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Home visits have the power to ease the clinical trial process for patients, but complex study design, tight timelines, busy clinical operations teams, and overburdened sites can sometimes make home health feel like yet another moving piece to manage. Individual variables that play a large role in establishing timelines can include factors like: * Amount of protocol-specific training required. * Level of engagement during a visit. * On-site processing requirements. * Drug or sample stability. * Recruitment goals. [...]all training should be to the full satisfaction of the principal investigator overseeing the study. Since sites are still responsible for the conduct of home visits from a regulatory perspective, there is often a concern about how they can remain in control of the progress without overwhelming the already busy study team and staff.
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Objectives: Treatment of severe respiratory distress syndrome (ARDS) due to COVID-19 by veno-venous extracorporeal membrane oxygenation (VV-ECMO) had a mortality of up to 70% in Germany. Many patients with COVID-19 need VV-ECMO support longer than 28 days (long-term VV-ECMO). Evidence on mortality, complications during intensive care, functional status after discharge and mortality-predictors for patients supported with long-term VV-ECMO is lacking. Method(s): Retrospective study of 137 consecutive patients treated with VV-ECMO for ARDS due to COVID-19 at University Hospital Regensburg from March 2020 to March 2022. Result(s): 38% (n=52;87% male) of patients needed longterm VV-ECMO support. In these, SOFA score (median [IQR]) at ECMO initiation was 9 [8-11], age 58.2 [50.6- 62.5] years, PaO2/FiO2-ratio 67 [52-88] mmHg, pCO262 [52-74] mmHg, Murray-Score 3.3 [3.0-3.6] and PEEP 15 [13 - 16] cmH2O. Duration of long-term support was 45 [35-65] days. 26 (50%) patients were discharged from the ICU. Only one patient died after hospital discharge. At VVECMO initiation, baseline characteristics did not differ between deceased and survivors. Complications were frequent (acute kidney injury: 31/52, renal replacement therapy: 14/52, pulmonary embolism: 21/52, intracranial hemorrhage 8/52, major bleeding 34/52 and secondary sclerosing cholangitis: 5/52) and more frequent in the deceased. Karnofsky index (normal 100) after rehabilitation was 70 [57.5-82.5]. Twelve of the 18 patients discharged from rehabilitation had a satisfactory quality of life according to their own subjective assessment. Four patients required nursing support. Mortality-predictors within the first 30 days on VV-ECMO only observed in those who deceased later, were: Bilirubin >5mg/dl for > 7 days, pulmonary compliance <10ml/mbar for >14 days, and repeated serum concentrations of interleukin 8 >150ng/L. Conclusion(s): Long-term extracorporeal lung support in patients with COVID-19 resulted in 50 % survival and subsequently lead to a satisfactory quality of life and functionality in the majority of patients. It should preferably be performed in experienced centers because of a high incidence of complications. Several findings during the early course were associated with late mortality but need validation in large prospective studies.
