Survey Responses Research Articles

Utilizing machine learning to predict participant response to follow-up health surveys in the Millennium Cohort Study

The Millennium Cohort Study is a longitudinal study which collects self-reported data from surveys to examine the long-term effects of military service. Participant nonresponse to follow-up surveys presents a potential threat to the validity and generalizability of study findings. In recent years, predictive analytics has emerged as a promising tool to identify predictors of nonresponse. Here, we develop a high-skill classifier using machine learning techniques to predict participant response to follow-up surveys of the Millennium Cohort Study. Six supervised algorithms were employed to predict response to the 2021 follow-up survey. Using latent class analysis (LCA), we classified participants based on historical survey response and compared prediction performance with and without this variable. Feature analysis was subsequently conducted on the best-performing model. Including the LCA variable in the machine learning analysis, all six algorithms performed comparably. Without the LCA variable, random forest outperformed the benchmark regression model, however overall prediction performance decreased. Feature analysis showed the LCA variable as the most important predictor. Our findings highlight the importance of historical response to improve prediction performance of participant response to follow-up surveys. Machine learning algorithms can be especially valuable when historical data are not available. Implementing these methods in longitudinal studies can enhance outreach efforts by strategically targeting participants, ultimately boosting survey response rates and mitigating nonresponse.

Predictors of Food Insecurity and Food Assistance Program Usage Among Puerto Ricans Before and During the COVID-19 Pandemic in Holyoke, Massachusetts.

Puerto Rican households often face elevated rates of food insecurity. Frequently, households experiencing food insecurity turn to federal and emergency nutrition assistance for urgent or prolonged aid. This study analyzes factors influencing food insecurity and food assistance program involvement among Puerto Ricans in Holyoke, Massachusetts, amidst the COVID-19 pandemic. Using a combination of community-based participatory recruitment, purposive sampling, and web-based tools, we collected 284 survey responses. Our paper employed Pearson's chi-square, logistic regression, and hierarchical linear models to assess relationships between demographic and household attributes and food access outcomes. Variables such as having children in the household and age significantly influenced food relief participation and food insecurity outcomes. Puerto Rican heritage and low educational attainment were strong predictors of obtaining federal food aid. Low-income participants disproportionately faced food shortages and depended on emergency food initiatives. Our findings indicate that demographic and household factors significantly influence food insecurity and accessibility. Our study demonstrates that the pandemic made it challenging for households to obtain consistent, safe, and affordable nourishment. The impacts were unequally spread; hence, Puerto Rican communities and low-income groups were most affected.

Effect of Virtual-Reality-Based Training on Emotions of Medical Students Undertaking Radiation Emergency Medicine: An Educational Experimental Study.

Integration of head-mounted virtual reality (VR) devices has been revolutionary in health professions education. In disaster preparedness training, VR simulation-based learning exposes health care professionals to the unique challenges of diverse scenarios, enhancing their adaptability. The aim of the study was to evaluate the effectiveness of a head-mounted VR tool for teaching basic radiation emergency medicine skills to medical students. The participants were 64 medical students (5th-year) who underwent a 3-hour training session in radiation emergency medicine that was conducted via head-mounted VR devices. Students scored their perceived emotion, performance, and self-efficacy at various time points in a self-reported online questionnaire. Comparison of survey responses before and after the session showed significant differences in terms of neutral emotion (P = 0.011), negative activating emotions (P < 0.001), and negative deactivating emotions (P = 0.004). The post-hoc test revealed statistically significant differences in negative activating emotions between before and during (P < 0.05), and between before and after (P < 0.05) the VR simulation. In addition, negative deactivation and neutral emotions changed significantly after the simulation. The use of head-mounted VR devices was effective in modulating medical students' emotions and contributed to improving their perceived performance in radiation emergency medicine.

