Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency

AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.

Climate change impacts and forest adaptation in the Asia–Pacific region: from regional experts' perspectives

Expert opinions have been used in a variety of fields to identify relevant issues and courses of action. This study surveys experts in forestry and climate change from the Asia–Pacific region to gauge their perspectives on the impacts of climate change and on the challenges faced by forest adaptation in the region, and explores recommendations and initiatives for adapting forests to climate change. There was consensus regarding the impacts of climate change on forest ecosystems and on economic sectors such as agriculture and forestry. Respondents also indicated a lack of public awareness and policy and legislation as challenges to addressing climate change. However, the results indicate differences in opinion between regions on the negative impacts of climate change and in satisfaction with actions taken to address climate change,highlighting the need for locally specific policies and research. The study presents specific recommendations to address issues of most concern, based on subregion and professional affiliation throughout the Asia–Pacific region.The results can be used to improve policy and forest management throughout the region. This research will also provide valuable suggestions on how to apply research findings and management recommendations outside of the AP region. The conclusions should be communicated relative to the level of the research and the target audience,ensuring that scientific findings and management recommendations are effectively communicated to ensure successful implementation of forest adaptation strategies.

Farmers′ Perception to Farmland Conversion: A Questionnaire Survey in Xining City, Qinghai Province, China

China is experiencing a fast process of farmland conversion which is conducted mainly by local governments to fuel economic development.Social tension is aroused and policy makers take great concerns on coordinating interests among different stakeholders,especially for increasing farmers′ interest.The purpose of this study is to get some insights related to land acquisition institution by exploring farmers′ perception to farmland conversion.Participatory Rural Appraisal(PRA) was applied for the investigation in peri-urban area,of Xining City,Qinghai Province,China.The total of 519 householders from 15 villages completed valid questionnaire survey from July to November,2012.The results indicate that farmland conversion has several impacts on farmers′ life.Most farmers are gradually adapting to city life.Higher living expenses and more income are perceived by farmers with average score of 4.21 and 2.69,respectively.The average scores of 2.38 and 2.46 are for improvement of life security and more job opportunities.Farmers expect to get some stable ways of compensation in addition to lump-sum compensation in cash.Stable subsidies every year and obtaining same number of land received strong proposal.And these two options are cited by 49.6% and 43.9% of respondents.Farmland conversion brings about cleaner living condition and more amenities,but lower air visibility and drier air.Results reflect landless farmers′ economic and life pressures and various demands.Local government should pay more attention to increase farmers′ income and improve rural security system.

Questionnaire survey regarding the current status of superextended lymph node dissection in Japan

AIM To verify the current status of super-extended lymph node dissection for advanced gastric cancer according to a questionnaire survey.METHODS One-hundred and five institutions responded to the questionnaire.The survey included the following items: Number of experiences,whether performed prophylactically and/or therapeutically,whether preoperative chemotherapy was provided,number of preoperative chemotherapy rounds,and therapeutic options after chemotherapy.RESULTS Eighty-seven of the 105 institutions(83%) had performed D3 gastrectomy in the past or continued to perform D3 gastrectomy at present.However,D3 gastrectomy was rarely performed prophylactically in clinical practice.Seventy-eight institutions(74%) indicated that preoperative chemotherapy with curative intent was required for patients suspected of having para-aortic node(PAN) metastases.After chemotherapy,a D3 gastrectomy was scheduled for patients with a complete or partial response,stable disease,and progressive disease at 36(46%),28(36%),and 13(17%) of the institutions,respectively.CONCLUSION For patients with apparent PAN metastasis,a D3 gastrectomy is typically planned if a few courses of preoperative chemotherapy yield at least a stable disease condition.

Expert Survey on the Prevention and Treatment Situation of Traditional Chinese Medicine for Coronary Artery Disease

Objective: To grasp the current situation of Traditional Chinese Medicine (TCM) on prevention and treatment for coronary artery disease (CAD) and the possible advantages and disadvantages. Method: Using a survey in the form of questionnaire among 60 cardiovascular disease experts, to grasp current situation of TCM on prevention and treatment of CAD and the possible advantages and disadvantages. Results: In most areas of China, CAD is common, and angina is the most common clinical type. More than 91% experts choose to integrate traditional and western medicine for treatment and prevention of CAD. TCM proprietary medicine, traditional herbal decoction and intravenous TCM are widely used in the clinical work. Clinical advantages of TCM in the prevention of CAD that are listed in the questionnaire include improving symptoms, enhancing quality of life, increasing exercise tolerance, improving cardiac function, relieving angina, secondary prevention of myocardial infarction, etc. The shortcomings include troublesome brewing of herbal medicine, unpleasant taste of decoction, minimal clinical evidence, slow onset of effects and non-standardized prescription of medicine, etc. Conclusion: The survey reflects the present situation of clinical diagnosis and treatment of TCM on prevention and treatment of CAD to a certain extent;more accurate conclusions need the broader, deeper and large-scale clinical survey.