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Objective To explore the effect of WeChat group management on blood pressure control rate and drug compliance of hypertension patients during the epidemic of coronavirus disease 2019 (COVID-19) . Methods A total of 428 consecutive patients with essential hypertension in our outpatient department from Jan. 2020 to Dec. 2020 were enrolled and randomly divided into experimental group and control group with a ratio of 1 : 1. There were 214 patients in the experimental group, 110 males and 104 females, with an average age of (55.48+/-6.11) years. There were 214 cases in the control group, 108 males and 106 females, with an average age of (56.52+/-5.19) years. WeChat groups were established for the 2 groups separately. Information on education, supervised medication and lifestyle of hypertension was provided to the patients in the experimental group through WeChat, while no active intervention was given to the control group. The blood pressure control rate and medication possession ratio (MPR) were calculated at 1, 3, 6 and 12 months of intervention, and the differences between the 2 groups were compared. Results There were no significant differences in the blood pressure control rate (91.12%195/214 vs 90.65% 194/214, 86.67%182/210vs 89.62%190/212or MPR (0.90+/-0.03 vs 0.90+/-0.05, 0.85+/-0.04 vs 0.88+/-0.03) between the 2 groups at 1 or 3 months of intervention (all P>0.05). At 6 and 12 months, the blood pressure control rate (81.73%170/208vs 88.57%186/210,75.12%154/205vs 85.99%178/207) and MPR (0.74+/-0.04 vs 0.87+/-0.05, 0.58+/-0.05 vs 0.85+/-0.03) of patients in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion During the COVID-19 epidemic, WeChat group management of hypertension patients by doctors could improve patients' blood pressure control rate and drug compliance and strengthen patients' self-management ability.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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The novel coronavirus (COVID-19) pandemic and strategies meant to mitigate infections caused disruptions to healthcare services across the globe. To evaluate the impact of the COVID-19 pandemic on the healthcare of patients with type 2 diabetes in the VA healthcare system, this work enumerated a cohort of patients with type 2 diabetes who utilized care in the VA across all months between March 2018 and February 2022 and analyzed service utilization, medication adherence, and diabetes-related short-term outcomes.The first objective was to determine the effect of the pandemic's interruption on the utilization of diabetes-related outpatient encounters. Results showed that the share of patients with diabetes with at least one virtual care visit increased from 3.4% in the pre- COVID year (March 2019 to February 2020) to 16.4% in the first year during COVID (March 2020 to February 2021) while the percent of patients with diabetes with an in- person diabetes-related outpatient visit fell from 89.8% to 72.3%.Second, large changes in oral antidiabetic medication use, adherence (i.e., proportion of days (PDC) covered >=80%), and discontinuation (zero days covered) were discovered during the pandemic among patients with treated type 2 diabetes. The mean percent adherent was 23.4%, 11.6%, and 30.1% during the pre-pandemic (i.e., March 2018-February 2020), pre-vaccine pandemic (i.e., March 2020-December 2020), and post-vaccine pandemic (i.e., January 2021-February 2020) periods, respectively.Finally, this study evaluated changes in average A1C measurement, glycemic control, and preventable diabetes outcomes before and during the COVID-19 pandemic. The percent of eligible patients with A1C measurement decreased by 8.6% when the pandemic began, trending back to pre-pandemic levels by January 2021, at which point it fell by about 1% per month to end of study. The rate of uncontrolled diabetes averaged 400 per 100,000 before the pandemic, but rose to almost 550 per 100,000 patients during the pandemic. Likewise, the rate of short-term complications averaged 30 per 100,000, but rose to 49 per 100,000 at its high during the pandemic.The pandemic's interruptions caused vast differences in the healthcare routines of patients with diabetes, which initially led to more negative outcomes than before the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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In December 2019, a novel coronavirus broke out in Wuhan City, Hubei Province, and, as the center of the coronavirus disease 2019 (COVID-19) epidemic, the economy and production throughout Hubei Province suffered huge temporary impacts. Based on the input–output and industrial pollution emissions data of 33 industrial industries in Hubei from 2010 to 2019, this article uses the non-parametric frontier analysis method to calculate the potential production losses and compliance costs caused by environmental regulations in Hubei's industrial sector by year and industry. Research has found that the environmental technology efficiency of the industrial sector in Hubei is showing a trend of increasing year-on-year, but the overall efficiency level is still not high, and there is great room for improvement. The calculation results with and without environmental regulatory constraints indicate that, generally, production losses and compliance costs may be encountered in the industrial sector in Hubei, and there are significant differences by industry. The potential production losses and compliance costs in pollution-intensive industries are higher than those in clean production industries. On this basis, we propose relevant policy recommendations to improve the technological efficiency of Hubei's industrial environment, in order to promote the high-quality development of Hubei's industry in the post-epidemic era.
