not know about the method of controlling its spread. Conclusions The study was conducted among 250 respondents from a rural community in North India. Despite almost 75% of participants identifying the weed, more than half were neither aware of its ill effects nor knew about the methods of control. Furthermore, most participants were educated individuals yet remained ignorant. Emphasis needs to be made on awareness campaigns about the fast-spreading Parthenium and its ill effects.

A Text-Based Measure of Transactive Memory System Strength

We develop a method to assess the three indicators of transactive memory systems (TMS)—specialization, credibility, and coordination—through computer-aided text analysis. First, human coders assessed group transcripts for phrases representative of these indicators. From those phrases, we identified words that occurred frequently to develop a dictionary of TMS indicators. In total, we analyzed 262 groups composed of 1,091 individuals. Both the human-coded and dictionary-based assessments of TMS indicators are significantly related to a popular survey-based assessment of TMS. Our approach could be used to advance understanding of TMS by analyzing it in contexts where administering surveys is not feasible.

Survey-Based Assessment of Water, Sanitation, and Animal-Associated Risk Factors for Moderate-to-Severe Diarrhea in the Vaccine Impact on Diarrhea in Africa (VIDA) Study: The Gambia, Mali, and Kenya, 2015-2018.

Pediatric exposures to unsafe sources of water, unsafely managed sanitation, and animals are prevalent in low- and middle-income countries. In the Vaccine Impact on Diarrhea in Africa case-control study, we examined associations between these risk factors and moderate-to-severe diarrhea (MSD) in children <5 years old in The Gambia, Kenya, and Mali. We enrolled children <5 years old seeking care for MSD at health centers; age-, sex-, and community-matched controls were enrolled at home. Conditional logistic regression models, adjusted for a priori confounders, were used to evaluate associations between MSD and survey-based assessments of water, sanitation, and animals living in the compound. From 2015 to 2018, 4840 cases and 6213 controls were enrolled. In pan-site analyses, children with drinking water sources below "safely managed" (onsite, continuously accessible sources of good water quality) had 1.5-2.0-fold higher odds of MSD (95% confidence intervals [CIs] ranging from 1.0 to 2.5), driven by rural site results (The Gambia and Kenya). In the urban site (Mali), children whose drinking water source was less available (several hours/day vs all the time) had higher odds of MSD (matched odds ratio [mOR]: 1.4, 95% CI: 1.1, 1.7). Associations between MSD and sanitation were site-specific. Goats were associated with slightly increased odds of MSD in pan-site analyses, whereas associations with cows and fowl varied by site. Poorer types and availability of drinking water sources were consistently associated with MSD, whereas the impacts of sanitation and household animals were context-specific. The association between MSD and access to safely managed drinking water sources post-rotavirus introduction calls for transformational changes in drinking water services to prevent acute child morbidity from MSD.

Impact of Covid-19 on Mental Health among Medical Students

Background: The COVID-19 pandemic is a major health crisis affecting several nations. Such widespread outbreaks are associated with adverse mental health consequences. Objectives: To conduct a survey-based assessment of mental health among medical students during the COVID-19 pandemic. Aimed at identifying severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress. Methods: An analytical cross-sectional study was chosen as the study design for this research to study the association between demographic social and mental health among medical students during the pandemic COVID-19. Results: The results of this study were collected by respondents through questionnaires as the respondents were needed to answer about 16 questions and the main question was asked mostly about their mental health condition during the pandemic COVID-19. 101 respondents participated in the study. Discussion: the impact of COVID-19 on mental health among medical students has been studied. Due to the long-lasting pandemic situation and numerous measures such as lockdown and stay-at-home orders, COVID-19 brings negative impacts on higher education of medical students, self and social isolation, disconnection from friends and teachers resulting in more medical students than ever experiencing feelings of helplessness, isolation, grief, anxiety and depression. The issue of mental health is not only relevant but crucial. Demand for health support services has increased exponentially as a result. Conclusion: In this study, severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress have increased due to many factors such as social isolation, own health and the health of loved ones, financial difficulties, suicidal thoughts, depressive thoughts, class workload, changes in living environment, eating patterns and sleeping habits.

Real-world data from India on clinical practices in the management of autoimmune haemolytic anaemia: A survey-based cross-sectional assessment.

