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Background A psychologically safe environment is defined as one where individuals feel comfortable to take risks without fear of negative consequences. When an individual feels psychologically safe in simulation, they are more likely to engage in the experience and reflect on their own and others’ performance. Despite this, little is known about what creates this type of environment from the learner perspective. Methods A qualitative descriptive study was conducted to explore prelicensure nursing students’ perceptions of psychological safety as it exists within the prebrief, scenario, and debrief phases of a simulation learning experience. Data were collected using a series of open-ended questions through an online survey tool. Three researchers independently, then collaboratively, reviewed the data, identifying themes and patterns across each phase. Results Eighty-six prelicensure nursing students completed the online survey. Across the three phases, five themes emerged: (1) faculty presence; (2) learning without fear; (3) working together; (4) setting expectations; and (5) positive conversations. Conclusions Our findings support much of the current literature on psychological safety in simulation but also highlight unique findings, including bullying, learner control and not being rushed.

Background Antimicrobial stewardship (AMS) requires a multidisciplinary approach to address the global emergence of antimicrobial resistance (AMR). Nurses have potential roles to influence appropriate antibiotic use. Objective The objective of the study was to investigate knowledge of registered nurses (RNs) on antibiotics, AMR and their understanding of AMS. Design A cross-sectional survey design was used. Participants and Setting Participants were RNs from the greater Auckland region of New Zealand. Methods Qualtrics (Provo, Utah, USA), an online survey tool was used to collect data for a three-month period. Descriptive and inferential data was analysed using IBM® SPSS® Statistics version 23. Statistical significance was established at P ≤ 0.05. Results Two hundred and ninety-eight (N = 298) respondents completed the survey. The majority rated having ‘average’ knowledge of antibiotics and generally of AMR. Lack of knowledge about AMS (211/298, 71%) was viewed as the most challenging factor in integrating AMS in clinical practice. The majority (251/298, 84%) were unaware of AMS programme being implemented in the workplace despite its presence in major district health boards in Auckland. Educating patients on safe antibiotic use (292/298, 98%) and ensuring that antibiotics are initiated and administered at the correct time (289/298, 97%) were highly viewed as fundamental nursing roles as antimicrobial stewards. Younger nurses had higher expectations for antibiotics to be prescribed by their doctor for the common cold or flu than older nurses (means 2.19/5 and 1.75/5, P = 0.001). Expectations to receive antibiotics for these viral illnesses was also higher among less experienced than the more experienced RNs (means 2.21/5 and 1.64/5, P Conclusion Nurses play an essential role in promoting AMS practices. However, a good understanding of antibiotics, AMR and AMS is needed to effectively embed these concepts in clinical practice. Hence, addressing these educational needs is of paramount importance.

Introduction Globally, cervical cancer is the 4th most common cancer and is one of the leading cancers causing death in India. Cervical cancer is one of those cancers which can be easily prevented by screening women who are aged above 30 years and by vaccinating young girls against HPV. Lack of awareness about cervical cancer makes early detection and timely screening difficult. Awareness about cervical cancer among people will help us to decide on an appropriate model of behavior change communication to control the disease. Objectives 1.To assess the awareness about cervical cancer among women residing in urban slums. 2.To find the association between awareness and socio-demographic profiles of women. 3.To assess the awareness about HPV vaccination and screening. Methodology The cross-sectional study was carried out from October to November of 2018 in the urban slums of Mysuru city. Arbitrarily 5 registered slum areas were selected. 211 consenting participants were enrolled in the study. The Cervical Cancer Awareness Measure (CAM) was used as the survey tool for interviewing women. Results Among 211 women, 26.1% were aware of cervical cancer. Among those who were aware, 9.1% had good knowledge, 27.30% had average knowledge about cervical cancer and 63.60% had poor knowledge about cervical cancer. Chi-square test showed an association between age category, education level and awareness to be statistically significant at a p-value of

Background Studies that examine the perceptions and behaviors of patients regarding patient hand hygiene rarely examine the viewpoint of patients about their hand hygiene behavior relative to current resources provided in the hospital. Methods Voluntary interviews that employed a 16-item survey tool were used among patients (N = 107) in outpatient clinics at post-admission visits. The survey was created using the Behavior Change Wheel, Capability, Opportunity, Motivation Behavior model. Patients were asked whether they brought hand sanitizer to the hospital, used hospital resources to clean their hands, and their perspective on patient hand hygiene importance compared with hospital staff, as well as their satisfaction or lack of satisfaction with hand hygiene independence. Results Most of the participants (65, 60.7%) reported that prior to being admitted to the hospital, they were able to maintain cleaning their hands with little or no difficulty. During their admission, only 21 (19.6%) of the participants reported needing little or no assistance. More than one-half of the participants, 34 (31.8%) and 23 (21.5%), respectively, reported, mostly or completely agreeing that the hand hygiene of the health care staff was more important than their own. Close to one-half of the participants (50, 46.7%) reported not being satisfied at all with their ability to maintain their hand hygiene in the hospital, whereas only 10 (9.3%) were very satisfied with their ability to maintain hand hygiene. Conclusions Findings from this study will enhance our understanding of how to incorporate inpatient hand hygiene into existing infection control programs in inpatient settings.

Study Design This is a cross-sectional survey research. Introduction Current evidence provides efficacy of graded motor imagery (GMI) in chronic pain conditions but also reveals barriers to its implementation. Purpose of the Study The purpose of this study was to describe current utilization of GMI in hand therapy practice. Methods Survey tool, informed by literature and Revised Neurophysiology of Pain Questionnaire (NPQ) was electronically distributed to members of the American Society of Hand Therapists. Results 132 therapists completed the survey. 65.2% reported they would always or very likely use GMI in clients with central sensitization, but no relationship between the likelihood of therapists using GMI to score achieved on the NPQ was found. Lack of patient buy-in, was the main barrier cited. “Sell it well” with pain neuroscience education the most cited strategy. Discussion GMI is frequently used in clients with central sensitization but requires client buy-in. Conclusions Understanding and explaining pain mechanism is essential for implementing GMI.

