Survey Link Research Articles

Survey to identify barriers and enablers to implementation of genomics in pharmacy practice across healthcare sectors in a rural community

Abstract Introduction The potential for genomics to improve patient outcomes is being harnessed via national strategy to embed genomic testing into NHS practice, and drive use of precision medicines and pharmacogenomics1. The national pharmacy genomics education and training strategic framework aims to empower the pharmacy workforce, across all sectors, to use genomics to support medicines optimisation2. Cornwall, a rural and coastal county, has areas of marked deprivation with poorer health outcomes3 and challenges in recruiting and retaining healthcare professionals. It is key that rural/coastal communities have equitable access to genomic services and expertise to avoid exacerbating pre-existing health inequalities. Aim To identify barriers and enablers to the implementation of genomics into pharmacy practice in a rural community. Methods Pharmacists and pharmacy technicians working in Cornwall were eligible to participate. An anonymised survey was compiled via Microsoft Forms of closed, multiple choice and optional open questions. Following piloting, the survey link was disseminated via email by pharmacy leaders in community pharmacy, primary and secondary care in May 2024. Responses were stored securely via NHS password protected IT systems and analysed via quantitative and thematic analysis. As this project is defined as a service evaluation, according to the UK NHS Health Research Authority, ethical approval was not required. Results Fourteen pharmacists and 7 pharmacy technicians participated, from primary and secondary care and community hospitals, with no participants from community pharmacy. Seven had received prior training in genomics (teaching sessions (n=5), webinars (n=1), podcasts (n=1), articles in journals (n=2)). One participant had received formal undergraduate training. Key barriers to the implementation of genomics included a lack of education and training (n=5), perceived cost of genomic testing (n=2), difficulty in accessing genomic services (n=1) and lack of expert panels (n=1). It was also felt that genomics services were limited to secondary/tertiary care (n=2). Respondents stated that the rural location impacted the availability of face-to-face training and resources to support training (n=17). Key enablers were the opportunity for precision prescribing (n=8), and improved patient outcomes (n=7). Genomics education and training (n=5) and resources to support training (n=11) were viewed as being pivotal to supporting the mainstreaming of genomics. Discussion and conclusion Participants were keen to further their genomics knowledge, with a preference for face-to-face training. Respondents also highlighted the need for allocated resources to support training. As emphasised in the strategic framework2, workforce upskilling is vital to the successful mainstreaming of genomics, particularly when the majority of pharmacy staff had not received any formal training. There were no participants from community pharmacy, indicating a requirement to further explore barriers and enablers in this cohort. Community pharmacy staff may be reluctant to participate if they perceive genomics to relate solely to secondary/tertiary care. Survey methodology also limited the detail that could be obtained from respondents. This provides helpful preliminary insights on barriers and enablers to genomics implementation into pharmacy practice in rural/coastal areas. Themes could be further explored via semi-structured interviews, with the aim of shaping interventions necessary to ensure equitable provision of genomics services and expertise to these communities.

Social media use by teachers during work and its effects on their performance: the role of teacher’s wellbeing and social media addiction

BackgroundAlthough extant literature has investigated the impacts of social sites on employees’ job performance in different sectors, scholars have given little attention to teachers’ job performance (TJoP) in higher educational institutes.PurposeWe aimed to investigate the direct and mediating impact of social media use (SMU) on TJoP. Based on social cognitive theory, this study proposed a model that consists of six hypotheses.Methodology: To empirically test the model, we develop a survey link to collect data from respondents working in universities in Jiangsu province, China. Partial least square structural equation modeling (PLS–SEM) using SmartPLS 4 has been used for analyzing 454 respondents.ResultsResearch findings demonstrate the significant effects of SMU on TJoP, well-being, and social media addiction (SMAdd). In addition, teachers’ well-being and SMAdd have a positive and negative significant effect, respectively, on TJoP. Moreover, this research evidenced a significant partial mediation of teachers’ well-being and SMAdd.ConclusionThis study points out the key role of SMU in the direct and indirect influences of TJoP through well-being and SMAdd. Further, it brings into view the urgency of higher education to prudently consider the implications of SMU on performance and general well-being among its faculty.

The critical need for child and youth perceptions of active living in India: capturing context complexity in rural and urban regions.

