Purpose: Visual impairment poses significant challenges in daily life, especially when navigating unfamiliar environments, resulting in inequalities and reduced quality of life. This study aimed to gain an in-depth understanding of the needs and perspectives of visually impaired people in sports-related contexts through surveys and focus groups, and to understand whether their needs are being met by current technological solutions.
Materials and methods: To accomplish this, opinions gathered from focus groups and interviews were compared to the technological solutions found in the literature. Since many unmet needs were identified, participants from associations and organizations were asked to identify key characteristics for the development of a robot guide. The results underscored the paramount importance of an easy-to-use guide that offers accurate and personalized assistance. Participants expressed a strong desire for advanced features such as object recognition and navigation in complex environments, as well as adaptability to the user\'s speed while providing the necessary safety features to ensure a high level of autonomy.
Results: This research serves as a bridge between technological advances and the needs of the visually impaired, contributing to a more accessible and inclusive society. By addressing the unique challenges faced by the visually impaired individuals and tailoring technology to meet their needs, this study takes a significant step toward reducing disparities and improving the independence and quality of life for this community.
Conclusions: As technology continues to advance, it has the potential to be a powerful tool in breaking down barriers and fostering a world where everyone, regardless of their visual ability, can navigate the world with confidence and ease.
Inclusive design: Recognizing the importance of incorporating the unique requirements and perspectives of visually impaired individuals can guide the development of rehabilitation technology and services, ensuring they effectively support daily activities and active participation in sports and physical pursuits.Tailored-assistive technology: Understanding the specific needs of visually impaired individuals with regards to assistive technology, such as dependable robotic guides and essential features, can inform the design and customization of rehabilitation aids to enhance mobility and independence.Promising technologies: Exploring promising technologies like Aira, Be My Eyes, RoboCart, and Wayband can inspire the integration of these innovations into rehabilitation programs, facilitating better orientation, mobility, and accessibility for individuals with visual impairments.Continued research and development: Emphasizing the necessity for ongoing research and development efforts underscores the importance of advancing rehabilitation solutions that effectively address the distinct needs of visually impaired individuals, particularly in navigating unfamiliar environments.

UNASSIGNED: Spinal cord injury (SCI) often leads to neuropathic pain that negatively affects quality of life. Several qualitative research studies in individuals with SCI who experience neuropathic pain indicate the lack of adequate information about pain. We previously developed an educational resource, the SeePain, based on scientific literature and a series of qualitative interviews of people with SCI, their significant others/family members, and SCI healthcare providers.
UNASSIGNED: However, to quantitatively evaluate the utility of this educational resource in a larger sample, we examined the agreement and usefulness ratings of statements regarding clarity/comprehensibility, content, and format of the SeePain, derived from the thematic analysis of our previous qualitative interviews. Participants completed a survey that provided a digital version of the SeePain and then rated their agreement/usefulness with the statements using numerical rating scales.
UNASSIGNED: There were overall high perceived agreement and usefulness ratings regarding the SeePain\'s clarity, content, and format. A factor analysis reduced the agreement and usefulness ratings into 4 components (content, clarity, format, and delivery medium). Group comparisons showed that individuals with higher education were more likely to endorse electronic and website formats, and the usefulness of a shorter version of the SeePain; females and younger individuals showed greater endorsement for clarity. Finally, higher pain intensity ratings were associated with greater agreement and usefulness of the content of the SeePain.
UNASSIGNED: Overall, these results support the utility of the SeePain as a source of information regarding pain that may facilitate communication about pain and its management following SCI.

The world surrounding us is subject to constant change. These changes, frequently described as concept drift, influence many industrial and technical processes. As they can lead to malfunctions and other anomalous behavior, which may be safety-critical in many scenarios, detecting and analyzing concept drift is crucial. In this study, we provide a literature review focusing on concept drift in unsupervised data streams. While many surveys focus on supervised data streams, so far, there is no work reviewing the unsupervised setting. However, this setting is of particular relevance for monitoring and anomaly detection which are directly applicable to many tasks and challenges in engineering. This survey provides a taxonomy of existing work on unsupervised drift detection. In addition to providing a comprehensive literature review, it offers precise mathematical definitions of the considered problems and contains standardized experiments on parametric artificial datasets allowing for a direct comparison of different detection strategies. Thus, the suitability of different schemes can be analyzed systematically, and guidelines for their usage in real-world scenarios can be provided.