Purpose: There is a recognized shortage of Communication Sciences and Disorders (CSD) professionals who hold a Doctor of Philosophy (PhD) degree in the field of CSD. The purpose of this study was to explore CSD students׳ views towards pursuing a PhD and to investigate the relationship between CSD students׳ exposure to research and their views regarding the pursuit of a PhD in order to understand and generate possible solutions to the PhD shortage. Method: The quantitative cross-sectional survey study included undergraduate (n = 49) and graduate (n = 51) CSD students from 12 Midwestern CSD institutions in the United States. The CSD PhD survey was administered via an online survey tool. Data analyses included descriptive statistics, correlational analyses, and the nonparametric Friedman׳s test with a series of post-hoc Wilcoxon signed-rank tests. Results: Participants most frequently ranked research interest, desire for knowledge, and making a contribution to the discipline as the most important reasons why one would pursue a PhD. Participants most frequently ranked lack of research interest, satisfaction with current degree and position, and cost of doctoral program as the most important reasons why one would not pursue a PhD. There was a statistically significant positive relationship between CSD students׳ interest in research and their views about pursuing a PhD. Discussion: The implications of this study support the need to further investigate the relationship between students׳ exposure and interest in research and their views about pursuing a PhD in order to optimize PhD recruitment efforts. Keywords: Communication Sciences and Disorders, Audiology, Speech-language pathology, Doctorate, Research

We investigated mothers' needs in forming partnerships with nurses based on children's postoperative recovery in a paediatric cardiac intensive care unit.This was a descriptive study using prospective data.Data were collected from 36 mothers enrolled in a mother-nurse partnership program.We investigated mothers' need for information and participation activities using a self-made survey tool, as well as the duration of mothers' care participation and physical engagement and psychological connectedness.The mothers desired information on their infants' postoperative stability in the early recovery phases and information on infants' transfer and care in the later phases. Mothers' mean duration of care participation increased as infants' recovery progressed (15.82 ± 8.76 minutes in the second phase of recovery to 29.46 ± 4.53 minutes in the fifth phase; F = 19.54, p .001). Mothers' physical engagement and psychological connectedness also increased with infants' recovery (F = 200.95, p .001; F = 93.27, p .001, respectively). Mothers generally passively participated at first and gradually developed more positive and enthusiastic participation as infants recovered.Infants' condition heavily influenced mothers' needs regarding partnerships. Thus, nurses must individually provide mothers with information and encourage them to participate in care.

The purpose of this study was to explore the effect of customer relationship management (CRM) dimensions on employee-based brand equity. By looking at the past literature, it can be noticed that the majority of earlier studies on brand equity examined it from customers' perspective, while the employees' perspective received less emphasis. Thus, the required data was obtained using a survey tool from 164 employees in the ride-hailing industry in Saudi Arabia. The obtained data was analyzed by the Covariance-Based Structural Equation Modeling (CB-SEM) method to test the hypothesis and reach at conclusions. The findings showed that CRM in general has a positive effect on employee-based brand equity. Specifically, it was found that CRM organization has a significant positive impact on employee-based brand equity. It was also verified that knowledge management and customer orientation have positive effects on overall employee-based brand equity. Finally, the results confirmed that technology-based CRM has a significant positive impact on employee-based brand equity. These results add to the body of literature on this topic and verify the significance of customer relationship management dimensions in affecting employee-based brand equity.

This study aimed to assess current food safety gaps among small growers in Texas to identify key areas of focus for potential education and training materials for these stakeholders. Small growers earn ≤$25,000 in annual sales over a 3-year period and have an average food sale of less than $500,000. To this end, a survey tool was designed to determine the gaps in small farm growers’ food safety knowledge. A total of 29 questions were disseminated to participants at fruit and vegetable conference. The questions included topics such as food safety practices and perceptions, and current and past food safety training experiences. Data from 70 growers was collected and analyzed and the results demonstrated that more than 34% of growers use manure and 51% have domestic animals on the farm premises. Even though more than 51% of participants use bare hands for harvesting, 39% of growers do not provide handwashing facilities for workers, and 46% of the growers do not provide toilet facilities for their workers. Only 25% of the growers surveyed have access to food safety training materials for their employees. The results also showed that 21% of participants have previous food safety training. Furthermore, half of the growers surveyed used soil amendments and approximately 87% did not test irrigation water. About 30% of growers believe that organic produce is safer than conventional produce and 37% believe that organically grown produce has fewer harmful bacteria. Also, > 41% of participants could not recognize the difference between hydroponically grown produce and conventional systems. The results indicated specific areas of opportunity, gaps in resources needed by growers, and lack of food safety training materials. The results of this study will help in the design of targeted and specific food safety training materials for small growers.

Objectives The high incidence of Acute Otitis Media (AOM) along with low antibiotic efficacy in the treatment of AOM is particularly favorable for the emergence of antimicrobial resistance. The promotion of more conservative antibiotic prescription habits has become an important focus of governments and academic societies. Little is known about the awareness and use of AOM practice guidelines by physicians in the Middle East. Our aim is to characterize AOM management in Lebanon by using an anonymous survey instrument to uncover potential disparities in treatment trends and evaluate differences in clinical guideline adherence patterns. Methods A total of 75 practicing physicians were anonymously surveyed in Beirut, Saida, Nabatieh, Bekaa and Tripoli, Lebanon. The survey tool used was previously used in Amman, Jordan by our colleagues at the University of Michigan. The survey we used assessed awareness of and adherence to practice guidelines by prompting responses to hypothetical AOM cases. Differences in performance between various physician groups were noted. Results Overall, physician participants answered 67% of the survey questions correctly. Trainees did better overall in terms of AOM management (62% correct responses as compared to 48% in attending physicians, p = 0.0175). Trainees also performed better in terms of their ability to manage cases of potential AOM in two-year old children and their ability to choose the appropriate medications (79% correct response rate compared to 71% in attending physicians, p = 0.0278). Participants who reported guideline adherence most or all of the time had a 67% correct response rate in regards to their ability to diagnosis AOM, compared to a 57% correct response rate in those who reported adhering sometimes or rarely to the guidelines (p = 0.0489). In the cases requiring antibiotic treatment for body temp of over 39C with/without otalgia, only 47–57% of participants identified the appropriate antibiotic regimen. Conclusion There are areas of potential improvement in adherence to clinical guidelines in the management, diagnosis, and treatment of AOM by Lebanese physicians. Conducting interventions among physicians to improve awareness of clinical guidelines and current treatment recommendations in Lebanon will likely improve adherence to guidelines, enhance clinical outcomes, and may help advance the fight against antimicrobial resistance.

