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This chapter explores individual careers that involve living and working in different countries. Such international careers are increasingly common among global professionals. The management of global careerists is a challenge for organizations and global mobility (GM) departments due to the many micro- and mesoelements that have an influence on the outcomes of working abroad. Career counselors would benefit from understanding the key determinants of working in GM in order to refine suggested career interventions. Therefore, the chapter discusses organizational considerations, the roles of GM professionals, and their particular challenges. Moreover, it proposes a framework for GM work and presents reflections on the impact of COVID-19 on GM, delineating recent substantial changes to global careers and their impact on those who manage GM. The chapter predominantly focuses on the micro- and mesolevel perspectives and, at times, depicts the wider context. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Early childhood caries (ECC) is a multifactorial disease with known etiologic factors and can be very devastating to the oral and general well-being of a child, including psychological impact on a growing child. The irony is among the different factors responsible for milk that is wholesome nutrition, if fed in a wrong pattern, can be the main factor that helps this type of rampant caries spread within no time, leading to pulp exposures and complicating proceedings. Awareness is the mainstay in prevention, and creating it becomes our sole responsibility as a pediatric dentists. A multidisciplinary approach with the involvement of mothers as a main stakeholder in this front becomes a very promising move, so this project is phase two of interprofessional collaboration involving mothers in prevention;the aim of the study is to create awareness among mothers during COVID lockdown so as to prevent ECC in this COVID pandemic. Materials and methods: A total of 222 mothers with 9–24 months old children were selected and added to the e-groups. The allocated mothers were given a pretest questionnaire and collected back with a photo of their child's oral health, and anticipatory guidance and in-depth interviewing were given to them. Follow-up is done in 2, 4, and 6 months. Awareness is evaluated by pre-and posttest questionnaires. Reversal of the white spot is evaluated through indices, and progression is noted. Statistical analysis: The data was analyzed using Statistical Package for the Social Sciences 13. Result: Pretest and postquestionnaire analysis were done using the Chi-squared test. The test shows the marked raise in knowledge, attitude, and practice of mothers on their children after postintervention, which was given through motivational interviewing (MI). Conclusion: In summary, the MI intervention appeared to improve maternal knowledge but had no effect on oral health behaviors or on the progression of early childhood caries (ECC). © The Author(s). 2023 Open Access.
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COVID-19 has undergone several mutations and is still spreading in most countries now. PA has positive benefits in the prevention of COVID-19 infection and counteracting the negative physical and mental effects caused by COVID-19. However, relevant evidence has indicated a high prevalence of physical inactivity among the general population, which has worsened due to the outbreak of the pandemic, and there is a severe lack of exercise guidance and mitigation strategies to advance the knowledge and role of PA to improve physical and mental health in most countries during the epidemic. This study surveyed the effects of COVID-19 on PA in Chinese residents during the pandemic and provided important reference and evidence to inform policymakers and formulate policies and planning for health promotion and strengthening residents' PA during periods of public health emergencies. ANOVA, Kolmogorov-Smirnov, the chi-square test and Spearman correlation analysis were used for statistical analysis. A total of 14,715 participants were included. The results show that nearly 70% of Chinese residents had inadequate PA (95%CI 58.0%-82.19%) during the COVID-19 outbreak, which was more than double the global level (27.5%, 95%CI 25.0%-32.2%). The content, intensity, duration, and frequency of PA were all affected during the period of home isolation, and the types of PA may vary among different ages. The lack of physical facilities and cultural environment is the main factor affecting PA. However, there was no significant correlation between insufficient PA and the infection rate. During the period of home isolation and social distance of epidemic prevention, it is necessary to strengthen the scientific remote network monitoring and guidance for the process of PA in China.
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BACKGROUND: The importance of palliative care provision has been highlighted in previous humanitarian emergencies. This review aimed to examine the breadth and depth of palliative care inclusion within global guidelines for responding to infectious disease outbreaks. METHODS: The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic searches of MEDLINE, Embase, Cumulative Index to Nursing and Allied Health, PsychInfo and grey literature were performed. Inclusion criteria were guidelines (recommendations for clinical practice or public health policy) for responding to infectious disease outbreaks in the general adult population. Results were limited to the English language, between 1 January 2010 and 17 August 2020. Analysis of the included articles involved assessing the breadth (number of palliative care domains covered) and depth (detail with which the domains were addressed) of palliative care inclusion. RESULTS: A total of 584 articles were retrieved and 43 met the inclusion criteria. Two additional articles were identified through handsearching. There was limited inclusion of palliative care in the guidelines examined. CONCLUSIONS: There is an opportunity for the development of guidelines that include information on palliative care implementation in the context of infectious disease outbreaks in order to reduce the suffering of key vulnerable populations worldwide.
