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Abstract The four-dimensional Postpartum Bonding Questionnaire (PBQ) is an original English self-report questionnaire aimed for detection of postpartum mother–infant bonding disorders. The aim of this study was to create a German version of the PBQ that corresponds conceptually and linguistically to the original questionnaire. The systematic multistep translation process followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research, consisting of forward and backward translations, pilot testing, and cognitive interviews of mothers and a panel of experts. Cognitive interviews with users (n = 10) resulted in 15 changes that improved the completeness and accuracy of the translation. The translation was reviewed by a panel of four experts for practicality, resulting in two changes. As a result of the translation process and cognitive interviews, the German PBQ is linguistically equivalent to the original English version and can be evaluated in psychometric validation for further use in primary care.

Background: Chronic inguinal pain (CIP) can be caused by musculoskeletal or neurological pathologies and by surgical trauma after inguinal hernia repair among other. The aim of this prospective cohort observational study was to find the incidence and causes of CIP unrelated to surgical trauma 12 months after inguinal hernia repair., Methods: During sixteen months patients consulting a hernia center for groin-related symptoms were included in the study. Patients were evaluated by surgeons and filled out preoperatively the Inguinal Pain Questionnaires and a Numerical Rating Scale pain-questionnaire. For patients undergoing inguinal hernia repair, postoperative questionnaires similar to the pre-operative ones were sent out at 12 months. Patients scoring pain on pain questionnaires were evaluated by phone and physical examination., Results: 289 patients (78.1%) of 370 repaired patients filled in the postoperative questionnaires. 62 (21.4%) patients scored pain, of these patients 5 (1.7%, 5/289) answered incorrectly in the pain questionnaires and 14 (4.8%, 14/289) had non-surgical trauma causes of pain: 5 musculoskeletal, 4 neurological and 3 other medical pathologies., Conclusions: This cohort study found CIP unrelated to surgical trauma in 4.8% of patients undergoing a groin hernia repair. Most causes of pain unrelated to surgical trauma were musculoskeletal and neurological pathologies. Nearly a third of patients scoring inguinal pain on pain-questionnaires did not have chronic post-surgical pain (CPSP), therefore incidence of CPSP should not be based solely on pain questionnaires. Clinical assessment of patients with pain is necessary to excluded CIP unrelated to the surgical trauma., Competing Interests: Declarations Previous presentation of the study Part of the paper has previously been presented as abstracts at the EHS-AHS joint congress Hernia 2021 in Copenhagen, at the EHS-2022 congress in Manchester, at the AHS-22 congress in Charlotte, USA and at the BJS prize of the EHS-24 congress in Prag, therefore the abstract was published as a supplement of BJS (https://doi.org/10.1093/bjs/znae122.001). The original paper has not been published and will not be simultaneously submitted or published elsewhere. Disclosure The authors have nothing to disclose., (© 2024. The Author(s).)

Background: The German version of the SarQoL ® , a sarcopenia-specific quality of life (QoL) questionnaire, has not been validated hindering its widespread use. This study aimed to evaluate the psychometric properties of the German SarQoL ® ., Methods: Via a cross-sectional study participants were recruited in two geriatric outpatient facilities and one acute geriatric ward in Munich (Germany). Sarcopenia and probable sarcopenia were diagnosed with the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm. From 185 participants (age 79.8 ± 6.1), 77 had probable sarcopenia, and 51 had sarcopenia. Participants completed the SarQoL ® and the European Quality-of-Life 5-Dimension (EQ-5D) questionnaires. The validation included examination of the discriminative power, construct validity, internal consistency, test-retest reliability, and floor/ceiling effects., Results: Lower SarQoL ® scores for sarcopenic (p = 0.002) and probable sarcopenic subjects (p < 0.001) compared to controls indicated good discriminative power. Consistent construct validity was found for sarcopenic subjects: moderate to high correlations with domains capturing similar constructs of the EQ-5D: 'Activities of daily living' (r = -0.58, p < 0.001), 'Mobility' (r = -0.72, p < 0.001) and low correlations with domains related to different constructs like 'Pain' (r = -0.32, p < 0.022). Similar correlations were found for probable sarcopenic subjects. The Cronbach's alpha was 0.8. Test-retest reliability was excellent (intraclass coefficient correlation of = 0.96; 95% CI = 0.91-0.99), and no floor/ceiling effects were observed., Conclusion: QoL was similarly reduced in both patient cohorts compared to controls. The German SarQoL ® is a valid and reliable instrument for measuring QoL in patients > 65 years of age with sarcopenia and probable sarcopenia and can now be used in epidemiological studies and clinical trials in a German-speaking population., Trial Registration: German Clinical Trials Register (DRKS)-ID: DRKS00020504 (March 12th, 2021) ., Competing Interests: Declarations Consent for publication Not applicable. (Informed consent was obtained from all participants included in the study, but the manuscript does not contain data from any individual person.) Competing interests The authors declare no competing interests. Ethics approval The Ethics Committee of the Medical Faculty of LMU approved the study (Project no.: 23–0376)., (© 2024. The Author(s).)

Diurnal preference to eveningness might predispose to depression. There is preliminary evidence of infrared-A (IR-A) induced whole-body hyperthermia (WBH) in the treatment of depression. In this exploratory study with 19 adults, we investigated the effects of a 20-min exposure of water-filtered IR-A (wIRA) to the skin of back and buttock area, without inducing WBH, on mood and assessed the outcome by diurnal preference (#R19047, approval on 7 May 2019). The skin received irradiation with an integrated power of 102.4 W in the wavelength region of 550-1350 nm and a total dose of 123 kJ over the total area of 0.0483 m 2 . The diurnal preference was assessed with a 6-item version of the Morningness-Eveningness Questionnaire (mMEQ). The 40-item Profile of Mood States (POMS) questionnaire was used to assess total mood disturbance (TMD). Core temperature was measured 30 min before, during and 30 min after the irradiation. Skin surface temperature was measured on baseline and every two minutes during the irradiation. The TMD improved immediately after the exposure, and this positive effect lasted for 24 h (p = 0.001) as well as for 2 weeks (p = 0.02). Concerning the diurnal preference, the positive effect on mood was immediate and lasted for 24 h in evening types (p = 0.02) and for 2 weeks in morning types (p = 0.04). During the exposure, core body temperature was constantly lower in morning types compared to evening types. This study gives us new information on the effects of near-infrared radiation, without inducing WBH, through the skin on mood., Competing Interests: Declarations Conflict of interest The authors declare that they have no competing interests., (© 2024. The Author(s).)

The usage of face mask has been encouraged globally to combat the COVID-19 pandemic. However, their improper disposal has begun to impact the environment. In the present study, face mask littering was assessed in sixteen stations across the beaches in Coromandel coast of South India for a period of four weeks. Moreover, an online questionnaire was recorded to evaluate the people's perception about face mask usage and littering. In terms of land use pattern, stations with both fishing and tourism activities had higher abundance of face mask littering when compared with exclusive fishing and tourism stations. The study also found that mask littering was higher in streets when compared to the beaches. Of 163 respondents, most of the respondents preferred using disposable single use masks and 39.9% of the respondents preferred to dispose of the face masks along with other wastes. The study highlights the lack of proper solid waste management, negligent littering, and the need for raising awareness, strategic intervention to control this menace., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: This study aimed to understand current prehospital trauma air-ambulance policies and triage guidelines across Canada. The research question centered on understanding the guidelines used by provinces and territories and identifying potential regional variations in air-ambulance triage., Methods: We conducted a cross-sectional survey from November 2022 to May 2023, involving trauma leaders from Canada's 13 provinces and territories. Participants were identified via the Trauma Association of Canada and professional networks. The survey, developed with expert input and pilot tested for clarity, focused on prehospital trauma-triage guidelines, level of adoption of Center for Disease Control and Prevention (CDC) triage guidelines, and auto-launch air-ambulance policies. Data were collected using an 18-item electronic survey. Potential response bias was considered, and confidentiality was maintained. A cross-sectional qualitative analysis was used to evaluate the guidelines' adoption and variations, with responses compared across regions., Results: The analysis revealed a nationwide adoption (11 of 11 respondents) of the CDC guidelines, indicating a standardized approach to patient transportation. Notably, many provinces and territories (5 of 11) endorse auto-launch protocols for air ambulances in specific scenarios. These policies offer advantages in geographically vast regions weighed against the cost of over-triage and inefficient resource allocation. Each province and territory tailors its approach based on factors such as geographic areas served, and available resources., Conclusion: This study provides a snapshot of the current state of prehospital trauma-triage guidelines in Canada. With some differences in nomenclature, Canadian provinces and territories widely apply the CDC guidelines to serve their populations. There is some regional variation on how transport is initiated within their borders. The findings underscore the delicate balance required for optimizing air-ambulance policies, considering factors such as timely access, resource allocation, and the local application of guidelines., Competing Interests: Declarations Conflict of interest There are no conflicts of interest to declare., (© 2024. The Author(s), under exclusive licence to the Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)