Background Despite safe and effective childhood immunizations, decreased acceptance of vaccines has become an emerging global problem. The WHO SAGE Working Group on Vaccine Hesitancy developed a common diagnostic tool, the Vaccine Hesitancy Scale (VHS), to identify and compare hesitancy in different global settings. We field tested the VHS in rural and urban Guatemala. Methods We analyzed data from the enrollment visit of a study conducted at four public health clinics in Guatemala. Infants ages 6 weeks-6 months presenting for their first wellness visit were enrolled March-November 2016. Parents completed a demographic survey that included the 10 dichotomous and 10 Likert scale VHS questions. Chi-square or Fisher’s exact for categorical and ANOVA test for continuous variables were used to assess significance levels in survey differences. We conducted a factor analysis to assess the Likert scale questions. Results Of 1088 families screened, 871 were eligible and 720 (82.7%) participated. No parent had ever refused a vaccination, and only eight parents (1.1%) had been reluctant or hesitated to get a vaccination for their children. However, only 40.8% (n = 294) of parents said that they think most parents like them have their children vaccinated with all the recommended vaccines. Factor analysis identified two underlying constructs that had eigenvalues of 1.0 or greater and a substantive lack of variability in response across the Likert scale. There were consistent differences between how study clinics responded to the ordinal scaling. Conclusion Our results suggest problems with interpretation of the VHS, especially in the presence of vaccine shortages and using a Likert scale that does not resonate across diverse cultural settings. Our factor analysis suggests that the Likert scale items are more one-dimensional and do not represent the multiple constructs of vaccine hesitancy. We suggest more work is needed to refine this survey for improved reliability and validity. Clinical Trial Registry: NCT02567006 .

Geodetic Stations and Differential Global Positioning Systems are the dominant instruments for mapping in archaeological contexts. However, there are not equal counterparts for cave archaeology survey. There is no way for DGPSs to work inside a cave and use of geodetic station is limited only in relatively dry and wide parts of the caves. This paper is reviewing the current available applications on cave mapping and it is presenting the use of Heeb's Paperless Mapping technique as a mainstream survey tool for subterranean archaeological projects. Ultimately a step by step methodology is proposed.

Aim To describe nurses’ and midwives’ social media use, knowledge, attitudes and information needs, in the context of e-professionalism. A secondary aim was to identify any relationship between these variables and age, or professional role. Background Midwives and nurses are viewed by the public as trusted professionals. On social media, the boundary between professional and personal identities can be blurred. Previous research has explored how student nurses navigate professional behaviour online, or e-professionalism. However, confusion persists amongst established nurses and midwives, despite the policies which guide and regulate their online conduct. Design A cross-sectional designwas applied. The STROBE guideline informed reporting of the findings. Methods A validated survey tool was modified to the study setting. Responses to 17 survey items were analysed using Chi-square and Fisher’s exact tests. Qualitative content analysis was conducted on responses to two open-ended questions. Results In total, 311 nurses and midwives from one Western Australian tertiary hospital participated between August 2019 and February 2020. Social media use was widespread (97.4%, n = 299). Associations were identified between age group and eight survey items assessing social media use, knowledge and attitudes. No associations were identified between professional role and social media use, knowledge and attitudes. Content analysis revealed five themes: Maintaining professional boundaries; Avoidance; Protecting self; Responsibilities and consequences; and Social media as a tool. Conclusions Midwives and nurses in this study approached social media with caution yet many were curious about its potential. If midwives and nurses are to be held accountable to social media policies and use the benefits social media affords, they must be supported to evolve into proficient users by educators and policy makers. Tweetable abstract Nurses and midwives must be supported through policy and education to embrace social media as a tool of the future.

Background Given the oral health implications of smoking, vaping, and using smokeless tobacco products (STPs), the dental office can be an effective setting for clinicians to offer smoking cessation counseling and treatment (SCCT). Methods A survey tool was developed to assess dentists' approach and experience with SCCT. This survey was deployed electronically on May 21, 2021, to the American Dental Association Clinical Evaluators (ACE) Panel (N = 982), and 1 week later, nonresponders were sent reminders. Results were summarized in SAS Version 9.4. Results Of the 283 survey responders, one-half offered SCCT to their patients. Of those who offered SCCT, 69% would be willing to prescribe pharmacologic agents to help with cessation. Nine of 10 times, SCCT conversations included the dentist. Of the 49% of respondents who did not offer SCCT, one-quarter were current or past smokers, vapers, or STP users. Out of all of the survey respondents, 40% were aware that SCCT is part of most medical benefits. Most respondents (82%) perform surgeries on patients who smoke, vape, or use STPs. Conclusions Implementation of SCCT in the dental office was split among ACE panelists, but when it was offered, the dentist was almost always involved. Awareness about SCCT medical benefits and surgical protocols for current smokers, vapers, and STP users differed among this sample. Practical Implications Dentists can benefit from more formal training and resources around SCCT and access to reimbursement for having these crucial conversations with their patients.

Comparisons of subjective scale measures across countries can be distorted by the use of different response thresholds in different countries. Anchoring vignettes are a survey tool designed to address this problem, and are becoming widely used to adjust comparisons of subjective measures across groups, primarily within countries or across relatively similar high-income countries. This paper expands the existing literature by comparing six domains of self-reported health across the United States, England, and two countries with very different income levels, cultures, and geographic locations – Indonesia and China. In the raw data, respondents from the U.S. and England appear to be in worse health than their Indonesian and Chinese counterparts, but across the majority of health domains, this relationship completely reverses once I account for threshold differences.

Background Despite evidence supporting the implementation of supervised injection facilities (SIFs) by multiple stakeholders, no evaluation of emergency physicians' attitudes has ever been documented towards such facilities in Canada or internationally. The primary goal of our study was to determine the opinions and perceptions of emergency physicians regarding the implementation of SIFs in Canada. Methods We conducted a national electronic survey of staff and resident emergency physicians in Canada using an iteratively designed survey tool in consultation with content experts. Invitations to complete the survey were sent via email by the Canadian Association of Emergency Physicians. Inclusion criteria required respondents to have treated an adult patient in a Canadian emergency department within the preceding 6 months. The primary measure was the proportion of respondents who would support, not support or were unsure of supporting SIFs in their community with the secondary measure being the likelihood of respondents to refer patients to a SIF if available. Results We received 280 responses out of 1353 eligible physicians (20.7%), with the analysis conducted on 250 responses that met inclusion criteria (18.5%). The majority of respondents stated they would support the implementation of SIFs in their community (N=172; 74.5%) while 10.8% (N=25) would not and 14.7% (N=34) did not know. The majority of respondents said they would refer their patients to SIFs (N=198; 84.6%), with 4.3% (N=10) who would not and 11.1% (N=26) who were unsure. Conclusion The findings from our study demonstrate that the majority of emergency physician respondents in Canada support the implementation of such sites (74.5%) while 84.6% of respondents would refer patients from the emergency department to such sites if they did exist. Given that many Canadian cities are actively pursuing the creation of SIFs or imminently opening such sites, it appears that our sample population of emergency physicians would both support this approach and would utilize such facilities in an effort to improve patient-centered outcomes for this often marginalized population.