Workers’ experiences of pregnancy loss: qualitative insights from a mixed-methods study

Abstract Background Pregnancy loss affects approximately one in four pregnancies. The workplace is an important context to consider in pregnancy loss experiences as most women of reproductive age are in paid employment. Currently in the Republic of Ireland (ROI) there are no statutory leave entitlements if a pregnancy ends &amp;lt;24 weeks. Given the lack of research in this area internationally, we aimed to explore workplace experiences of early pregnancy loss. Methods In 2023, we conducted an online mixed-methods survey study (Mar-Apr), followed by qualitative interviews (Jun-Sept). People who experienced a pregnancy loss &amp;lt;24 weeks-whilst working and living in ROI in the preceding five years-were eligible to participate. The survey was distributed through professional/social networks and contained quantitative and qualitative questions-addressing pregnancy loss, experiences of workplace supports, and desired supports. Survey participants were asked to indicate their willingness to participate in a follow-up interview and were purposively sampled. The interview topic guide focused on specific aspects of workplace experiences which required further exploration following preliminary analysis of survey responses. Qualitative data were analysed in NVivo using reflexive thematic analysis. Results Most survey participants (N = 913) were female (74%), employed full-time (86%) and experienced a first-trimester miscarriage (75%). We conducted interviews with 13 people, across a range of demographics. Three initial themes were identified: (1) Personal experiences of pregnancy loss and dealing with emotional and physical impacts at work; (2) Challenges with the social side of pregnancy loss-disclosure and workplace interactions; (3) Workplace supports (4) Public policy and awareness. Conclusions Our analysis highlights the need for statutory leave, appropriate workplace policies and procedures, and education and training to better support workers who experience pregnancy loss. Key messages • There is a gap between workers’ needs and workplace supports regarding pregnancy loss &amp;lt;24 weeks gestation. Statutory leave, workplace policies and procedures, and education and training, are needed. • There is a need to discuss pregnancy loss in workplaces and society, to raise awareness and reduce the stigma/taboo on the topic. Recognition from Government is crucial to promote this.

3.L. Round table: Outcomes from a public debate on the future health priorities of the European Union

Abstract Objective and background In the run up to the European elections, the European Observatory on Health Systems and Policies facilitated a public debate on the future health priorities of the European Union. The purpose of the debate was to provide insights to the European Commission on the views of stakeholders and the public health community with regards to the future of the European Health Union (EHU). The EHU was established as a comprehensive health systems and public health response to the COVID-19 pandemic, featuring enhanced budgets, expanded mandates for existing bodies, and the introduction of new entities like the Health Emergency Response Authority (HERA) alongside new strategies. Methods The methodology for this comprehensive debate included workshops and plenary sessions at various conferences like the 2023 EUPHA conference in Dublin, an interactive webinar series, and a detailed stakeholder survey featuring both closed and open-ended questions. Data was collected and analyzed using diverse qualitative and quantitative tools, including AI-driven analysis of survey responses. Preliminary outcomes Preliminary analysis shows that participants actively engaged in the debate, and mostly expressed support for the EHU’s achievements to date. There was a consensus on the significant value added by the EHU, with many advocating for stronger EU action on a range of discussion topics. Stakeholders and the public health community could also relate to the discussion framework designed to guide the public debate, which included nine topics: enhancing health security; addressing the determinants of health through Health in All Policies and Health for All Policies; supporting health system transformation; enhancing the labour market for health and care workers; achieving universal health coverage; implementing digital solutions and AI; improving the performance and resilience of health systems; addressing long-term challenges, such as population ageing or climate change; and strengthening the EU’s global voice and leadership. The importance placed on these topics varied among different groups. Young participants prioritized climate-related actions, the public health community emphasized addressing the determinants of health, and policymakers concentrated on issues related to health system resilience, universal coverage, and transformation. Digital solutions and AI were recognized as crucial, but they were typically considered integral and transversal to broader issues rather than standalone priorities. The debate also surfaced priorities not initially included in the discussion framework, such as health promotion, prevention, and equity within health systems, which were repeatedly highlighted. Key messages • The debate on the EU’s future health priorities demonstrates that stakeholders and the public health community acknowledge the value of the EHU and would like to see further action to build on it. • Stakeholders and the public health community have formulated concrete action to take the EHU further. Speakers/Panelists Giada Scarpetti TU Berlin, Berlin, Germany Caroline Costongs EuroHealthNet, Brussels, Belgium Isabel de La Mata DG SANTE, European Commission, Luxembourg, Luxembourg