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Disease Outbreaks , Palliative Care , Adult , Disease Outbreaks/prevention & control , Humans , Palliative Care/methodsABSTRACT
The scarcity of professional ophthalmic equipment in rural areas and during exceptional situations such as the COVID-19 pandemic highlights the need for tele-ophthalmology. This late-breaking work presents a novel method for guiding users to a specific pose (3D position and 3D orientation) near the eye for mobile self-eye examinations using a smartphone. The user guidance is implemented utilizing haptic and visual modalities to guide the user and subsequently capture a close-up photo of the user's eyes. In a within-subject user study (n=24), the required time, success rate, and perceived demand for the visual and haptic feedback conditions were examined. The results indicate that haptic feedback was the most efficient and least cognitively demanding in the positioning task near the eye, whereas relying on only visual feedback can be more difficult due to the near focus point or refractive errors. © 2023 Owner/Author.
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Since the 1970's the number of scientific publications with sustainability as a keyword has increased from 1 in 1975 to 13,628 in 2019. Research, like all human endeavors, has impacts on the environment due to the activities required to generate the supporting data (i.e., use of vehicles, resources, and materials). Researchers have a responsibility to minimize their impacts as part of their work and to make environmentally responsible decisions. A life-cycle approach is currently the best-developed means of assessing the impact of a group or organization. This article presents a case study of organizational life cycle assessment (O-LCA) of a research project. The objectives of this study were to (i) estimate the impact of the project, focusing on travel. (ii) Use a post hoc approach to determine impact reduction opportunities. (iii) Apply O-LCA as a decision-making tool in project management of research and (iv) profile the environmental impact of the project using public data (manufacturers figures) and proprietary datasets. The results of this study indicate that the greatest impact arising from the project was due to commuting followed by conference and training attendance, fieldwork and meetings. Scenarios modeling, alternative vehicle use, flexible working arrangements and stakeholder events highlighted the reduction potential that could have been implemented as part of the project. O-LCA proved to be an appropriate tool for assessing the impact of a research group and that it has the potential to inform decisions and management of academic projects and events. It should be noted that the ability of research groups or personnel to bring about change might be limited, typically due to their placement within a larger organization (e.g., a higher education institute). The recent COVID-19 pandemic, has hastened the shift to remote working practices for many organizations. Recent surveys indicate that more than 80% of respondents would like to work remotely, at least some of the time, after the pandemic. This modal shift in working practices offers an immediate opportunity for environmental relief. It is recommended that O-LCA be incorporated into groups and organizations to support their decision-making practices to foster responsible and sustainable research. Copyright © 2021 Cooney, Tahar, Kennedy and Clifford.
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The ongoing development and integration of telehealth within CF care has been accelerated in response to the Covid-19 pandemic, with many centres publishing their experiences. Now, as the restrictions of the pandemic ease, the use of telehealth appears to be waning, with many centres returning to routine traditional face-to-face services. For most, telehealth is not integrated into clinical care models, and there is a lack of guidance on how to integrate such a service into clinical care. The aims of this systematic review were to first identify manuscripts which may inform best CF telehealth practices, and second, to analyse these finding to determine how the CF community may use telehealth to improve care for patients, families, and Multidisciplinary Teams into the future. To achieve this, the PRISMA review methodology was utilised, in combination with a modified novel scoring system that consolidates expert weighting from key CF stakeholders, allowing for the manuscripts to be placed in a hierarchy in accordance with their scientific robustness. From the 39 found manuscripts, the top ten are presented and further analysed. The top ten manuscripts are exemplars of where telehealth is used effectively within CF care at this time, and demonstrate specific use cases of its potential best practices. However, there is a lack of guidance for implementation and clinical decision making, which remains an area for improvement. Thus, it is suggested that further work explores and provides guidance for standardised implementation into CF clinical practice.