Objective: This study aims to assess current diagnostic and management for systemic Juvenile Idiopathic Arthritis (sJIA) among physicians, evaluate the challenges encountered in diagnosis and treatment, and identify the educational needs and professional development engagements of physicians managing sJIA., Methods: A nationwide survey was conducted from November 2023 to March 2024 across tertiary and secondary pediatric and general hospitals in China. The survey targeted physicians with at least three years of specialty experience, resulting in 310 valid responses from 25 provinces, autonomous regions, and municipalities. The survey collected data on diagnostic practices, treatment approaches, and professional development related to sJIA. Data collection was facilitated through WeChat, and statistical analysis was performed using descriptive statistics. Ethical approval was obtained from the Ethics Committee of Beijing Children's Hospital, with informed consent provided electronically by participants., Results: The survey indicated that all physicians encountered suspected or confirmed cases of sJIA, highlighting its prevalence and the diagnostic challenges associated. Regarding diagnostic standards, 53.9% of physicians used the "Consensus on the Diagnosis and Treatment of sJIA and Macrophage Activation Syndrome," 18.1% followed the International League of Associations for Rheumatology (ILAR) standards, and 24.8% adhered to the Pediatric Rheumatology International Trials Organization (PRINTO) standards. In treatment strategies, glucocorticoids and IL-6 receptor monoclonal antibodies were extensively used, with the latter receiving "excellent" and "satisfactory" ratings of 46.5% and 36.1%, respectively, demonstrating high efficacy and acceptance. Main challenges included high treatment costs, complexity of diagnosis, patient compliance issues, and potential long-term side effects of biologics. Additionally, 126 doctors (40.7%) actively participated in more than three academic conferences or systematic learning courses related to sJIA, indicating a strong demand for ongoing education, particularly in new treatment developments and diagnostic skills., Conclusion: The findings emphasize the necessity for standardized diagnosis and customized treatment plans tailored to patient-specific conditions in managing sJIA. Key Points • The survey highlights the prevalence and clinical challenges of sJIA among physicians, emphasizing the importance of vigilant diagnosis, multi-system involvement, and differential diagnosis to improve treatment outcomes and patient quality of life., (© 2024. The Author(s).)

Objectives: This study evaluates the performance of AI models, ChatGPT-4o and Google Gemini, in answering rheumatology board-level questions, comparing their effectiveness, reliability, and applicability in clinical practice., Method: A cross-sectional study was conducted using 420 rheumatology questions from the BoardVitals question bank, excluding 27 visual data questions. Both artificial intelligence models categorized the questions according to difficulty (easy, medium, hard) and answered them. In addition, the reliability of the answers was assessed by asking the questions a second time. The accuracy, reliability, and difficulty categorization of the AI models' response to the questions were analyzed., Results: ChatGPT-4o answered 86.9% of the questions correctly, significantly outperforming Google Gemini's 60.2% accuracy (p < 0.001). When the questions were asked a second time, the success rate was 86.7% for ChatGPT-4o and 60.5% for Google Gemini. Both models mainly categorized questions as medium difficulty. ChatGPT-4o showed higher accuracy in various rheumatology subfields, notably in Basic and Clinical Science (p = 0.028), Osteoarthritis (p = 0.023), and Rheumatoid Arthritis (p < 0.001)., Conclusions: ChatGPT-4o significantly outperformed Google Gemini in rheumatology board-level questions. This demonstrates the success of ChatGPT-4o in situations requiring complex and specialized knowledge related to rheumatological diseases. The performance of both AI models decreased as the question difficulty increased. This study demonstrates the potential of AI in clinical applications and suggests that its use as a tool to assist clinicians may improve healthcare efficiency in the future. Future studies using real clinical scenarios and real board questions are recommended. Key Points •ChatGPT-4o significantly outperformed Google Gemini in answering rheumatology board-level questions, achieving 86.9% accuracy compared to Google Gemini's 60.2%. •For both AI models, the correct answer rate decreased as the question difficulty increased. •The study demonstrates the potential for AI models to be used in clinical practice as a tool to assist clinicians and improve healthcare efficiency., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Objective: To assess the unmet needs of South Africans with axial spondyloarthritis (axSpA) focusing on the patient journey, functional disability, and health-related quality of life., Methods: One hundred forty-six South African axSpA patients completed the International Map of Axial Spondyloarthritis (IMAS) online survey. Patient journey, functional disability, activities of daily living, and psychological stress were analyzed in relation to socio-demographic characteristics, disease activity, diagnostic delay, extra-musculoskeletal manifestations, and drug therapy., Results: Majority were female (82.2%) and Caucasian (89.7%) and the mean age of participants, age at onset of initial symptoms, and diagnostic delay were 44.7, 26.7, and 10.8 years, respectively. Participants reported a mean of 3.4 visits to healthcare professionals prior to a definitive diagnosis of axSpA, mostly made by rheumatologists (77.9%). Active disease (BASDAI ≥ 4) was reported by 87%, 69.9% suffered from psychological distress (general health questionnaire-12 score ≥ 3), and more than two-thirds suffered functional limitations in daily, personal, and social activities. Multivariable logistic analysis showed that active disease was more common in females [OR (95% CI) = 4.3 (1.2-15.2)] and was associated with greater functional limitation [OR (95% CI) = 1.1 (1.0-1.2)]., Conclusion: Of all the regions assessed in the IMAS (n = 5557 participants, 27 countries), South Africans reported the longest delay in diagnosis. The South African patient journey depicts a process burdened with diagnostic challenges and delays, coupled with patients experiencing significant personal and social limitations. These results emphasize the urgent need to establish local diagnostic and treatment guidelines for axSpA in South Africa, to reduce diagnostic delay, and to control disease activity associated with functional limitation in axSpA. Key Points • Axial spondyloarthritis (axSpA) in South Africans is associated with significant limitations in physical, mental, and social functioning. • First study to describe the unmet needs of South African patients with axSpA., (© 2024. The Author(s).)

Background: Healthcare workers have an increased risk of depression and anxiety, and medical staff have faced a wide variety of challenges, especially during the COVID-19-pandemic. The aim of the VOICE study was to investigate risk and protective factors for workplace-related stress experience and mental health., Method: A multicentre, web-based and prospective survey (VOICE study) was initiated in the spring of 2020 by a network of five psychosomatic university clinics (Erlangen, Ulm, Bonn, Cologne and Dresden). More than 25,000 respondents took part in the study at five measurement points., Results: Of 3678 employees examined in a hospital setting during the first wave of the pandemic, 17.4% and 17.8% of physicians, 21.6% and 19.0% of nurses and 23.0% and 20.1% of medical-technical assistants (MTA) were affected by symptoms of depression and anxiety, respectively, to a clinically relevant extent. The most important risk factors for depressive and anxiety symptoms were insufficient relaxation during leisure time, increased alcohol consumption, lower trust in colleagues in difficult work situations and increased fear of becoming ill with COVID-19. Predictors for increased post-traumatic symptoms were increased generalized anxiety and depression as well as increased fear of infecting family members. Sense of coherence, social support, optimism and reward level acted as protective factors., Discussion: The psychological effects of workplace-related stress during the pandemic were found to be significant. Therefore, regular mental health screening and prevention programmes for healthcare workers are indicated., (© 2024. The Author(s).)

