ABSTRACT
Clinical trial patient recruitment is arguably the most difficult aspect of pharmaceutical development, because it involves a variety of factors beyond study sponsors' control. The aggregation of data across 80 hospitals and 20 systems, for the purpose of understanding patients, doing feasibility studies, or engaging in decentralized recruitment, is the trend we're seeing." Nimita Limaye, PhD, is the vice president of research for the life sciences R&D strategy and technology division at the International Data Corporation (IDC), a market research and advisory firm specializing in the technology industry and headquartered in Boston, Mass. Limaye says the rise of social media-based patient recruitment has opened the door for sponsors and investigators to mine real-world data and to give patients a more central focus in research.
ABSTRACT
BackgroundPeriodic follow-up (FU) is necessary for patients with Rheumatic Diseases (RDs). In the case of a stable clinical condition or low disease activity, FU can be carried out also by rheumatology nurses (RNs). Recent studies focusing on FUs led by RNs either in Rheumatology Clinics and with Telenursing (TN), showed promising results in terms of outcomes, cost reduction and users' satisfaction.ObjectivesTo evaluate the feasibility of a Telenursing FU in a Rheumatology Centre in Florence, Italy.MethodsIn this pilot study, patients with stable inflammatory arthritis or low disease activity were contacted, after their first visit, through TN (T0) and then assessed during the following in-person visit (V12) by RNs for treatment adherence, for pain, for mental and physical health, for workability, for perception of disease activity and satisfaction concerning the TN service.ResultsOut of 27 interviewed patients, 59.3% (n=16/27) was affected by Rheumatoid Arthritis (RA), 18.5% (n=5/27) by Spondyloarthritis (AS), 14.8% (n=4/27) by Psoriatic Arthritis (PsA) and 7.4% (n=2/27) by Juvenile Idiopathic Arthritis. The mean age was 57.5±13.1 (M± DS) years and the treatment adherence level was optimal. 11.1% (n=3/27) of patients was referred for medical consultation because of the urgent clinical situation assessed by the RNs according to the clinical multidisciplinary checklist. After specialist consultation, 1 patient was revalued in presence for a transient ischemic attack;1 patient was contacted by the rheumatologist following independent discontinuation of methotrexate therapy;1 patient was redirected to urgent dermatology consultation because of a suspected cutaneous drug reaction.During the TN period (12 months), 33.3% (n=9/27) of the patients contracted SARS-CoV-2 infection and 11.1% (n=3/27) contracted urinary or upper respiratory tract infections.RA patients showed a mean Rheumatoid Arthritis Impact of Disease-RAID score of 2.4 at T0 and 2.5 at V12 (Range 0-10);AS patients showed a mean Assessment of Spondyloarthritis International Society-ASAS score of 0.3 in both periods and PsA showed a mean Psoriatic Arthritis Impact of Disease-PSAID score of 0.7 and 0.8 at T0 and V12, respectively. Among RA, AS and PsA patients, as a pain score of 3 was recorded in both periods.In order to attend the in-person FU visit, 68.4% (n=13/19) of the patients took work leave. 37% (n=10/27) of them waited 40.9±18.6 minutes at V12 control. The average distance between the Rheumatology Centre and patients' home was 29.3±25.6 km. 15.4% (n=5/13) of the respondents did not own a car and 23.1% (n=3/13) was accompanied to visit by their caregiver.All the included patients expressed high satisfaction for the TN service, corresponding to 5 point Likert scale.ConclusionThe data show that TN FU is a valuable model for maintaining an adequate level of therapeutic adherence, reducing the travel time and working day loss, intercepting remotely clinical issues, as well as registering a high level of user acceptance and satisfaction. Further studies on larger samples are needed to confirm our findings.References[1] Bech B et al (2020) 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Annals of the Rheumatic Diseases;79:61-68. doi: 10.1136/annrheumdis-2019-215458.[2] Alcazar B, Ambrosio L. (2019) Tele-nursing in patients with chronic illness: a systematic review. An Sist Sanit Navar;42(2):187-197. doi: 10.23938/ASSN.0645.[3] Larsson I et al. (2013) Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. Journal of Advanced Nursing;70(1), 164–175., 2013 doi:10.1111/jan.12183Acknowledgements:NIL.Disclosure of InterestsNone Declared.
