Attitude toward second opinions in Germany – a survey of the general population

Background Second medical opinions (SOs) can assist patients in making informed treatment decisions and improve the understanding of their diagnosis. In Germany, there are different approaches to obtain a structured SO procedure: SO programs by health insurers and SOs according to the SO Directive. Through a direct survey of the population, we aimed to assess how structured SOs should be provided to fulfil patients’ needs. Methods A stratified sample of 9990 adults (≥18 years) living in the federal states of Berlin and Brandenburg (Germany) were initially contacted by post in April and sent a reminder in May 2020. The survey results were analyzed descriptively. Results Among 1349 participants (response rate 14%), 56% were female and the median age was 58 years (interquartile range (IQR) 44–69). Participants wanted to be informed directly and personally about the possibility of obtaining an SO (89%; 1201/1349). They preferred to be informed by their physician (93%; 1249/1349). A majority of participants would consider it important to obtain an SO for oncological indications (78%; 1049/1349). Only a subset of the participants would seek an SO via their health insurer or via an online portal (43%; 577/1349 and 16%; 221/1349). A personally delivered SO was the preferred route of SO delivery, as 97% (1305/1349) would (tend to) consider this way of obtaining an SO. Participants were asked to imagine having moderate knee pain for years, resulting in a treatment recommendation for knee joint replacement. They were requested to rate potential qualification criteria for a physician providing the SO. The criteria rated to be most important were experience with the recommended diagnosis/treatment (criterion (very) important for 93%; 1257/1349) and knowledge of the current state of research (criterion (very) important for 86%; 1158/1349). Participants were willing to travel 60 min (median; IQR 60–120) and wait 4 weeks (median; IQR 2–4) for their SO in the hypothetical case of knee pain. Conclusion In general, SOs were viewed positively. We found that participants have clear preferences regarding SOs. We propose that these preferences should be taken into account in the future design and development of SO programs.

Prevalence of Musculoskeletal Disorders and Self-Reported Pain in Artisanal Fishermen from a Traditional Community in Todos-os-Santos Bay, Bahia, Brazil

Musculoskeletal disorders (MSDs) can be characterized from their occupational etiology and their occurrence; their chronicity generates negative repercussions for the health of workers, especially of artisanal fishing. To investigate the prevalence of generalized musculoskeletal disorders by body region and self-reported pain in a fishing population of northeastern Brazil, an epidemiological cross-sectional study was carried out in Santiago do Iguape, Bahia-Brazil, in 2017. The Brazilian version of the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the socio-demographic and labor conditions were applied to a random stratified sample of 248 artisanal fisheries. There were 170 female shellfish gatherers and 78 fishermen, with a mean age of 36.7 years (SD = 10.5 years) and 43.3 years (SD = 11.8 years), respectively. The beginning of the labor activity was initiated at approximately 11 years of age. The average weekly income varied from 17.64 USD to 29.10 USD. The prevalence of MSD independent of occupation occurred in at least one body region in 93.5% and the presence of musculoskeletal pain/discomfort over the last seven days in 95.2% of the fishing workers. The highest prevalence of MSD was found in shellfish gatherers in: lower back (86.4%), wrist and hand (73.5%), and upper back (66.8%). In relation to the presence of pain in the last year, the frequency of pain was greater in the fishermen compared to the shellfish gatherers. The generalized severity of the MSD in 93.5% of this community of fishermen is evident, with emphasis in the following regions: lower back, wrist and hand and upper back in both groups, with occurrence of pain in more than one body region at the same time.

Measuring Achievement, Affiliation, and Power Motives in Mobility Situations: Development of the Multi-Motive Grid Mobility

The current study introduces the Multi-Motive Grid Mobility (MMG-M) in an age-stratified sample (N = 206) that aims to disentangle six motive components – hope of success, hope of affiliation, hope of power, fear of failure, fear of rejection, and fear of power – in mobility-related and mobility-unrelated scenarios. Similar to the classical Multi-Motive Grid (MMG), we selected 14 picture scenarios representing seven mobility and seven non-mobility situations. The scenarios were combined with 12 statements from the MMG. Both the MMG-M and MMG were assessed to allow comparability between psychometric criteria. The results of confirmatory factor analyses yielded a good model fit for a six-factor solution with an additional mobility factor for the MMG-M. Internal consistency of the items was similar to the MMG. Lastly, we investigated associations between the motive components and mobility-related variables. We found that risk awareness was positively related to all fear components in both mobility and non-mobility scenarios. Most importantly, physical constraint was positively associated with fear of rejection and fear of power in mobility situations underlining the importance to create support systems to reduce these concerns in people’s everyday lives.