Weinland Park, an urban neighborhood adjacent to The Ohio State University, has been targeted for revitalization following several decades of disinvestment. The goal of these efforts is to develop holistic solutions that break the cycle of poverty. Such an undertaking requires collecting baseline data to understand community needs, inform programming, and guide revitalization efforts. This paper describes the development and implementation of the Weinland Park Evaluation Project (WPEP) – a collaborative and comprehensive neighborhood survey and needs assessment. Using the RE-AIM framework as a conceptual model, the paper describes how the WPEP was designed to meet short-, medium-, and long-term community needs. In addition, it offers lessons learned as a guide for researchers designing neighborhood surveys and conducting community assessments. An Appendix A includes indicators measured via the survey tool.

Background Examining social networks helps to explain the connectedness of individuals, groups or communities, and is useful in demonstrating the potential that lies within and between networks. When evaluating social networks, relationships are viewed as “nodes” (eg individuals or points) and their connecting “ties” (eg the relationships between the nodes). Detailing food pantry and client “connectedness” through social network analysis can assist researchers and policymakers to enhance efficiency and effectiveness of the informal emergency food system. Objective The objective of the study was to examine the degree to which urban church food pantries are connected to the clients they serve using the social network theory. Study Design, Setting, Participants The research design was a population-based, cross-sectional study using a snowball sampling method of church food pantries in Nashville, Tennessee, from 2015–2018. The study population included 93 urban churches with 46 having on-site food pantries. Measurable Outcome/Analysis Zip codes for church-based pantries and clients served were collected via an electronic survey tool sent to urban churches. Social network ties between church food pantries and clients were analyzed utilizing UCINET 6 software. Results From the social network analysis a sociogram (eg visual matrix) was developed depicting 56 nodes (26 churches; 30 client zip codes) and 148 ties. Five large churches (membership ≥ 300), 13 medium-sized churches (membership = 100 to 299), and 8 small churches (membership ≤ 100) were identified within 23 zip codes. Large churches had 31 ties, medium-sized churches had 98 ties and small churches had 19 ties. Two central, medium-sized churches had the most ties with 20 and 30, respectively. Conclusions Although it was assumed that larger churches would have more social network ties, church size was not a limiting factor in serving urban areas through food pantries. Further research is needed to evaluate if current church food pantry social networks ensure vulnerable populations are being adequately served.

Attitude is a factor noted to be a determinant of practice and behavior; thus, has become a topic of interest for many scholars. This present study investigated the attitude toward print-based and electronic-based reading of 562 senior high school students (mean age = 17.71, standard deviation = 0.0889) sampled across 10 schools (4 of which are privately managed). The study employed a descriptive-quantitative-correlational design in determining the attitude of the respondents across reading versions, significant difference in attitude of the respondents toward print-based and digital reading, statistical difference in the attitude across the dichotomous variable gender, and the relationships between attitudes. Moreover, data gathering was realized through the use of a survey tool pilot tested (with reliability of Cronbach’s alpha = 0.811). The analysis of the data revealed that the respondents harbor an attitude characterized as ‘somehow negative’ towards both versions of reading. In addition, there is a significant difference in the respondents’ attitude toward print and e-reading. Moreover, gender differences exist in the attitude toward print reading with females exhibiting better attitudes. Last, there is a significant correlation between the respondents’ attitude toward print and electronic reading.

Background Noncommunicable diseases, including those requiring surgical care, are increasingly straining low- and middle-income countries. Globally, 11% of all disability-adjusted life-years lost result from conditions requiring surgery; however, little is known about country-specific burden. We piloted a household-based survey in a periurban district of Uganda to estimate the prevalence of surgical conditions and to identify logistical challenges. Methods Our sample comprised 57 households in 5 enumeration areas in the Wakiso District, in central Uganda. Our survey tool was the Surgeons OverSeas Assessment of Surgical need. A household representative completed demographic and household death information, and 2 randomly selected household members completed questions on surgical conditions. Results Of 96 participants, 6 (6.3%; 95% CI, 2.3–13.1) had an existing, untreated surgical condition. The lifetime prevalence of surgical conditions was 26% (25/96). The most common barrier to access to care was lack of financial resources. Of the 3 deaths reported, 2 were associated with surgery. The mean household interview time was 36 minutes. The greatest challenge was efficient coordination with local team members and government officials. Conclusion In this setting, the current prevalence of surgical conditions was nearly 1 in 10 persons, and lifetime occurrence was high, at 1 in 4 persons. Addressable challenges led to question revisions and a change in the data collection platform. A full-country study is both feasible and necessary to characterize the met and unmet need for surgical care in Uganda.

The prevalence of risk factors for osteoporosis in persons with epilepsy, patients' awareness of their risk, and their engagement in osteoprotective behaviors were assessed in this study. Two hundred and sixty patients with epilepsy (F=51.5%, average age=42) completed a survey tool. Of 106 patients with a dual energy X-ray absorptiometry (DXA) result, 52% had low bone mineral density, and 11% had osteoporosis. The results suggest that the majority of patients with epilepsy do not engage in bone-protective behaviors. Those who have undergone a DXA scan may be more likely to take calcium and vitamin D supplementation compared with those who did not undergo a DXA scan, but they do not engage in other osteoprotective behaviors. Many patients did not accurately report their DXA results, indicating that better patient education is warranted.

Introduction Sick and or preterm neonates who are admitted to the Neonatal Intensive Care Unit (NICU) frequently require inotropes and vasopressors which support the cardiovascular system to function adequately. There are many different clinical practices that nurses can adopt to perform inotrope and vasopressor infusion line and syringe changes, some of which have the theoretical potential to cause fluctuations in blood pressure. The purpose of this study was to identify current inotrope infusion line change practices in the neonatal intensive care population of Australia and New Zealand and examine what drives these current clinical practices. Methodology An observational, exploratory quantitative study was carried out in all 28 Australian and NICUs. An electronic survey tool was distributed to one member of each unit who responded on behalf of their clinical setting. Results The results showed that variation exists in the practice of inotrope and vasopressor line change practices across the 22 participating NICUs. The most popular method was the quick change method with 54.5% of Neonatal Intensive Care Units implementing this practice in their unit. The most frequently reported basis for current practice was literature (54.5%) followed by expert opinion (40.9%), previous clinical practices (36.4%) and multidisciplinary consensus (22.7%). Conclusion This study has identified areas requiring further research in order for a standard, safe and efficient practice to be implemented in the Neonatal Intensive Care Unit for these critically sick neonates.