ABSTRACT
In this commentary, we report on lessons learned over 2 years (2020-2022) from conducting primary care research through a novel alliance of an ACO consisting of independent practices, a health plan, and several academic researchers, with the support of a private foundation. Am J Manag Care. 2023;29(6):In Press _____ Takeaway Points The process of collaborating on research was mutually beneficial for a network of independent practices and a group of academic researchers. * The process benefited the practices by facilitating more precise thinking about quality improvement, motivating the staff, and enabling readiness for health system change. * The process benefited the researchers by illuminating nuances of clinical and organizational workflow and revealing the practices' in-depth understanding of the communities they serve. * If practices have more federally funded opportunities to consistently participate in research, it could help speed greater adoption of payment reform models to promote health equity at the state and national levels. _____ A 2021 National Academies of Sciences, Engineering, and Medicine report, Implementing High-Quality Primary Care, has called out the persistent "neglect of basic primary care research" in the United States.1 A 2020 study by the RAND Corporation found that primary care research represents only 1% of all federally funded projects (including projects funded by the National Institutes of Health, the Agency for Healthcare Research and Quality [AHRQ], and the Veterans Health Administration).2 However, innovation in primary care is central to advancing health care delivery. Leaders in health care innovation recently called for CMS to test a proposal for primary care payment reform in accountable care organizations (ACOs) composed of independent practices (ie, practices not owned by hospitals).3 By innovating in independent practices, these leaders argued that CMS would provide incentives for those practices to stay independent, thereby potentially decreasing the vertical market consolidation that contributes to rising health care costs.3 Yet these same practices may have less experience with the kind of systematic innovation that leads to generalizable insights, because what little funding is available for primary care research is mostly awarded to large academic medical centers.1 AHRQ's practice-based research networks have not fully addressed this gap, as they have struggled to find infrastructure and maintain funding.1 In this commentary, we report on the lessons we learned over 2 years (2020-2022) from conducting primary care research through a novel alliance of an ACO consisting of independent practices, a health plan, and several academic researchers, with the support of a private foundation. [...]ACPNY found that experience with research facilitates innovation and readiness for health system change (lesson 1C).
ABSTRACT
Less than half of women with urinary incontinence (UI) receive treatment, despite the high prevalence and negative impact of UI and the evidence supporting the efficacy of pelvic floor muscle training (PFMT). A non-inferiority randomized controlled trial aiming to support healthcare systems in delivering continence care showed that group-based PFMT was non-inferior and more cost-effective than individual PFMT to treat UI in older women. Recently, the COVID-19 pandemic highlighted the importance of providing online treatment options. Therefore, this pilot study aimed to assess the feasibility of an online group-based PFMT program for UI in older women. Thirty-four older women took part in the program. Feasibility was assessed from both participant and clinician perspectives. One woman dropped out. Participants attended 95.2% of all scheduled sessions, and the majority (32/33, 97.0%) completed their home exercises 4 to 5 times per week. Most women (71.9%) were completely satisfied with the program's effects on their UI symptoms after completion. Only 3 women (9.1%) reported that they would like to receive additional treatment. Physiotherapists reported high acceptability. The fidelity to the original program guidelines was also good. An online group-based PFMT program appears feasible for the treatment of UI in older women, from both participant and clinician perspectives.
Subject(s)
COVID-19 , Telerehabilitation , Urinary Incontinence, Stress , Urinary Incontinence , Humans , Female , Aged , Feasibility Studies , Pelvic Floor , Pandemics , Pilot Projects , Urinary Incontinence/therapy , Exercise Therapy , Treatment OutcomeABSTRACT
Digital tools have evolved into a way of life, and as a result, they have become a growing area of interest for academics who research teaching and learning. Scholars increasingly agree that because digital tools affect human-to-human connection, a greater emphasis on understanding their function in engagement from an interdisciplinary viewpoint is required. However, there does not appear to have been much research on how these tools facilitate social engagement, especially in teaching and learning. This mixed methods study employs a case-study design and explores how digital tools help or hinder social engagement in teaching and learning at a South African-based tertiary institution. A questionnaire consisting of open and closed questions was used to collect data from 88 students from four academic departments at a University of Technology (UoT): Media, Retail and Business Management, Entrepreneurship, and Food Science. Based on the concept of social engagement and the uses and gratifications theory, this interdisciplinary project examines how different fields employ digital tools for social engagement. Some of the findings are that of the communication technologies considered, WhatsApp (97%), video conferencing via Blackboard Collaborate (96.6%) and blackboard course content (95.5%) were the top three ranked tools. Further, WhatsApp was the preferred digital tool for communication with lecturers and peers, while Blackboard was the preferred platform for accessing course materials such as readings and videos. Other than video conferencing platforms such as Zoom, Blackboard Collaborate and YouTube, students use digital tools for engagement with peers. For example, around a quarter of students who used Blackboard Discussion Forums reported engaging with each other. From the qualitative reflections, the study found that students were communicating more with their lecturers through digital tools. Despite having access to lecture recordings, there was still a sense that the educational experience was not as engaging as students wanted it to be because of the lack of in-person engagement.