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Increased awareness of the carbon footprint associated with pharmaceutical products and the replacement of high global warming potential (GWP) constituents used in the final product, or within the manufacturing process, may drive further diversification of formulation approaches in the future. [...]the nose offers an opportunity to deliver drugs directly to the brain or central nervous system (CNS) via the olfactory pathway. Two relatively recent commercializations for intranasal delivery are naloxone nasal spray to treat suspected opioid overdose emergencies and diazepam nasal spray for short term rescue treatment of seizure clusters. [...]in cystic fibrosis, the overproduction of mucus and alteration of mucus properties, represents a challenge for effective drug delivery by inhalation alone.
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A revised series of standards from the International Organization for Standardization (ISO), the identification of medicinal products (IDMP), were formulated for the creation of an integrated global data source for medicinal products (1). From an International Council for Harmonization (ICH) perspective, the standardized product identification would be able to support multiple processes, but in the EU, new legislation came into force in 2016 concerning data submission on authorized medicines, to primarily optimize connection of pharmacovigilance (PV) signals to products. ingredients, batches, and so on, using standardized data, replacing the existing Article 57 database. XEVMPD provides for more limited data fields than are required for IDMP submissions, but it has paved the way for data exchange as a means of product information delivery and discovery, reducing reliance on static documents. Making a fundamental change to regulatory information management approaches now, then, is likely to pay dividends in the long run-once multiple documents can be built from one definitive data set based on agreed international standards.
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Introduction: The covid-19 disease can be prevented, including by knowledge and public compliance, especially with adolescents in efforts to prevent Covid-19 disease. A preliminary survey of 40 adolescents showed that 30% of teenagers are knowledgeable and 60% of teenagers in Bangkalan are non-compliant in covid-19 prevention efforts. This study aimed to determine the level of compliance to prevent Covid-19. Methods: This research was conducted using a quantitative descriptive survey method. The population and sample were taken by simple random sampling, namely, all adolescents aged 14-21 years in Bangkalan as many as 200 respondents. The instrument uses a questionnaire about Covid-19 prevention efforts. Quantitative data analysis by calculating the frequency of values in a variable. Results: The results showed that 66% of adolescents washed their hands, 95.5% stated that they already knew how to wash their hands properly, and 96.5% used clean water and soap to wash their hands. All adolescents still leave the house, 46% avoid crowds and 97% have kept their distance. 96.5% of adolescents used masks when leaving the house. 84.5% of respondents exercised during a pandemic. 64% of respondents consume nutritious food, exercise, and add vitamins to maintain their immunity, and 59% wear masks, wash their hands and keep a suitable distance health protocol as an effort to prevent Covid-19. Conclusion: The level of adolescent adherence is very good in terms of all aspects of the efforts to prevent Covid-19 except for the physical distancing aspect, so there is a need for increased socialization to eliminate the stigma about physical distancing. [ FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Objectives: Investigate the utilization of cycled antineoplastic therapies (where dosages vary per monthly supply) for various cancers among Medicare-eligible patients, and medical costs and outcomes associated with discontinuation gaps in monthly adherence. Method(s): This retrospective study used the MarketScan Supplemental and Coordination of Benefits Design databases from 2019-2020. Discontinuations were calculated for 2020 utilizing cycled medications (8 generic products) from 6 therapeutic categories, where discontinuation was defined as the first gap in medication supply during the last 6 months of the year at intervals of >=1.5*prior supply. Continuous enrollment was required, as were ICD oncology diagnosis codes for those at least 65 years of age. New to therapy/diagnosis was inferred from 2019 metric files. Patients were excluded if hospice care and inpatient transplant services were indicated. Models examined adherence level (discontinued or not) and 10 covariates (including COVID-19 indications), with interaction terms, for significant associations with medical costs (inpatient and