Social Cohesion in Different Periods of the Pandemic: What Works in Reducing COVID-19 Mortality

Abstract Background Inconsistent results were reported regarding the effects of social cohesion dimensions on COVID-19 mortality rate (MR). Most studies have indicated that trust in civil services, but not participating in social activities, reduces COVID-19 MR, possibly because of the highly contagious nature of this disease. In this study, we investigated how the effects of various dimensions of social cohesion on COVID-19 MR vary across different phases of the pandemic. Methods This longitudinal study was conducted using data from 86 countries that participated in the 2017-2020 World Values Survey. The measures of social cohesion were identified by aggregating survey responses to the country level. COVID-19 MR was calculated-using data from the European Centre for Disease Prevention and Control-separately for three distinct periods during the pandemic (January 2021-June 2022). A factor analysis was conducted to identify the dimensions of social cohesion, and negative binomial regression models were constructed to analyze data for each period. Results The factor analysis revealed three dimensions of social cohesion: social participation and inclusion, health service equality, and trust in civil services and democracy. Our findings suggest that each dimension of social cohesion uniquely affected COVID-19 outcomes in different periods of the pandemic. Trust in civil services and a positive attitude toward democracy are strongly associated with a low COVID-19 MR. However, this association was observed only in the early and middle stages of the pandemic. By contrast, our study demonstrated that in the late stage of the pandemic, increased social participation and inclusion helped combat COVID-19. Conclusions This study underscores the importance of collective cohesion and solidarity in mobilizing public responses against pandemic situations. This study emphasizes that preventive or regulatory interventions should be tailored to different phases of a pandemic. Key messages • COVID-19 mortality rate was negatively associated with trust in civil services during the early two periods and with social participation and social inclusion during the late period of the pandemic. • This study emphasizes that preventive or regulatory interventions should be tailored to different phases of a pandemic.

The Impact of Artificial Intelligence Adoption Intensity on Corporate Sustainability Performance: The Moderated Mediation Effect of Organizational Change

With the rapid development of the economy and society, enterprises are increasingly prioritizing environmental and social sustainability alongside economic benefits. As a critical driver of technological innovation, the effective application of artificial intelligence (AI) to enhance corporate sustainability performance has garnered considerable attention from both academia and industry. This study explores the impact of AI adoption intensity on corporate sustainability performance, with a particular focus on the mediating role of organizational change and its moderated mediation effect. Employing an empirical analysis approach, this study collected 451 employee survey responses from manufacturing enterprises. The results indicate that AI adoption intensity substantially enhances corporate sustainability performance, reflected in comprehensive improvements in economic, environmental, and social benefits. Furthermore, organizational change serves as a crucial mediator between AI adoption and sustainability performance, with this mediation effect moderated by internal and external environmental factors. The study finds that enterprises with high digital capabilities and innovative cultures are more effective in leveraging AI to enhance sustainability performance. This suggests that in promoting AI applications, enterprises should not only focus on technology adoption but also emphasize internal organizational change and the development of digital capabilities to fully achieve sustainability goals. Through empirical analysis, this study provides an in-depth understanding of the application paths and mechanisms of AI in corporate sustainability, offering a theoretical foundation and practical guidance for corporate managers in strategy and policymaking.

Exposure to firearm injury and suicide in a rural Pennsylvania county: implications for mental and behavioral health.

To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457-6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115-1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.

Use and perceptions of involuntary civil commitment among post-overdose outreach staff in Massachusetts, United States: A mixed-methods study.