ABSTRACT
Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its strengths and weaknesses. Forty students with Down syndrome were selected and randomly divided into intervention and control groups. A total of 36 (22 male and 14 female) students out of 50 at two special schools for children with special needs between October 2020 and March 2021 were recruited for the study. Participants were aged 12.888 +or- 2.375 (12.954 +or- 2.609 for boys and 12.785 +or- 2.044 for girls) years. The 18 students in the intervention group participated in the exercise sessions, 2 or 3 sessions per week for 12 weeks. Pre- and post-tests were performed on both groups. The Physical Exercise Package included the principles of exercise, the preferred exercise methods, and the details of exercise planning for Down syndrome individuals (FITT-VP) based on the etiology of Down syndrome and the characteristics of people with this syndrome. Motor proficiency was measured using the Bruininks Oseretsky Test of Motor Proficiency (BOT-2). Results: The results of the study showed that the designed exercise package was adhered to with all the participants attending 93.2% of the sessions, and participants significantly improved their total motor proficiency score, manual dexterity, upper-limb coordination, strength, balance, upper-limb coordination, running speed and agility and fine motor Integration (P < 0.05). However, the exercises did not significantly change the bilateral coordination and fine motor precision (P > 0.05). Conclusions: the current study result shows that developing and implementing the individualized exercise package and observing the principles set out in the program could have significant positive impacts on the motor proficiency of students with Down syndrome.
ABSTRACT
OBJECTIVES/GOALS: Responsive infant feeding (RIF) promotes healthy dietary patterns and infant weight gain. Research is needed to assist caregivers recognize infant hunger/satiety cues and overcome barriers to using RIF. The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach to promote RIF. METHODS/STUDY POPULATION: Guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, this proof-of-concept study tests the feasibility and fidelity of the LEIFc intervention in mother-infant dyads (N=25). Study visits from the 3rd trimester of pregnancy to 4 months postpartum (PP) are conducted in family homes. Use of RIF via subjective (survey) and objective (video) measures is collected at 1 and 4 months PP. Prenatally written and video material on infant feeding and infant hunger/satiety cues is provided. At 2 and 3 months PP, coaching during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR (super, Setting the Stage, Observation & Opportunities, Problem Solving & Planning, Reflection & Review) approach. Qualitative data on LEIFc are provided by the interventionist and participants. RESULTS/ANTICIPATED RESULTS: To date 25 dyads have been enrolled and 4 have completed all study visits. Preliminary analyses showed that subjective measure of awareness of infant cues increased post intervention (pre, M=4.38 vs post, M=4.63). LEIFc has been well accepted by participants including use of the SS-OO-PP-RR approach. Data suggests refinement to LEIFc is needed to include breastfeeding and mental health support as well as a longer duration of intervention through at least 6 months PP. An experienced interventionist is key to success of the research. All lost to follow-up (n=7) have occurred before the first PP visit suggesting that at study visit closer to birth is needed. Enrollment will continue through December 2022 and data collection through April 2023. DISCUSSION/SIGNIFICANCE: After refinement, the LEIFc intervention will be tested in a pilot RCT. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs who serve vulnerable populations;those that often have infant feeding practices that do not align with recommendations and are less likely to use RIF.