Objectives The first objective of this survey was to determine if there is a common grading scale utilized in Doctor of Pharmacy programs throughout the United States. Based on preliminary research, this question has not been addressed for professional pharmacy education. The study’s second objective was to begin to explore different aspects of grading scales used, academic freedom in grading, and the institutional breakdown of grading scales. Methods An online survey tool was developed and distributed to the School of Pharmacies’ respective Dean of Academic Affairs or alternate via e-mail to elicit responses. Subsequent second and third e-mail requests were sent at one-week intervals after a nonresponse. Results The net survey response rate was 61%. The overall study results determined that there was no grade scale predominately used by pharmacy schools or colleges, whether compared across all courses or across only specific type courses (didactic, laboratory, and experiential), and regardless of whether public or private, or what size the enrollment. There were significant consistencies in what constitutes a passing grade as well as the percentages that correlate to specific grades. Conclusions The results provide guidance for both established and new schools of pharmacy, in that any grading scale adoption is essentially acceptable among pharmacy schools. Future research should compare Doctor of Pharmacy program grading policies with other professional doctorate programs, to determine if other professional programs have developed common grading policies.

BACKGROUND Tracking hand hygiene compliance (HHC) is an important function in healthcare to monitor compliance and validate accountability. Using a covert approach to monitoring hand hygiene limits the ability to collect a sufficient number of observations that are non-biased and highly reliable. Our objective is to create a program to reduce bias, be more reliable, yield a greater number of observations, and provide real time feedback. METHODS We implemented an overt observation program to collect data and provide real-time feedback to staff at a 900-bed multi-facility academic medical center. Paid overt observers, who wear blue vests, used an electronic survey tool on mobile tablets to collect hand hygiene observations on all staff disciplines entering and exiting patient care areas. Observers had to collect both the entry and exit of the staff member to count as one observation. The observers also gave immediate feedback, both positive acknowledgment and constructive reminders for missed opportunities. Captured in real time, the data was distributed weekly and monthly to unit and discipline leadership. RESULTS The total number of observations from the overt program was 24,598 for fiscal year (FY) 2016 compared to 8,548 covert observations in FY 2015. HHC improved from 68% to 88% from FY 2016 to FY 2017. The increase in HHC was statistically significant using the Chi square test. Verbal feedback given to staff increased from 67% in FY 2017 to 88% in FY 2018. CONCLUSIONS Since overt observers are not unit specific, they are able to provide an unbiased perspective when gathering observations. Assessments of the program are continuous. Observers complete competencies on an established schedule to ensure accuracy and consistency of each observer. With the implementation of the overt program, there was a statistically significant increase in the number of observations collected, improved compliance, and the ability to give and track feedback.

Objective Hosting a reception for prospective interns the evening before the interview has become a well-established expectation. It is thought that these initial impressions significantly influence the ranking process. Despite these well-held beliefs, there has been a paucity of studies exploring the preinterview reception. Design A survey tool was created and piloted to ensure validity. The survey was then administered to a fourth-year class of allopathic medical students immediately after interviews but before Match Day. Setting A university, teaching hospital. Participants Fourth-year allopathic medical students. Results The response rate was 100% ( n = 69). Ninety-six percent of programs hosted an event. Although these events were minimally stressful (86%), the same percent felt that not attending would limit their knowledge of the program, and 66% felt that it would negatively affect their application. Forty percent believe this event to be extremely important to residency programs in selecting interns. Ninety-five percent are attended by residents only, and approximately half were at a casual restaurant. Most applicants (97%) never paid for their own meal, and 69% felt that if they did, it would leave a negative impression of the program. Conclusions Candidates believe the preinterview reception is important in the selection process, that failing to attend would negatively affect their application, and provides insight about the program. Alcohol is often provided but rarely has a negative effect. Applicants prefer an informal setting with unfettered interactions with the residents.

Objective In 2005, the World Health Organization reclassified the parakeratinizing odontogenic keratocyst as a neoplasm. This article reviews the research leading to this reclassification, and validates a new survey tool that can be easily used to pool surgical and recurrence data from multiple offices. Study design All odontogenic lesions accessioned in the Iowa Surgical Oral Pathology Laboratory between 1949 and 2010 were identified from the database. A survey tool to assess treatment and follow-up was created. A total of 46 surgeons agreed to participate. Results A total of 70 keratocystic odontogenic tumors (KOTs) had documented recurrences at follow-up intervals ranging from 6 months to 5 years. Primary tumors that recurred ranged in size as measured by greatest radiographic diameter from 0.7 to 6 cm. Conclusions This survey tool is recommended as standard allowing treatment of cases by multiple practitioners to be compared retrospectively or prospectively.

Emotional intelligence (EI) in the UK radiographer workforce has been benchmarked using the trait emotional intelligence model and the profile of the profession in the UK has begun to emerge. There are cultural differences between countries that have been shown to have an effect on EI, therefore this paper aims to benchmark the Global and four factor scores of Trait EI in the Australian radiographer population; to explore any differences within the two main professional groupings, diagnostic and therapeutic radiographers, and to compare the Australian radiographer workforce scores with those of the UK previously published. The published and validated trait EI questionnaire of Petrides was used as the survey tool for the Global EI and the four factors of Well-being, Emotionality, Self-control and Sociability. There was only one difference found in the five factors studied between the UK and Australian radiographer workforce, that of Well-being ( p ≤ 0.01). No differences emerged between the diagnostic and therapy disciplines nor was a relationship found between EI and the Australian leadership in contrast to the UK workforce findings. Differences were found in the demographic profiles of the two countries and the implications of the above findings are discussed. This paper has benchmarked the EI of the Australian workforce and found a difference in well-being between the UK and Australian radiographer workforce. The Australian diagnostic and therapy disciplines were no different in their EI profiles. No relationship was found between EI and leadership in the Australian radiographer workforce.

Objectives This study examined social media use by pharmacy faculty members and their strategies for Facebook friending of students. Additional objectives included determining faculty members' opinions regarding e-professionalism, how they responded to e-professionalism transgressions, and their use of social media for teaching, learning, and professional interests. Methods A 32-item questionnaire was sent to 358 pharmacy faculty members at five schools via a web-based survey tool. Results One hundred and fifty-nine faculty members completed the questionnaire for a 44.4% response rate. Almost 65% ( N =103) of the respondents use Facebook. The most common (37.6%, N =38) Facebook-friending philosophy was not to accept any student friend requests. Half ( N =27) of the faculty members who have viewed student profiles noticed an e-professionalism transgression. Fifty-nine (50.1%) faculty members responded that they were either likely or very likely to use social media for teaching. A little less than half (46.6%, N =54) of the respondents reported using social media for professional networking purposes. Conclusions A majority of pharmacy faculty members have an online social media presence, with Facebook being the most common application. Strategies for Facebook-friending students varied, but in general they were very conservative. The majority does not accept any Facebook friend requests from students, or accepts them only when students have graduated. Most faculty members agreed that social media connections with students might compromise the instructor–student relationship boundary. It is important that higher education faculty adapt to the paradigm and examine the appropriate contexts of use for professional, educational, and networking purposes.