Involuntary civil commitment (ICC) is a legal process by which people are compulsorily admitted to substance use treatment. This study explored views about and promotion of ICC procedures for substance use disorders among public health-public safety post-overdose outreach programs and their outreach team members in Massachusetts, USA. In this mixed-methods study, survey data were collected from post-overdose outreach programs in 2019, and semi-structured interviews were conducted with outreach team members in 2019 and 2020. Massachusetts, USA. We received 138 survey responses and conducted 38 interviews with post-overdose outreach team members (law enforcement officers, recovery coaches, social workers and harm reductionists) who were majority male (57%) and white (66%). We used the survey instrument to categorize programs as more (discussed ICC at 50% or more of outreach encounters) or less ICC focused (discussed ICC at less than 50% of outreach encounters) and to identify program characteristics that corresponded with each categorization. Semi-structured interviews explored staff perceptions of ICC effectiveness. Among 138 programs, 36% (n = 50) discussed ICC at 50% or more of outreach encounters. Discussing ICC at a majority of visits was positively associated with abstinence-only program philosophies (36% v. 6%, P < 0.001) and collaborating with drug courts (60% v. 30%, P < 0.001), but negatively associated with naloxone distribution (48% v. 75%, P < 0.001) and referring to syringe service programs (26% v. 65%, P < 0.001). Qualitative interviews identified three themes: 1) some programs viewed ICC as a first line tool to engage overdose survivors in treatment; 2) other programs considered ICC a last resort, skeptical of its benefits and concerned about potential harms; 3) families commonly initiated discussions about ICC, reportedly out of desperation. Promotion of involuntary civil commitment (ICC) appears to vary widely across post-overdose outreach programs in Massachusetts, USA, with approaches ranging from seeing it as a first step to treatment to being a tool of last resort. Demand for ICC among family members may relate to inadequate access to voluntary treatment. Family interest in ICC appears to be driven by inadequate availability of treatment and other services. ICC at post-overdose outreach visits should be limited, if used at all.

The role of clinical exchange programs in postgraduate obgyn training: A case-study of the FIGO-WATOG One World Exchange.

To evaluate the role of clinical exchange programs in postgraduate obgyn training using the International Federation of Gynecology and Obstetrics (FIGO)-World Association of Trainees in Obstetrics and Gynecology (WATOG) One World Exchange (OWE), a clinical exchange program held in France in October 2023, as a case-study. This was a cross-sectional study. A 31-item structured questionnaire designed with Google Forms was electronically distributed to the 51 obgyn postgraduate trainees (OWE fellows) who participated in the OWE, to collect information about the exchange. Collected data was analyzed using IBM Statistical Product and Service Solutions (SPSS) Statistics for Windows. The survey response rate was 68.6%. The mean age of the respondents was 33.0 ± 4.0 years. Majority of the them were females (26, 74.3%), married (19, 54.3%), at least in their third year of training (30, 85.7%) and from Africa (11, 31.4%). During the period of the exchange program, fellows observed various obstetric and gynecologic procedures, including open and minimal access procedures, with more than one-fifth (8, 22.9%) of them reporting that they were allowed to assist in some of these procedures. The fellows noted salient differences in practice between their exchange hospitals and their home countries. An overwhelming majority (30, 85.7%) of the fellows believed the OWE was beneficial and would positively impact their clinical practices back in their home countries. Clinical exchange programs like the OWE provide valuable benefits in improving the clinical knowledge and skills of postgraduate obgyn trainees.

Occupational burnout in nuclear medicine technologists working in Australia and New Zealand - results of a multi-national survey.

Occupational burnout can be associated with negative feelings about the workplace and feeling that a person's efforts are of little consequence. Within a healthcare setting, occupational burnout can be attributed to a high workload or a non-supportive work environment. Higher levels of burnout are associated with increased absenteeism and turnover, increased medical errors and decreased patient care. The aim of this study was to investigate the levels of occupational burnout within nuclear medicine technologists (NMTs) working in Australia and New Zealand. An online questionnaire was distributed via QuestionPro. The questionnaire consisted of four sections, including the Professional Quality of Life Scale (ProQOL) Version 5 (2009) measuring compassion satisfaction, burnout and secondary traumatic stress in the workplace. For this study, only the burnout component of this scale is reported. There were 162 survey responses. Of the 18 New Zealand participants, 10 (56%) reported moderate levels of burnout. Of the 144 Australian participants, 114 (79%) reported moderate levels of burnout. No NMTs reported high levels of burnout. All states of Australia were represented in the survey, with Queensland, Western Australia and Victoria having the highest number of participants reporting moderate levels of burnout. This study revealed that more than half of New Zealand participants and three quarters of Australian participants reported moderate levels of burnout. It is imperative to address the wellbeing needs of NMTs working in Australia and New Zealand at an individual and organisational level to support NMTs to be more engaged in their work and help organisations retain staff.