The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective. As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA. Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β=18.020, 95% CI [5.890 to 30.149], p=0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β=-21.921, CI [-36.195 to -7.647], p=0.003) and perceptions of air pollution (β=-12.472, CI [-23.797 to -1.147], p=0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β=32.391, CI [9.264 to 55.518], p=0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models. These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution.

A multi-national survey-based evaluation of undergraduate/predoctoral endodontic education.

To evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide. The current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data. Amongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training. According to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.

A Survey of Dental Hygiene Pre-Clinic Instrumentation Selection and Sequence.

The purpose of this study was to assess the selection and sequence of dental hygiene instruments taught during dental hygiene pre-clinical education in the United States. Exempt status was received from the University of New Mexico's IRB (ID 21-336). A survey was developed with questions to be answered involving decisions for clinical teaching and sequencing on various assessment and implementation instruments during pre-clinic education. The instrument was 11 questions with multiple choice, ranking and short answer. A survey link was included through email invitation and successfully sent to 301 accredited dental hygiene programme directors in the United States. Results were collected and analysed through descriptive statistics. Forty-three of the invited participants completed the survey, a 14% response rate. Almost half (n = 24) of the participants chose to teach the periodontal probe first and 19 chose the explorer. Twenty-five participants selected they teach the sickle scalers first, 14 teach the universal curette scalers first and 4 teach the Gracey curette scalers first. All participants teach electronically powered scalers with 33 teaching after hand instrumentation and 8 before. Results from this study emphasise that educators teach clinical instrumentation from professional opinion, but no attestation specifically suggests the use of evidence-based pedagogical standards for clinical teaching. Dental hygiene programmes could benefit from further research on pre-clinic instrument selection and sequencing as a way of standardised clinical teaching. These clinical implications could advance the science for standardised teaching of clinical instrumentation and sequencing in dental hygiene education.

Design and evaluation of a visual genomic explainer: a mixed-methods study

ObjectiveTo design and assess a visual genomic explainer focusing on plain language and engaging imagery. The explainer aimed to support doctors’ comprehension of complex genomic concepts and results and act...

Exploring the Effects of Using AI Technologies in Higher Education Institutions in UAE

This study aimed to explore the effects of using artificial intelligence (AI) technologies in higher education institutions in UAE on students and faculty members. Through designing a survey on Google Form and adopting a descriptive analytical approach, the intended goals were met. This survey employs the five point Likert scale and includes two main parts. The first part collects data about (gender, name of the university, and academic rank). The second part targets two areas. The first area is the effects of using AI technologies in higher education institutions in UAE on students and the second area is the effects of using AI technologies on faculty members. The researchers shared the survey link on several WhatsApp groups that target faculty members in eight universities in UAE. The survey was filled by 244 faculty members. Thus, the purposive sampling method was used. SPSS program was used for conducting an analysis for the collected data. It was found that using AI technologies in higher education institutions in UAE has positive effects on students and faculty members. In terms of students using AI technologies develops the critical thinking, research, critical thinking and time management skills of students.

Communicating with Deaf Patients in the Clinical Environment: Lessons Learned from a Virtual Patient Panel

Background Communication and cultural differences predispose Deaf patients to suboptimal healthcare. Despite this disparity, health professionals have historically received little to no training in caring for Deaf patients. Patient panels are an effective tool in medical education to model communication strategies. Objective In this paper, we describe the design, implementation, and results of a virtual patient panel focused on communicating with Deaf patients in clinical contexts. We offer practical suggestions for incorporating similar educational interventions in health professions education to prepare trainees to effectively navigate these conversations with their patients. Methods The panel consisted of a one-hour question and answer discussion facilitated by the authors with Deaf patients and Certified Deaf Interpreters (CDI). The panel was presented to 271 second-year medical students at our institution in November of 2023. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using pile-sorting qualitative analysis to identify main themes. Results There were 73 respondents, with a response rate of 27%. After the panel, the most popular takeaway points from student reflections included communication (n=56, 77%) and access to care (n=47, 64%), followed by autonomy (n=17, 23%), the doctor-patient relationship (n=15, 21%), and culture (n=11, 15%). Based on this initiative, we identified and offer twelve tips for developing similar exercises. These tips are thematically presented under three groupings: Planning Considerations, Patient Panelist Considerations, In-Session Considerations, and Post-Session Considerations. Conclusion This patient panel was the first of its kind in our medical school curriculum. Important considerations in panel design and implementation should focus on delivery time constraints with live-interpreting and further exploring the role of trust and communication in the physician-patient relationship.