We describe the development and practical field testing of a rugged, unbaited video lander as a visual survey tool for fishes inhabiting structurally complex, high-relief, deepwater rocky reefs. Our autonomous, high-resolution, low-light, color video lander system utilized a smooth frame design that incorporated a series of breakaway attachments and inexpensive sacrificial steel bases to maximize the potential for camera system recovery from complex rocky habitats. Initial field tests at five reef complexes off Oregon (n = 421) and a larger study evaluating the western boundary of Oregon's Yelloweye Rockfish Conservation Area (YRCA, n = 527) showed that the video lander could be deployed and reliably retrieved from high-relief rocky habitat without damage to the camera system and with minimal losses of sacrificial bases. Acceptable visibility for counting fish from the lander video was common at offshore reefs like Stonewall Bank, but less so at nearshore reef complexes. The video lander system was effective for discriminating differences in fish species assemblages at the various reefs surveyed (one-way ANOSIM, P < 0.001) and for identifying seafloor habitat types and species-habitat associations for yelloweye rockfish (Sebastes ruberrimus) at Stonewall Bank (P < 0.05). The video lander data showed that the area outside and to the west of the YRCA enclosed similar quantities of yelloweye rockfish and their preferred habitats in comparison with the area inside the YRCA (0.179 yelloweye rockfish/station outside, versus 0.144 yelloweye rockfish/station inside, Wilcoxon test, P = 0.417). Our visual survey data also showed that the current western YRCA boundary is not optimal for protecting yelloweye rockfish at Stonewall Bank from fishery harvest.

Objective To assess the impact of a diabetes-focused advanced pharmacy practice experience on students' diabetes-related confidence and knowledge. Methods A survey tool was created, including 22 confidence and 30 knowledge questions centered on diabetes care. Students entering into a diabetes-focused advanced pharmacy practice experience (APPE) during rotation 7 served as the intervention group, whereas students without this experience were the control group. Both groups completed the survey before and after rotation 7. Results Twenty-two students (13 intervention, 9 control) completed the baseline survey and 14 students (9 intervention, 5 control) completed the follow-up. The intervention group showed a significant improvement in total confidence compared with control (3.92–5.52, p = 0.002). Within-group analyses showed a significant improvement in knowledge in the intervention group (18.6–22.4, p = 0.04) compared with no difference in the control group (17.8–18.3, p = 0.85). Conclusions This pilot study suggests that a diabetes-focused APPE improves students' diabetes-related confidence and knowledge.

Background High-fidelity computer-assisted simulation devices have been introduced as a way to improve student confidence and performance. However, these devices have not been verified to improve intravenous (IV) insertion skills in a patient care experience. Method An experimental randomized controlled study was conducted to determine whether instruction supported by high-fidelity computer-assisted simulation technology enables a student to access veins more confidently and efficaciously than does the use of current latex arm task-trainer technology. The sample included 94 junior baccalaureate nursing students. Skill, confidence, and actual IV insertion into a patient were evaluated by means of skill return demonstration, confidence survey tool, and clinical self-reporting. Results Univariate analyses of the skill scores found no statistically significant difference in return demonstration skill by simulation instruction method used (p = .7). Similarly, no significant difference was seen in the student confidence score versus simulation method. The ability to insert an IV into a patient did not correlate with either instruction device used. Conclusion Although high-fidelity computer-assisted simulation has helped in many areas of student education, it does not appear to assist students in IV insertion in either skill ability or confidence.

Background Infection prevention and control (IPC) is a critical, although often neglected, part of long-term care (LTC) management. Little is known about what IPC resources are available for LTC and how that impacts patient care and safety. Methods One hundred eighty-eight LTC facilities were randomly selected out of all British Columbia facilities and surveyed using a validated survey tool. The tool was used to collect data regarding IPC resources grouped within 6 indices: (1) leadership, (2) infection control professionals (ICP) coverage, (3) policies and procedures, (4) support through partnerships, (5) surveillance, and (6) control activities. All components measured have been identified as key for an effective IPC program. Survey responses were used to calculate scores for IPC programs as a whole and for each of the 6 indices. Results Of 188 randomly selected facilities, 86 institutions participated. Facilities were compared by region, funding source, and ICP coverage. Overall, LTC facilities lacked IPC leadership, especially physician support. Having no dedicated ICP was associated with poorer scores on all indices. Only 41% of practicing ICPs had more than 2 years experience, and only 14% were professionally certified. Twenty-two percent of ICPs had additional roles within the institution, and 44% had additional roles outside of the institution. Thirty-five percent of institutions had no IPC dedicated budget. Discussion LTC institutions—with bed numbers exceeding those in acute care—represent an important aspect of health services. These data show that many LTC facilities lack the necessary resources to provide quality infection control programs.

The education occurring within the operating room is fundamental to the development of a surgical resident. The purpose of this study was to investigate differing perceptions of surgical residents and faculty in regard to preoperative preparation, intraoperative teaching, and postoperative feedback.A validated survey tool was slightly adapted, piloted, and then administered to the surgical residents and faculty of a university-based general surgery residency program. The wording of the survey was specific to either residents or faculty and consisted of similar questions with responses on a 5-point Likert scale (1: strongly disagree to 5: strongly agree). The responses of the 2 groups for each question were averaged and compared using Wilcoxon-Mann-Whitney test to determine significant differences.In all, 27 residents and 30 faculty members completed the survey for a response rate of 100%. With respect to preoperative preparation, significant differences were found in perceptions about reading (4.22 vs 2.59; p0.001) and anatomy review (4.11 vs 2.31; p0.001) before the procedure. Considering intraoperative perceptions, significant differences were found with respect to teaching the operative steps (3.59 vs 4.06 p = 0.048), surgical skills (2.85 vs 3.78; p = 0.001), instrument handling (3.19 vs 4.00; p = 0.002), and surgical technique (3.44 vs 4.28; p0.001). Significant disagreement was found in the perceived effort of the faculty to act as a teacher in the operating room (3.56 vs 4.09; p0.007). Postoperatively, significant differences were found in perceptions of positive feedback (2.63 vs 3.34; p = 0.01) and feedback on areas to improve (2.78 vs 3.50; p = 0.009).Although there is agreement on the need to improve intraoperative education, there is significant disparity in perceptions of preoperative preparation as well as intraoperative and postoperative feedback between residents and surgical faculty.

