Virtual learning before and during the COVID-19 pandemic: A mixed methods study of Pharmacy students

Background It is a challenge for pharmacy courses worldwide to combine theoretical knowledge with practical skills to equip students for their future practice. Computer-based simulation offers a way of building a bridge between theory and practice. In recent years, digital simulation has expanded rapidly as a new technique of virtual learning. The digital platform ''Pharmacy Simulator'' proposes computer-based encounters with virtual patients to train clinical and communication skills in a community pharmacy setting. However, during the COVID-19 pandemic, while students were digitally resilient and endured the endless challenges of online lectures, many were dealing with Zoom and screen fatigue. Purpose To investigate pharmacy students' acceptance of Pharmacy Simulator before and during a pandemic situation. This focuses on students' self-assessment and confidence in counselling after playing the scenarios on Pharmacy Simulator. Method Two cohorts of Master of Pharmacy students at The University of Western Australia played two scenarios on Pharmacy Simulator in 2019 (anaphylaxis and salbutamol) and 2021 (anaphylaxis and vaccination). A mixed-method analysis was performed with data from (i) qualitative semi-structured interviews carried out in 2019 pertaining to participants' acceptance of Pharmacy Simulator and in 2021 (ii) a questionnaire with 25 items derived from the interviews. The interviews were transcribed verbatim into electronic format with the data management assistance MAXQDA and analyzed inductively using the Framework Method. Questionnaire responses were analyzed in Microsoft Excel using descriptive statistics. Openended questions were evaluated inductively. Findings Data were collected from 20 interviews and 31 answered questionnaires. In 2019, participants reported that Pharmacy Simulator was a fun, engaging, and straightforward learning tool and, therefore, user-friendly. They reported the feedback at the end of the session to be most valuable. The platform was perceived to fill the gap between the theory from lectures and community pharmacy practice. In 2021, participants ''agreed'' (median: 4, on a 5-point Likert scale) with seven statements about Pharmacy Simulator's usability, such as it being a helpful tool for acquiring new knowledge. Participants' confidence in counselling regarding the scenario topics improved. One participant stated, ''It taught me more through trial and error''. Conclusion Pharmacy students reported similar acceptance levels of Pharmacy Simulator before and during the COVID-19 pandemic. The use of simulation during virtual patient encounters seems to facilitate the transfer from theory to practice, independently of learning conditions that were predominantly screen-based.

Assessment of the knowledge, attitudes, and behaviors of individuals presenting to family medicine polyclinics for COVID-19 and influenza vaccines: a study in a Turkish population

BACKGROUND: Vaccines are one of the most important weapons in protection against diseases, especially pandemics lacking available treatment. The objective of this study was to investigate the knowledge, attitudes, and behaviors of individuals presenting to family medicine polyclinics for COVID-19 and influenza vaccines. METHOD(S): The cross-sectional descriptive study comprised healthy individuals who presented to family medicine polyclinics in Ankara Training and Research Hospital, Ankara, Turkiye between 10 December 2020 and 31 January 2021. Data on participants' knowledge and attitudes for COVID-19 and influenza vaccines were collected through questionnaire surveys. In total, 521 individuals aged older than 18 years were included in the study. RESULT(S): If a COVID-19 vaccine were available, 34.4% (N.=179) of respondents would be vaccinated, and 35.3% (N.=184) of respondents would not consider vaccination. Of those considering COVID-19 vaccination, 55.3% (N.=99) of respondents deemed the vaccine an effective way of providing protection against the virus. Increased willingness to have the COVID-19 vaccine was associated with the following factors: considering the influenza vaccine an effective protection method (P<0.001), a history of influenza vaccination (P=0.003), and concern about COVID-19 related death rates (P=0.008). CONCLUSION(S): The most common reasons for COVID-19 vaccine hesitancy and refusal were fear of vaccine-related side effects and a lack of perceived research evidence on the vaccine. Having a positive view of the influenza vaccine had a positive impact on attitudes toward the COVID-19 vaccine.Copyright © 2022 EDIZIONI MINERVA MEDICA.

Factors Influencing Work Satisfaction and Compliance of Using Ppe among Shop Assistants during Covid-19

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.

Knowledge, attitude, practice, and acceptability towards COVID-19 vaccination among medical professionals in Puducherry - A cross-sectional study

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.