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Purpose of Study: Residents have experienced changes in educational structure, format, content, and patient experience due to the COVID-19 pandemic. Resident physicians across the country have reported changes in workload including a decrease in well child checks and immunizations resulting in limited clinical exposure. This study aimed to assess the confidence of first year pediatric residents (interns) in conducting routine preventive screening for children and to identify potential gaps in knowledge among this cohort. Methods Used: We conducted a cross-sectional observation study that included 13 categorical first year pediatric residents. A voluntary, anonymous online survey was administered in September 2022. The survey assessed confidence levels, and perceived comfort regarding common preventive pediatric encounters and screening tools. The survey included 7-questions based on the 4th Edition Bright Future's Guidelines and respondents rated their answers on a 5-point Likert scale. The surveys were distributed anonymously via e-mail using Survey Monkey, a web-based software platform that provided an intuitive interface for validated data capture. Participants were given 2 weeks to complete the survey and reminders were sent via email. Summary of Results: Eight of 13 interns participated for a response rate of 62%. Sixty-three percent of the residents had completed a subinternship in pediatrics. Of our respondents, 75% reported feeling "not at all confident" in executing well child check-ups for children <12months old and 63% reported feeling "very confident" in examining children> 13months old. Regarding the ability to perform a genitourinary examination in children >12years of age, 63% of respondents stated that they were "slightly" or "not at all confident". We asked interns to rate their confidence in providing anticipatory guidance to their patients. Interns perceived being somewhat confident regarding guidance about safe sex, tobacco use, and healthy lifestyles but less confident regarding newborn care, breast feeding and infant nutrition. Nearly 40% reported comfort in recommending and advising parents about the risks and benefits of age appropriate immunizations. We asked residents to report their ability in administering and interpreting screening tools (ASQ, MCAT, EPDS). Interns reported that were able to interpret results but lacked confidence in providing guidance. Conclusion(s): Our study identifies opportunities to bridge experiential knowledge gaps and confidence among pediatric interns who may have had limited clinical exposure to pediatrics following the COVID-19 pandemic. Graduate medical education programs should consider developing tailored educational interventions specifically geared for identified learning gaps to mitigate the challenges posed by the pandemic.
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Objectives: In support of schools restarting during the COVID-19 pandemic, some schools partnered with local experts in academia, education, community, and public health to provide decision-support tools for determining what actions to take when presented with students at risk for spreading infection at school. Methods: The Student Symptom Decision Tree, developed in Orange County, California, is a flow chart consisting of branching logic and definitions to assist school personnel in making decisions regarding possible COVID-19 cases in schools which was repeatedly updated to reflect evolving evidence-based guidelines. A survey of 56 school personnel evaluated the frequency of use, acceptability, feasibility, appropriateness, usability, and helpfulness of the Decision Tree. Results: The tool was used at least 6 times a week by 66% of respondents. The Decision Tree was generally perceived as acceptable (91%), feasible (70%), appropriate (89%), usable (71%) and helpful (95%). Suggestions for improvement included reducing the complexity in content and formatting of the tool. Conclusions: The data suggest that school personnel found value in the Decision Tree, which was intended to assist them with making decisions in a challenging and rapidly evolving pandemic.
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Premature unblinding of individual participants is rarely reported in publications, but such unblinding can disrupt vaccine trials by causing worry and drop-out of other participants or "pseudo unblinding," in which participants or investigators over-interpret certain symptoms as being related to receiving an investigational product. This review summarizes appropriate reasons for unblinding in vaccine trials. Regulatory guidance could be improved by distinguishing guidance for vaccine trials from drug trials, with the recognition that unblinding individual participants in vaccine studies is rarely needed for management of adverse events following immunization.
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Vaccination , Vaccines , Humans , Vaccination/adverse effects , Vaccines/adverse effectsABSTRACT
BACKGROUND: Cannabis is the most-frequently used illicit drug in Europe. Over the last few years in Spain, treatment demand has increased, yet most cannabis users do not seek treatment despite the related problems. A web-based self-help tool, like CANreduce 2.0, could help these users to control their consumption. METHODS: This study protocol describes a three-arm randomized controlled trial (RCT) comparing the effectiveness of three approaches, in terms of reducing cannabis use among problematic cannabis users, the first two treatment arms including the Spanish version of CANreduce 2.0 (an adherence-focused, guidance-enhanced, web-based self-help tool) (1) with and (2) without psychological support; and the third group (3) treatment as usual (TAU). Study hypotheses will be tested concerning the primary outcome: change in the number of days of cannabis use over the previous week, comparing assessments at 6 weeks and 3 and 6 months follow-up between groups and against baseline. Secondary outcomes related to cannabis use will be tested similarly. Mental disorders will be explored as predictors of adherence and outcomes. Analyses will be performed on an intention-to-treat basis, then verified by complete case analyses. DISCUSSION: This study will test how effective the Spanish version of CANreduce 2.0 (CANreduce-SP) is at reducing both the frequency and quantity of cannabis use in problematic users and whether adding psychological support increases its effectiveness. TRIAL REGISTRATION: This trial is registered with the Clinical Trials Protocol Registration and Results System (PRS) number: NCT04517474 . Registered 18 August 2020, (Archived by archive.is https://archive.is/N1Y64 ). The project commenced in November 2020 and recruitment is anticipated to end by November 2022.