Summary Background & aims We sought to establish the level of knowledge of celiac disease (CD) and gluten sensitivity (GS) among the general public and chefs, and to compare dining habits of people with CD and the general public. Methods Surveys assessing knowledge of CD and GS as well as dining habits were administered through an Internet survey tool or face-to-face. The chef survey also assessed training/education. Results Among 861 persons from the general public 47% had heard of CD, 67% of GS and 88% of peanut allergy. Chefs were more likely than the general public to have heard of CD (77% vs. 47%, p p n = 790) reported that they avoid restaurants because of the gluten-free diet and ate take-out food and restaurant food significantly less often than the general public. Trained chefs had more knowledge than untrained chefs (83% vs. 52%, p $65: 94%, p Conclusions Awareness of gluten-related issues was prominent. Surprisingly, both the public and chefs were more likely to have heard of GS than CD. Most with CD avoid restaurants, and eat outside the home less frequently than the general public. Knowledge of CD among chefs exceeds that of the general public, but varies considerably.

Objective. To determine preceptor perceptions of the value of experiential quality assurance site visits between virtual and onsite visits, and to gauge preceptor opinions of the optimal method of site visits based on the type of visit received. Methods. Site visits (12 virtual and 17 onsite) were conducted with 29 APPE sites located at least 200 miles from campus. Participating preceptors were invited to complete an online post-visit survey adapted from a previously validated and published survey tool measuring preceptor perceptions of the value of traditional onsite visits. Results. Likert-type score averages for survey questions ranged from 4.2 to 4.6 in the virtual group and from 4.3 to 4.7 in the onsite group. No statistically significant difference was found between the two groups. Preceptors were more inclined to prefer the type of visit they received. Preceptors receiving onsite visits were also more likely to indicate no visit type preference. Conclusion. Preceptors perceived value from both onsite and virtual site visits. Preceptors who experienced virtual site visits highly preferred that methodology. This study suggests that virtual site visits may be a viable alternative for providing experiential quality assurance site visits from a preceptor's perspective.

Each relationship a child establishes with adults in every stage of his/her development has a unique role. After he/she dis-attaches himself/herself from the parents or another child-rearing-person, the adults that a child builds meaningful relationships with are often the pre-school teachers. Psychology literature asserts that “attachment styles” are related to the person's character. Therefore, we argue that it is crucial to determine the “personal attachment styles” of the pre-school teachers. In this study we aim to discuss the four different styles of attachment of the pre-school teachers, which are secure, fearful, dismissive, and preoccupied. Our study objects are 91 senior students in the Pre-school Education program at the Ankara University. In this research, relationship/s scale will be used as the survey tool. This study shows that, from among 91 fourth-year students in the Department of Preschool Teaching, 48% have secure-dismissive attachment styles which can be deemed positive and 52% have fearful-preoccupied attachment which can be deemed negative.

A fundamental premise of establishing collaborative relationships between residents and nurses is a basic understanding of the attributes of each group. The intent of this study was to determine what surgical nurses know about surgical residents.A piloted survey tool was administered to a cross-section of nurses working in 3 surgical intensive care units, a surgical intermediate unit, and 2 general surgical floors. Surgical residents completed the same survey tool. The percentage of residents giving the most frequent response was compared with the percentage of nurses giving the same response.A university, teaching hospital.One hundred twenty-four of 129 surgical nurses and 24 of 25 surgical residents who completed the survey tool.The response rate for nurses on the 2 survey days was 94%, or 54% of all surgical nurses employed by the hospital, and 96% for residents. The nurses surveyed were equally distributed between the units. Ninety-nine percent of nurses did not have a surgical resident as a significant other, 55% of nurses had greater than 5 years experience, and 95% were licensed registered nurses. Seventy-eight percent of nurses correctly indicated that a medical doctorate is the highest degree required to start residency (p = 0.01), but only 57% accurately identified the length of surgical residency (p = 0.02). Nurses perceived residents devoted less time to patient care (p0.01) and more time to studying (p0.01). Forty percent of nurses do not think interns are legally physicians (p0.01) or hold a medical license (p0.01). Forty percent of nurses are aware of the 80-hour work week restriction (p0.01). Eighteen percent of nurses have the perception that residents are not allowed to perform bedside procedures without an attending physician present (p = 0.03), while 56% have the perception that residents are not allowed to perform any part of an operation without an attending physician (p0.01). There is a misperception among 32% of nurses that residents pay tuition for residency (p0.01), while only 52% accurately identified the range of a resident's salary (p = 0.01) and 11% the amount of resident debt (p0.01).Despite the importance of the collaborative relationship in surgical patient care, surgical nurses have a limited understanding of surgical residents. Educating nurses about the education, roles, and responsibilities of surgical residents might improve collaborative relationships and ultimately patient care.

Urinary incontinence impacts on women's quality of life and their wellbeing. The objectives of this study were to obtain knowledge and information on midwives' assessment and management practices of urinary incontinence in childbearing women and to explore midwives' knowledge of risk factors associated with developing urinary incontinence. A non-experimental descriptive research design was used, and participants were current members of the Victorian branch of the Australian College of Midwives. Data was obtained using a survey tool that contained both qualitative and quantitative questions. Key findings indicated that the majority of midwives do not assess women for urinary incontinence during the peripartum period and guidelines for bladder management in maternity services were lacking.

Background We propose that the standardized work-hour limitations have created an ethical dilemma for residents. Methods A survey tool was designed to assess factors that influence the number of hours residents work and report. The program directors of pediatrics, internal medicine, and general surgery at our institution supported their residents’ participation. A voluntary, anonymous survey of these residents was performed. Results One hundred seventy of 265 eligible residents were surveyed. Eighty-one percent of residents surveyed responded. Eighty percent of respondents reported exceeding work-hour restrictions at least once within the past 6 months. The factor of greatest influence measured was concern for patient care (80%). Forty-nine percent of respondents admitted underreporting their work hours. Conclusions The Accreditation Council for Graduate Medical Education work-hour restrictions have created an ethical dilemma for residents. Our data show that a significant number of residents feel compelled to exceed work-hour regulations and report those hours falsely.

