Towards an understanding of the engagement and emotional behaviour of MOOC students using sentiment and semantic features

Online learning and teaching increased in 2020, driven by the COVID-19 pandemic. As many researchers attempted to understand the impact stress had on the emotional behaviours and academic performance of students, most studies explored these pre- and during-COVID behaviours in the context of brick and mortar institutions transitioning to online delivery. There is an opportunity to compare the experiences of students in the MOOC environment in this period, particularly in terms of the difference of engagement, semantics and sentiment/stress behaviours in 2019 and 2020. In this study, we use a dataset from AdelaideX between this time period to identify the most significant features that impact student outcomes. Where previous machine learning approaches used singular features such as student interaction or sentiment in discussion forum posts, we incorporate three feature categories of engagement, semantics and sentiment/stress in an ensemble model is based on voting and stacked methods to determining the relationship between them and academic performance. From our results, we discover that sentiment/stress played little part in academic performance and was relatively unchanged in online courses in this dataset between 2019 and 2020. We present two individual student cases to further contextualise our findings. © 2023 The Author(s)

What is the past, present and future of virtual physiotherapy consultations? A UK survey of physiotherapists

Keywords: Virtual consultation;Physiotherapy;Survey Purpose: The use of digital and remote technologies features highly within the NHS Long Term Plan, which sets out a vision for the future of the NHS. The COVID-19 pandemic created an immediate need to implement the use of remote physiotherapy. The purpose of this survey of UK based physiotherapists was to understand how virtual consultations (VCs) have been used by practising physiotherapists across the UK during the pandemic and to seek views on the future of VCs. Methods: This mixed methods survey was developed in SurveyMonkey and circulated to five physiotherapists to pilot data collection and check for coherence. Descriptive statistics were employed for quantitative and thematic analysis were used for the qualitative data analysis. The survey was circulated via iCSP and across the DIPG, ATOCP and ACPRC groups. Results: No changes were made following the pilot. Fifty-six participants with complete responses were included for data analysis. Participants were working across primary care (30%), community care (25%), secondary care (24%) and tertiary care (16%). Most participants worked in musculoskeletal (MSK) outpatients (64%), with a small proportion (7%) from both respiratory and paediatrics and 4% from neurology settings. Prior to the pandemic, 29% were using phone and 9% using video consultations. However, during the pandemic 88% adopted phone and 72% adopted video consultations. MS teams was the most used platform (36%) followed by Zoom and Attend Anywhere (both 16%). Thirteen different platforms were used across the sample. Seventy-two percent used these platforms for 1:1 session, 27% for group classes, 21% for group and education sessions and 14% used for joint sessions. In most cases, (55%) the decision about which virtual platforms to use was made at board level, with 25% at individual level and 23% at team level. Thirty-six percent were not evaluating patient or clinician experience and 43% were not evaluating clinical effectiveness. Beyond COVID-19, 80% believe they will use phone consultations and 71% video consultations. On average, participants believed 36% of patients would continue to be seen virtually. Qualitative data provided insight into the quantitative data. Conclusion(s): There was a high proportion of adoption of both video and phone consultations due to COVID-19. There is a large variation in software being used and in type of session offered. It was anticipated that these types of consultations would be sustained post COVID. Many participants are not evaluating patient or clinical experience or effectiveness. The limitations of the study are a low sample size combined with most of the sample coming from an MSK background. Consequentially, these results may not be representative. The study does, however, give insight into some key policy considerations, including design, evaluation, and scope of services. Impact: The findings from this project raise important issues such as how we design services to include VCs, what software should be used and how we can evaluate these services. There is a need to share practice, to establish an evidence-based consensus on appropriate use of VCs and to implement appropriate and effective use of VC in physiotherapy. Funding acknowledgements: The work was not funded.

Safety of elective paediatric surgery during the coronavirus disease 2019 pandemic.

INTRODUCTION: Corona-virus Disease 2019 (COVID-19) has had a huge impact on the delivery of healthcare worldwide, particularly elective surgery. There is a lack of data regarding risk of postoperative COVID-19 infection in children undergoing elective surgery, and regarding the utility of pre-operative COVID-19 testing, and preoperative "cocooning" or restriction of movements. The purpose of this present study was to examine the safety of elective paediatric Otolaryngology surgery during the COVID-19 pandemic with respect to incidence of postoperative symptomatic COVID-19 infection or major respiratory complications. MATERIALS AND METHODS: Prospective cohort study of paediatric patients undergoing elective Otolaryngology surgery between September and December 2020. Primary outcome measure was incidence of symptomatic COVID-19 or major respiratory complications within the 14 days after surgery. Parents of prospectively enrolled patients were contacted 14 days after surgery and enquiry made regarding development of postoperative symptoms, COVID-19 testing, or diagnosis of COVID-19. RESULTS: 302 patients were recruited. 125 (41.4%) underwent preoperative COVID-19 RT-PCR testing. 66 (21.8%) restricted movements prior to surgery. The peak 14-day COVID-19 incidence during the study was 302.9 cases per 100,000 population. No COVID-19 infections or major respiratory complications were reported in the 14 day follow-up period. CONCLUSION: The results of our study support the safety of elective paediatric Otolaryngology surgery during the pandemic, in the setting of community incidence not exceeding that observed during the study period.