Delivering Higher Education in public Health Emergencies

With the general closure of universities and schools in Sierra Leone due to the COVID-19 pandemic, digital learning has become a credible alternative to maintain students in educational, training, and research links. The study responds to three primary questions: 1) What digital learning modalities have shown to be most effective for providing continuity in learning amid temporary or permanent school closures? 2) What digital learning modalities are promising for their use but evidence for their use evidence about them is still lacking? 3) What are the challenges and considerations when planning for and implementing digital learning? The study utilised qualitative research methods: interviews; focus group discussions; qualitative survey; and document reviewing. A stratified sample of 260 participants (161 male and 99 female) was randomly drawn from teachers, education officials and information technology experts. This paper provides snapshots of the different distance learning initiatives and program that have been implemented, including both the promises they offer.

Learning Algorithms of Sentiment Analysis

The uncritical application of automatic analysis techniques can be insidious. For this reason, the scientific community is very interested in the supervised approach. Can this be enough? This chapter aims to these issues by comparing three machine learning approaches to measuring the sentiment. The case study is the analysis of the sentiment expressed by the Italians on Twitter during the first post-lockdown day. To start the supervised model, it has been necessary to build a stratified sample of tweets by daily and classifying them manually. The model to be test provides for further analysis at the end of the process useful for comparing the three models: index will be built on the tweets processed with the aim of detecting the goodness of the results produced. The comparison of the three algorithms helps the authors to understand not only which is the best approach for the Italian language but tries to understand which strategy is to verify the quality of the data obtained.

Descriptive Epidemiology and Outcomes of Hospitalizations With Complicated Urinary Tract Infections in the United States, 2018

Background Hospitalizations with complicated urinary tract infection (cUTI) in the United States have increased. Though most often studied as a subset of cUTI, catheter-associated UTI (CAUTI) afflicts a different population of patients and carries outcomes distinct from non-CA cUTI (nCAcUTI). We examined the epidemiology and outcomes of hospitalizations in these groups. Methods We conducted a cross-sectional multicenter study within the 2018 National Inpatient Sample (NIS) database, a 20% stratified sample of discharges from US community hospitals, to explore characteristics and outcomes of patients discharged with a UTI diagnosis. We divided cUTI into mutually exclusive categories of nCAcUTI and CAUTI. We applied survey methods to develop national estimates. Results Among 2 837 385 discharges with a UTI code, 500 400 (17.6%, 19.8% principal diagnosis [PD]) were nCAcUTI and 126 120 (4.4%, 63.8% PD) were CAUTI. Though similar in age (CAUTI, 70.1 years; and nCAcUTI, 69.7 years), patients with nCAcUTI had lower comorbidity (mean Charlson, 4.3) than those with CAUTI (mean Charlson, 4.6). Median (interquartile range [IQR]) length of stay (LOS) was 5 (3–8) days in nCAcUTI and 5 (3–9) days in CAUTI. Overall median (IQR) hospital costs were similar in nCAcUTI ($9713 [$5923–$17 423]) and CAUTI ($9711 [$5969–$17 420]). Though low in both groups, hospital mortality was lower in nCAcUTI (2.8%) than in CAUTI (3.4%). Routine discharges home were higher in nCAcUTI (41.5%) than CAUTI (22.1%). Conclusions There are >626 000 hospital admissions with a cUTI, comprising ~1.8% of all annual admissions in the United States; 4/5 are nCAcUTI. Because CAUTI is frequently the reason for admission, preventive efforts are needed beyond the acute care setting.