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Cannabis , Counseling , Marijuana Abuse , Patient Acceptance of Health Care , Health Behavior , Humans , Internet , Marijuana Abuse/therapy , Mental Disorders , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
The increasing mental health issues among university students during the COVID-19 pandemic and the challenges of delivering face-to-face interventions during lockdowns have increased the demand for online interventions. The report presents results from a randomized controlled trial investigating the benefits of online mindfulness interventions delivered by videoconference or podcast during the early phase of the pandemic in Germany. Fifty university students were randomized to a mindfulness intervention conducted by videoconference (n = 25) or to an unguided training provided by podcasts (n = 25). All students participated in a 7-week mindfulness intervention. Outcome measures included mindfulness, depression, anxiety, and life satisfaction preintervention and postintervention. The study showed a larger reduction in depression in the videoconferencing group than in the podcast group across per protocol (PP) and intention-to-treat (ITT) analyses. There was a significant increase in mindfulness (PP and ITT samples) and life satisfaction (ITT sample) in both groups. The frequency of home practice was related to positive changes in outcomes but only for the videoconferencing group. The results suggest that mindfulness training delivered via videoconferencing can be a viable option to address depressive symptoms among students. However, both interventions were effective in increasing mindfulness and life satisfaction.
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603,711,760 confirmed cases of COVID-19 have been reported throughout the world and 6,484,136 individuals have died from complications of COVID-19 as of September 7, 2022. Significantly, the Omicron variant has produced the largest number of COVID-19 associated hospitalizations since the beginning of the pandemic. Cardiac injury occurs in >= 20% of the hospitalized patients with COVID-19 and is associated with cardiac dysrhythmias in 17 to 44%, cardiac injury with increases in blood troponin in 22 to 40%, myocarditis in 2 to 7%, heart failure in 4 to 21%, and thromboembolic events in 15 to 39%. Risk factors for cardiac complications include age >70 years, male sex, BMI =30 kg/m(2), diabetes, pre-existing cardiovascular disease, and moderate to severe pneumonia at hospital presentation. Patients with prior cardiovascular disease who contract COVID-19 and experience a significant increase in their blood troponin concentration are at risk for mortality rates as high as 69%. This review focuses on the prevalence, the pathophysiologic mechanisms of CoV-2 injury to the cardiovascular system and the current recommended treatments in hospitalized patients with COVID-19 in order that medical personnel can decrease the morbidity and mortality of patients with COVID-19 and effectively treat patients with Covid and post Covid syndrome.
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Significant conceptual and empirical evidence has been found through qualitative research about the benefits, limitations, and uses of individual interviews. However, there is scant research illustrating how researchers use specific techniques that center participants' intersecting identities to build rapport, trust, and authentic connections during individual interviews, and especially during interviews with Black women. We illustrate how we used eight empirically grounded techniques in our qualitative individual interviews with Black women. Through our analysis of the interviews, the concept of safety emerged. "This person is safe" reflects the combined stories the women reported regarding their experiences engaging in individual interviews. In this article, we provide a brief background on individual interviewing in qualitative research, followed by the framing of our work. Thereafter, we provide context about the exemplar study, outline techniques shown to be effective in the literature, and provide examples from the exemplar study to show how each technique was used. Further research is needed to examine how researchers use various techniques in qualitative individual interviews in general, but with Black women more specifically.
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ObjectiveTo identify and summarise the digital health interventions (DHIs) implemented for non-communicable disease (NCD) management for COVID-19. DesignRapid scoping review. Three reviewers jointly screened titles-s and full texts. One reviewer screened all excluded records. Data were mapped to WHO DHI Classification and narratively summarised. Data sourcesPubMed, CENTRAL, CINAHL, EMBASE. Eligibility criteria for selecting studiesPeer-reviewed primary research published between 1 November 2019 and 19 September 2021 on DHI for NCD management during the COVID-19 pandemic. Reviews, editorials, letters, commentaries, opinions, conference s and grey literature were excluded. ResultsEighty-three studies drawn from 5275 records were included. A majority of the studies were quantitative in design. Forty per cent of the DHIs were implemented in the Americas. Nearly half of these DHIs targeted mental health conditions. A majority of the interventions were delivered remotely and via telephones. Zoom (26.5%), email (17%) and WhatsApp (7.5%) were the top three platforms for care delivery. Telemedicine, targeted client interventions, personal health tracking and on-demand information services for clients were the most frequently implemented interventions. Details regarding associated costs, sustainability, scalability and data governance of the DHI implementations were not described in the majority of the studies. ConclusionWhile DHIs supported NCD management during the COVID-19 pandemic, their implementation has not been equitable across geographies or NCDs. While offering promise towards supporting the continuum of care during care delivery disruptions, DHIs need to be embedded into healthcare delivery settings towards strengthening health systems rather than standalone parallel efforts to overcome system level challenges.