Background: Artificial intelligence models such as ChatGPT (Open AI) have performed well on the exams of various medical and surgical fields. It is not yet known how ChatGPT performs on similar metabolic and bariatric surgery (MBS) questions., Objective: Assess the performance of ChatGPT on Focused Practice Designation in Metabolic and Bariatric Surgery board-style questions., Setting: United States., Methods: Questions obtained from the largest commercially available bank of FPD-MBS practice questions were entered into ChatGPT-4, as is, without prior training. We assessed the overall percentage correct as well as the percentage correct within each of the five American Board of Surgery (ABS) question categories. One-way ANOVA was used to determine if the frequency of correct answers differed between categories., Results: Out of 255 questions, ChatGPT-4 correctly answered 189 (74.1%). Between the five question categories there was no difference between the frequency of correct answers (p = 0.22). It did not matter if questions were entered individually or in groups of up to 10., Conclusion: Without prior training, ChatGPT-4 scored highly when evaluated on the largest practice question bank for the FPD-MBS exam., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Many surgical fellowship programs incorporate robotic surgery, yet not all residency programs offer robotic training for residents. Given the variability of pre-fellowship robotic exposure, the goal of this study was to explore whether standardized robotic skills assessment would be useful to fellows at the start of their training., Methods: In partnership with the Fellowship Council, we surveyed current fellows of accredited Thoracic, Colorectal, HPB, and Advanced GI/MIS/Bariatrics/Foregut Fellowship programs. Main outcome measurements included amount of robotic exposure during residency, fellows' robotic skills at the start of fellowship, and fellows' attitudes towards a standardized skills assessment., Results: In total, 78 fellows completed the survey. Mean percentage of cases performed robotically during fellowship was 38.1% (SD ± 32.25%). From our respondents, 46% had no robotic curriculum during residency and 86.9% felt a standardized robotic curriculum during residency would have been beneficial. When asked if they started fellowship with adequate robotic skills to operate autonomously, 31% strongly agreed, but 24.4% strongly disagreed. The majority of fellows reported their fellowship program did not conduct an assessment of their robotic skills (71.5%), or provide a specific robotic curriculum (75.6%). On the other hand, 73.3% felt a formal proficiency assessment at the start of fellowship would be helpful for individualized support and training., Conclusions: Given the significant variability in resident exposure to robotic surgery, a standardized robotic curriculum during residency would likely be beneficial. Additionally, a robotic skills assessment at the start of fellowship could help provide a tailored training experience for fellows interested in this skillset., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To describe the development and validation of a novel patient reported scale, which is a comprehensive assessment of the physical function and health specific for patients with axial spondyloarthritis (axSpA)., Methods: This is a multiphase, mixed methods study. Based on opinion collection and discussions of multidisciplinary consensus meetings and patients, an initial item pool covering all of the ranges of functioning was generated. The item optimization, model fit, response category functioning, differential item functioning, reliability, structure validity, and unidimensionality were tested by confirmatory factor analysis and Rasch measurement theory framework., Results: After the consensus meeting and the two rounds of surveys in patients with axSpA, the initial pool of 135 items was reduced to 25 items formed in five dimensions, which exhibited preferable item reliability, item fit, and person fit to the Rasch model. The Five-Dimensional Comprehensive Assessment Scale (5DCAS) had the best reliability and validity (Kaiser-Meyer-Olkin was 0.919, and the standardized Cronbach's α coefficient was 0.932). The final version of 5DCAS had good unidimensionality, and the Person Separation Index ranged from 0.77 to 0.85. 5DCAS significantly correlated with ASAS-HI, SF-36, BASFI, and disease activity with p values of < 0.001., Conclusion: 5DCAS is a novel patient-reported outcome specific to axSpA, and it forms five dimensions providing a linear sum score of 25 items. 5DCAS comprehensively and significantly represents the physical function and health status of patients with axSpA, although its performance needs further validation in future clinical practices. Key Points • The primary goal in the management of axial spondyloarthritis is to maximize health-related quality of life. Except for the current instruments of ASAS-HI, BASFI, or SF-36, the heterogeneous clinical symptoms and rapid updated treat-to-target concept require a new instrument which can comprehensive and significant evaluate the changes of physical function and health-related quality of life due to disease. • 5DCAS is a novel patient-reported outcome specific to axSpA, and it forms five dimensions providing a linear sum score of 25 items, which contained aspect of pain involvement, spine mobility, global body performance and activity, social participation and environment, and mental health. All of the items were set to a 4-point semantic rating scale measuring severity, frequency, or interference from score 0 to 3. Total 5DCAS score ranges from 0 to 75; higher scores represented greater symptom burden and worse physical function. • 5DCAS is a comprehensive, multidisciplinary, and convenient disease outcome measurement specific for axSpA. It provides a new evaluation instrument in clinical trial and treat-to-target clinical remission for patients and physicians, and also provides a sensitive and accurate assessment standard for optimized health benefits., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) was one crucial element to overcome the coronavirus disease 2019 (COVID-19) pandemic. Even though anaphylaxis to vaccines is rare, 47 patients came to the Allergy Unit at the University Hospital Graz, Austria, reporting immediate anaphylactoid symptoms after administration of COVID-19 vaccines. In addition, 29 patients with known drug-induced anaphylaxis wanted to be tested for a possible sensitization against COVID-19 vaccines or excipients, such as polyethylene glycol (PEG) or polysorbate 80 (PS80) before the first COVID-19 vaccination. Skin prick tests and intradermal tests were performed in all 76 patients, mostly using PEG 2000, and/or PS80. Skin prick tests with COVID-19 vaccines were performed depending on availability., Objective: Our aim was to characterize this patient cohort in terms of patients' anaphylactoid responses, their willingness to future vaccinations against SARS-Cov‑2, and reasons for their decision., Methods: We developed a questionnaire and analyzed 34 completed copies., Results: Of the 47 patients with anaphylactoid reactions to COVID-19 vaccination, most were female (40 female/7 male). The skin tests, even when performed with the respective COVID-19 vaccine, were negative in all but one patient. Most patients who experienced anaphylactoid reactions after a COVID-19 vaccination, did not want another COVID-19 vaccination at the time of answering the questionnaire because of anxiety for another anaphylactoid response at the next shot. Premedication with antihistamines significantly lowered (n = 74 vaccinations) the severity of anaphylactoid responses after COVID-19 vaccinations., Conclusion: Anxiety about another anaphylactoid episode hinders patients to be vaccinated against SARS-CoV‑2 again. Premedication with antihistamines and collaboration of allergologists with psychologists might lower the risk of an anaphylactic/anaphylactoid response as well anxiety in drug-induced anaphylactic patients., (© 2024. The Author(s).)

Introduction: Laparoscopic cholecystectomy is performed very commonly but laparoscopic common bile duct exploration (LCBDE) is performed infrequently. We aimed to determine the most significant barriers to performing LCBDE and to identify the highest yield interventions to facilitate adoption., Methods and Procedures: A national survey was designed by content experts, who regularly perform LCBDE. The survey was distributed by email to the Society of American Gastrointestinal and Endoscopic Surgeons and the American Association for the Surgery of Trauma memberships. Non-U.S. surgeon responses were excluded. Descriptive statistics were used to analyze the results., Results: Seven hundred twenty six practicing surgeons responded to the survey, 543 of which were US surgeons who perform laparoscopic cholecystectomy. Only 27% of respondents preferred to manage choledocholithiasis with LCBDE. Their technique of choice was choledochoscopy (70%). Despite this, 36% of surgeons did not have access to a choledochoscope or were unsure if they did. Seventy percent of surgeons who performed LCBDE did not have supplies readily available in a central stocking location. Only 8.5% of surgeons agreed that routine LCBDE would impact their referral relationship with gastroenterology. About half the respondents (47%) considered LCBDE worth the time, but only 25% knew about reimbursement for the procedure. Almost all (85%) of surgeons understood that LCBDE results in shorter length of stay compared to ERCP., Conclusions: Only a quarter of the surgeons performing cholecystectomy perform LCBDE. Multiple barriers contribute to low LCBDE utilization. Increasing availability of appropriate equipment, a dedicated supply cart, and teaching fluoroscopic LCBDE interventions may address limitations and increase adoption. These efforts may also increase efficiency, minimizing perceived time and skill restraints. Although many surgeons understand LCBDE decreases length of stay, they are unaware of surgeon-specific LCBDE financial benefits. Systematically addressing these barriers may increase LCBDE adoption, improve patient care, and decrease healthcare costs., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The recognition of adverse drug reactions (ADRs) is an important part of daily clinical work. However, medical education in this field is mostly drug-based and does not address adequately the complexity of this field regarding individual risk factors and polypharmacy. This study investigates the potential of the web-based serious game SeeMe (side-effect exposure-medical education) in pharmacological education of medical students to improve the recognition of relevant ADRs., Methods: One hundred fifty-seven medical students were recruited to evaluate the serious game SeeMe. SeeMe was developed to improve knowledge and recognition of ADRs in clinical practice. Players take on the role of a physician trying to understand fictional patients with ADRs. Before and after an 8-week playing period, an evaluation was carried out through a pre- and post-questionnaire and a pre- and post- knowledge test., Results: The students achieved significantly better results in the knowledge test, as almost twice as many exam-relevant questions were answered correctly (p < 0.001). The serious game had a positive effect on the students' perception of the importance of ADRs., Conclusion: This study demonstrates the potential of web- and case-based fictional serious games in medical education. The improved recognition of side effects represents a crucial step for education and training in clinical pharmacology. Future versions of the serious game may take this further and focus on training in the treatment of ADRs and their relevance in various healthcare professions., (© 2024. The Author(s).)

