scholarly journals Caffeine Consumption Among Orthopedic Residents Is Higher Than the General Population

2021 ◽  
Vol 4 (1) ◽  
Keyword(s):  
General Population ◽  
Orthopedic Surgery ◽  
The United States ◽  
Multiple Choice Questions ◽  
Caffeine Consumption ◽  
Level Of Evidence ◽  
Electronic Survey ◽  
Program Coordinators ◽  
Significant Relationships ◽  
High Doses

Background: Orthopaedic surgery residency can be quite demanding at times and leads many residents to consume stimulants, caffeine, to perform their work duties. Question/Purpose: The purpose of this study was to evaluate caffeine consumption among orthopedic surgery residents. We hypothesized that compared to the general population, residents will consume more caffeine. Patients/Methods: An electronic survey consisting of 13 multiple-choice questions was created to query residents on their caffeine consumption. The survey link was e-mailed to all residency program coordinators in the United States who then forwarded the survey to their residents. A subgroup analysis was performed based on respondents’ post-graduate year (PGY), to identify variations in caffeine use. Results: We received 209 surveys which represents 5.4% of orthopedic residents in the country. Of those 209 residents, 189 (90.4%) indicated regular caffeine usage. Of those who consume caffeine 59.8% indicated that they need caffeine to perform their work while 64.6% indicated that they are dependent on caffeine. Nearly one-fourth (24.3%) of respondents indicated that they consume more than 400 mg of caffeine/day. There were no significant relationships across resident PGY groups. Conclusion: We have demonstrated a large proportion of orthopedic surgery residents consume caffeine. When used in moderation, caffeine can be beneficial by improving efficiency, alertness and memory however, in high doses it may have undesirable side effects. Level of Evidence: Level IV evidence

scholarly journals Caffeine Consumption Among Orthopedic Residents is Higher Than the General Population

2021 ◽  
Author(s):  
Christopher Garrett ◽  
Mohammed Kareem Shaath ◽  
Frank Avilucea
Keyword(s):  
General Population ◽  
Orthopedic Surgery ◽  
The United States ◽  
Multiple Choice Questions ◽  
Caffeine Consumption ◽  
Level Of Evidence ◽  
Electronic Survey ◽  
Program Coordinators ◽  
Significant Relationships ◽  
High Doses

Abstract Background:Orthopaedic surgery residency can be quite demanding at times and leads many residents to consume stimulants, caffeine, to perform their work duties. Question/Purpose:The purpose of this study was to evaluate caffeine consumption among orthopedic surgery residents. We hypothesized that compared to the general population, residents will consume more caffeine.Patients/Methods:An electronic survey consisting of 13 multiple-choice questions was created to query residents on their caffeine consumption. The survey link was e-mailed to all residency program coordinators in the United States who then forwarded the survey to their residents. A subgroup analysis was performed based on respondents’ post-graduate year (PGY), to identify variations in caffeine use.Results:We received 209 surveys which represents 5.4% of orthopedic residents in the country. Of those 209 residents, 189 (90.4%) indicated regular caffeine usage. Of those who consume caffeine 59.8% indicated that they need caffeine to perform their work while 64.6% indicated that they are dependent on caffeine. Nearly one-fourth (24.3%) of respondents indicated that they consume more than 400 mg of caffeine/day. There were no significant relationships across resident PGY groups.Conclusion:We have demonstrated a large proportion of orthopedic surgery residents consume caffeine. When used in moderation, caffeine can be beneficial by improving efficiency, alertness and memory however, in high doses it may have undesirable side effects.Level of Evidence:Level IV evidence

Misinterpretation of online surgical outcomes: The British Association of Urological Surgeons Surgical Outcomes Audit

2018 ◽  
Vol 12 (3) ◽  
pp. 205-210
Author(s):  
Niranjan J Sathianathen ◽  
Jacob Albersheim-Carter ◽  
Lucas Labine ◽  
Brett Watson ◽  
Badrinath R Konety ◽  
...  
Keyword(s):  
General Population ◽  
Confidence Interval ◽  
Complication Rate ◽  
Surgical Outcomes ◽  
Odds Ratio ◽  
British Association ◽  
Healthcare Decision ◽  
Level Of Evidence ◽  
Electronic Survey ◽  
Primary Output