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Objective The coronavirus disease 2019 (COVID-19) pandemic has led to a global restriction of public behavior due to lockdowns in various major cities. Lifestyle changes and reduced rates of outpatient lifestyle guidance/consulting may have had some impact on glycemic control in patients with type 2 diabetes. This study analyzed the impact of changes in the frequency of nutritional guidance/consulting (NGC) during the COVID-19 pandemic on outpatient care for type 2 diabetes. Methods Among 785 patients, 67 who received regular NGC during the COVID-19 pandemic were assigned to the continuation group (CG), 143 whose NGC was discontinued after the pandemic were assigned to the discontinuation group (DG), and 575 who did not receive regular NGC regardless of the COVID-19 pandemic status were assigned to the irregular NGC group (IGG). The three groups were followed up for two years. Analyses among the three categories were performed using the chi-square test or an analysis of covariance. Results The number of diabetes medications after the declaration of the COVID-19 emergency did not markedly increase in the CG (2.0±1.4 to 2.1±1.5, p>0.05) but significantly increased from 2.2±1.4 to 2.6±1.4 in the DG (p<0.005) and from 2.2±1.4 to 2.4±1.4 in the IGG (p<0.005). The increase in HbA1c adjusted for confounders was unchanged at 0.12±1.06% for the CG and -0.07±1.29% for the IGG but was significantly increased at 0.19±1.49% for the DG (p<0.05). Conclusion In patients with type 2 diabetes mellitus, regular nutritional guidance may be important for maintaining good glycemic control, even during the COVID-19 pandemic.
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COVID-19 , Diabetes Mellitus, Type 2 , Humans , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/drug therapy , Pandemics , Glycemic Control , Glycated Hemoglobin , Communicable Disease Control , Immunoglobulin G/therapeutic useABSTRACT
In the past few years, technology has changed drastically and due to COVID-19 pandemic, people spend more time on screen. The use of social media platforms has also been increased and this affects the human mind and decision taking ability. Online career counseling is largely supported these days and hence this paper proposes an online career prediction system using supervised machine learning based on the user's profile. This research attempted to develop a model for the user which predicts the career path in a precise manner and gives actionable feedback and career recommendations to encourage them to make significant career judgments. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
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Recently, accurate segmentation of COVID-19 infection from computed tomography (CT) scans is critical for the diagnosis and treatment of COVID-19. However, infection segmentation is a challenging task due to various textures, sizes and locations of infections, low contrast, and blurred boundaries. To address these problems, we propose a novel Multi-scale Wavelet Guidance Network (MWG-Net) for COVID-19 lung infection by integrating the multi-scale information of wavelet domain into the encoder and decoder of the convolutional neural network (CNN). In particular, we propose the Wavelet Guidance Module (WGM) and Wavelet &Edge Guidance Module (WEGM). Among them, the WGM guides the encoder to extract infection details through the multi-scale spatial and frequency features in the wavelet domain, while the WEGM guides the decoder to recover infection details through the multi-scale wavelet representations and multi-scale infection edge information. Besides, a Progressive Fusion Module (PFM) is further developed to aggregate and explore multi-scale features of the encoder and decoder. Notably, we establish a COVID-19 segmentation dataset (named COVID-Seg-100) containing 5800+ annotated slices for performance evaluation. Furthermore, we conduct extensive experiments to compare our method with other state-of-the-art approaches on our COVID-19-Seg-100 and two publicly available datasets, i.e., MosMedData and COVID-SemiSeg. The results show that our MWG-Net outperforms state-of-the-art methods on different datasets and can achieve more accurate and promising COVID-19 lung infection segmentation. IEEE
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AREAS COVERED: An initial investigation of US medical device guidelines is presented, with the aid of those of medicines as qualitative comparator. Since the first recorded FDA medical device guideline (February 1975) until the mid-2010s, the number of medical device guidelines has been basically stable, then rapidly rose. EXPERT OPINION: The rise of the COVID-19 pandemic and digital health technologies explains 50% of the upward momentum in guidelines since the mid-2010s. Concomitantly, medical device and medicinal guidelines became moderately correlated. This perspective posits that this trend will continue irrespective of the ebbing pandemic as it is embedded in the concept of 'innovation saltus' - i.e. discrete periods of elevated innovation. A key aspiration of this work is to inspire additional research into this interesting area of regulatory science; namely, examination of guidelines (as proxy measures of regulations) and their influence on innovation.