Autoimmune haemolytic anaemia (AIHA) is a decompensated acquired haemolysis caused by the host's immune system acting against its own red cell antigens. The aim of this national survey is to capture real-world data of clinical practices in AIHA by collecting responses from clinical haematologists across India. In this cross-sectional study, a structured, 26-question online survey was conducted in India by few members of the special interest group in immunohaematology between January and March, 2022. The final survey consisted of questions covering place of work, amount of AIHA cases being evaluated by the haematologist over preceding years, basic demographic, clinical and laboratory features of the patients being treated under them etc. Descriptive statistical analysis was performed during the assessment. The survey response rate was 48.2% (53/110), 69.8% (37/53) have diagnosed and managed more than 10 AIHA cases in the last 3years with a female preponderance. There was considerable variability in response. While 56.6% (30/53) of respondents do have the access to the facilities to subtype AIHA cases; 32.1% (17/53) of clinicians would prefer administering high dose steroids for 6weeks or more in non-responding patients, and only 45.3% (24/53) would assess the risks of thrombosis in AIHA. There is unanimous agreement among the participants that health-related quality of life should be taken into consideration in patients and the need for a national registry of patients with AIHA in India. The current national survey showed that some aspects of AIHA management were consistent; others were less so, but also significant variations were observed in certain clinical practices, where the evidence base is limited. A joint effort is needed to establish a national patient registry by including both clinical haematologists and transfusion medicine specialists which could potentially standardise AIHA management and future research in India.

A Survey-Based Assessment of the Practices Governing Morbidity and Mortality Conferences and the Effects of the COVID-19 Pandemic.

Morbidity and mortality (M&M) conferences are essential components for resident education and provide a valuable tool to improve patient safety and quality of care. M&M conferences help identify important gaps in safety and reduce avoidable events in future patient care. Active methods to improve the utilization of M&M conferences have been shown to enhance their educational value for residents, faculty and multidisciplinary teams in healthcare institutions. The purpose of this study was to use a survey-based methodology to assess how morbidity and mortality conferences are conducted in residency programs, including characteristics such as frequency, involvement of personnel and the effects of COVID-19. From February to October 2021, a validated 19 question survey was electronically distributed to residency program directors in anesthesiology, emergency medicine and general surgery, after a search for email addresses in the ACGME database. The survey was created and hosted on Google Forms. A total of 125 of 713 program directors (17.5%) responded to the survey. Eighty-three percent of respondent programs reported mandatory participation for residents, with residents providing most of the presentations. Case presentations utilized various formats including SBAR, adverse event analysis and root cause analysis as the most common modalities. Though most programs reported no change in frequency of M&M conferences due to COVID-19, most respondents reported a shift to a virtual or hybrid platform. M&M conferences are an important educational and quality improvement modality, and many residency directors changed practice to incorporate virtual platforms due to the COVID-19 pandemic to maintain uninterrupted educational sessions. Nonetheless, significant variation still exists in how these conferences are conducted between different institutions.

Understanding Vaccine Perceptions and Willingness to Receive COVID-19 Vaccination: Opportunities to Strengthen Public Health Responses and COVID-19 Services for People Who Use Drugs.

People who use drugs (PWUD) are at high risk for COVID-19 infection, morbidity, and mortality. COVID-19 vaccines are safe and effective at reducing serious illness and death from COVID-19. There are sparse data on the perceptions and willingness of PWUD to receive COVID-19 vaccination. In order to assess the perceptions of, and willingness to receive, COVID-19 vaccination among PWUD, we conducted a rapid survey-based assessment of 100 PWUD in NYC (Spring 2021) who reported not having received COVID-19 vaccination and who reported past 30-day illicit drug use. More than 80% of respondents agreed that personally receiving a COVID-19 vaccine was important for the health of others in the community, and endorsing this belief was significantly associated with COVID-19 vaccine willingness reflecting a high prevalence of altruistic beliefs (p-value: 0.01). Other reported perceptions that were significantly associated with COVID-19 vaccine willingness were believing that COVID-19 vaccines are safe for PWUD and trusting COVID-19 information from their healthcare providers (p-values &lt; 0.05). That said, 62% reported being unwilling to receive a COVID-19 vaccine, and 70-83% had concerns about general vaccine safety/efficacy. Examining pairs of questions to explore potential ambivalence between vaccine endorsement and vaccine concerns identified that 56-65% simultaneously reported vaccine safety/efficacy concerns and beliefs that vaccination was an important intervention. Of the 75 respondents who reported past 30-day use of harm reduction and/or substance use disorder (SUD) programs, nearly 90% reported these programs as trusted sources of COVID-19 information. Most participants reported altruistic beliefs about the role of vaccines for community health, including COVID-19 vaccines, and this altruism was associated with willingness to be vaccinated against COVID-19. These findings suggest a complex relationship between beliefs about the role of vaccination in community health and the safety/efficacy of vaccines; this ambivalence suggests that COVID-19 vaccine willingness may not be firmly fixed, indicating potential opportunities to address questions and build vaccine confidence. Harm reduction and SUD programs could be leveraged to further engage PWUD in receipt of COVID-19 information and/or vaccination. Recognizing vaccine ambivalence, emphasizing collective and individual benefits of vaccination, and messaging from trusted sources may be promising approaches to increase vaccination in this population.