outpatient), hospitalizations, and length of hospital stay (LOS). Result(s): Patients who met metric criteria (n=1,357;Mean age 73.9) had a discontinuation rate of 16.7%. A total of 64.0% were new to therapy/diagnosis and 5.2% were identified having COVID-19 in 2020. However, COVID-19 was not significantly correlated with a discontinuation. Hospitalization rate was at 30.3% with mean LOS=9.8. Models found significant discontinuation effects with increased total medical costs ($11,977, p<.03), odds of hospitalization (2.7, p<.0001), and LOS (5.4, p<.03). COVID-19 patients had significantly higher total medical costs ($18,145, p<.007), odds of hospitalization (6.3, p<.0001), and non-oncology LOS (4.6, p<.009). Significant covariate interactions are discussed in the poster. Conclusion(s): Medication adherence (fewer gaps in medication coverage) on cycled oral antineoplastics can lead to lower medical costs and fewer hospitalization events or LOS as compared to lower adherence levels. This was independent of COVID-19 indications that were associated with increased costs, hospitalization, and non-cancer LOS.Copyright © 2023
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Objectives: The objectives of the study was to assess the level of work satisfaction, assess compliance of using PPE among shop assistants during COVID-19 and to find the factors influencing work satisfaction. Method(s): A quantitative approach with descriptive design was used for the study. Eighty samples were selected by using convenient sampling technique. The study was conducted in 4 districts of Kerala through online platform as well as through offline mediums. Result(s): From the study, it is evident that majority of the subjects (55%) were satisfied with their work at the time of COVID-19 and more than half (55%) of the samples have enough compliance with the use of PPE and only 7.5% have less compliance with the use of PPE. Demographic variables such age, relationship status, and work experience were found to be statically significant (p<0.05) with work satisfaction, and other variables did not have a significant association. Conclusion(s): This study provides a baseline for assessing the level of work satisfaction and compliance of PPE among shop assistants in selected areas. Periodic reinforcements, proper education, availability and trainings on the use of PPE can reduce the spread of Corona Virus and improve PPE compliance to an extend. Good working environment support from family and good rapport with colleagues can help to improve work satisfaction .Copyright © 2023 The Authors.
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Background: Coronavirus disease 2019 (COVID-19) pandemic is still spreading worldwide and it has resulted in severe economic disruptions and unrivalled challenges to health-care system. Aims and Objectives: This study was planned to evaluate the knowledge, attitude, practice, and acceptability of COVID-19 vaccination among medical professionals. Material(s) and Method(s): A questionnaire-based cross-sectional study was conducted on 276 medical professionals working in Puducherry using convenience sampling method. Data were collected using self-administered questionnaire. Descriptive statistics such as frequencies and percentages were computed. Statistical analysis was done using SPSS software 28.0 Version. Pearson's Chi-square analysis and multinomial regression analysis were performed. Result(s): Among the 276 respondents, 71 (25.7%) were affected with COVID-19 infection, 274 (99.2%) got vaccinated. Two doses were taken by 90.6% and 24 (8.7%) had received one dose of vaccination during the study period. Adequate knowledge was seen (P = 0.029) among the doctors who received two doses of vaccination (P = 0.019). Positive attitude was observed among the professionals who were vaccinated with CoviShield (P <= 0.001) and received two doses of vaccination (P = 0.003). About 79% of participants experienced common side effects due to vaccination. About 83.3% of participants were willing to take Booster dose and their choice of vaccine was CoviShield 76.4%, Covaxin 21.7%, and only 12% endorsed Sputnik V. About 69.2% of them have accepted that after mass vaccination campaigns, COVID-19 infection has been reduced. Conclusion(s): The present study findings showed adequate knowledge, favorable attitude, good practice, and acceptability of COVID-19 vaccination. Public health officials should utilize this opportunity and engage the medical professionals in educational campaigns which could reduce the misconceptions and alleviate the fear about the vaccination among the general population.