ABSTRACT
In order to control the first wave of COVID-19 pandemic in 2020, many models have shown effectiveness in predicting the spread of new coronary pneumonia and the different interventions. However, few models can collect large amounts of high-quality real-time data faster under the premise of protecting privacy, considering the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant and the mass vaccination program as a new intervention. Therefore, we developed a mobile intelligent application that can collect a large amount of real-time data while protecting privacy and conducted a feasibility study by defining a new COVID-19 mathematical model SEMCVRD. By simulating different intervention measures, the prediction model of the mobile intelligent application used in this article simulates the epidemic situation in the U.K. as an example. The findings are as below: the optimal intervention strategy is to suppress the intervention at [Formula Omitted] (intervention intensity: the average number of contacts per person per day) before the end of March 2021, then gradually release the intervention intensity at a rate of [Formula Omitted], and finally release the intensity to [Formula Omitted] in June 2021. The COVID-19 pandemic will end at the end of June 2021, when the total number of deaths will reach 128772. This strategy will be able to balance the tradeoff between loss of life and economic loss. Compared with the official statistics released by the U.K. government on May 31, 2021, our model can accurately predict the relative error rate of the total number of cases is less than 6.9%, and the relative error rate of the total number of deaths is less than 1%. Furthermore, the model is also suitable for collecting data from countries/regions around the world.
ABSTRACT
Existing indoor closed ultraviolet-C (UVC) air purifiers (UVC in a box) have faced technological challenges during the COVID-19 breakout, owing to demands of low energy consumption, high flow rates, and high kill rates at the same time. A new conceptual design of a novel UVC-LED (light-emitting diode) air purifier for a low-cost solution to mitigate airborne diseases is proposed. The concept focuses on performance and robustness. It contains a dust-filter assembly, an innovative UVC chamber, and a fan. The low-cost dust filter aims to suppress dust accumulation in the UVC chamber to ensure durability and is conceptually shown to be easily replaced while mitigating any possible contamination. The chamber includes novel turbulence-generating grids and a novel LED arrangement. The turbulent generator promotes air mixing, while the LEDs inactivate the pathogens at a high flow rate and sufficient kill rate. The conceptual design is portable and can fit into ventilation ducts. Computational fluid dynamics and UVC ray methods were used for analysis. The design produces a kill rate above 97% for COVID and tuberculosis and above 92% for influenza A at a flow rate of 100 L/s and power consumption of less than 300 W. An analysis of the dust-filter performance yields the irradiation and flow fields.
ABSTRACT
Over the past two decades health has been identified as a key area for increased cross-border working on the island of Ireland. To date though, the approach has been minimalist and often project specific. The global pandemic, the continuing fallout from Brexit and the establishment of the Shared Island initiative have pushed the broad issue of healthcare cooperation up the policy agenda. Theoretically, closer cooperation could deliver economies of scale, value for money, opportunities for clinical specialisation, and facilitate the sharing of knowledge. However, despite its obvious potential and policy significance, cross-border collaboration in healthcare has been the subject of remarkably little research attention. This small-scale qualitative study is based on in-depth interviews with 49 individuals with expertise and experience in this area. From these interviews six broad themes emerged: support for collaboration, lack of strategic direction, knowledge sharing, CoviD-19, data and opportunities for future cooperation. Given the similar social, economic and political pressures faced by both healthcare systems, it is concluded that leveraging the strengths from cross-border collaboration should be a policy priority.