OBJECTIVE: To examine which workplace factors contribute to health care leader well-being in rural settings.
METHODS: Working with two rurally focused organizations, we administered a Rural Leader Burnout survey to executive leaders. The survey contained 25 questions; 24 were closed-item multiple choice and 1 open-ended question. The survey was based on the Mini Z 10 item burnout survey with 5 additional items for leaders. Logistic regression and qualitative content analysis determined factors associated with job satisfaction, burnout, and intent to leave (ITL).
RESULTS: There were 288 respondents (response rate 22%). Of 272 with complete data, 61.4% were women and 51.8% had worked > 10 years. About 81% reported job satisfaction, 40.2% were burned out, and 49.8% intended to leave their administrative roles within 2 years. Factors statistically associated with satisfaction were work control (OR = 3.0), values alignment with leadership (OR = 2.1), and trust in organization (OR = 2.0). Work control (OR = 0.3), trust in organization (OR = 0.4), and stress (OR = 4.1) were associated with burnout. Trust in organization (OR = 0.5), feeling valued (OR = 0.6), and stress (OR = 1.8) associated with ITL. Qualitative data revealed three themes relevant to rural leaders: (1) industry challenges, (2) daily operational issues, and (3) difficult relationships.
CONCLUSIONS: These exploratory analyses demonstrate practical ways to improve work conditions to mitigate burnout and turnover in rural leaders. Promoting thriving in leaders would be an important step in maintaining the rural health care workforce.

OBJECTIVE: To identify current practices in the management of selective fetal growth restriction (sFGR) in monochorionic diamniotic (MCDA) twin pregnancies.
METHODS: Cross-sectional survey.
METHODS: International.
METHODS: Clinicians involved in the management of MCDA twin pregnancies with sFGR.
METHODS: A structured, self-administered survey.
METHODS: Clinical practices and attitudes to diagnostic criteria and management strategies.
RESULTS: Overall, 62.8% (113/180) of clinicians completed the survey; of which, 66.4% (75/113) of the respondents reported that they would use an estimated fetal weight (EFW) of <10th centile for the smaller twin and an inter-twin EFW discordance of >25% for the diagnosis of sFGR. For early-onset type I sFGR, 79.8% (75/94) of respondents expressed that expectant management would be their routine practice. On the other hand, for early-onset type II and type III sFGR, 19.3% (17/88) and 35.7% (30/84) of respondents would manage these pregnancies expectantly, whereas 71.6% (63/88) and 57.1% (48/84) would refer these pregnancies to a fetal intervention centre or would offer fetal intervention for type II and type III cases, respectively. Moreover, 39.0% (16/41) of the respondents would consider fetoscopic laser surgery (FLS) for early-onset type I sFGR, whereas 41.5% (17/41) would offer either FLS or selective feticide, and 12.2% (5/41) would exclusively offer selective feticide. For early-onset type II and type III sFGR cases, 25.9% (21/81) and 31.4% (22/70) would exclusively offer FLS, respectively, whereas 33.3% (27/81) and 32.9% (23/70) would exclusively offer selective feticide.
CONCLUSIONS: There is significant variation in clinician practices and attitudes towards the management of early-onset sFGR in MCDA twin pregnancies, especially for type II and type III cases, highlighting the need for high-level evidence to guide management.

Multiple sclerosis (MS) is uncommon in China and the standard of care is underdeveloped, with limited utilization of disease-modifying treatment (DMT). An understanding of real-world disease burden (including direct medical, non-medical, and indirect costs, such as loss of productivity), is currently lacking in this population. To investigate the overall burden of managing patients with MS in China, a cross-sectional survey of physicians and their consulting patients with MS was conducted in 2021. Physicians provided information on healthcare resource utilization (HCRU; consultations, hospitalizations, tests, medication) and associated costs. Patients provided data on changes in their life, productivity, and impairment of daily activities due to MS. Results were stratified by disease severity using generalized linear models, with a p value < 0.05 considered statistically significant. Patients with more severe disease had greater HCRU, including hospitalizations, consultations and tests/scans, and incurred higher direct and indirect costs and productivity loss, compared with those with milder disease. However, the use of DMT was higher in patients with mild disease severity. With the low uptake and limited efficacy of non-DMT drugs, Chinese patients with MS experience a high disease burden and significant unmet needs. Therapeutic interventions could help save downstream costs and lessen societal burden.

UNASSIGNED: Infectious disease treatment and prevention are threatened by antimicrobial resistance (AMR) globally. The knowledge and attitudes of doctors regarding AMR and the responsible use of antibiotics are critical to improving prescribing behaviours and mitigating the danger that AMR poses. This study aims to assess the knowledge attitudes and practices of doctors in Nigeria regarding AMR.
UNASSIGNED: This was an online survey of doctors in Nigeria. A 31-item self-administered questionnaire was distributed via an online forum for doctors. The questionnaire consisted of knowledge, attitudes, and practices sections. Demographic and practice data were also collected from respondents. Data were analyzed using IBM-SPSS and were mainly descriptive. Bivariate correlation was used to determine the relationship between knowledge attitudes and practices.
UNASSIGNED: Two hundred and fifty -two doctors completed the survey. There were 105 (42%) resident doctors who participated in the study. Good knowledge and fair knowledge of AMR were shown by 95(41%) and 146(58%) doctors, respectively. There were few respondents with good attitudes and practices: 40 (16%) and 16 (6%), respectively. A large proportion of respondents had fair attitudes and practices -204(81%) and 185(73%) respectively. The relationship between practice, knowledge, and attitude was negligible. (r<1, p>0.05).
UNASSIGNED: Most doctors in this study showed fair to good knowledge, attitudes, and practices regarding AMR. Efforts to reduce the incidence of AMR should leverage the perceptions and behaviours of these healthcare workers.