Amplifying Student E-Learning Impact on Academic Performance in Higher Education

Current research investigates the impact of students' E-Learning Attitudes (ELA), Digital Readiness (DR), and Academic Engagement (AE) on their academic performance in higher education. A survey in the form of an online questionnaire was administered to students through the networks established by the research teams. These networks encompassed academic staff from diverse Malaysian private as well as public universities. These academic staff were directed to share the survey link with their undergraduate students through WhatsApp or email. Two hundred eighty-six (286) valid surveys were collected from students at six public and private university campuses in Malaysia that offer courses and have used E-learning for at least one semester as part of COVID-19. In contrast to previous debates and studies, the outcomes of employing structural equation modeling through PLS 4.0 revealed a positive and noteworthy influence of E-learning platforms on students' academic performance. These findings hold broader implications for policymakers in higher education, researchers as well as educators, particularly in terms of considering the potential incorporation of social media tools within higher education, especially in developing nations. This research suggests that educational institutions that embrace change by aligning the goals of both students and instructors to establish a constructive and encouraging online learning atmosphere. This will foster active academic participation and enhance students' academic achievements.

Mental health and wellness of medical students in Ontario – A mixed methods approach

Medical students are highly susceptible to distress and burnout, raising concern about how this can carry over into their careers, impacting wellness, professionalism, and patient care. The aims of this study are to assess the mental health and wellness status of medical students in Ontario. This study electronically surveyed medical students across M1-M4 attending a medical school in Ontario, Canada, using the Brief COPE, DASS21, and Copenhagen Burnout Inventory (CBI) to examine their coping mechanisms, levels of stress, anxiety, and depression, the prevalence of personal, work-related, and patient-related burnout, and perceived support. Participants were recruited through mass email containing a survey link. BriefCOPE results show that students tend to rely on self-distraction, emotional support, instrumental support, and acceptance as coping mechanisms. DASS21 demonstrates that M4 students report severe stress and anxiety and mild depression. Results of CBI show moderate personal and work-related burnout, and low patient-related burnout. Qualitative analysis of students’ opinion on how the institution can enhance their wellness resulted in three themes: enhanced student scheduling, more communication from the administration, and more elective wellness sessions and social events. The data presented in this study will provide insight into the overall mental health and wellness of medical students studying in Ontario and may have important implications for medical education, healthcare institutions, and health policymaking.

Scalpel and strife: Assessing the impact of Sudan's ongoing civil war on surgical practice and healthcare delivery

BackgroundThis study aims to shed light on the profound ramifications of the military conflict that started in April 2023 on surgical practice in Sudan. MethodsThis is a survey-based study. The survey link was disseminated to Sudanese medical practitioners via various social media (WhatsApp, Telegram, X (previously twitter) and Facebook) channels. We included only responses from medical practitioners working in the surgical specialities. ResultsA total of 90 responses have been collected. All participants were working in surgical service provision institutes. Sixty per cent of the responses were from the age group 25–35 years old, and two-thirds of the total cohort either left Sudan or was internally displaced because of the conflict. Moreover, 51% are no longer practising because they had to flee the conflict area (75%) or because the hospital is out of service (20%). There was a significant drop in the average number of emergency and elective lists. ConclusionThe military conflict affected Sudan's already strained health system. There was a significant drop in the average number of emergency and elective lists with surgeons out of practice because they had to flee the conflict area and hospitals were out of service.

Feasibility and Acceptability of a REDCap-Embedded HIPAA-Compliant Text Messaging Application to Track Medication Adherence in Adolescents With Lupus.

Despite advances in clinical care and treatment options, adolescents with lupus continue to experience adverse health outcomes. Poor adherence to medication regimens is a major contributor to these negative outcomes. The utility of short message service (SMS) in tracking barriers to adherence prospectively remains untested for adolescents with lupus. Our objectives were (1) feasibility of incorporating a Health Insurance Portability and Accountability Act (HIPAA)-compliant SMS text messaging application into REDCap and (2) acceptability of using SMS text messaging to track barriers to medication adherence in adolescents with lupus. This study is a 12-week pilot cohort study of adolescents with SLE per the 1997 revised American College of Rheumatology. A REDCap-embedded HIPAA-compliant text messaging application was used to send biweekly messages with survey link to track medication adherence. Measures were completed. Descriptive statistics were used to summarize demographics, medical, and acceptability data. Response to text messages and survey completion rates were reported as a measure of feasibility. Most eligible adolescents approached agreed to participate (n = 17, 71% enrollment rate). The cellphone ownership rate among adolescents eligible for participation was 92%. Nine subjects responded to all text messages sent (53% response and completion rate). Eleven subjects (65%) responded to two thirds of the text messages. Overall, 77% of enrolled subjects completed at least half of the surveys sent. Reminders to complete surveys were sent to 30% of enrolled adolescents. This study shows that embedding a HIPAA-compliant SMS text message application in REDCap is feasible and can be used to engage adolescents with chronic conditions in monitoring between clinic visits.