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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The current study analyzed 212 college students' decisions to express or suppress negative feelings about the extent to which others enact recommended COVID-19 precaution behaviors. Using a phronetic iterative analysis, participant experiences were examined in terms of (a) choices to express or suppress their negative feelings and (b) the reasons underlying their disclosure decisions. Significant themes emerged with both response categories. The themes and study findings are discussed in relation to privacy management, subjective norms, and bystander intervention work. Further implications of these findings are also discussed in their extension of and relevance to existing work on compliance-centered interventions and disclosure decisions in health-related contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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BackgroundJanus kinase inhibitors drugs (JAKi) are novel small molecule medications known to cause abnormalities such as elevations in hepatic transaminases, decreases in neutrophil and lymphocyte counts and elevations in cholesterol and creatinine kinase. Blood monitoring is recommended and dose adjustments are advised if abnormalities arise. Recent warnings by the EMA and MHRA have highlighted the importance of monitoring these medications.Timely review and management of patients on JAKi drugs is difficult to maintain with increasing workload amongst the rheumatology team. A baseline audit (2020) demonstrated that hospital blood monitoring guidelines for JAKi drugs were not being followed. The rheumatology multidisciplinary team met and utilised Quality Improvement methodology including fish and driver diagrams to address this. This led to the creation of a pharmacist-led JAKi blood monitoring clinic.ObjectivesTo establish a pharmacist-led rheumatology blood monitoring clinic for the JAKi drug class in order to: increase patient safety with increased compliance to blood monitoring, save consultant/nurse time, improve communication with primary care on the frequency of blood testing required, increase patient understanding of the importance of blood monitoring with JAKi drugs, reinforce counselling advice such as risk of infections, shingles and thrombosis and promote medication adherence.MethodsThe clinic was established in March 2021. Patients commencing JAKi drugs are referred to the pharmacist-led clinic by the medical team. The pharmacist contacts the patient by phone following delivery of their medication. The patient is counselled on their new medication and dates for blood checks are agreed. A letter is sent to the patient and their GP providing this information. The patient is booked into virtual telephone appointments and bloods are monitored every month for the first 3 months and every 3 months thereafter. Any change or abnormality in blood results are flagged early in the patient's treatment and if necessary, discussed with the consultant. Adjustments are made to the patient's dose if appropriate.ResultsIn order to evaluate the benefit of the pharmacist clinic a re-audit of compliance with blood monitoring (March 2021- September 2022) was carried out alongside a patient satisfaction postal survey (August 2022).A total of 58 patients were sampled in the re-audit. The re-audit found an increase in compliance in blood monitoring since the introduction of the pharmacist clinic. 98% of patients had their full blood count performed at 3 months compared to 56% in audit 1 and 95% of patients had their lipid profile completed at 3 months compared to 15% in audit 1 (Table 1).A patient satisfaction survey (N=62, response rate 48%) found that 28 (93%) patients either agreed or strongly agreed that they were more aware of the importance of attending for regular blood monitoring when prescribed JAKi therapy as a result of the clinic.The pharmacy team made several significant interventions (self-graded Eadon grade 4 and 5). For example by improving medication adherence, detecting haematological abnormalities that required JAKi dose reduction, identifying patients suffering from infection requiring intervention including shingles and Covid-19.Table 1.Comparison of audit results pre (Audit 1) and post (Audit 2) clinic establishmentAudit 1 (N=48)Audit 2 (N=58)Number of patients with full blood count completed at weeks 4, 8 & 1227 (56%)57 (98%)Number of patients with lipid profile completed at week 127 (15%)55 (95%)Number of patients LFTs completed at weeks 4, 8 & 1226 (54%)54 (93%)ConclusionIntroduction of the pharmacist-led clinic has increased patient safety by ensuring compliance with blood monitoring as per hospital guidelines. The clinic has paved the way for improved communication with primary care teams and has provided patients with extra support during their first months on treatment with their JAKi. It has also expanded the role of the rheumatology pharmacy team and saved nursing and medical time.Acknowled ementsI wish to thank the SHSCT Rheumatology team for all their help, support and guidance with this project.Disclosure of InterestsNone Declared.