A novel eHealth model of care to effectively manage chronic hepatitis C in community and prison-based settings

Background and Aim: The rising burden of chronic disease in the developed world has resulted in an accumulation of patients requiring long-term specialist input in care, despite relatively stagnant capacity in tertiary hospital services. Newer models of care, incorporating specialist input while empowering and enabling community-based treatment in the more cost-effective primary care setting, are urgently needed. Digital health technologies have been proposed as one such novel model. The evolving digital technology paradigm shift instigated by the coronavirus 2019 pandemic has placed further emphasis on the need for evidence-based eHealth interventions. Chronic hepatitis C virus (HCV) represents a model disease in which rapid treatment advances have allowed care to shift from tertiary to community-based treatment models;however, barriers remain in achieving elimination targets and scaling up treatment to at-risk populations. We aimed to explore the efficacy, acceptability, and feasibility of an eHealth model to connect community and prison-based clinicians with specialist teams for HCV treatment. Methods: We conducted a multicenter quasi-experimental pre-post study using a hybrid effectiveness-implementation design with referring community and prison-based clinicians, in consultation with eight tertiary centers in Australia. The pre-intervention control group was treated through existing paper, fax, or remote consultation methods between 1 March 2016 and 28 February 2017. The eHealth model of care (using the HealthELink system) was prospectively implemented from 1 August 2017 to 30 April 2019. Key elements of the web-based eHealth model include HCV-specific clinical decision support, including University of Liverpool drug-drug interaction integration, secure electronic messaging, task management, email alerts, and an electronic patient portal. The primary outcome was sustained virological response at 12 weeks after treatment (SVR12), based on intention-to-treat analysis. Secondary outcomes included an implementation analysis comprising usability, acceptability, quality, safety, and uptake/utilization measures. Results: In total, 249 patients (180 community, 69 prison) were treated in the eHealth group, and 681 (588 community, 87 prison) in the control group. Sixty-one general practitioners, 12 specialists, 24 nurses, and four prison systems registered to use the eHealth system. In the community-based group, SVR12 was confirmed in 106/180 patients (59%), compared with 383/588 (65%) in the control group (P = 0.13), and 44/69 (64%) versus 61/87 (70%) in the prison-based group (P = 0.32). Completion of repeat liver biochemistry at the time of SVR12 testing (88% vs 51%, P = 0.01) and adherence to guideline-based treatment (100% vs 98%, P = 0.03) were higher in the eHealth group. Timeto specialist approval (median, 1 vs 7 days;P < 0.01) and SVR12 confirmation from the intention to treat when adjusted for treatment duration (175 vs 208 days, P = 0.05) were both significantly reduced in the eHealth group. Uptake of the eHealth model was greatest in nurse-led and prison-based cohorts. Low uptake was found among GP users, primarily due to few HCV patients encountered during the study. High levels of usability (median system usability score, 76) and acceptability were found among most users, with the clinical decision support features found to be most useful. Low technological failure rates were seen, with browser compatibility the most frequent issue encountered, in less than 5% of users. Conclusion: This eHealth model of care resulted in similar clinical outcomes to the current standard of care. However, treatment efficiency and adherence to guideline-based care were improved using eHealth. The model was acceptable and displayed good usability for most users. This study shows that a multifaceted eHealth system is a valuable and scalable model to manage HCVand serves as a blueprint for other chronic diseases.

Guidelines for the management of diabetes in care homes during the Covid-19 pandemic.

The National Diabetes Stakeholders Covid-19 Response Group was formed in early April 2020 as a rapid action by the Joint British Diabetes Societies for Inpatient Care, Diabetes UK, the Association of British Clinical Diabetologists, and Diabetes Frail to address and support the special needs of residents with diabetes in UK care homes during Covid-19. It was obvious that the care home sector was becoming a second wave of Covid-19 infection and that those with diabetes residing in care homes were at increased risk not only of susceptibility to infection but also to poorer outcomes. Its key purposes included minimising the morbidity and mortality associated with Covid-19 and assisting care staff to identify those residents with diabetes at highest risk of Covid-19 infection. The guidance was particularly created for care home managers, other care home staff, and specialist and non-specialist community nursing teams. The guidance covers the management of hyperglycaemia by discussion of various clinical scenarios that could arise, the management of hypoglycaemia, foot care and end of life care. In addition, it outlines the conditions where hospital admission is required. The guidance should be regarded as interim and will be updated as further medical and scientific evidence becomes available.