Assessing burnout among Obstetrics & Gynecology residents during night float versus day float in a large academic hospital

BackgroundThe prevalence estimates of burnout among residents vary widely. Resident physicians working overnight have additional stressors and therefore, may be at higher risk of developing burnout.ObjectiveTo determine the rates of burnout among residents working night rotations versus day rotations.MethodsThis is a prospective, cross sectional, survey-based assessment of the prevalence of burnout among Obstetrics and Gynecology (OBGYN) residents on nights versus days rotations conducted at a large academic residency program that spans two separate hospitals in New York. All residents in the residency program were asked to complete the Maslach Burnout Inventory – Human Services Survey for Medical Personnel (MBI-HSS (MP)) after the first rotation of the academic year in 2018, 2019, and 2020. The results for each of the three aspects of the MBI-HSS (MP): emotional exhaustion, depersonalization, and personal accomplishment, were then compared for those on nights versus day rotations using students t-test.ResultsA total of 76 responses were received, 13 from residents on night rotations and 63 from residents on day rotations with a response rate of 61.8%. Comparing resident responses for a night versus day rotation, the residents averaged a low level of emotional exhaustion (a score of 17 ± 9) on day shift, compared to a moderate level of emotional exhaustion (a score of 18 ± 14) on nights (p = 0.37). Similarly, 55.6% of respondents reports low personal accomplishment on days, compared to 76.9% while on nights.ConclusionsEmotional exhaustion scores were lower for residents on daytime rotations (mean score 17, SD 9), compared to those on nights rotations (mean 18, SD 14). Although there was no difference in depersonalization when comparing the day and night shift, 45% of the responses indicated high levels of depersonalization regardless of the type of shift. These results highlight the need to continue efforts to minimize burnout in medical training.

Patient and Health Care Professional Perspectives on Quality of Life and Unmet Needs of People with Chronic Neutropenia: A Survey-Based Assessment

Introduction Chronic neutropenia (CN) encompasses different blood disorders all characterized by low levels of neutrophils (absolute neutrophil count [ANC] <1500/µL for >3 months), that substantially alters quality of life (QoL) of affected individuals due to disease-related symptoms [James RM. Arch Dis Child. 2006; Donadieu J. Exp RevHematol. 2021]. Granulocyte colony-stimulating factor (G-CSF) treatment can improve clinical outcomes, but chronic use is associated with debilitating side effects, such as bone pain, that have negative impact on QoL [Michniacki TF. Blood. 2019; Dale DC. N Engl J Med. 2017; Mehta HM. J Immunol. 2015; Donadieu J. Orphanet J Rare Dis. 2011]. This survey evaluated views of patients/caregivers (P/Cs), and health care professionals (HCPs) on unmet needs, treatment patterns, impact on daily life, and QoL of people living with CN. Methods Participants were recruited via direct emails to patients with CN and outreach to CN Facebook groups from Savvy Cooperative and X4 Pharmaceuticals. P/Cs (n=22) completed up to 29 survey questions; 13 screening questions captured demographics, neutropenia type, and treatment setting. Patients with chemotherapy-induced neutropenia were ineligible. Additional 16 questions captured information on severity, symptoms, impact on daily life, treatment types, and unmet needs. HCPs (n=7) completed a 13-question survey; 7 screening questions captured data on medical specialty and experience treating neutropenia, and 6 questions captured patient neutropenia type, treatment patterns, and unmet needs. Preliminary results per responses through July 8, 2022, are presented; additional updates are pending upon survey close. Results Patients (n=18)/caregivers (n=4) completed a validated survey. Included patients were aged 2 to 65 years (45%, 45-65 years). Neutropenia types were idiopathic (32%), congenital (23%), cyclic (18%), autoimmune (14%), and unsure (14%). Most HCPs (86%) served at large academic institutions, with 57% practicing for >21 years. Medical specialties included pediatric hematology/oncology (57%) and adult/pediatric immunology (57%). Medications prescribed included G-CSF (71%), immunoglobulin (Ig) replacement (43%), and antibiotics (14%). G-CSF (29%) and Ig (29%) had the most difficult-to-manage side effects. When asked which symptoms most impacted health of a person with CN, P/Cs listed fatigue (77%) and frequent/severe infections (77%) as top symptoms, while HCPs listed mouth sores (71%), dental issues (57%), and frequent/recurrent infections (57%). P/Cs reported long-term neutropenia (90%), emotional stress (68%), and disruption to family/social life and social isolation (64%) as top 3 daily life concerns. When asked what treatment improvements are needed, P/Cs listed administration of medication (64%) and reducing fatigue (36%) at the top; HCPs listed fewer/less frequent severe infections (57%) and administration of medication (57%). Improvements in "administration of medication” included alleviation of the burdens associated with injection/intravenous treatments including injection site reactions. P/Cs reported G-CSF as the most prescribed treatment (64%). Top issues with G-CSF treatment were bone pain (71%) and fatigue (50%); 50% reported G-CSF dose/frequency adjustments; 45% were due to side effects such as bone pain. Six of 7 HCPs (86%) reported adjusting G-CSF dose/frequency, and 1 (17%) attributed the change to side effects. Conclusions Interim survey results show differing perspectives between P/C and HCPs on impact of CN and its treatment on QoL. P/Cs cited fatigue as most impactful symptom and fatigue reduction as a priority treatment need, while HCPs ranked fatigue at the bottom or not at all. Notably, the relationship between fatigue and CN is poorly understood and requires further study. Although both groups reported improvement in medication administration as a need, perceptions of patient experience with current treatment differ. P/Cs more commonly cited side effects as the cause of medication changes. Survey results show considerable impact of CN on the lives of people diagnosed and suggest the existing treatment paradigm is burdensome and insufficiently addresses physical health/QoL needs. Additional studies are required to understand unmet needs of people with CN and reasons behind differing perspectives between P/C and HCP communities.