SATB2-associated syndrome (SAS) is a genetic syndrome characterised by intellectual disability, severe speech delay, and palatal and dental problems. Behaviours that challenge (BtC) are reported frequently; however, there is limited research on specific forms of BtC and the correlates of these behaviours. The current study explores correlates of well-defined BtC, self-injury, aggression, and property destruction, in SAS. Eighty-one parents/caregivers of individuals with SAS (53.1% male, Mage 10.12 years) completed questionnaire measures of health, behavioural, emotional, and autism characteristics. Individuals with SAS were grouped based on caregiver responses to the presence or absence of self-injury, aggression, and property destruction on the Challenging Behaviour Questionnaire. Rates of self-injury, aggression and property destruction were 42%, 77% and 49%, respectively. Between-group comparisons were conducted to compare characteristics between behaviour groups. Significantly differing characteristics were entered into separate hierarchical logistic regressions for each form of BtC. Behavioural comparisons indicated variation in the characteristics associated with each behaviour. All hierarchical logistic regression models were significant (p < .001): self-injury (χ 2 (5) = 38.46, R 2  = 0.571), aggression (χ 2 (4) = 25.12, R 2  = 0.414), property destruction (χ 2 (4) = 23.70, R 2  = 0.346), explaining between 34.6% and 57.1% of the variance in behaviour presence. This is the first study to identify correlates of self-injury, aggression, and property destruction in SAS. Variability in the characteristics associated with each behaviour highlights the importance of specificity when examining BtC. Understanding correlates of specific forms of BtC has important implications for informing SAS-associated pathways to behavioural outcomes and the implementation of tailored behavioural interventions., (© 2023. The Author(s).)

Background: Autism spectrum disorder (ASD) is a multifactorial, pervasive, neurodevelopmental disorder, of which intestinal symptoms collectively represent one of the most common comorbidities., Methods: In this study, 1,222 children with ASD and 1,206 typically developing (TD) children aged 2-7 years were enrolled from 13 cities in China. Physical measurement and basic information questionnaires were conducted in ASD and TD children. The Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC) were used to evaluate the clinical symptoms of children with ASD. The six-item Gastrointestinal Severity Index (6-GSI) was used to evaluate the prevalence of intestinal symptoms in two groups., Results: The detection rates of constipation, stool odor, and total intestinal symptoms in ASD children were significantly higher than those in TD children (40.098% vs. 25.622%, 17.021% vs. 9.287%, and 53.601% vs. 41.294%, respectively). Autistic children presenting with intestinal comorbidity had significantly higher scores on the ABC, SRS, CARS, and multiple subscales than autistic children without intestinal symptoms, suggesting that intestinal comorbidity may exacerbates the core symptoms of ASD children., Conclusion: Intestinal dysfunction was significantly more common in autistic than in TD children. This dysfunction may aggravate the core symptoms of children with ASD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

People on the autism spectrum can learn about autism from various sources, likely differing in the information, portrayal, and discussion they offer. The present study investigates where autistic people learn about autism, and whether their information source is associated with their level of autism knowledge, perceptions of stigma, and development and expression of an autism identity. A survey of 198 Australian adults with an autism diagnosis showed that learning about autism from conventional sources (e.g., professionals, parents) was associated with more internalised stigma, lower endorsement of special abilities and autism identity, whereas online blogs and social media showed the opposite pattern as well as more accurate knowledge of autism. The findings raise questions about how authoritative sources of information discuss autism., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Participation in Organised Extracurricular Social Activities (OESA) can provide positive outcomes for children. This study investigated whether children aged 4 to 12 years diagnosed with autism differ in their OESA participation and experience compared to neurotypical peers. Parents of autistic children (n = 35) and those of neurotypical peers (n = 171) responded to questions that asked them to reflect on their child's participation and experiences in OESAs. Parents of autistic children reported significantly less OESA participation compared to parents of neurotypical children. Additionally, when evaluating factors that facilitated OESA participation, parents of autistic children rated their child's individual abilities and behaviour, the OESA's features, and the social environment less positively, compared to parents of neurotypical children. OESA participation and experiences differ for autistic and neurotypical children. This study identifies factors that can be adjusted to mitigate this difference., (© 2023. The Author(s).)

Family-history assessment can identify individuals above population-risk for cancer to enable targeted Screening, Prevention and Early Detection (SPED). The online patient-facing cancer Family History Questionnaire Service (cFHQS) is a digitalised, resource efficient tool for family history data capture to facilitate this. The capturing of digital data from cFHQS allows for data interrogation of patients referred to Clinical Genetics for the purposes of service improvement. Digital data from 4,044 cFHQS respondents over a three-year period was collected and interrogated with respect to the number and type of familial tumour diagnoses to enable service improvement and streamlining of referral pathways. 81% of colorectal and 71% of breast screening assessments were population- or moderate-risk. Most patients who completed cFHQS reported more than one diagnosis of cancer/tumour/polyps in their family. 2.5% of family history assessment patients had a second indication that required assessment that would have been missed if single tumour type assessment was undertaken. Implementation of an innovative, digital family history data collection pathway has allowed large scale interrogation of referral patterns and assessment outcomes to enable service development. The high volume of inappropriate referrals to Clinical Genetics for population and moderate risk patients highlighted the need for dedicated secondary care pathway provision for these patients. The use of cFHQS streamlined family history assessment allows for redistribution of resources to improve equity and access to genetic cancer risk assessment., (© 2024. The Author(s).)

Background: Decision regret is an emerging patient reported outcome. The aim of this study was to assess the incidence of regret in patients with appendiceal cancer (AC) who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)., Patients and Methods: An anonymous survey was distributed to patients through the Appendix Cancer and Pseudomyxoma Peritonei (ACPMP) Research Foundation. The Decision Regret Scale (DRS) was employed, with DRS > 25 signifying regret. Patient demographics, tumor characteristics, postoperative outcomes, symptoms (FACT-C), and PROMIS-29 quality of life (QoL) scores were compared between patients who regretted or did not regret (NO-REG) the procedure., Results: A total of 122 patients were analyzed. The vast majority had no regret about undergoing CRS-HIPEC (85.2%); 18 patients expressed regret (14.8%). Patients with higher regret had: income ≤ $74,062 (72.2% vs 44.2% NO-REG; p = 0.028), major complications within 30 days of surgery (55.6% vs 15.4% NO-REG; p < 0.001), > 30 days hospital stay (38.9% vs 4.8% NO-REG; p < 0.001), a new ostomy (27.8% vs 7.7% NO-REG; p = 0.03), >1 CRS-HIPEC procedure (56.3% vs 12.6% NO-REG; p < 0.001). Patients with worse FACT-C scores had more regret (p < 0.001). PROMIS-29 QOL scores were universally worse in patients with regret. Multivariable analysis demonstrated > 30 days in the hospital, new ostomy and worse gastrointestinal symptom scores were significantly associated with regret., Conclusions: The majority of patients with AC undergoing CRS-HIPEC do not regret undergoing the procedure. Lower income, postoperative complications, an ostomy, undergoing > 1 procedure, and with worse long-term gastrointestinal symptoms were associated with increased regret. Targeted perioperative psychological support and symptom management may assist to ameliorate regret., (© 2024. Society of Surgical Oncology.)