ABSTRACT
Background: Depression is a top-ranking global health concern increasing in magnitude. Available treatments for adolescents and young adults are not convincingly effective and relapse rates remain high. Training for Awareness, Resilience and Action (TARA) is a group treatment program targeting specific pathophysiological mechanisms of depression in young people. TARA is feasible, acceptable, preliminarily efficacious in depressed American adolescents, and it affects postulated brain-circuitry. Methods: As an initial step of a multicenter randomized controlled trial (RCT) we performed a single-arm multicenter pilot-study on TARA. Thirty-five depressed individuals (15-21 years old, 28 females) received TARA for 12 weeks face-to-face or online. Data was collected before (T0), during, and after the intervention (T1). The trial was pre-registered at clinicaltrials.gov, NCT Registration: identifier [NCT04747340]. Feasibility outcomes included recruitment, attendance rates, and session ratings. Adverse events were recorded weekly and extracted from medical records at the end of the trial. Primary effectiveness outcome was self-rated depression severity on Reynolds Adolescent Depression scale 2nd ed. at T1. Secondary outcomes were Children's Depression Rating Scale-revised (CDRS-R) and Multidimensional Anxiety Scale for Children (MASC) at T1. Results: TARA was feasible and safe in the present trial. No significant RADS-2-change was seen (adjusted mean difference -3.26, 95 % CI -8.35 to 1.83; p= 0.20), however a significant decrease in CDRS-R scores is reported (adjusted mean difference -9.99, 95% CI -14.76 to -5.22; p < 0.001). MASC-scores did not change significantly (adjusted mean difference 1.98, 95% CI -0.96 to 4.91; p=0.18). Additional feasibility aspects are presented and discussed. Discussion: Limitations include substantial loss-to-follow-up, no randomization to control, and that some participants received concomitant treatment(s). The Coronavirus pandemic complicated both implementation and interpretation of the trial. In conclusion TARA was feasible and safe in depressed adolescents and young adults. Preliminary signs of effectiveness were seen. The initiated RCT will be important and worthwhile to conduct, and several improvements to the design are suggested based on the present results. Clinical Trial Registration: clinicaltrials.gov, identifier NCT04747340.
ABSTRACT
Purpose: The paper provides a summary of the findings from GOOD Awaits - The Regenerative Tourism New Zealand (NZ) Podcast and envisions a regenerative future for tourism in Aotearoa. Design/methodology/approach: This paper is based on the findings from the GOOD Awaits Podcast, a series of interviews with pioneers and practitioners of regenerative tourism. The podcast was created as a platform for the collective discovery of a new way forward for tourism in the wake of COVID-19, and the series provides a detailed summary of the regenerative tourism movement in NZ. Findings: Through these interviews, a vision for a regenerative visitor economy in Aotearoa emerged. This new model is rooted in indigenous knowledge and living systems theory. It is a paradigm shift that allows us to see tourism as a living ecosystem and requires innovative economic models, such as social entrepreneurship, systems level changes to the way tourism operates and is governed, local tourism solutions with community thriving as the primary aim and much more collaboration both within tourism and across sectors. Originality/value: Regenerative tourism is an emerging model and one that is rapidly gaining traction in NZ and globally. The GOOD Awaits podcast is a unique, thoughtful and practical demonstration of what this model could look like in Aotearoa. It demonstrates the potential and feasibility of regenerative tourism practice, and the response has shown the desire for these conversations at a national and international scale. This paper is an accessible summary of the podcast's first season and has value for anyone interested in the regenerative tourism movement in Aotearoa.
ABSTRACT
Since the introduction and enforcement of the Control of Noise at Work Regulations in 2008 continuing research has been undertaken on more than five thousand students of the Royal Academy of Music to understand their hearing acuity. Standard pure tone audiometric screening methods were employed for both entry and exit testing for the undergraduate and postgraduate students. Due to COVID-19 standard audiometry was not possible, however it presented an opportunity to trial an otoacoustic emission based hearing assessment. A feasibility study was undertaken in July 2021 involving 119 classical music students. The results showed very similar trends in hearing and thus provide reassurance that OAE can be used to assess the hearing of music students. © 2022 Internoise 2022 - 51st International Congress and Exposition on Noise Control Engineering. All rights reserved.
ABSTRACT
This study aimed to explore therapists' perceptions and acceptability of providing internet-delivered, therapist-guided, self-help acceptance and commitment therapy (ACT) for family carers of people with dementia (iACT4CARERS). To achieve this, a qualitative approach with semi-structured interviews was employed with eight novice therapists recruited from primary and secondary care services taking part in a feasibility study of iACT4CARERS. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. Four over-arching themes were identified: (1) positive attitudes towards the intervention, (2) therapists' workload, (3) therapists' confidence to perform their role, and (4) connecting with family carers in a virtual context. Theme 1 included seeing their involvement as an opportunity for personal growth and perceiving benefits to the family carers, which contributed to greater acceptability. Theme 2 reflected that while workload and the user-friendliness of the online platform were highly acceptable among the therapists, there were also time-consuming cases that increased therapists' burden. Theme 3 revealed that practical resources provided during the training, continued supervision, and opportunities to learn from other therapists, increased therapist confidence and facilitated greater acceptability. Finally, Theme 4 highlighted that improving the connection between therapists and carers was critical in a virtual context and strategies to improve the therapist–carer relationship were recommended. The implementation of iACT4CARERS was largely acceptable for the therapists involved in the trial. Ways to strengthen the therapeutic relationship in the virtual context and practical strategies to deal with common problems may enhance therapist experience and delivery in a full-scale effectiveness trial.Key learning aims(1) To understand which factors facilitated therapists' positive perceptions and acceptability of providing internet-delivered guided self-help ACT (iACT4CARERS).(2) To understand what challenges acted as barriers to therapists' positive perceptions and acceptability of providing iACT4CARERS.(3) To learn what aspects of the training and the intervention can be refined to improve the acceptability to therapists in trials involving internet-delivered guided self-help interventions for family carers.
