ABSTRACT
Background: Providing care for patients with Diabetes in Pregnancy (DiP) provides unique challenges beyond those faced in standard antenatal care, or diabetes outside of pregnancy. Teleclinics (use of telephone, email, or other technologies) as an alternative to in-person clinic appointments have become more widely used for care since the start of the COVID-19 pandemic. To understand how teleclinics might be improved for ongoing use, it is important to understand the experiences and perceptions of the clinicians involved in DiP care. Method(s): A qualitative study using semi-structured interviews of healthcare providers in a large DiP service. Twenty staff members (midwifery, obstetrics, physician, dietician, and administration) were approached to participate. Fifteen staff across 5 specialties consented to be interviewed. Template analysis of interview transcripts was performed, with a focus on 3 themes: collaboration and working together are important for providing DiP care;the need for flexibility in scheduling and the ability to individualise the way care is provided;challenges to adapting to new technology. Result(s): Potential benefits of teleclinics were acknowledged, but respondents also viewed teleclinics as not suitable for all DiP patients due to different needs and risks. Challenges to using teleclinics include establishing good rapport and the limited current infrastructure and patient resources. Conclusion(s): Healthcare providers viewed teleclinics as a way of supporting rather than replacing current care. Maintaining flexibility in clinic scheduling to allow incorporating teleclinics into patient's current schedule of visits ad hoc and providing extra technical and administrative support are important considerations for developing a teleclinic service.
ABSTRACT
Recent research on argumentative dialogues has focused on persuading people to take some action, changing their stance on the topic of discussion, or winning debates. In this work, we focus on argumentative dialogues that aim to open up (rather than change) people's minds to help them become more understanding to views that are unfamiliar or in opposition to their own convictions. To this end, we present a dataset of 183 argumentative dialogues about 3 controversial topics: veganism, Brexit and COVID-19 vaccination. The dialogues were collected using the Wizard of Oz approach, where wizards leverage a knowledge-base of arguments to converse with participants. Open-mindedness is measured before and after engaging in the dialogue using a questionnaire from the psychology literature, and success of the dialogue is measured as the change in the participant's stance towards those who hold opinions different to theirs. We evaluate two dialogue models: a Wikipedia-based and an argument-based model. We show that while both models perform closely in terms of opening up minds, the argument-based model is significantly better on other dialogue properties such as engagement and clarity.
Subject(s)
COVID-19ABSTRACT
Recently, Altay et al. (Altay et al. 2021. J. Exp.Psychol.: Appl. (doi:10.1037/xap0000400)) showed that 5 min of interaction with a chatbot led to increases in positive COVID-19 vaccination attitudes and intentions in a French population. Here we replicate this effect in a vaccine-hesitant, UK-based population. We attempt to isolate what made the chatbot condition effective by controlling the amount of information provided, the trustworthiness of the information and the level of interactivity. Like Altay et al., our experiment allowed participants to navigate a branching dialogue by choosing questions of interest about COVID-19 vaccines. Our control condition used the same questions and answers but removed participant choice by presenting the dialogues at random. Importantly, we also targeted those who were either against or neutral towards COVID-19 vaccinations to begin with, screening-out those with already positive attitudes. Replicating Altay et al., we found a similar size increase in positive attitudes towards vaccination, and in intention to get vaccinated. Unlike Altay et al., we found no difference between our two conditions: choosing the questions did not increase vaccine attitudes or intentions any more than our control condition. These results suggest that the attitudes of the vaccine hesitant are modifiable with exposure to in-depth, trustworthy and engaging dialogues.
ABSTRACT
Background The majority of those infected by ancestral Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the UK first wave (starting March 2020) did not require hospitalisation. Most had a short-lived mild or asymptomatic infection, while others had symptoms that persisted for weeks or months. We hypothesized that the plasma proteome at the time of first infection would reflect differences in the inflammatory response that linked to symptom severity and duration. Methods We performed a nested longitudinal case-control study and targeted analysis of the plasma proteome of 156 healthcare workers (HCW) with and without lab confirmed SARS-CoV-2 infection. Targeted proteomic multiple-reaction monitoring analysis of 91 pre-selected proteins was undertaken in uninfected healthcare workers at baseline, and in infected healthcare workers serially, from 1 week prior to 6 weeks after their first confirmed SARS-CoV-2 infection. Symptom severity and antibody responses were also tracked. Questionnaires at 6 and 12 months collected data on persistent symptoms. Findings Within this cohort (median age 39 years, interquartile range 30–47 years), 54 healthcare workers (44% male) had PCR or antibody confirmed infection, with the remaining 102 (38% male) serving as uninfected controls. Following the first confirmed SARS-CoV-2 infection, perturbation of the plasma proteome persisted for up to 6 weeks, tracking symptom severity and antibody responses. Differentially abundant proteins were mostly coordinated around lipid, atherosclerosis and cholesterol metabolism pathways, complement and coagulation cascades, autophagy, and lysosomal function. The proteomic profile at the time of seroconversion associated with persistent symptoms out to 12 months. Data are available via ProteomeXchange with identifier PXD036590. Interpretation Our findings show that non-severe SARS-CoV-2 infection perturbs the plasma proteome for at least 6 weeks. The plasma proteomic signature at the time of seroconversion has the potential to identify which individuals are more likely to suffer from persistent symptoms related to SARS-CoV-2 infection. Funding information The COVIDsortium is supported by funding donated by individuals, charitable Trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from University College London Hospitals (UCLH) Charity. This work was additionally supported by the Translational Mass Spectrometry Research Group and the Biomedical Research Center (BRC) at Great Ormond Street Hospital.