Introduction: Endoscopy is an essential skill for all surgeons. However, endoscopic competency, training, and practice may vary widely among them. The EAES Flexible Endoscopy Subcommittee is working towards a standardized set of fundamental endoscopic knowledge and skills. To best advise on current practice patterns of flexible endoscopy among surgeons worldwide, a snapshot audit was conducted on the training, use, and limitations of flexible endoscopy in practice., Methods: An online survey was distributed via email distribution and social media platforms for EAES, SAGES, and WebSurg members. Respondent demographics, training, and practice patterns were assessed. The main outcome measure was the annual endoscopic volume. Multivariate regression and machine learning models analyzed relationships between outcomes and independent variables of age, geographic region, laparoscopic surgery practice, and surgical specialization., Results: A total of 1486 surgeons from 195 countries completed the survey. Respondents were mainly general (n = 894/1486, 60.2%), colorectal (n = 189/1486, 12.7%), bariatric (n = 117/1486, 7.9%), upper gastrointestinal (GI)/foregut (n = 108, 7.3%), hepatobiliopancreatic/HPB (n = 59/1486, 4%), and endocrine surgeons (n = 11/1486, 0.7%) in active practice. Eighty-two percent (n = 1,204) mentioned having used endoscopy in their practice, and 64.7% (n = 961/1486) received formal flexible endoscopy training. Of those performing endoscopy annually, 64.2% (n = 660/1486) performed between 0 and 20 endoscopies, 15.2% (n = 156/1486) performed between 20 and 50 endoscopies, 10.1% (n = 104/1486) performed between 50 and 100 endoscopies, and 10.5% (n = 108/1486) performed over 100 endoscopies. From the regression analysis, there was no statistical correlation between the annual endoscopy volume and age, geographic region, laparoscopic surgery practice, or surgical specialization. Performing advanced endoscopy was directly related to the bariatric subspecialty and to performing over 50% of cases in a minimally invasive fashion., Conclusions: This international snapshot audit revealed significant heterogeneity in endoscopic practices among surgeons worldwide. There was a nonindependent relationship between endoscopy volumes and other variables tested. Barriers to practicing and receiving endoscopy training were common among respondents. The EAES Flexible Endoscopy Subcommittee will consider such results when developing an equitable and effective standardized flexible endoscopy curriculum., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: An internal model deficit is considered to underlie developmental coordination disorder (DCD); thus, children with DCD have an altered sense of agency (SoA), which is associated with depressive symptoms. Furthermore, the perception of action-outcome regularity is present in early development, is involved in the generation of SoA, and has roles in adaptive motor learning and coordinated motor skills. However, perceptual sensitivity to action-outcome regularity has not been examined in children with DCD., Methods: We investigated perceptual sensitivity to action-outcome regularity in 6-15-year-old children with DCD and age- and sex-matched typically developing (TD) children. Both groups were assessed for coordinated motor skills with the Movement Assessment Battery for Children-2nd Edition, while the DCD group was assessed with the DCD Questionnaire, Social Communication Questionnaire, Attention-Deficit/Hyperactivity Disorder-Rating Scale, and Depression Self- Rating Scale for Children., Results: Perceptual sensitivity to action-outcome regularity was significantly reduced in children with DCD. However, there was a significant correlation between perceptual sensitivity to action-outcome regularity and age in DCD and TD children. Perceptual sensitivity to action-outcome regularity was significantly lower in younger children with DCD than in younger and older TD children, but there were no significant differences between older children with DCD and younger and older TD children., Conclusion: The current results suggest that children with DCD have significantly reduced perceptual sensitivity to action-outcome regularity at younger ages, which may alter SoA and inhibit internal model development, thereby reducing motor skill coordination., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The Social Responsiveness Scale (SRS) is frequently used in research settings to measure characteristics associated with autism spectrum disorders (ASD). A short version has been developed but not yet tested for certain properties of the full SRS, such as familiality. The purpose of this study was to determine if prior familiality findings for the full SRS can be replicated using the short form by measuring the associations of the parental Social Responsiveness Scale-Short Form (SRS-SF) scores with child ASD diagnoses and child SRS-SF scores., Methods: We used a nested case-control study within a longitudinal cohort study design. Participants were selected from the Nurses' Health Study II (NHS II). Cases were children of study participants who had been diagnosed with ASD, while controls had not been diagnosed with ASD and were frequency matched by year of birth to cases. 2144 out of 3161 eligible participants returned SRS forms for a child and at least one parent. Participants in NHS II completed SRS forms for their spouses and spouses completed SRS forms for NHS II participants. Parental SRS-SF scores were based on a subset of 16 questions from the SRS. ASD diagnosis among children was reported by the mothers and validated in a subset using the Autism Diagnostic Interview-Revised, as well as child SRS-SF scores., Results: Children whose parents both had elevated SRS-SF scores (those in the top 20% of the study distribution) had a higher odds of ASD diagnosis than those who did not have elevated parental scores (OR 2.25; 95% CI 1.41, 3.58). Additionally, children whose fathers had elevated SRS-SF scores had a higher odds of ASD diagnosis (OR 2.18; 95% CI 1.60, 2.97) than those whose fathers scores were not elevated. In sex-stratified analyses, male children with elevated parental SRS-SF scores had a higher odds of ASD diagnosis than those who did not have elevated parental scores. These associations were not as evident among female children. Parental SRS-SF scores also predicted child SRS-SF scores among controls., Conclusion: These findings are similar to prior findings for the full SRS and support the ability of the SRS-SF to capture familiality of ASD-related traits., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Information on the general health of transgender and gender diverse (TGD) individuals continues to be lacking. To bridge this gap, the National Institute of Health in Italy together with the National Office against Racial Discriminations, clinical centres, and TGD organizations carried out a cross-sectional study to define the sociodemographic profile, health-related behaviours, and experiences of healthcare access in Italian TGD adult population., Methods: A national survey was conducted by Computer-Assisted Web Interviewing (CAWI) technique. Collected data were compared within the TGD subgroups and between TGD people and the Italian general population (IGP)., Results: TGD respondents were 959: 65% assigned female at birth (AFAB) and 35% assigned male at birth (AMAB). 91.8% and 8.2% were binary and non-binary TGD respondents, respectively. More than 20% of the TGD population reported to be unemployed with the highest rate detectable in AMAB and non-binary people. Cigarette smoking and binge drinking were higher in the TGD population compared with IGP (p < 0.05), affecting TGD subgroups differently. A significant lower percentage of AFAB TGD people reported having had screening for cervical and breast cancer in comparison with AFAB IGP (p < 0.0001, in both cases). Over 40% was the percentage of AFAB and non-binary TGD people accessing healthcare who felt discriminated against because of their gender identity., Conclusions: Our results are a first step towards a better understanding of the health needs of TGD people in Italy in order to plan the best policy choices for a more inclusive public health., (© 2024. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Purpose: To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD., Methods: A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression., Results: Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721)., Conclusion: Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Despite higher breast cancer screening rates, black women still are more likely to have late-stage disease diagnosed. This disparity is influenced in part by structural and interpersonal racism. This prospective study sought to determine how interpersonal factors, including perceived discrimination, influence screening and stage of disease at diagnosis., Methods: A prospective cohort study analyzed adult women with stages I to IV breast cancer from the Miami Breast Cancer Disparities Study. Perceived discrimination and mistrust of providers were assessed using previously validated questionnaires. Multivariable logistic regression was used to evaluate the odds of screening mammography utilization and late-stage breast cancer at diagnosis., Results: The study enrolled 342 patients (54.4 % Hispanic, 15.8 % white, and 17.3 % black). Multivariate regression, after control for both individual- and neighborhood-level factors, showed that a higher level of perceived discrimination was associated with greater odds of late-stage disease (adjusted odds ratio [aOR], 1.06; range, 1.01-1.12); p = 0.022) and lower odds of screening mammography (aOR, 0.96; range, 0.92-0.99; p = 0.046). A higher level of perceived discrimination also was negatively correlated with multiple measures of provider trust., Discussion: This study identified that high perceived level of discrimination is associated with decreased odds of ever having a screening mammogram and increased odds of late-stage disease. Efforts are needed to reach women who experience perceived discrimination and to improve the patient-provider trust relationship because these may be modifiable risk factors for barriers to screening and late-stage disease presentation, which ultimately have an impact on breast cancer survival., (© 2024. The Author(s).)

According to the available studies, mobile applications have provided significant support in improving the diverse skills of special individuals with social pragmatic communication disorder (SPCD). Over the last decade, SPCD has affected 8 to 11% of individuals, and therapy sessions cost between $50 and $150 per hour. This preliminary study aims to develop an interactive, user-friendly intervention to enhance social and emotional interaction skills in individuals with SPCD. The proposed intervention is an Android application that enhances social and emotional interaction skills. This pilot study involved 29 human subjects aged 7-13 years with pragmatic communication deficits. In a randomized controlled trial, the intervention was developed and implemented with consideration of caregiver and professional requirements. The improvement was analyzed using standard scales, including the Social Communication Questionnaire (SCQ) and the Social Communication Disorder Scale (SCDS). Moreover, the outcomes were examined through statistical parameters (mean, standard deviation) and tests (t-test). The intervention significantly improved the social and emotional skills of individuals with deficits. Before using the intervention, the identified statistical values for SCQ (mean = 6.48 and standard deviation = 3.37) and SCDS (mean = 8.17 and standard deviation = 4.79). However, after using the intervention, values for SCQ (mean = 8.24 and standard deviation = 3.95) and SCDS (mean = 9.48 and standard deviation = 4.72) were improved in comparison to the before-intervention outcome. The evaluation of the t-scores and p-values indicates that there has been significant improvement in the performance of individuals after the successful completion of the intervention. The proposed and applied intervention resulted in a significant impact in terms of improvement in social and emotional skills. The study concluded that it allows individuals to practice social and emotional interaction skills in a structured, controlled, and interactive environment. The proposed intervention has been found acceptable as per the reviews of caregivers and professionals, based on essential criteria including user experience, usability, interactive nature, reliability, and creditability., (© 2024. International Federation for Medical and Biological Engineering.)