ABSTRACT
This research investigated whether consistent practice with a simple, low-cost physical activity intervention could lead to behavior change in older adults and, correspondingly, create a personal acknowledgement of this change. Using a combination of quantitative and qualitative methodologies in addition to recognized forms of walking activities, the researchers sought to achieve the fullest possible exposure to data collection tools for the participants to ascertain and confirm behavior change at the conclusion of a twelve-week study. Study participants were either already associated with various New Mexico Senior Olympics, Inc. track and field sporting events or casual walkers who were not affiliated with New Mexico Senior Olympics, Inc. Further, the researchers attempted to show an association between the study participants' intervention results and component steps of a new aging concept, which focuses on awareness, desire to participate, willingness to engage, commitment, knowledge, ability, and epiphany. This research was conducted in its entirety during the COVID-19 pandemic.
ABSTRACT
Transdiagnostic Cognitive Behavioural Treatment (TCBT) (targeting depression and a range of anxiety disorders) is an effective treatment that targets the common factors and processes underlying anxiety and depressive symptoms.68 Previous trials evaluating TCBT have been internet-based or face-to-face in individual or group form.9 Treatment lengths have typically been 10-18 sessions,912 although a large TCBT study evaluated brief (seven session) group TCBT for emotional disorders in primary care.13 This study reported sustained improvements for anxiety, depression, somatisation and reliable recovery for those receiving TCBT compared to treatment with general practitioners (GPs), but the treatment intervention was longer than is typically provided in the New Zealand context and the study did not include an active therapy control. Exclusion criteria Patients not eligible included those for whom alcohol and drugs were identified as the main clinical issue, those for whom a referral to specialty services was required to manage moderate-severe illness or high levels of risk and those with significant cognitive problems or language barriers that meant psychological interventions and completion of rating scales was not possible unless in modified form. Group content included the following: socialisation to the group, goal setting and motivation, introduction to the TCBT model, understanding the function of emotion, emotion-driven behaviours and the role of avoidance, behavioural activation, learning to observe emotions and thoughts (mindfulness exercises), thinking biases and thought restructuring, behavioural experiments, awareness of and tolerating physiological sensations (including interoceptive exposures) and relapse prevention. Reliable recovery was measured by scoring above clinical cut-off for PHQ-9 (>10) and GAD-7 (>8) at baseline assessment, scoring below clinical cut-off for PHQ-9 and GAD-7 at the follow-up time point and showing reliable improvement over treatment (pre-post change in PHQ-9>5.2 and GAD-7>3.53).19 The PHQ-9 is a reliable, valid self-administered measure of depression20 and the GAD-7 is a valid and efficient self-report measure for the assessment of generalised anxiety disorder.21 Secondary outcome measures were: 1.
ABSTRACT
Feasibility study of brief Group Transdiagnostic Cognitive Behavioural Treatment delivered via Zoom for anxiety and depression in primary care Ben Beaglehole, Jenny Jordan, Chris Frampton, Alison Alexander, Angela Spencer, Cameron Lacey, Richard John Porter, Caroline J Bell Our study assesses whether it is feasible to deliver Transdiagnostic Cognitive Behavioural Therapy (TCBT) using Zoom for patients with anxiety and depression in primary care. A clinical review of monkeypox for the Aotearoa New Zealand clinician Teena Mathew, Eamon Duffy, Erasmus Smit, Jay narrower, Jeannie Oliphant, Noah Bunkley R Joan H Ingram, Rupert Handy, Annabelle Donaldson Mpox or previously known as monkeypox infection has been reported in Aotearoa New Zealand since July 2022 as part of the global outbreak mainly among individual identifying as gay, bisexual or other men who have sex with men. Airborne transmission: a new paradigm with major implications for infection control and public health Anna Stevenson, Joshua Freeman, MarkJermy Jason Chen At the start of the COVID-19 pandemic precautions against infection were based on the understanding that the virus would transmit largely by droplet spread.