Physicians’ attitudes toward gastroprotective strategies for nonsteroidal anti-inflammatory drug prescription

Introduction There is a paucity of information regarding providers’ attitudes toward gastric-protective strategies with concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to assess gastric-protective strategies used upon prescribing NSAIDs and providers’ awareness of societal guidelines for preventing NSAID-induced gastric complications. Methods A standardized 10-item questionnaire was sent to all orthopedic providers in North Carolina and South Carolina. The survey design and refinement were based on a literature review, item generation, and small and large focus group discussions. Results Forty-two orthopedists responded to the survey (response rate 16%). The most frequently used NSAIDs were meloxicam (79%), naproxen (69%), and ibuprofen (64%). NSAIDs were most commonly prescribed on an as-needed basis (52%), followed by <3 months (43%). The most common indications were degenerative arthritis (95%) and herniated disk (45%). Gastrointestinal adverse effects of NSAIDs were managed by discontinuing NSAID therapy (73%) or switching to a cyclooxygenase-2 (COX-2) inhibitor (40%). A small proportion were managed by referring to another physician (36%). Some clinicians prescribed gastric prophylaxis for patients at high risk for NSAID-induced gastric complications (24%). The academic setting was significantly associated with gastric prophylaxis and frequent assessment for NSAID-induced gastric adverse events. Providers with >20 years of experience showed similar trends. In low-risk patients, compliance with gastroprotective prophylaxis prescription was low (5%). Most providers were unaware of the societal guidelines for NSAID-induced gastric complications or the preventive strategies. Conclusion Prescription of gastric-protective medications with concurrent NSAID therapy is relatively low among orthopedists. Academic setting and higher years of experience showed a significant trend toward more gastric-protective medication prescription, COX-2 inhibitor use, and frequent assessments for gastric adverse events when prescribing NSAID therapy. Provider education on the latest societal guidelines and computer-based alerts can increase compliance and assessment for NSAID-induced gastric complications and preventive strategies.

How does gamification affect learning effectiveness? The mediating roles of engagement, satisfaction, and intrinsic motivation

ABSTRACT Academic institutions have implemented methods to enhance student engagement, increase satisfaction levels, and maximize the efficacy of the learning process. Gamification has been increasingly used in education to enhance the efficacy of student learning, in contrast to traditional teaching methods. This study quantitatively examines the impact of gamification on learning efficacy by assessing variables such as engagement, satisfaction, and intrinsic motivation based on data from 255 survey responses by undergraduate and graduate students enrolled in Vietnamese institutions. Participants had prior experience with gamified instructional methods. The findings indicate that individuals’ level of enjoyment and challenges impacted the effectiveness of their learning through the mediating processes of engagement, satisfaction, and intrinsic motivation. This study offers valuable insights for educational institutions, schools, teachers, and other scholars examining the impacts of intrinsic motivation, satisfaction, and engagement on learning effectiveness within the educational setting of gamification.

Going back to anatomy roots: Exploring the integration of anatomy sessions during clinical clerkships.