Objective: The purpose of this study was to evaluate whether the information presented in the British Association of Urological Surgeons Surgical Outcomes Audit is comprehended by the general population. Methods: An in-person electronic survey was administered at the local state fair in 2016. Participants were presented with an representative output from the British Association of Urological Surgeons Surgical Outcomes Audit and were asked to estimate the complication rate and make a hypothetical healthcare decision. The primary output depicted a complication rate of 6.7% which was above the 99th percentile. The degree of misinterpretation and the risk of making an inappropriate healthcare decision was evaluated. Results: Of the 350 completed responses, only 142 (40.6%) correctly estimated the surgeons’ complication rate. Individuals who were not college educated (odds ratio 3.02, 95% confidence interval 1.88–4.95) were more likely to misinterpret the information. Only 7.6% recognized that the surgeon’s complication rate was above the 99th percentile. Despite the high complication rate, 16.6% decided to continue with the surgery as planned and not ask the surgeon about their rates, seek a second opinion or change surgeons. Misinterpreters had a higher risk of making an inappropriate hypothetical decision (odds ratio 2.75, 95% confidence interval 1.42–5.62). Conclusion: The general population have difficulty in interpreting the data presented by The British Association of Urological Surgeons Surgical Outcomes Audit and are thus vulnerable to making poor healthcare decisions or decisions which are inconsistent with their goals of care. Level of evidence: IIb

Speech-Language Pathologists' Perceptions of Their Preparation and Confidence for Providing Dysphagia Services

2020 ◽  
Vol 5 (6) ◽  
pp. 1666-1682
Author(s):  
Lena G. Caesar ◽  
Merertu Kitila
Keyword(s):  
Service Delivery ◽  
Graduate School ◽  
Online Survey ◽  
The United States ◽  
Academic Preparation ◽  
Speech Language Pathologists ◽  
Confidence Levels ◽  
Graduate School Preparation ◽  
Graduate Preparation ◽  
Significant Relationships

Purpose The purpose of this study was to investigate the perceptions of speech-language pathologists (SLPs) regarding their academic preparation and current confidence levels for providing dysphagia services, and the relationship between their perceptions of graduate school preparation and their current levels of confidence. Method This study utilized an online survey to gather information from 374 American Speech-Language-Hearing Association–certified SLPs who currently provide dysphagia services in the United States. Surveys were primarily distributed through American Speech-Language-Hearing Association Special Interest Group forums and Facebook groups. The anonymous survey gathered information regarding SLPs' perceptions of academic preparation and current confidence levels for providing dysphagia services in 11 knowledge and skill areas. Results Findings indicated that more than half of respondents did not feel prepared following their graduate academic training in five of the 11 knowledge and skill areas related to dysphagia service delivery. However, about half of respondents indicated they were currently confident about their ability to provide services in eight of the 11 knowledge and skill areas. Findings also indicated that their current confidence levels to provide dysphagia services were significantly higher than their perceptions of preparation immediately following graduate school. However, no significant relationships were found between respondents' self-reported current confidence levels and their perceptions of the adequacy of their academic preparation. Conclusions Despite SLPs' low perceptions of the adequacy of their graduate preparation for providing dysphagia services in specific knowledge and skill areas immediately following graduation, they reported high confidence levels with respect to their actual service delivery. Implications of these findings are discussed.

scholarly journals Mathematical pattern of Kessler psychological distress distribution in the general population of the U.S. and Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shinichiro Tomitaka ◽  
Toshiaki A. Furukawa
Keyword(s):  
United States ◽  
General Population ◽  
National Survey ◽  
Goodness Of Fit ◽  
Quadratic Function ◽  
The United States ◽  
Depression Screening ◽  
Distribution Model ◽  
Epidemiological Surveys ◽  
Screening Scale

Abstract Background Although the 6-item Kessler psychological scale (K6) is a useful depression screening scale in clinical settings and epidemiological surveys, little is known about the distribution model of the K6 score in the general population. Using four major national survey datasets from the United States and Japan, we explored the mathematical pattern of the K6 distributions in the general population. Methods We analyzed four datasets from the National Health Interview Survey, the National Survey on Drug Use and Health, and the Behavioral Risk Factor Surveillance System in the United States, and the Comprehensive Survey of Living Conditions in Japan. We compared the goodness of fit between three models: exponential, power law, and quadratic function models. Graphical and regression analyses were employed to investigate the mathematical patterns of the K6 distributions. Results The exponential function had the best fit among the three models. The K6 distributions exhibited an exponential pattern, except for the lower end of the distribution across the four surveys. The rate parameter of the K6 distributions was similar across all surveys. Conclusions Our results suggest that, regardless of different sample populations and methodologies, the K6 scores exhibit a common mathematical distribution in the general population. Our findings will contribute to the development of the distribution model for such a depression screening scale.