Health Related Quality of Life and Mental Health in ICU Survivors: Post-Intensive Care Syndrome Follow-Up and Correlations between the 36-Item Short Form Health Survey (SF-36) and the General Health Questionnaire (GHQ-28)

We investigated the relationship between health-related quality of life (HRQOL) and psychological distress in intensive care unit (ICU) survivors 12 months after ICU discharge. The purpose of this study, conducted and completed before the onset of the COVID-19 pandemic, was to find correlations among psychiatric symptoms detected by a screening tool as the General Health Questionnaire-28 (GHQ-28) and the different domains of HRQOL measured with the SF-36 health survey (SF-36), in order to identify ICU survivors with Post-Intensive Care Syndrome (PICS) who need a specific psychiatric intervention to improve their HRQOL. Among 298 ICU survivors who stayed in the ICU for at least 72 hours, 48 patients were enrolled one year after discharge undergoing a clinical interview to assess their functional impairment (Barthel index), mental health (GHQ-28), and health-related quality of life (SF-36). 19% of those subjects had a GHQ-28 ≥ 5 and were identified as “psychiatric cases”, and they were older and experienced a greater impairment in HRQOL. Anxiety, insomnia, and depressive symptoms seemed to be particularly involved in the impairment of HRQOL. A negative correlation between GHQ-28 total scores and subscales and SF-36 subscales was found. Our findings highlighted that psychological distress in ICU survivors may negatively impact physical health recovery and quality of life;conversely, physical impairment and functional disability may trigger the onset of psychiatric symptoms after discharge. The present study is firstly to investigate the correlations between HRQOL and psychological distress in ICU survivors through the GHQ-28, and then affirms the need to carry out follow-up checks for psychiatric symptoms in ICU survivors.

Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis

AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.

Landscape Architecture and Female Development Based on Questionnaire Survey

In view of gender difference in the development of landscape architecture, questionnaire survey and comparative analysis were applied to investigate landscape architecture students' studies and opinions on landscape architecture, and figure out differences between male and female students. By analyzing obstacles that female students and staffs encounter in this field, role of female in landscape architecture was explored, and strategies of developing female talents in landscape architecture were proposed.

Multi-center investigation of breast reconstruction after mastectomy from Chinese Society of Breast Surgery:A survey based on 31 tertiary hospitals(CSBrS-004)

Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.

A survey of ventilation strategies during cardiopulmonary resuscitation

BACKGROUND:Many controversies still exist regarding ventilator parameters during cardiopulmonary resuscitation(CPR).This study aimed to investigate the CPR ventilation strategies currently being used among physicians in Chinese tertiary hospitals.METHODS:A survey was conducted among the cardiac arrest team physicians of 500 tertiary hospitals in China in August,2018.Surveyed data included physician and hospital information,and preferred ventilation strategy during CPR.RESULTS:A total of 438(88%)hospitals completed the survey,including hospitals from all 31 Chinese mainland provinces.About 41.1%of respondents chose delayed or no ventilation during CPR,with delayed ventilations all starting within 12 minutes.Of all the respondents who provided ventilation,83.0%chose to strictly follow the 30:2 strategy,while 17.0%chose ventilations concurrently with uninterrupted compressions.Only 38.3%respondents chose to intubate after initiating CPR,while 61.7%chose to intubate immediately when resuscitation began.During bagvalve-mask ventilation,only 51.4%of respondents delivered a frequency of 10 breaths per minute.In terms of ventilator settings,the majority of respondents chose volume control(VC)mode(75.2%),tidal volume of 6–7 mL/kg(72.1%),PEEP of 0–5 cmH2O(69.9%),and an FiO2 of 100%(66.9%).However,62.0%of respondents had mistriggers after setting the ventilator,and 51.8%had high pressure alarms.CONCLUSION:There is a great amount of variability in CPR ventilation strategies among cardiac arrest team physicians in Chinese tertiary hospitals.Guidelines are needed with specific recommendations on ventilation during CPR.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire for patients with head and neck cancer and their caregivers