The topic of vertical integration of the basic and clinical sciences is an area of great concern and active investigation in medical education. To explore the feasibility of integrating basic sciences into the clinical phase of medical education, gross anatomy was selected as an appropriate discipline. Anatomy faculty, clerkship directors, medical students, and graduate students developed case-based anatomy modules with a design consistent with the principles of self-directed learning. This pilot study aimed to explore medical student responses to the integration of anatomy sessions during clinical clerkships. One-hour anatomy sessions were conducted during rotations of the following clerkships: internal medicine, pediatrics, family medicine, neurology, obstetrics and gynecology, and general surgery during the academic year 2022-2023. Each session consisted of four case-based stations. Voluntary, anonymous surveys were distributed at the end of each session. Descriptive statistics of survey responses from the 490 participants revealed the overall ratings of the anatomy sessions to be above an 8.50 on a scale of 1.00 (low) to 9.00 (high). A small q thematic analysis of the open-ended survey questions revealed the following themes: relevance of clinical correlations presented, a timely review of anatomical content, appreciation for the collaborative setting and interactivity among the participants, and constructive feedback regarding areas needing improvement. Students reported a high overall rating of the anatomy sessions and shared positive comments about these vertically integrated anatomy experiences. With a reduction in the amount of anatomy instruction during the pre-clinical years and limited exposure during the clinical years, anatomy sessions like the ones proposed could allow for the fluid incorporation of gross anatomy across all 4 years of medical school.

Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes

ObjectivesTo determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent...

Association of deployment characteristics and exposures with persistent ill health among 1990-1991 Gulf War veterans in the VA Million Veteran Program

BackgroundVeterans of the 1990–1991 Gulf War have experienced excess health problems, most prominently the multisymptom condition Gulf War illness (GWI). The Department of Veterans Affairs (VA) Cooperative Studies Program #2006 “Genomics of Gulf War Illness in Veterans” project was established to address important questions concerning pathobiological and genetic aspects of GWI. The current study evaluated patterns of chronic ill health/GWI in the VA Million Veteran Program (MVP) Gulf War veteran cohort in relation to wartime exposures and key features of deployment, 27–30 years after Gulf War service.MethodsMVP participants who served in the 1990–1991 Gulf War completed the MVP Gulf War Era Survey in 2018–2020. Survey responses provided detailed information on veterans’ health, Gulf War exposures, and deployment time periods and locations. Analyses determined associations of three defined GWI/ill health outcomes with Gulf War deployment characteristics and exposures.ResultsThe final cohort included 14,103 veterans; demographic and military characteristics of the sample were similar to the full population of U.S. 1990–1991 Gulf War veterans. Overall, a substantial number of veterans experienced chronic ill health, as indicated by three defined outcomes: 49% reported their health as fair or poor, 31% met Centers for Disease Control and Prevention criteria for severe GWI, and 20% had been diagnosed with GWI by a healthcare provider. Health outcomes varied consistently with veterans’ demographic and military characteristics, and with exposures during deployment. All outcomes were most prevalent among youngest veterans (< 50 years), Army and Marine Corps veterans, enlisted personnel (vs. officers), veterans located in Iraq and/or Kuwait for at least 7 days, and veterans who remained in theater from January/February 1991 through the summer of 1991. In multivariable models, GWI/ill health was most strongly associated with three exposures: chemical/biological warfare agents, taking pyridostigmine bromide pills, and use of skin pesticides.ConclusionsResults from this large cohort indicate that GWI/chronic ill health continues to affect a large proportion of Gulf War veterans in patterns associated with 1990-1991 Gulf War deployment and exposures. Findings establish a foundation for comprehensive evaluation of genetic factors and deployment exposures in relation to GWI risk and pathobiology.

Impact of a National Virtual Oncology Course on Medical Student Competency and Interest in Oncology.

Globally, surveys have identified that medical learners of all levels perceive their oncology instruction to be inadequate. To address these gaps, we systematically developed and implemented the Oncology National Course for Advocacy, Research, and Education (ONCARE), a novel, nationally organized virtual course available to all Canadian medical students and evaluated its impact on oncology competency and interest. ONCARE was designed utilizing Kern's Six-Step Model for Curriculum Development. Components of ONCARE included lectures, career panels, and a mentorship program. Pre-course and post-course survey responses were collected to determine course impact on oncology knowledge and interest. Between October 2023 and March 2024, ONCARE enrolled 235 students representing 14 Canadian medical schools. One hundred forty (60%) students enrolled reported having only 0 to 10h of formal oncology instruction. Baseline interest in a career in oncology was high (mean Likert score 3.9/5) and remained unchanged following course completion. ONCARE increased both self-perceived knowledge in clinical oncology (mean Likert score 3.9/5 vs 2.9/5, p < 0.001) and confidence in oncology communication skills (mean Likert score 3.6/5 vs 3.1/5, p < 0.001). Ninety-seven percent of students were satisfied with the course (mean Likert score 4.6/5). The implementation of ONCARE as a proof-of-concept initiative builds upon previous educational interventions in oncology and highlights important principles for the development of related initiatives. Future work will target greater interdisciplinary and multinational collaboration as well as long-term follow-up of the ONCARE cohort.