ABSTRACT
This study aims to determine the feasibility of Augmented Reality Creative Mathematics learning media for geometric materials in elementary schools. The development of Augmented Reality Creative Mathematics learning media uses research and development methods or Research & Development, which produces a three-dimensional learning media using Augmented Reality technology in the Assemblr Edu application. This research and development use the ADDIE development model, which includes 5 development steps, namely: 1) analysis, namely needs analysis;2) design, namely design or planning;3) development, namely development;4) implementation, namely implementation and 5) evaluation, namely evaluation. Based on the feasibility test results, it can be concluded that the Augmented Reality Creative Mathematics media is suitable for use as a learning medium for geometric materials in class V SDIT Istiqamah Balikpapan. [ABSTRACT FROM AUTHOR] Copyright of Technium Social Sciences Journal is the property of Technium Press Constanta 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 abstract 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 abstract. (Copyright applies to all Abstracts.)
ABSTRACT
BACKGROUND: It is important to investigate remotelearning options for medical education. We evaluated retention of research-related knowledge after exposure to pre-recorded audio-based didactics (AUDIO) versus video conference-based didactics (ZOOM). METHODS: Obstetrics and Gynecology residents over the 2020-2021 academic year were randomized to didactics delivered in AUDIO versus ZOOM formats. At baseline, immediately post-exposure, and 3-month post-exposure, objective knowledge was assessed through 15 multiple choice questions. Confidence and satisfaction were assessed on a 5-point Likert scale. Median differences and 95% confidence intervals (CI) were applied to identify a 10% non-inferiority margin. RESULTS: Thirty of thirty-one (30/31, 96.8%) eligible residents participated. At 3-month post-exposure, AUDIO was non-inferior to ZOOM (6.3% mean difference in knowledge scores, 95% CI -3.5-16.2). There were no differences in satisfaction or confidence, though a greater proportion of AUDIO participants indicated they would use a similar resource independently (p=0.008). CONCLUSION: AUDIO didactics may be non-inferior to ZOOM.
ABSTRACT
IntroductionRubber band ligation (RBL) is a procedure commonly performed in colorectal clinics for internal haemorrhoids. Overall, 90% of patients experience pain following RBL. We aimed to complete a feasibility randomised control trial assessing the role of topical anaesthetic before RBL of internal haemorrhoids.MethodsWe performed a prospective, single-centre, single blinded, randomised (1:1) control feasibility trial. Patients presenting with symptomatic haemorrhoids suitable for banding were randomised to undergo the procedure with local anaesthetic or without (control). Pain scores and vasovagal symptoms were assessed at 0 minutes, 30 minutes, 4 hours and 72 hours after the procedure. Primary outcome measures were recruitment rate, participant retention rate and patient and surgeon acceptability. Secondary outcome measures were pain scores up to 72 hours, vasovagal episodes, new use of analgesia and adverse outcomes.ResultsIn total, 35 patients (18 topical anaesthetic, group A;17 no anaesthetic gel, group B) were recruited. Mean recruitment rate was 11.7 participants per month. Thirty-three (94%) participants remained in the study until completion, with two patients lost to telephone follow-up. The treatment was acceptable for 35 (97%) eligible patients. One patient declined enrolment. The treatment was acceptable to all surgeons (100%). There was a significant difference in median pain scores of −2 (95% CI −4.0 to −1.0, p=0.0006) at the 30-minute time point only. There was no significant difference in vasovagal symptoms (p=0.10) or new analgesia use (p=0.85).ConclusionWe have shown that a phase III clinical trial is feasible for assessing the role of topical anaesthetic before RBL of internal haemorrhoids. We have demonstrated excellent patient recruitment and retention as well as patient and surgeon acceptability.