Satisfaction of visually disabled users with California educational websites

BACKGROUND: College and university websites in the United States are legally required to meet accessibility standards to promote equal opportunity in education for blind and visually disabled students. Web Content Accessibility Guidelines are the recognized standard for website accessibility. OBJECTIVE: Determine how satisfied blind and visually disabled college and university students are with college and university websites in California, and whether compliance with Web Content Accessibility Guidelines is a good predictor of that satisfaction. METHODS: A random sample of websites from California colleges and universities was evaluated for accessibility compliance. A stratified sample of six websites was taken from the initial sample. Thirty blind or visually disabled students performed a prescribed series of tasks on each of the six websites, then answered a Likert-format survey regarding their satisfaction with each website. RESULTS: Sixty-three percent of websites did not meet the first priority accessibility criteria. Participant responses showed a majority were satisfied with websites, both compliant and non-compliant, and a strong correlation between satisfaction and accessibility compliance. CONCLUSIONS: Despite legal requirements, a majority or large minority of college and university websites in California do not meet accessibility guidelines, indicating a significant opportunity to improve the accessibility of those websites.

The Degree of Exercise of secondary school principals in the Kasbah Al-Mafraq district of administrative delegation in light of the Corona pandemic: درجة ممارسة مديري المدارس الثانوية في لواء قصبة المفرق للتفويض الإداري في ظل جائحة كورونا

This study aimed at revealing the programs of secondary school principals’ practice in the general beginning of delegation and administrative delegation in light of the general rule from their point of view. The researcher used the descriptive approach، and the beginning was represented by a questionnaire consisting of (30) ... distributed to a stratified sample of (74) principals and interested persons in the whole community in secondary schools in Kasbah Al-Mafraq District، and the most prominent results of the study in the stage of practicing secondary schools in Kasbah Al-Mafraq district for administrative delegation in light of the Corona pandemic، from their point of view، obtained an overall average (2.39 out of 3) with a high degree (high ) and at a level; The domain of delegation in the administrative domain got the highest average (2.48) then the educational domain with an average of (2.37)، both with a degree of delegation (high) in the domain، terms and responsibilities with an average of (2.33) (medium) and there were no statistically significant differences at the level of ( 0.05≥α) in 2014 was re-developed article.

Public Perceptions of Deer Management in Scotland

In Scotland, large deer populations are associated with negative ecological and socioeconomic impacts, such as damage to peatlands and forests, agricultural and commercial forestry losses, Lyme disease transmission, and road accidents. Increasing the annual deer cull might help address these negative impacts, but could be ethically controversial. A stratified sample of adults living in Scotland (n = 1,002) responded to our online questionnaire measuring perceptions of deer management, including the acceptability of increasing the deer cull if doing so would help achieve a variety of ecological and social objectives. Overall, respondents indicated that it would be acceptable to increase the deer cull if doing so would serve public interests by reducing negative impacts of deer, with deer welfare, environmental conservation, and public health and safety being the most relevant ethical considerations. Although rural and urban respondents reported significantly different experiences and perceptions of deer, their values (i.e., attitudes, beliefs, and policy preferences) regarding deer management were very similar. Understanding values of the general public, beyond vocal interest groups, can help inform decisions on contentious wildlife management issues.

Measurement Validation of Factors Influence SME Business Performance in Malaysia

Organizations are increasingly under pressure to shift their production methods from traditional to sustainable, reinforcing the requirement to monitor their sustainability performance. The slow performance growth of Malaysian manufacturing companies remains a concern. The goal of this research is to highlighted the measurement used in the Malaysian SME context. Data were collected using survey method. A survey method was employed to collect a total of 1,071 responses in SME firms using proportional stratified sample technique. Using statistical packages for the social sciences (SPSS) version 27, this research focused on data validity and reliability. Findings of factor analysis confirmed 3 factors for the ICT adoption variable, were formed while 1 factor for the innovation variable, 4 factors for the competitiveness variable and 1 factor for the business performance. Only 2 items were dropped due to the weak loadings. Meanwhile the reliability analysis also indicates all the constructs and dimensions achieve good reliability value at more than 0.8. This research demonstrates the measurement validity and reliability of the research variables were inconsistent due to culture setting. This research highlighted the measurement used in the Malaysian SME context. The findings of this research withdraw a conclusion that the validity and reliability of item and construct of this research is proficient and consistent with the previous studies.