Lifestyle and career satisfaction among US-based oral and maxillofacial surgeons: Results of a nationwide survey

This study aims to investigate overall career satisfaction rate amongst US-based oral and maxillofacial surgeons (OMSs) and to evaluate possible predictors of professional stress and quality of life. Members of the American Association of Oral and Maxillofacial Surgeons were invited to complete an online survey-based assessment. Descriptive statistics were computed; univariate analysis was performed to identify predictors for satisfaction. The overall response rate was 29%. Most of respondents were male (88.6%), aged >45 years (71.7%), married (91.7%), and working at private and/or group-based practices (55.9%) for >15 years (66.6%). Most surgeons 91.3% reported being satisfied with their career with 84.9% willing to choose a career in OMS again. No significant difference was noted in satisfaction rates between academic and non-academic surgeons. On univariate analysis, no demographic characteristic was predictive of satisfaction. Reportedly, 91.3% of US-based OMSs have a significant degree of career satisfaction, and a majority would choose the specialty as their profession again.

Economic Impact of Urological Conditions in Men and Women in Belize

Urological disease is prevalent in low- and middle-income countries. Concurrently, the inability to maintain employment or provide family care contributes to poverty. We assessed the microeconomic impacts of urological disease in Belize. We conducted a prospective survey-based assessment of patients evaluated during surgical trips by the charity Global Surgical Expedition. Patients completed a survey focusing on impact of urological disease on work and caretaker responsibilities, as well as its economic impact. The primary study outcome was income loss resulting from work impairment or work time missed related to urological disease. Income loss was calculated using the validated Work Productivity and Activity Impairment Questionnaire. A total of 114 patients completed surveys. Overall, 87.7% and 37.2% of respondents reported a negative impact of urological disease on job and caretaking responsibilities, respectively. Nine (7.9%) patients were unemployed secondary to their urological disease. Sixty-one (53.5%) patients provided financial data sufficient for analysis. In this cohort, median weekly income was $250 Belize dollars (approximately $125 United States Dollars), while median weekly cost for urological disease treatment was $25 Belize dollars. Among the 21 (34.5%) patients who missed work due to urological disease, median weekly income loss was $35.6 Belize dollars, representing 55% of their total income. A vast majority (88.6%) of patients reported that cure of urological disease would increase ability to work and/or care for family. In Belize, urological disease results in significant impairment of work and caretaking responsibilities, as well as income loss. Efforts are necessary to provide urological surgeries in low- and middle-income countries as urological disease impacts not only quality of life, but also financial health.