Objectives:This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire(HaNiQ).Methods:The HaNiQ was translated into a Chinese version using internationally recognized forwardand back-translation procedures.The reliability and validity of the HaNiQ were measured using Cronbach’s a coefficient,split-half reliability,exploratory factor analysis,and Pearson correlation analysis.Results:A total of 207 patients in different head and neck cancer(HNC)stages and 174 caregivers completed the Chinese version of the HaNiQ.Internal consistencies varied between good and very well(Cronbach’s α coefficient 0.74-0.90);the split-half coefficient and the content validity index(CVI)of the questionnaire were 83.5%and 83.33%,respectively.The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41%and 61.19%,respectively.However,there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items.Items 22,23,and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers.Conclusions:The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers.Though the structure of the Chinese versionwas different from the English version for caregivers of HNC patients,the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing.

Academic institutional repositories in China:A survey of CALIS member libraries

Purpose: China Academic Library & Information System(CALIS) planned to launch an institutional repository(IR) project to promote IR development and open access at colleges and universities in China. In order to get to know the current state of IRs in academic institutions, with the help of Peking University Library, CALIS Administrative Center conducted this survey.Design/methodology/approach: We conducted an online survey of CALIS member libraries.Findings: Firstly, the development of IRs at China's colleges and universities is still in its infancy. Secondly, the Chinese colleges and universities have reached a consensus on the objective for having an IR. Thirdly, they are having high expectations of IR functions. Fourthly,they prefer to establish a centralized IR system at a minimum cost. Finally, there are both similarities and differences between the Chinese academic institutions and their counterparts in other countries in the state of IR development.Research limitations: The questionnaire needs to be improved because there is a lack of enough questions for those who do not plan to build an IR. Comparatively lower rate of valid questionnaire return can affect the accuracy of the results. It is hard to go into an in-depth discussion only based on the data collected from this questionnaire survey, and consequently,the findings from the survey can hardly present an accurate and comprehensive picture of the current state of IR development in the academic sector in China.Practical implications: The survey results provide essential foundation for CALIS IR project,and meanwhile the research can serve as a reference source for the future studies of the development of IRs at China's colleges and universities.Originality/value: It is the first national survey focused on the development of IRs in academic institutions in China.

A survey study on motivations for citation:A case study on periodicals research and library and information science community in China

A large number of theoretical and empirical studies on citation behavior have been conducted internationally. Although some theoretical studies on such topic have been carried out in China, few studies have focused specifically on this area from an empirical perspective, resulting in the lack of literature on the findings of actual surveys. To address this challenge, we conducted two questionnaire surveys to understand the motivations of the researchers on citation. One survey covers the authors who published articles in Chinese Journal of Scientific and Technical Periodicals, while the other targets the most productive and most cited Chinese authors in library and information science. The results show that citation behavior is not only motivated by rational factors, but also by other social factors.

DEVELOPMENT OF FAULT RECOGNITION EXPERT SYSTEM

The fault recognition is a constructional problem involved in the plane inter-pretation of seismic information.This paper presents a fault recognition expert system(FRES)built on blackboard model and introduces its technical characteristics such as rea-soning about control,focusing by step,integration of human inteUigcnce and machine in-telligence.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data

A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.

The current state of, and outstanding issues relating to, nursing diagnosis, as taught in basic nursing education in Japan <br>—Based on a questionnaire study implemented by nursing universities—

This report attempts to ascertain the current state of, and outstanding issues relating to, nursing diagnosis, as taught in nursing education in Japan, and to obtain basic resources that will allow the improvement of said nursing diagnosis training. A self-completed, anonymous survey was carried out in regard to teaching staff responsible for classes in “nursing process” or “nursing diagnosis” at 183 university institutions involved in nursing education nationwide. Responses were received from 82 people, which clarified the following three points. 1) Of the 63 universities teaching nursing process as an independent subject, approximately 62% included nursing diagnosis. 2) A diverse range of educational materials were used in nursing diagnosis training, including NANDA-I nursing diagnosis. 3) In implementing nursing process using nursing diagnosis, issues raised included the following: the limitations of education “on paper”, using theoretical patients, insufficient skills among teaching staff, the difficulty of realizing practical training in a clinical setting, and the tendency to try to make a simple diagnosis fit the circumstances. In the future, this study suggests that it may be important to create a set of guidelines guaranteeing a minimum level of educational content in relation to nursing diagnosis, which must be learned before graduation.