Trend-Driven Innovation for RTE Food Market: A Comparison Study Between Consumers from Malaysia and Indonesia

The ready-to-eat (RTE) food market is growing worldwide. Nevertheless, a limited study was found where researchers compare consumer behavioral intention toward RTE foods between countries. This study compares consumers in Malaysia and Indonesia regarding their food preferences and behavioral intentions toward RTE foods. Using a quantitative cross-sectional approach, the researchers developed an online survey and distributed the survey link to consumers aged 18 years and above from both countries via social media platforms. The dataset comprised 321 responses from Malaysia and 262 from Indonesia. Based on the analyses, findings reported some similarities and differences in consumer preferences and behavior intention between both countries. The highest percentages of Malaysian respondents were recorded for plant-based, genetically modified, gluten-free, and allergen-free foods. Interestingly, the highest percentage of Indonesian respondents reported for insect-based food than the Malaysians. More Malaysian consumers preferred ethnic foods from different cultures than Indonesians. About the same highest percentages of consumers from both countries preferred cell-cultured meat, 3D printed foods, and vegan foods. For Malaysian samples, attitude and subjective norms significantly influenced their behavior intention toward RTE foods. For Indonesian samples, subjective norms and behavioral control significantly influence consumer behavior intention toward RTE foods. Findings are relevant for food producers and marketers to explore the young consumer market and to identify new products to fulfill the market demand. This study broadens and deepens the current understanding of both countries' RTE food trends and consumer behavioral patterns. Food producers should promote RTE food products by highlighting their benefits through marketing channels.

The mediating role of flow state between recovery and energy levels: An experience sampling method study.

This study uses a resource perspective that combines theories used commonly to explore recovery experiences as a theoretical framework and investigate the effects of recovery at the beginning of the workday on exhaustion and vigour at the end of the workday, with workflow in the morning as a mediator. An experience sampling method was used to collect data from 84 fulltime employees. Participants received three survey links each workday over a 2-week period, resulting in 837days-level and 2517 data points. Hierarchical linear regression was used to test hypotheses, with results suggesting that greater recovery at the beginning of the workday correlated negatively with exhaustion and positively with vigour at the end of the workday. Recovery at the beginning correlated positively with flow state in the morning, and flow state correlated positively with vigour at the end of the workday. Flow state in the morning mediated the relationship between recovery level at the beginning and vigour at the end of the workday. These findings suggest the importance of recovery and the effects of flow state on employees' vigour.

The relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity: A study of collegiate student-athletes

The COVID-19 pandemic provided athletes with an entirely new unforeseen circumstance, as many collegiate sport events and seasons were halted or canceled, forcing athletes into premature and non-normative retirement from sport. In the current study we analyzed the relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity while controlling for student-athletes’ year of eligibility and NCAA division. Three-hundred and twenty-five student-athletes (232 females; 88 males; 5 non-binary) participated in the study by completing a demographic survey, the Athletic Identity Measurement Scale, the Brief Resilience Scale, the Depression Anxiety Stress Scale-21, and the COVID-specific worries questionnaire, which were administered electronically through a Qualtrics survey link. A stepwise hierarchical regression analysis revealed that (a) being either a senior (β = -0.15, p = .03) or a junior (β = -0.12, p = .01) was associated with lower levels of athletic identity; and (b) higher psychological distress scores were positively related to athletic identity (β = 0.14, p = .01). A path analysis revealed that resilience predicted psychological distress (β = -0.159, p = .01), which in turn predicted both COVID worries (β = 0.43, p < .01) and athletic identity (β = 0.12, p = .03).

Oncology nurses’ assessment of providing equitable care for patients with developmental disabilities.