Manual Therapy in Preadolescent Children: A Delphi Investigation of Physical Therapists in the United States

2021 ◽  
Author(s):  
Jenifer L Dice ◽  
Doug Dendy ◽  
Phillip S Sizer ◽  
Chad E Cook ◽  
Sara Feuling ◽  
...  
Keyword(s):  
United States ◽  
Manual Therapy ◽  
Physical Therapists ◽  
Initial Step ◽  
The United States ◽  
Group Differences ◽  
Electronic Survey ◽  
Craniosacral Therapy ◽  
Barriers To Use ◽  
Composite Scores

ABSTRACT Objective Limited research has investigated the use of manual therapy to treat the preadolescent (0–12 years of age) population with musculoskeletal and neurological impairments. The purpose of this study was to identify the following among physical therapists holding advanced credentials in pediatrics, neurodevelopmental treatment, or manual therapy: (1) consensus regarding effective techniques in the preadolescent population, (2) differences in opinion, and (3) perceived decision-making barriers and factors regarding use of manual therapy techniques. Methods Credentialed physical therapists in the United States were recruited for a 3-round Delphi investigation. An electronic survey in Round 1 identified musculoskeletal and neurological impairments and the manual techniques considered effective to treat such conditions, in addition to factors and barriers. Responses were used to create the second round, during which a 4-point Likert scale was used to score each survey item. A third round of scoring established consensus. Descriptive statistics and composite scores were calculated for each manual technique by impairment. Between-group differences were calculated using Mann–Whitney U with Bonferroni correction. Results Consensus was determined for several concepts. First, neuromuscular techniques were considered effective across all impairments, and joint mobilizations (grades I-IV) were believed to be effective to treat joint and muscle and myofascial impairments. Second, visceral manipulation and craniosacral therapy were considered ineffective in treating most impairments. There was lack of consensus and clear differences of opinion regarding the use of grade V mobilizations and dry needling. Significant barriers to use of manual therapy were: lack of knowledge, lack of evidence, and fear of litigation and harming patients. Conclusion This study is an initial step for developing manual therapy guidelines, research, and educational opportunities regarding manual therapy in pediatric physical therapy.

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States

2021 ◽  
pp. 194173812110129
Author(s):  
Kevin K. Chen ◽  
Jimmy J. Chan ◽  
William Ranson ◽  
Nicholas Debellis ◽  
Hsin-Hui Huang ◽  
...  
Keyword(s):  
Large Scale ◽  
Injury Rate ◽  
Collegiate Athletes ◽  
The United States ◽  
Extensor Mechanism ◽  
Surveillance Program ◽  
Level Of Evidence ◽  
Severe Injuries ◽  
Male Athletes ◽  
Collegiate Level

Background: Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. Results: A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women’s soccer (IR = 2.59), women’s field hockey (IR = 2.15), and women’s cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Conclusion: Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Clinical Relevance: Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.

scholarly journals Enabling patient-reported outcome measures in clinical trials, exemplified by cardiovascular trials

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Theresa M. Coles ◽  
Adrian F. Hernandez ◽  
Bryce B. Reeve ◽  
Karon Cook ◽  
Michael C. Edwards ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Outcome Measures ◽  
Contextual Factors ◽  
The United States ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Think Tank ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Evidentiary Standards

Abstract Objectives There has been limited success in achieving integration of patient-reported outcomes (PROs) in clinical trials. We describe how stakeholders envision a solution to this challenge. Methods Stakeholders from academia, industry, non-profits, insurers, clinicians, and the Food and Drug Administration convened at a Think Tank meeting funded by the Duke Clinical Research Institute to discuss the challenges of incorporating PROs into clinical trials and how to address those challenges. Using examples from cardiovascular trials, this article describes a potential path forward with a focus on applications in the United States. Results Think Tank members identified one key challenge: a common understanding of the level of evidence that is necessary to support patient-reported outcome measures (PROMs) in trials. Think Tank participants discussed the possibility of creating general evidentiary standards depending upon contextual factors, but such guidelines could not be feasibly developed because many contextual factors are at play. The attendees posited that a more informative approach to PROM evidentiary standards would be to develop validity arguments akin to courtroom briefs, which would emphasize a compelling rationale (interpretation/use argument) to support a PROM within a specific context. Participants envisioned a future in which validity arguments would be publicly available via a repository, which would be indexed by contextual factors, clinical populations, and types of claims. Conclusions A publicly available repository would help stakeholders better understand what a community believes constitutes compelling support for a specific PROM in a trial. Our proposed strategy is expected to facilitate the incorporation of PROMs into cardiovascular clinical trials and trials in general.

scholarly journals Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

2021 ◽  
Vol 5 ◽  
pp. 239920262110056
Author(s):  
John B Hertig ◽  
Shannon M James ◽  
Connor J Hummel ◽  
Matthew J Rubin
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Access To Medicines ◽  
The United States ◽  
Pharmacy Education ◽  
Electronic Survey ◽  
Medication Therapy ◽  
Online Pharmacies ◽  
Effective Medication ◽  
Selection Of

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

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