BACKGROUND: Foot complications in diabetes are common and destructive, resulting in substantial healthcare costs and high rates of morbidity. Coastal areas have a significantly higher burden of disease. People with diabetes experience disproportionately high rates of psychological health issues, including anxiety, depression and diabetes distress. These can affect self-management and concordance with preventive measures and treatments of foot complications, negatively impacting on outcomes. Access to psychological health services is variable across the United Kingdom and there is a paucity of high-quality evidence for the effectiveness of treatments for diabetes distress. This study aimed to explore experiences of psychosocial burden and perceptions and experiences of psychosocial support, among patients with diabetes and foot complications living in a coastal area.
METHODS: Patients were eligible to participate if they had experienced diabetes-related foot complications (amputation, ulceration and/or Charcot neuroarthropathy) within the last 5 years and scored positive for diabetes distress on a validated screening tool (DDS2). Eligible patients completed cross-sectional questionnaires describing symptoms of diabetes distress (DDS17), anxiety (GAD-7) and depression (PHQ-9) and to take part in a face-to-face, semi-structured interview. Questionnaires were analysed using frequencies and interviews were analysed using reflexive thematic analysis.
RESULTS: A total of 183 patients completed the DDS2 screening questionnaire. Of these, 56 (30.6%) screened positive for diabetes distress. Twenty-seven patients completed DDS17, GAD-7 and PHQ-9 questionnaires. Eleven (40.7%) participants indicated high levels of diabetes distress and four (14.8%) indicated moderate distress. Seventeen participants (age range 52-81 years; 12 men) took part in an interview. Four key themes were identified: impact of living with foot problems; emotional consequences of foot problems; experiences and perceptions of psychological support; and strategies to cope with the emotional impact of foot problems.
CONCLUSIONS: Diabetes distress was prevalent among patients with diabetes-related foot complications. Foot problems impacted on participants\' daily activities, social lives and ability to work. Despite expressing feelings of ongoing fear, worry and depression relating to their foot problems, only one participant had accessed formal psychological support. Many participants relied on talking to podiatrists at routine appointments and described developing various strategies to cope. The psychosocial burden of living with foot complications in diabetes must not be overlooked by health professionals. Findings from this study can inform the design of future services and interventions.

OBJECTIVE: The objectives were to assess trends over the past 10 years in vaccination coverage rates (VCR) among adolescents in France aged 14-15 years, factors influencing decisions to vaccinate, and mothers\' opinions on adolescent vaccination.
METHODS: The \'Vaccinoscopie\' internet survey is completed each year by mothers of adolescents, with questions about vaccinations received by their children, and their attitudes and barriers to vaccination. The 2012 to 2021 surveys were analyzed in this study, including data from 1500 adolescents in 2012 and 1000 adolescents each year from 2013 to 2021.
RESULTS: None of the adolescent VCR targets were met, despite significant increases since 2012 for vaccines with the lowest coverage rates and vaccines with high but insufficient coverage i.e., meningococcal C (28.7% to 60.8%), HPV in girls (14.2% to 40.8%), hepatitis B (31.6% to 47.3%) and pertussis (76.3% to 91.0%). Physicians remained the primary source of vaccination information for 90.4% of mothers, and their advice had a real impact on improving VCRs. Adolescents were increasingly involved (40.1%) in decisions about vaccination. Depending on the vaccine, over 80% of mothers currently consider adolescent vaccination as useful or essential. Since 2017, they also feel better informed.
CONCLUSIONS: Low and under-target VCRs put adolescents at risk of severe disease, and do not enable herd immunity or reduced transmission to other vulnerable age groups to be accomplished. Healthcare professionals must take every opportunity to check adolescents\' vaccination status and recommend catch-up vaccines where applicable. Vaccination in schools should be considered.

Canada legalized the use of non-medical cannabis in 2018. This study examines youth and young adults\' knowledge and perceptions of harms, benefits, and education around cannabis use since legalization. An online survey was completed by a convenience sample of 1,759 individuals aged 12-25 years living in Manitoba, Canada. Most participants (n = 1,525, 86.7%) reported receiving education on the potential effects/harms related to cannabis; the most common topics included driving and cannabis use (79.9%), the mental harms of cannabis (67.4%), and addiction and dependency (66.3%). Youth who reported using cannabis more than once (n = 1,203) were more knowledgeable about the effects of cannabis than youth who never used cannabis or used cannabis once (n = 580; mean score: 6.6 versus 5.7 out of 8, respectively; p < .001). Vaping cannabis oil was perceived as the most harmful cannabis product among all participants. Among participants with experience using cannabis, the most frequently reported benefits were relaxation, improved sleep, and enhanced enjoyment of food/music. Half of the participants reported ever being in a car with someone driving high, of which, 40% of these participants reported doing so in the last 30 days. Future tailored education is needed to address knowledge related to cannabis use among youth and young adults who use and do not use cannabis.