164 Background: Access to quality health care can be challenging, especially for people with developmental disabilities (PwDD). Developmental Disabilities (DD) occur before age 22 and include physical, learning, language, or behavioral impairments. Studies of training and experience of oncology nurses (RNs) who care for PwDD are limited. The purpose of this study was to explore to what extent RNs working in a community oncology practice are prepared to provide quality patient-centered care to patients with DD. Methods: As no tool exists to capture oncology RNs experiences caring for PwDD, a survey was developed with input from a group of oncology nurse experts. Both academic IRB and Privacy Board approvals were completed prior to recruitment. A Qualtrics survey link was shared with RNs and Advanced Practice RNs via email. Questions about nurses’ background, perceptions of clinic resources and accommodation and referral to clinical trials were included in the survey. Nurses were also presented with 3 scenarios of oncology patients who have either been blind since birth, have autism or cerebral palsy. RN respondents were asked how to care for them, what challenges might be encountered, and what resources would be available to them. Results: Usable surveys were completed by 122 RNs. 77 RNs cared for PwDD in a statewide Oncology practice, 81 RNs had previously cared for PwDD in any setting and 54 RNs have friends or family members with DD. Only 7 RNs reported no experience with PwDD. Seven nurses knew of PwDD who had participated in clinical trials. Themes identified through the qualitative analysis include Accommodations, Strategies, Communication and Referrals. Conclusions: This study provides an initial step in understanding how to reduce disparities for oncology patients with DD. Key elements revealed additional training needs, standardized facility accommodation needs, and advocacy for clinical trials participation. Through a team approach and engagement with patient advocacy groups, the challenge of engaging PwDD in clinical trials will be tackled. More training and resource education for RNs and staff regarding care of PwDD will be built and disseminated through a standardized process to bridge gaps to impact delivery of care.

Patient, Care Partner, and Physician Voices in Treatment Decision-Making for Multiple Myeloma.

Treatment decision-making for multiple myeloma (MM) is complex. Individuals involved in decision-making may value treatment attributes differently based on their role as a patient, care partner, or physician. This study describes those attributes, and what is most important by role. We conducted a cross-sectional online survey with consenting adult patients with MM, MM care partners, and physicians treating MM. Respondents were recruited from US panels (Inspire and M3 Global Research) between September and December 2022. Survey items were informed by a targeted literature review, qualitative interviews, and a steering committee comprising clinical experts, a patient advocate, patient, and care partner. Descriptive statistics were generated and reported in aggregate. Email invitations were sent to 8071 Inspire members interested in or posting about MM. Of these, 4427 viewed the invitation, 941 responded, and 156 patients and care partners completed the survey (17% of respondents). For physicians, 5588 were invited via Email by M3 Global Research, with 761 viewing the invitation, 214 accessing the survey link, and 137 completing the survey (64% of respondents). Duration of response, side effects, and patients' quality-of-life (QoL) were the top three treatment attributes selected across the three cohorts; alignment of these attributes was consistent among patients regardless of disease severity. Separately, patients rated QoL and the amount of caregiving needed during/after treatment as the most important factors for future treatment decisions. If more effective MM treatments were offered, care partners were more willing to assume greater family burden (77%) compared to patients (49%), and patients were more accepting of potential serious side effects (50%) than were care partners (34%). Patients with MM, care partners, and physicians consider and value various treatment decision-making factors. Recognizing and addressing these differences is critical to meeting patients' preferences, needs, and optimizing patient outcomes.

Prevalence of offering menopause hormone therapy among primary care doctors and its associated factors: A cross-sectional study.