Purpose: Living with type 1 diabetes requires burdensome and complex daily diabetes self-management behaviors. This study aimed to determine the association between integrated behavior performance and HbA1c, while identifying the behavior with the most significant impact on HbA1c., Methods: A simple and feasible questionnaire was used to collect diabetes self-management behavior in patients with type 1 diabetes (n = 904). We assessed six dimensions of behavior performance: continuous glucose monitor (CGM) usage, frequent glucose testing, insulin pump usage, carbohydrate counting application, adjustment of insulin doses, and usage of apps for diabetes management. We evaluated the association between these behaviors and HbA1c., Results: In total, 21.3% of patients performed none of the allotted behavior, while 28.5% of patients had a total behavior score of 3 or more. 63.6% of patients with a behavior score ≥ 3 achieved HbA1c goal, contrasting with only 30.4% of patients with a behavior score of 0-1. There was a mean 0.54% ± 0.05% decrease in HbA1c for each 1-unit increase in total behavior score after adjustment for age, family education and diabetes duration. Each behavior was independently correlated with a lower HbA1c level, with CGM having the most significant effect on HbA1c levels., Conclusions: Six optimal self-management behaviors, especially CGM usage, were associated with improved glycemic control, emphasizing the feasibility of implementing a simplified version of DSMES in the routine clinical care., Registration Number: ClinicalTrials.gov Identifier: NCT03610984., (© 2024. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Goat farming in Peru is a husbandry activity that, although it is considered secondary in the country, has a great economic and social impact on the rural population, that is why government efforts to develop is so important. The objective of this study was to characterize dairy goat rearing systems in the coastal valleys of the Lima region to identify gaps and opportunities for improvement. This cross-sectional research was conducted in four provinces located in the Lima region, Peru. A total of 62 goat farmers participated in the trial. For data collection, a standard survey was prepared with open and closed questions distributed across two components (socioeconomic and productive). The surveys were processed for qualitative variables using a multiple correspondence analysis (MCA) followed by a hierarchical cluster analysis (HCA) to differentiate the types of farming systems prevalent based on the survey population. The hierarchical cluster analysis resulted in the formation of three separate groups of goat farmers, which can be classified as extensive systems differentiated by management practices and their production and marketing objectives. The test showed a significant difference; therefore, it can be affirmed that they are associated with the groups or clusters formed. These results will allow actors related to goat farming, such as state and regional entities, to focus efforts on addressing specific demands of the different types of goat farmers found in this study., (© 2024. The Author(s).)

This nationwide multidisciplinary survey found dissatisfaction among physicians with current osteoporotic vertebral compression fracture care, revealing significant disparities in diagnosis, treatment, and follow-up practices. Issues include poor communication and differing guidelines. Improving interdisciplinary collaboration and standardized care strategies is essential for better patient outcomes., Purpose: This survey aims to assess current preferred care practices for symptomatic osteoporotic vertebral compression fractures (OVCF) in the Netherlands, focusing on guideline adherence, identifying knowledge gaps, and clarifying consensus and collaboration across medical disciplines in OVCF treatment., Methods: This cross-sectional study was conducted via Qualtrics (Provo, UT) using a self-administered online survey distributed to 238 general practitioners and physicians in orthopedics, traumatology, internal medicine, rheumatology, and geriatrics working at 51 hospitals in the Netherlands. The survey, conducted in Dutch, included 36 multiple-choice and two open questions and was accessible via an anonymous email link or QR code. General practitioners received additional questions specific to their role. Data was anonymized, stored securely, and analyzed using descriptive statistics in Microsoft Excel and SPSS (Version 24). Open-ended responses were coded and categorized. The survey was conducted prior to the publication of the updated Federation of Medical Specialists guidelines in 2024., Results: Physicians across various disciplines uniformly expressed dissatisfaction with current OVCF care. The survey highlighted significant disparities in diagnosis, treatment, and follow-up practices. A lack of communication between primary and secondary care providers and differing guidelines further complicate OVCF management. These issues point to considerable variation in clinical practice and gaps in interdisciplinary collaboration., Conclusion: Addressing the identified issues requires fostering interdisciplinary collaboration and creating cohesive care strategies. Ensuring access to diagnostic resources in both primary and secondary care and establishing coordinated care models promises more structured and standardized treatment. These steps are crucial for enhancing patient outcomes in OVCF management., (© 2024. The Author(s).)

Empathy, defined as the ability to understand and share another person's feelings, is crucial in the healthcare setting, particularly for patients with cancer who face significant psychosocial challenges. We aimed to develop a novel tool, the Empathy, Life with Cancer, and Psychosocial Skills (ELPIS) Scale that prioritizes emotional and cognitive components in order to determine the reflection of the negative stigmatization of cancer in societies on individuals, excluding the behavioral and ethical dimensions of empathy. The study was conducted using a quantitative research design with a sample of first- and second-year medical students in Türkiye. An initial pool of 48 items was developed based on an extensive review of the literature and existing empathy scales. Following expert review and pilot testing, the scale was refined to 24 items. Exploratory factor analysis and confirmatory factor analysis were conducted to establish the scale's factor structure and validate its reliability and validity. The exploratory factor analysis revealed a three-factor structure comprising "emotional empathy," "sympathetic responses," and "realistic approaches," with a total of 20 items after refinement. Confirmatory factor analysis confirmed the model fit, with the scale demonstrating high internal consistency across all three dimensions. The scale's reliability was further supported by high Cronbach's alpha values. The results suggest that the ELPIS Scale is a reliable and valid instrument for measuring emotional empathy toward cancer patients. It offers a nuanced approach by separately assessing emotional, sympathetic, and realistic components of empathy, making it a valuable tool for both educational and clinical applications. Future research should explore the scale's application in diverse populations and settings, as well as its utility in tracking empathy development over time. In conclusion, the ELPIS Scale, which focuses on the emotional and cognitive components of empathy, a multifaceted construct, fills a critical gap in the measurement of empathy in the context of cancer care and provides a comprehensive tool that can improve both patient care and the education of healthcare providers., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The Association of Program Directors for Colon and Rectal Surgery (APDCRS) has sponsored a standardized robotics course for colorectal and minimally invasive surgery fellows since 2011. The study objective was to assess the impact of the APDCRS-sponsored course on surgical approaches adopted by young colorectal surgeons before, during, and after fellowship. An internet-based survey was administered to 2014-2022 ACGME-accredited colorectal surgery program graduates. Study variables were summarized using frequencies and proportions. Survey response rate was 43.2%. Laparoscopic and robotic volumes were consistently higher than open and hand-assist laparoscopic volumes over the study period. About 70.0% of fellows performed ≥ 20 laparoscopic cases before 2017, and over 80% had experience with ≥ 20 laparoscopic cases during/after 2017. An increasing trend of performing ≥ 20 robotic colorectal cases during fellowship was observed (before 2017: 75.0%, 2018-2019: 76.9%, and 2021-2022: 84.8%). Multivariate logistic regression analysis showed that higher robotic volume (≥ 25 colorectal cases) during general surgery residency increased odds of performing ≥ 50 robotic cases during fellowship (OR: 4.38, 95% CI 0.88, 26.1). Higher robotic volumes during fellowship correlated with higher robotic volumes in the first year of post-fellowship practice. 88.6% of respondents agree (21.0%) or strongly agree (67.6%) that the APDCRS robotics training course met expectations, and 83.8% agree or strongly agree that the course prepared them for post-graduate robotics practice. The APDCRS-sponsored robotics training course met expectations and prepared colorectal surgery fellows for adopting the robotic approach after graduation, with the majority of respondents reporting that they utilize robotics in their post-graduation colorectal practice., (© 2024. The Author(s).)