The World Health Organization (WHO) Global Agenda on Influenza, published in the Weekly Epidemiological Report (WER) on 7 June 2002, was formulated by a consensus of influenza experts and identified strengthening national and international surveillance systems as a major priority. The benefits of improving surveillance include enhancing data available for vaccine strain selection and expanding the “early warning system” for the detection of variant strains of influenza, including those with pandemic potential. Evaluating the activities and physical facilities of the National Influenza Centers (NICs) was one of the key action steps identified in the WHO Global Agenda. An assessment of NICS was conducted using a survey tool developed by WHO. A synopsis of the preliminary results of this survey was published in the Weekly Epidemiological Report on 18 October 2002. A draft Action Plan for strengthening the global influenza surveillance system has been developed as a result of the assessment. A brief description of the assessment tool and key components of the draft Action Plan are outlined here.

We report on the development of a survey tool used to assess resident perceptions of support and educational quality among multiple institutions in an integrated surgical residency, as well as its use in measuring the impact of re-engineering on that program.The University of Connecticut Integrated General Surgical Residency (UCIGSR) is a multisite program that was placed on probation by the Residency Review Committee in Surgery (RRC) in November 1998. This led to a re-evaluation and a re-engineering of the program. In order to better assess the residents' evaluation of the program, we serially examined their attitudes with a survey of 65 questions. A 4-point grading scale (1 = Poor, 4 = Excellent) was used, and each resident was required to complete a survey beginning shortly after RRC probation was announced and at 6-month intervals. Seven global questions in the survey, directed at residency program support and educational quality, were asked for each of the 4 individual adult hospitals, for a total of 28 questions. Statistical analysis of the data was performed using the Jonckhere-Terpstra and the Mann-Whitney U tests.The results demonstrated significant improvement for all 7 questions in all 4 hospitals between November 1998 (S1) and November 1999 (S3). Average scores for all 7 questions, Hospital Support (HS), Departmental Support (DS), Hospital Teaching (HT), Outpatient Teaching (OTC), Operating Room Teaching (ORT), Grand Rounds (GR), and Morbidity and Mortality Conferences (MM), improved in every hospital by 16-28%. In S1, 1 out of 28 questions received an average score greater than or equal to 3, whereas on the most recent survey, 17 of 28 scored greater than or equal to 3 and 78.5% of the questions demonstrated statistically significant improvement (p0.05). Three of the 4 hospitals now have a combined overall average score greater than or equal to 3 for all 7 questions. Areas of strength in each hospital had the least amount of improvement yet remained highly rated.The survey was able to detect weaknesses and variation in program support and educational quality among institutions in our surgical program. Over time, a re-engineering of the process of educating surgical residents demonstrated a positive effect on all of the institutions. While raising the overall satisfaction level of the residents throughout, the greatest improvement occurred in the lowest rated hospitals. Despite barriers of different institutional cultures and geographic locations, a multi-institutional residency program can institute positive change uniformly, and quantitatively monitor that change.

Objective. To provide an update to the 2007 ASHP-AACP survey by examining the current capacity of hospitals/health systems’ ability to conduct experiential education for doctor of pharmacy students.Methods. Pharmacists identified as pharmacy directors were sent an invitation to participate in an online survey tool. The survey tool asked IPPE- and APPE-specific questions, the nature of support provided by colleges/schools of pharmacy, the types of experiences available for students, and the factors influencing the quality, value, and challenges of experiential education.Results. Four hundred sixty five of the 2,911 surveys sent were completed yielding a response rate of 16%. Respectively, 45.1% and 28.5% of respondents believe that the capacity for APPE and IPPE will increase in the next five years. Overall, respondents believe that students receive a high-quality experiential education (91.4%).Conclusion. The results of this survey provide insight to the capacity, benefits and challenges of experiential e...

The purpose of this study was to examine the relationship between computer use and alcohol use among adolescents. In particular, the goal of the research was to determine the role of lifetime drinking and past month drinking on quantity as measured by amount of time on the computer (for school work and excluding school work) and on content as measured by the frequency of a variety of activities on the internet (e.g., e-mail, searching for information, social networking, listen to/download music). Participants (aged 13–17 years and residing in the United States) were recruited via the internet to complete an anonymous survey online using a popular survey tool ( N = 270). Their average age was 16 and the sample was predominantly female (63% girls). A series of analyses was conducted with the computer use measures as dependent variables (hours on the computer per week for school work and excluding school work; various internet activities including e-mail, searching for information, social networking, listen to/download music) controlling for gender, age, academic performance and age of first computer use. Based on the results, past month drinkers used the computer more hours per week excluding school work than those who did not. As expected, there were no differences in hours based on alcohol use for computer use for school work. Drinking also had relationships with more frequent social networking and listening to/downloading music. These findings suggest that both quantity and content of computer use were related to adolescent drinking.

This paper describes an interactive Web-based survey tool that was developed by researchers at the University of Illinois at Chicago to advance a community planning process. The team used a process taken from the work of Jack Nasar (1998) that involves surveying residents to create an “evaluative image” of the community that could guide future design and development. While Nasar’s original method used a phone survey, UIC researchers developed a Web site through which participants interacted with a map that was linked through a server to a GIS program. This project builds upon an earlier version of the survey by increasing the complexity and the coverage area of the interactive map (Al-Kodmany, 2000) .

A triage survey tool, was developed using the Delphi technique and piloted by thirty triage nurses across New South Wales (NSW). While the essential task of the triage nurse is to determine the patient's medical urgency this position frequently involves complex clinical decision-making, the fast tracking of patients and the initiation of investigations. The available literature has not adequately explored the processes underpinning neither triage practice nor the nature of clinical decisions made by triage nurses throughout New South Wales. This survey tool aims to capture current triage processes and the influences that impact upon the role so as to develop a better understanding of triage practice in both the rural and metropolitan settings.

An epidemiological survey was conducted on the seasonal variation of Echinococcus multilocularis prevalence in red foxes from 1997 to 1998, using a monoclonal antibody-based detection of the tapeworm coproantigen. Thirty-six breeding dens of reproductive fox families were identified in the endemic area of Koshimizu, eastern Hokkaido, Japan. Fecal samples from each site were examined by coproantigen detection assay and fecal egg examination. Whereas the prevalence of coproantigen positive feces showed no seasonal fluctuation (51.6–66.7%), variation was found in the prevalence of egg positive feces in which a higher prevalence was observed in the summer and winter (31.1 and 38.7%) than spring and autumn (13.3 and 13.5%). Significant differences were observed between juveniles and adult foxes in both examinations. Samples from juvenile foxes gave higher coproantigen positive results and taeniid egg intensity. Those results suggest more juveniles infected with the cestode than adults in the same period. The practical use of coproantigen assay as a survey tool and factors which affect the prevalence and host age-related difference are discussed.