Guidelines recommend Menopausal Hormone Therapy (MHT) as the most effective treatment for menopausal symptoms. However, a local study found that the usage of MHT among menopausal women was low (8.1%), with one of the main reasons being it is not recommended by doctors. Therefore, the objectives of this study are to determine the prevalence of offering MHT in treating symptomatic menopausal women among primary care doctors (PCDs) and its associated factors. This cross-sectional study involved PCDs from the Federal Territory of Kuala Lumpur, the Federal Territory of Putrajaya and the state of Selangor. All PCDs provided services in government primary care clinics from the three states were invited through the doctor in charge of each clinic. An online survey links was provided for the participants to the self-administered questionnaire. The questionnaire included PCDs' demographics, their menopause management practices, attitudes towards MHT, perceived barriers in offering MHT, knowledge of related guidelines and received training on menopause management. The outcome variable was offering MHT which defined as either prescription of MHT or referral to hospital for MHT initiation. Multivariate logistic regression analysis was performed to determine the factors associated with offering MHT. The response rate was 42.9% (559/1301). Of those who participated in the study, 77.8% of PCDs were female and 89.1% were medical officer. Although 66.9% of the participants reported offering MHT to their patients, the actual prescription rate was low (0.9%). Most PCDs (66%) would refer the patients to hospitals. 87.1% of PCDs (487/559) reported that MHT was not available in their clinic. In the past 12 months, 83% of PCDs had not received any related training. Female PCDs (AOR:2.5, CI: 1.51-4.13, p<0.001), perceiving MHT as preference treatment for menopause symptom (AOR:3.6, CI: 2.13-6.19, p < 0.001), having likelihood to recommend MHT to family and friends (AOR:3.0, CI: 1.87-4.83, p < 0.001), and receiving training on menopause management (AOR:2.7, CI: 1.30-5.56, p = 0.008) were the positive predictor of offering MHT. The negative predictors in offering MHT were no-experience in prescribing MHT (AOR: 0.4, CI: 0.15-0.87, p = 0.024) and lack of information regarding MHT for the patient (AOR: 0.4, CI:0.20-0.67, p < 0.001). The study revealed a low rate of MHT prescription among PCDs, with many relying on referrals to hospitals for managing menopausal symptoms. The findings underscore the need for strategies that includes fulfilling professional training gaps, improving MHT availability, and improving information dissemination for patient.

Are Turkish Midwifery Students Prepared for The Profession? Their Self-Confidence Levels and Associated Factors

Objective: To determine the self-confidence levels of midwifery students in line with the International Confederation of Midwives (ICM) competencies they are expected to possess before graduation and to explore effective factors. Materials and Methods: Descriptive and cross-sectional online survey design was used among quantitative research methods. The online survey link was spread through social media. In order to increase the response rate, the online survey links were posted every day. From March to June 2020, 763 midwifery students completed a survey on demographic characteristics and rated their confidence for essential midwifery skills listed by ICM. Results: Among the subscales, the highest average belonged to postpartum care (3.32 ± 0.66) and the lowest average to intrapartum care (2.94 ± 0.59). The students reported having less self-confidence in obstetrics emergencies, risky delivery, and neonatal care. The difference between descriptive characteristics and the ICM competencies subscales was found to be statistically significant (p

SQuID (subcutaneous insulin in diabetic ketoacidosis): Clinician acceptability.

We previously implemented the SQuID protocol (subcutaneous insulin in diabetic ketoacidosis [DKA]) demonstrating safe, effective treatment of low- to moderate-severity DKA in a non-intensive care unit setting. Since success and sustainability of interventions rely on staff buy-in, we assessed acceptability of SQuID among emergency department (ED) and inpatient clinicians. We conducted a cross-sectional study in an urban academic hospital (March 2023-November 2023), surveying ED nurses (RNs) and physicians (MDs) and floor RNs and MDs treating patients on SQuID via emailed survey links. Clinicians could only take the survey once. We used Sekhon's Theoretical Framework of Acceptability, validated for staff acceptability of a new intervention, assessing eight domains with 5-point Likert responses. Clinicians were asked about prior experience with SQuID, and we assessed ED MD and RN preference (SQuID vs. intravenous [IV] insulin). Surveys included free-text boxes for comments. We present descriptive statistics including proportions with 95% confidence interval and medians with interquartile ranges (IQRs) and conducted thematic analysis of free-text comments. Our overall response rate (107/133) was 80% (34/42 ED RNs, 13/16 floor RNs, 47/57 ED MDs, 13/17 floor MDs), with first-time users of SQuID ranging from 7.7% (hospitalist MDs) to 35.3% (ED RNs) of participants. ED clinicians preferred SQuID over IV insulin (67% vs. 12%, 21% no preference). Acceptability was high across all domains and clinician types (median 4, IQR 4-5). Overall percentage of positive responses (4s and 5s) across domains was 92% (ED RNs [89%], floor RNs [89%], ED MDs [97%], floor MDs [87%]). We identified several themes among participant comments. Acceptability was high across clinician types; 65% of ED clinicians preferred SQuID to IV insulin. Clinicians liked SQuID (affective attitude), found it easy to use (burden), were confident in its use (self-efficacy), felt that it improved outcomes (perceived effectiveness), found that it was fair to patients (ethicality), found that it made sense (intervention coherence), and found that it did not interfere with other activities (opportunity cost).