Monetary Incentives in Clinician Surveys: An Analysis and Systematic Review With a Focus on Establishing Best Practices.

Surveys involving health care providers continue to be characterized by low and declining response rates (RRs), and researchers have utilized various strategies to increase survey participation. An important approach is to employ monetary incentives to improve survey response. Using a systematic review and analyses of 100 randomized comparisons (published in 48 papers) between monetary incentives and a non-incentive condition, this paper seeks to advance the understanding of best practices for using monetary incentives in clinician surveys. These analyses show even small incentives (≤$2) to be effective in improving clinician response relative to non-incentive subgroups, with diminished returns associated with serial incremental increases above that amount up to amounts greater than $25, at which point there is an appreciable improvement, supporting the use of higher incentives in this population. Cash and direct cash equivalents (e.g., cash cards and checks) produced greater odds of survey participation compared to vouchers, lotteries and charitable contributions, with lotteries and charities being the least effective forms of monetary incentive. Survey mode, timing and ethical considerations are also addressed. Noting the challenges associated with surveying clinicians, researchers must make every effort to improve access to this difficult-to-reach population by implementing appropriate incentive-based strategies designed to improve participation rates.

Second Language Listeners’ Emotion and Eye Gaze: A Web-Based Eye-Tracking Study

ABSTRACT While previous studies have shown that L2 listeners tend to focus more on videos with additional information, like presentation slides, the amount of eye gaze did not necessarily translate to higher listening test scores . Unlike previous research focusing on the benefits of additional visual cues, this study explores how emotions impact L2 listeners’ viewing behavior. Sixty-four adults completed the Foreign Language Listening Anxiety Scale (FLLAS), watched three academic lectures with their eye movements tracked, and answered comprehension questions. According to the results, listening anxiety was not a significant predictor of viewing videos. The relationship between viewing time and comprehension scores was non-significant. Interviews and survey responses highlighted diverse attitudes toward the videos. The findings suggest that individual differences in listening anxiety may not significantly influence how much participants look at the videos. Furthermore, adding context videos to listening tests to increase authenticity does not seem to affect comprehension scores, consistent with previous studies. The implications for developing video-based listening tests are discussed.

Affective Engagement with Metaphor in Introductory Statistics Education

Metaphor is a popular pedagogical tool to help learners understand unfamiliar concepts, but its affective and interactional qualities remain underexplored compared to its cognitive benefits. This study investigates how metaphor may enhance affective engagement within introductory statistics education for linguistics students. As previous research tends to rely on delayed and self-reported data, this study employs a mixed-methods approach that combines real-time physiological measures of engagement with feedback through surveys and interviews. It compares metaphorical and literal instructional styles for teaching simple linear regression, focusing on: i) differences in teacher and learner skin conductance levels, ii) teacher-learner synchrony through skin conductance concordance, iii) the relationship between physiological measures and affect-related survey responses, and iv) learner reflections on their experiences. Results show that the metaphorical style is associated with higher engagement levels and stronger teacher-learner synchrony, affirming the role of metaphors in enhancing collaborative learning when elaborated over time in spontaneous interactive fashion. However, the qualitative data reveal nuanced learner perceptions, highlighting the importance of clearly communicating the scope of metaphor use. This study contributes to understanding the interplay between affective and cognitive engagement in metaphorical learning, offering practical recommendations for its effective implementation in complex subjects like statistics.