Continuing Professional Development: Needs, Facilitators and Barriers of Registered Nurses in India in Rural and Remote Settings: Findings from a Cross Sectional Survey

Background: Nurses constitute a major portion of the health care workforce in India. A priority to develop pre and post registration nurse education in India has increasingly been highlighted in nursing and health policy imperatives in recent years. Nurses are often the only health care professionals in primary and secondary care within rural and remote healthcare settings in India. They are confronted with the dual challenge of resource constraints and rapidly changing disease profile with little or no access to continuing professional development. Objectives: 1) To identify key continuing professional development priorities of registered nurses working in remote and rural health care settings in India. 2) To identify barriers and facilitators to continuing professional development as perceived by registered nurses working in these settings. 3) To identify preferred modes of continuing professional development by registered nurses working in remote and rural health care settings in India. Design: Quantitative Design. Setting: Two large health care facilities in remote and rural parts of India. Participants: Registered Nurses working in two large not for profit health care organisations participated in the study. Nursing assistants and student nurses were excluded from the study. 368 participants consented to participate in the survey and 271 (73.6%) participants completed the survey. Methods: A questionnaire based cross sectional survey was undertaken as part of the Continuing Professional Development needs assessment among registered nurses working in rural and remote settings. Results: Continuing Professional Development priorities included training on clinical competencies focussed on managing emergency situations related to non-communicable diseases [50%], managerial competencies related to ethical dilemmas [60%] such as support for families with financial difficulties accessing health care [17.8%], women undergoing abortions [14.6%], or those with HIV infection [12.9%]. Preferred modes for Continuing Professional Development included conference attendance [54%], skills training [48%] and in-house training [32%]. Key facilitators for Continuing Professional Development included, professional development [77%], personal interest [42%], opportunities for professional engagement with colleagues [39%], the need to reduce knowledge and skill gap [36%] and career progression [28%]. Geographic distance [59%], low staffing levels [51%], cost [43%], domestic responsibilities [40%], and work commitments [39%] were reported as key barriers to Continuing Professional Development. Conclusions: The findings from this survey, the first of its kind in India, provides evidence on priorities, barriers and facilitators for continuing professional development of registered nurses working in rural and remote settings in India.

Digital chromoendoscopy utilization in clinical practice: A survey of gastroenterologists in Connecticut

AIM:To use a survey to characterize and identify potential barriers to the use of digital chromoendoscopy(DC)by practicing gastroenterologists.METHODS:An anonymous,internet-based survey was sent to gastroenterologists in Connecticut who were members of one of three national gastrointestinal organizations.The survey collected demographic information,frequency of DC use,types of procedures that the respondent performs,setting of practice(academic vs community),years out of training,amount of training in DC,desire to have DC training and perceived barriers to DC use.Responses were collected anonymously.The primary endpoint was the proportion of endoscopists utilizing DC.Associations between the various data collected were analyzed usingχ2 test.RESULTS:One hundred and twenty-four gastroenterologists(48%)of 261 who received the online survey responded.Seventy-eight percent of surveyed gastroenterologists have used DC during the performance of upper endoscopy and 81%with lower endoscopy.DC was used in more than half of procedures by only 14%of gastroenterologists during upper endoscopy and 12%during lower endoscopy.Twenty-three percent(upper)and 21%(lower)used DC more than one quarter of the time.DC was used for 10%or less of endoscopies by 60%(upper)and53%(lower)of respondents.Endoscopists reported lack of training as the leading deterrent to DC use with36%reporting it as their primary deterrent.Eighty-nine percent of endoscopists never received formal training in DC.Lack of time(30%of respondents),lack of evidence(24%)and lack of reimbursement(10%)were additional deterrents.There were no differences in DC use relative to academic vs community practice setting or years out of training.CONCLUSION:DC is used infrequently by most endoscopists,primarily due to a lack of training.Training opportunities should be expanded to meet the interest expressed by the majority of endoscopists.