Patients' beliefs about their illness are of central importance in understanding how a person adjusts to their condition and adheres to self-management recommendations. No previous studies have set out to quantitatively examine Illness beliefs in patients with kidney stones (KS). 112 patients with radiological confirmation of KS (59% male, mean (x̄) age = 50.1 years [sd14.15 years], 50.5% previous surgical treatment) attending for clinical consultation completed the Brief-Illness Perception Questionnaire alongside a range of demographic and illness related variables. Template analysis was undertaken on the free text responses of patients' beliefs about what had caused their KS. Almost a third (31.2%) of patients did not know what had caused their KS. Of those who cited a cause, dietary factors, fluid intake, medical risk factors (e.g. Inflammatory bowel disease), genetics, and psychological factors were ranked as the most important. Patients generally believed they had a reasonable understanding of KS (x̄=6.32 [sd3.21]), but reported poor levels of personal control over their KS (x̄=2.90 [sd2.93]) and high confidence in the effectiveness of treatments (x̄=8.64 [sd1.90]). Patients with a recurrence believed KS had a significantly greater impact on their life (z=-2.56, p = 0.01) and had greater emotional consequences (z=-2.77, p < 0.01). Perceptions of poor personal control over KS and a strong belief in medical/surgical treatment was evident regardless of first or recurrent stone, gender, age, previous surgical management of KS or time since diagnosis. Results highlight the need to actively increase patients' perceptions of personal control in the management and prevention of KS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Our aim was to investigate the perception and future expectations of Single-Port (SP) surgery among urology trainees in the United States. A 34-item online survey was distributed to urological residency and fellowship programs across the US, covering demographic profiles, SP training opportunities, perceived educational impact, and future perspectives. Descriptive analysis and multivariable linear regression were used to assess predictors of SP adoption. 201 surveys were completed (28.6% completion rate). Among institutions with an SP platform, about 50% have used it regularly for over 2 years, though often in less than 50% of procedures. While robotic simulators are commonly available, only 17% offer both multi-port and SP simulators, and structured pre-clinical SP training is limited. Approximately 30% of respondents expressed concerns over limited hands-on experience and a steeper learning curve with SP. Around 40% felt that their robotic surgery exposure was negatively impacted by SP's introduction. SP surgery's benefits are seen mostly in the immediate post-operative period and a significant number of respondents foresee a major role for SP in urology. However, proficiency in SP surgery is not seen as crucial for career advancement or job opportunities. Academic job aspirations, SP platform availability, and SP surgery workload are predictors of future SP implementation. Trainees increasingly recognize the clinical benefits of SP procedures but express concerns about the potential negative impact on hands-on experience. Training programs should more systematically integrate SP technology into curricula. There is a correlation between training in high-volume SP centers and future SP adoption., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background and Aim: Some studies suggested an association between Temporomandibular Disorders (TMD) and psychosocial status, but most of them are focused on samples of patients looking for treatment or present limits of sample representativeness. The aim of the present study was to evaluate the psychosocial status in a large sample of adult population, further than to assess its association to TMD symptoms, oral behaviours, and self-reported facial trauma., Results: the study sample included 4299 subjects older than 18 years randomly recruited from general population in public spaces during their daily life (1700 Males, 2599 Females mean ± SD age = 40.4 ± 18.1). Psychosocial status and pain-related disability were assessed by means of Patient Health Questionnaire 4 (PHQ-4) and Graded Chronic Pain Scale (GCPS). TMD symptoms were assessed by RDC/TMD and validated screening tools for TMD pain. Oral Behaviours Checklist was used to investigate on oral behaviours. Logistic regression model was used to evaluate the association of the psychosocial status, TMD symptoms, trauma, and oral behaviours. The association was tested using both univariate and multivariate models. The PHQ4 evaluation showed a severe impairment in 4.6% of our sample, moderate in 18.8% and mild in 32.5%. We found a Characteristic Pain Intensity (CPI) level and Interference Score greater that 30 respectively in 36.2% and 22.2% of the study sample. The GCPS status revealed a high disability with severe limitation in 2.5% of the sample, high disability with moderate limitation in 7.0%, low disability high pain intensity in 7.4% and low disability low pain intensity in 37.8%. Anxiety and depression's levels were significantly associated with gender, TMD pain, coexistence of TMD Pain and sound, and oral behaviours. GCPS status was significantly associated with age, TMD Pain, coexistence of TMD pain and sound, trauma, and oral behaviours., Conclusions: In the general population, psychosocial impairment is associated to TMD pain, female gender, and report of oral behaviours. Hence, in adults with TMD accompanied by pain, psychosocial status should also be evaluated., (© 2024. The Author(s).)

Young Black women experience higher rates of dating violence victimization compared to their White peers. Religion is a cornerstone of African American culture, suggesting that Black women may use religious coping after experiencing trauma like dating violence. However, research has not explored the patterns of religious coping following dating violence experiences. The current study analyzed survey data from 481 young Black women aged 18-19 years on their religious coping behaviors, acceptance of violence beliefs, and dating violence victimization experiences. Results showed that victimization was positively associated with negative religious coping. Findings indicate that one way young Black women cope with dating violence victimization is through feelings of spiritual discontent, and they may see their victimization as a punishment from God., (© 2024 Springer Publishing Company.)

Introduction: Previous studies have focused on understanding the biopsychosocial implications of obesity stigma and have made proposals to minimize its negative consequences, as well as recommendations to eliminate or reduce this stigma; however, knowing which individuals stigmatize obesity and why will allow us to have a broader picture of stigmatization and thus help in planning interventions with greater impact., Objective: The aims were to describe the stigmatization toward obesity in preadolescents and adolescents and to determine whether there are differences in body dissatisfaction, abnormal eating behaviors and self-esteem among those with and without stigma toward obesity., Methods: A total of 307 preadolescents and 349 adolescents answered a set of questionnaires that evaluated abnormal eating behaviors, body dissatisfaction, self-esteem and stigma., Results: Fifty-nine percent of the participants stigmatized individuals with obesity, with preadolescents having the greatest stigma levels. Differences were observed only in body dissatisfaction, where the group of preadolescents who stigmatized individuals with obesity and the group of adolescents who did not stigmatize individuals with obesity reported higher levels of body dissatisfaction., Conclusion: Obesity is stigmatized at early ages, regardless of sex; however, preadolescents with stigma toward obesity and adolescents without stigma toward obesity have greater body dissatisfaction, indicating that body dissatisfaction plays a crucial role in the stigmatization of obesity., Level of Evidence: Level V, cross-sectional analytical study., (© 2024. The Author(s).)

Background: Orthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours., Objectives: This study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association., Methods: A representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale., Results: Cluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed., Conclusions: Our study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies., (© 2024. The Author(s).)

In order to assess the perceptions and expectations of the radiology staff about artificial intelligence (AI), we conducted an online survey among ESR members (January-March 2024). It was designed considering that conducted in 2018, updated according to recent advancements and emerging topics, consisting of seven questions regarding demographics and professional background and 28 AI questions. Of 28,000 members contacted, 572 (2%) completed the survey. AI impact was predominantly expected on breast and oncologic imaging, primarily involving CT, mammography, and MRI, and in the detection of abnormalities in asymptomatic subjects. About half of responders did not foresee an impact of AI on job opportunities. For 273/572 respondents (48%), AI-only reports would not be accepted by patients; and 242/572 respondents (42%) think that the use of AI systems will not change the relationship between the radiological team and the patient. According to 255/572 respondents (45%), radiologists will take responsibility for any AI output that may influence clinical decision-making. Of 572 respondents, 274 (48%) are currently using AI, 153 (27%) are not, and 145 (25%) are planning to do so. In conclusion, ESR members declare familiarity with AI technologies, as well as recognition of their potential benefits and challenges. Compared to the 2018 survey, the perception of AI's impact on job opportunities is in general slightly less optimistic (more positive from AI users/researchers), while the radiologist's responsibility for AI outputs is confirmed. The use of large language models is declared not only limited to research, highlighting the need for education in AI and its regulations. CRITICAL RELEVANCE STATEMENT: This study critically evaluates the current impact of AI on radiology, revealing significant usage patterns and clinical implications, thereby guiding future integration strategies to enhance efficiency and patient care in clinical radiology. KEY POINTS: The survey examines ESR member's views about the impact of AI on radiology practice. AI use is relevant in CT and MRI, with varying impacts on job roles. AI tools enhance clinical efficiency but require radiologist oversight for patient acceptance., (© 2024. The Author(s).)

The contamination of river systems by tailing dust remains a constraint to goat productivity in communal farming systems. A cross-sectional study was conducted to investigate how resource-limited households in subtropical regions assessed the effects of tailing dust contamination in drinking water on the health status of goats. In a study conducted in the Ba-Phalaborwa Local Municipality, 200 households from two villages were randomly selected and interviewed using a questionnaire. Forty-eight percent (n = 96) of the households were located in contaminated areas, while 52% (n = 104) were from uncontaminated areas. The study found that poor water quality, caused by tailing dust contamination, as well as a high incidence of diseases, were key factors affecting goat productivity. Water contamination was most severe during the hot and cool dry seasons. It was also noted that goats rely on freshwater as their primary source of supplemental water during dry seasons. Urine colour, oedema of the eyelids, and kid survival were indicators for assessing the health status of goats. Nominal binary logistic regression revealed that water contamination was 2.96 more likely to be reported by youth compared to elderly members. Farmers who received informal education were 37 times more likely to report contamination than those who received formal education. High kid mortality as a health status indicator was 50 times less likely to be reported in uncontaminated areas. Intervention strategies for reducing the adverse health effects of tailing dust in contaminated areas should focus primarily on the health of goats during dry seasons., (© 2024. The Author(s).)