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In the current chapter, we have detailed the course and results of our research to evaluate the five constructs of Health Behaviour Model (HBM) as well as the degree of compliance to preventive measures to contain the spread of COVID-19 among the Indian citizens. Additionally, we also examined the degree of association of the HBM constructs with the compliance. Finally, we investigated whether these constructs differed across various socio-demographic group. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The current (and largely unforeseen) COVID-19 pandemic highlights the value of scenario analysis as a complementary exercise to standard, extrapolative prediction. In this chapter, we review our main findings for geopolitical scenario analysis in general, and for Antarctic geopolitical futures in particular. We conclude that the Antarctic Treaty promotes effective governance of a region described in the Madrid Protocol as ‘a natural reserve devoted to peace and science'. We hope to have shown that a classical geopolitical lens is important and relevant to the study of Antarctic futures. On the specific topic of militarisation, we identified some key driving forces for change and equilibrium. How well the ATS responds to these driving forces will turn on its resilience as a governance system. By this, we mean ‘a capacity to prepare for, to respond to, or bounce back from problems or perturbations and disturbances, which cannot necessarily be predicted or foreseen in advance' (Chandler and Coaffee 2017). As we have seen, scenarios are useful in this zone beyond standard prediction—provided they are plausible, rigorous, and robust. It is our hope that like-minded Parties and researchers might collaborate in scenario work, to contribute to the resilience of the ATS in the challenging years ahead. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Introduction: de Quervain's syndrome is a painful condition commonly presented to hand therapists. Exercise is utilised as an intervention, but isometric exercise has not been investigated. We aimed to assess the feasibility and safety of isometric thumb extension exercise for de Quervain's syndrome and to explore differences between high-load and low-load isometric exercise. Method(s): This parallel-group randomised clinical feasibility trial included individuals with de Quervain's syndrome. All participants underwent a 2 week washout period where they received an orthosis, education, and range of motion exercises. Eligible participants were then randomised to receive high or low-load isometric thumb extension exercises, performed daily for 4 weeks. Feasibility and safety were assessed by recruitment and drop-out rates, adherence, adverse events, and participant feedback via semi-structured interviews. Secondary outcomes included patient-reported outcomes for pain and function, and blinded assessment of range of motion and strength. Result(s): Twenty-eight participants were randomised. There were no drop-outs after randomisation, and no serious adverse events. Adherence to exercise was 86.7%, with 84% of participants stating they would choose to participate again. There were clinically and statistically significant improvements in pain and function over time (p < 0.001) but not in range of motion or strength. There were no statistically significant between-group differences. Conclusion(s): Isometric thumb extension exercise within a multimodal approach appears a safe and feasible intervention for people with de Quervain's syndrome. A large multi-centre trial would be required to compare high- and low-load isometric exercises. Further research investigating exercise and multimodal interventions in this population is warranted.Copyright © The Author(s) 2023.