It has been widely recognized that accelerating green residential energy transition from traditional solid fuels (biomass and coal) to clean and high-efficient energy sources is critical for rural sustainable development. However, little attention has been paid to estimate panel data discrete choice models to analyze the dynamic behavior information of individual households in the process of energy transition. Hence, this paper investigates green residential energy transition using a panel dataset from 3308 rural households in eight provinces of China in 2015 and 2018. The results show that although traditional solid biomass still plays a dominating role in rural residential energy choice, fuel switching from solid fuels to modern clean energy alternatives is taking place. Off-farm employment plays an important role in the transition towards more sustainable energy sources, as households with off-farm employed heads and higher off-farm income level are highly likely to choose superior energy alternatives other than traditional biomass. Besides, the educational level of the household head and household location are also important influencing factors of household residential energy choices. Based on these findings, this paper suggests that job creation in non-farm sectors should be given a priority in future policy design to promote rural green energy transition in residential sector. North-south differences should be taken into account, whereas more policy options for optimizing biomass energy use should be explored., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Clinical specialists are supposed to inform childhood cancer patients of infertility risk and conduct fertility preservation (FP). However, little is known about whether doctors in China are fully prepared. This study aimed to investigate behavior, attitude, perception, and knowledge regarding FP among pediatric oncological specialists in a nation wide survey, to set the stage for improvements in current clinical practice patterns., Methods: This study was conducted on physicians and surgeons specialized in pediatric oncology using a questionnaire through the WeChat platform. The behavior, attitude, perception, and knowledge were assessed by Likert questions and results were quantified to obtain scores. Data were then described and analyzed using R and GraphPad., Results: Totally 373 specialists in pediatric tumors were included in the analysis. Hematologists, oncological surgeons, and reproductive medicine specialists won most trusts to be responsible for FP job. Most respondents did not have habits of delivering FP information or cooperating with FP specialists during treatment though they were well equipped with FP knowledge and desired for uniform national guideline for FP procedures. The severity of illness was regarded as the primary barrier of FP delivery. When a doctor was more educated and experienced, he was more likely to have better performance in FP. The total score, the knowledge score, and the single score concerning frequency of patients' inquiry showed aggregational trend on geographic distribution., Conclusion: Chinese pediatric oncologists demonstrated unsatisfactory practice behaviors based upon this self-reporting survey, although their attitude towards FP was generally positive., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction and Hypothesis: Postpartum urinary incontinence (UI) is common and a concern for many women, as UI leads to a lower quality of life and self-esteem. Perineal tears may be a risk factor for UI, yet few studies have investigated the association between the degree of perineal tear and risk of developing UI postpartum. The objective was to examine how the degree of perineal tear and selected obstetric risk factors were associated with any UI and stress ultrasound (SUI) 12 months postpartum among primiparous women., Methods: A prospective cohort study was conducted at four Danish hospitals. Baseline data were obtained at a clinical examination 2 weeks postpartum. Symptoms of UI were evaluated 12 months postpartum by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire (web-based). Multivariate regression analyses were performed to investigate the risk factors for UI., Results: A total of 603 primiparous women (203 with none/labia/first-degree tears, 200 with second-degree tears and 200 with third-/fourth-degree tears) were included between July 2015 and January 2018. Women with tears involving the perineal muscles reported any UI more often than women with no/labia or first-degree tears (spontaneous second-degree tear: RR 2.04, 95% CI 0.92-4.50; episiotomy: RR 2.22, 95% CI 0.99-4.96; third- or fourth-degree tear: RR 2.73, 95% CI 1.18-6.28). The same was found for SUI, but with wider confidence intervals., Conclusions: A higher prevalence of any UI and SUI was found among women with perineal tears involving any perineal muscles, compared with women with no, labia, or first-degree tears., (© 2024. The Author(s).)

Background: Recent studies show the high prevalence of child maltreatment in Germany and that assaults by hospital staff also pose a problem. Since 2020, the Joint Federal Committee has been calling for institutional safeguarding measures (ISM) to protect and support those affected in hospitals. The aim of this study is to analyze the level of knowledge and action competencies regarding child maltreatment among hospital staff and the extent to which ISM are implemented in hospitals., Methods: A survey was administered to 1011 participants before they took part in two online courses on child protection and protection measures in hospitals, with questions regarding self-assessed level of knowledge and competence on child protection and the occurrence of cases of maltreatment and protective measures in their own institution. Data were analyzed using descriptive methods., Results: It becomes apparent that the knowledge and competencies of hospital staff regarding child protection are in the middle range. In hospitals, cases of maltreatment that occur outside the institution are particularly common, but violence by staff or other patients of the same age also plays a significant role. Of the respondents, 93.6% stated that their institution had already developed at least one element of an ISM, but only 1.0% of respondents reported that all the elements surveyed had already been fully developed., Discussion: Hospitals in Germany seem to be largely on the path to better protect children and adolescents from maltreatment and to support those affected. However, there are still deficits in the competencies of employees and the implementation of the ISM elements. More resources need to be made available by hospital operators and the public sector for this purpose., (© 2024. The Author(s).)

Introduction and Hypothesis: Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS., Methods: A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group (n = 30) or a control group (n = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired t tests, independent t tests, Wilcoxon, and Chi-squared tests., Results: Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in "calmness" (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, p < 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS., Conclusion: Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS., (© 2024. The Author(s).)

Introduction and Hypothesis: Pelvic organ prolapse (POP) has a profound influence on a woman's quality of life (QoL). Assessment of QoL using patient-reported outcome (PRO) measures in pelvic organ prolapse surgery is common practice in developed countries, but despite the burden of POP in developing countries, such as Ethiopia, the use of PROs to record preoperative and postoperative QoL scores is limited. This study is aimed at assessing the QoL among Ethiopian women with POP before and after surgery using the validated Pelvic Organ Quality of Life (P-QoL) questionnaire. Additionally, we will compare postoperative QoL measurements of reconstructive procedures with those of obliterative procedures., Methods: This is a prospective observational study conducted at a single hospital in Ethiopia on women who were scheduled for surgery for symptomatic POP. Patients' QoL was assessed preoperatively using the P-QoL questionnaire and at each subsequent follow-up visit for 1 year (3, 6, 9, and 12 months). Patients undergoing an obliterative procedure were evaluated and compared with those having reconstructive procedures., Results: The mean score for general health perceptions, prolapse impact, role limitations, physical limitations, social limitations, and emotions was 0 at 12 months postoperatively. Despite significant improvements from baseline, personal relationships, sleep or energy disturbance, and symptom severity measures continued to negatively impact QoL at 12 months postoperatively., Conclusions: Quality of life among Ethiopian women with POP is poor across all domains. Native tissue repair employing either reconstructive or obliterative methods significantly improves QoL across all domains up to 12 months postoperatively. The use of validated tools to assess PROs is essential to provide evidence-based care that improves QoL in ways that are meaningful to patients., (© 2024. The International Urogynecological Association.)

Introduction and Hypothesis: This study surveyed urogynecologists and Advanced Practice Providers (APPs) in the USA to gauge their interest and willingness to embrace customizable pessaries as a viable treatment option. We hypothesize that clinicians might be interested in using customizable pessaries in their practice., Methods: A cross-sectional survey was conducted among urogynecologists and their APPs who fit pessaries to gain insights into their experiences with standard pessaries and perspectives on the value and feasibility of customizable devices. The survey was distributed through email lists associated with women's health and pelvic floor disorders and gathered data on the difficulty in fitting pessaries and the perceived advantages of integrating customizable options into clinical practice., Results: There were 122 participants, including 76 physicians and 46 APPs. Thirty-five percent of clinicians advocated for pessaries as a first-line therapy for pelvic floor disorders. APPs were more inclined to recommend pessaries as a primary therapy than physicians (p < 0.01). Fifty-three percent of providers reported occasional difficulties, and 12% reported frequent difficulties fitting patients with standard-shaped pessaries. APPs were significantly more likely to encounter fitting issues due to pessary shape (p = 0.023). Clinicians suggested additional practices, such as modifying pessaries to enhance retention in patients with an enlarged genital hiatus, shortened vaginas, or apical narrowing., Conclusions: This study indicates that clinicians are inclined to incorporate customizable pessaries into their treatment protocols for pelvic floor disorders, emphasizing the need for continued innovation in pessary customization that prioritizes a patient-centric approach to pelvic floor disorder management., (© 2024. The International Urogynecological Association.)

Introduction and Hypothesis: Coital incontinence (CI) is common, with a significant impact on quality of life and sexual function. This multicentre study was aimed at measuring the association between overactive bladder (OAB), stress urinary incontinence (SUI) and different aspects of CI including orgasm and penetration incontinence., Methods: Following ethical approval, data from the electronic Personal Assessment Questionnaire-Pelvic Floor patient-reported outcome measure was collated for Urogynaecology outpatients from seven participating UK Hospitals between April 2018 and January 2022. Data were anonymised and analysed centrally using Excel., Results: A total of 12,877 responses were obtained, of which 4,843 were valid for inclusion. 79.3% of women presented with urinary incontinence of whom 41.6% also reported CI. 96.8% of women with CI reported mixed OAB and SUI, with 2.1% and 1.1% reporting pure OAB and SUI respectively. There was a small subset (2.4%) with no overt urinary incontinence who occasionally experienced CI. Spearman's rank-order correlation demonstrated a statistically significant association between CI symptom score with both SUI (R = 0.57, p < 0.001) and OAB (R = 0.40, p < 0.001); orgasm incontinence with SUI (R = 0.49, p < 0.001) and OAB (R = 0.36, P < 0.001); penetration incontinence with SUI (R = 0.48, p < 0.001) and OAB (R = 0.35, p < 0.001)., Conclusions: Coital incontinence is experienced by 42% of women with urinary incontinence. There is a statistically significant association between both SUI and OAB with orgasm incontinence and penetration incontinence, suggesting (a) common underlying mechanism(s). Limitations of this study include the large amount of missing data and the NHS outpatient setting that limit the conclusions that can be drawn from the data., (© 2024. The International Urogynecological Association.)