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BACKGROUND: A comprehensive screening at delivery revealed that roughly 14% of pregnant women who tested positive for COVID-19 did not exhibit any symptoms. The SARS-CoV-2 antigen swab test is frequently utilized as a diagnostic technique. Inadequate implementation of health protocol compliance can enhance the vulnerability of a community to the COVID-19 virus, according to previous findings. This suggests that these health protocol compliance and the vaccination program are important for preventing and controlling the spread of the virus. AIM: This study aims to determine the relationship of vaccination history and health protocol compliance with positive antigen swab results among pregnant women at the Community Health Center in Medan. METHOD(S): This is a cross-sectional and observational study that was conducted in February 2022 at the Community Health Center in Medan, North Sumatra, Indonesia. Two hundred pregnant women who met the inclusion and exclusion criteria make up the sample population. Antigen sampling for SARS-CoV-2 was performed in the Pramita laboratory. Following the collection and processing of sample and antigen swab data, IBM SPSS version was utilized to conduct statistical analysis. RESULT(S): The result showed that four of the pregnant women were infected with COVID-19, and they accounted for 2% of the sample population. The health protocol carried out by pregnant women was not significantly related to the swab results. Therefore, vaccination history had no significant association with COVID-19 symptoms, but people who received vaccines had more negative swab test results compared to those who did not, where three out of four positive samples were unvaccinated. CONCLUSION(S): Based on the results, only 2% of pregnant women were infected with COVID-19 at the Community Health Centre in Medan, because this study was carried out when COVID-19 cases had decreased. The statistical analysis results showed that the history of vaccination was not significantly related to SARS-CoV-2 antigen swab results. However, there was a clinical tendency that vaccines can reduce the number of positive cases, where three out of four positive samples were not vaccinated.Copyright © 2023 Sarma Nursani Lumbanraja, Reni Hayati, Khairani Sukatendel, Johny Marpaung, Muhammad Rusda, Edy Ardiansyah.
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[...]it can be difficult to provide and ensure the same degree of quality, consistency, and compliance in a point-of-use facility compared to a centralized manufacturer. While you have possibly solved the issue of patient access and therapy transport, you have introduced logistical issues with maintaining supply chain and support (engineering, maintenance, calibration, etc.) logistics. The facility is intended to serve a local patient population instead of a global population. [...]the scale of production for a point-of-use facility is going to be smaller by design. The design team would need to account for the site location requirements, and, if the point-of-use facility is intended to be mobile and relocatable, the span of site requirements it may encounter.
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Practices of creativity and compliance intersect in interaction when directing local dances remotely for people living with dementia and their carers in institutional settings. This ethnomethodological study focused on how artistic mechanisms are understood and structured by participants in response to on-screen instruction. Video data were collected from two long-term care facilities in Canada and Finland in a pilot study of a dance program that extended internationally from Canada to Finland at the onset of COVID-19. Fourteen hours of video data were analyzed using multimodal conversation analysis of initiation–response sequences. In this paper, we identify how creative instructed actions are produced in compliance with multimodal directives in interaction when mediated by technology and facilitated by copresent facilitators. We provide examples of how participants' variably compliant responses in relation to dance instruction, from following a lead to coordinating with others, produce different creative actions from embellishing to improvising. Our findings suggest that cocreativity may be realized at intersections of compliance and creativity toward reciprocity. This research contributes to interdisciplinary discussions about the potential of arts-based practices in social inclusion, health, and well-being by studying how dance instruction is understood and realized remotely and in copresence in embodied instructed action and interaction. © 2023 by the authors.
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The article deals with the impact of the SARS-CoV-2 pandemic and related measures on the social interactions of refugees from Afghanistan and Syria in Vienna during the first lockdown in March/April 2020. The focus is on the challenges for these vulnerable groups in the field of tension between the contact minimisation prescribed in the Corona regulations of the federal government on the one hand and cramped housing conditions, precarious labour market positions, homeschooling and the "digital divide” on the other. Further focal points are how refugees deal with the measures of "social/physical distancing”, its consequences in view of the colliding cultural norms, the extent of contact reduction and its causal factors. The empirical basis was provided by a quantitative online survey and qualitative interviews with refugees as well as experts from refugee support NGOs and organisations from both groups of origin, who were involved in the underlying project within the framework of a community-based participatory approach. Contrasting with the criticism sometimes voiced in the media that primarily certain groups with a migration background have been less compliant with the measures to contain the pandemic, a more differentiated picture is drawn. Above all, the factors of family status, age and housing conditions have had a strong influence on compliance with the distancing measures. The inaccessibility of public space, which is a particularly important resource for the refugees, as well as the discontinuation of social services offered by NGOs have particularly affected these vulnerable groups. © 2022 Austrian Geographical Society. All rights reserved.