ID: 218414 Queen Mary University London Postgraduate Certification in Neuromodulation- Accreditation in Neuromodulation

Introduction: There is a distinct unmet need in structured, curriculum based, unbiased education in neuromodulation. Current teaching is through sporadic industry workshops, cadaver courses and peer proctorship. The COVID pandemic has created a unique opportunity where online platforms have enabled education to be delivered remotely in both synchronous and asynchronously. The William Harvey Research Institute, Queen Mary University, London, UK have initiated University based accreditation- Post Graduate Certificate in neuromodulation (PGCert) that provides candidate a qualification in one academic year through part-time study. Method(s): The program underwent rigorous staged university approval process (figure 1). To ensure market feasibility, two short proof of concept CPD programs "Executive Education in Neuromodulation (EEPIN)" were delivered in 2021. These courses attracted 87 candidates across Australia, Singapore, India, Germany, Poland, Czech Republic, Ireland, and UK. The faculty includes key opinion leaders that will deliver the program ensuring the candidates gain academic background and specialist skills to understand safe practice of neuromodulation. The PGCert advisory board has been established to ensure strict governance in terms of content and unbiased delivery confirming ACCME guidance. In order to obtain PGCert, candidates are required to complete 4 x 15 credit modules (60 credits). The four modules include Anatomy & Neurophysiology;Patient care and Procedurals skills;Devices and available technology;Intrathecal drug delivery for cancer and non-cancer pain. The modular nature of the program is designed to provide cumulative knowledge, from basic science to clinical application in line with the best available evidence. The modules comprise nine lectures, spreading over three consecutive days, followed by a written assignment with 40 direct contact hours in each module. The webpage can be accessed at Results: The anonymous data from EEPIN reported on Likert scale 1-5: Objectives defined 30.6% - 4 and 69.4% -5;Relevance of topics 10.2%- 4 and 89.8% -5;Content of presentations 22.4%- 4 and 77.6% -5;Organization 24.5% -4 and 69.4% -5;Candidate faculty interaction 14.3% -4 and 81.6% -5. 97% of the EEPIN candidates recommended the program to others whilst 81.8% expressed their strong interest to enroll for university-based post graduate qualification if offered. Conclusion(s): This PGcert Neuromodulation is a unique, university accredited program that provides qualification in neuromodulation with access to a flexible online e-learning platform to discuss and exchange ideas, share knowledge in candidate's own time. This will support the ongoing need for formal curriculum-based education in neuromodulation. Disclosure: Kavita Poply, PHD: None, Phillippe Rigoard: None, Jan Kallewaard, MD/PhD: None, FRANK J.P.M. HUYGEN, MD PhD: ABBOTT: Speakers Bureau:, Saluda: Consulting Fee:, Boston Scientific: Consulting Fee:, Grunenthal: Speakers Bureau:, Pfizer: Speakers Bureau:, Ashish Gulve, FRCA, FFPMRCA, FFPMCAI, DPMed, FCARCSI, MD, MBBS: None, Ganesan Baranidharan, FRCA: None, Sam ELDABE, MD, FRCA, FFPMRCA: Medtronic: Consulting Fee:, Medtronic: Contracted Research:, Mainstay Medical: Consulting Fee:, Saluda Medical: Consulting Fee:, Boston Scientific: Contracted Research:, Saluda Medical: Contracted Research:, James Fitzgerald, MA,PhD: St Jude Medical: Consultant: Self, Medtronic: Consulting Fee:, UCB: Contracted Research:, Merck: Contracted Research:, Serge Nikolic, MD: None, Stana Bojanic, BSc MBBS FRCS (SN): Abbott: Contracted Research:, Habib Ellamushi: None, Paresh Doshi, MS MCh: None, Preeti Doshi, MBBS, MD, FRCA: None, Babita Ghai, MBBS, MD, DNB: None, Marc Russo, MD: Presidio Medical: Ownership Interest:, Saluda Medical: Ownership Interest:, Boston Scientific: Contracted Research: Self, Mainstay Medical: Contracted Research: Self, Medtronic: Contracted Research: Self, Nevro: Contracted Research: Self, Saluda Medical: Contracted Research: Self, Presidio Medical: Contracted Research: Self, Freedom Ne ro: Ownership Interest - Own Stocks: Self, Lungpacer: Ownership Interest - Own Stocks: Self, SPR Therapeutics: Ownership Interest - Own Stocks: Self, Lawrence Poree, MD,MPH,PHD: Medtronic: Consulting Fee: Self, Saluda Medical: Contracted Research: Family, Nalu Medical: Contracted Research: Family, Gimer Medical: Consulting Fee: Self, Nalu Medical: Consulting Fee: Self, Saluda Medical: Consulting Fee: Self, Nalu: Ownership Interest:, Saluda Inc: Ownership Interest:, Alia Ahmad: None, Alaa Abd Sayed, MD: Medtronic, Abbott, SPR and StimWave: Consulting Fee:, Salim Hayek, MD,PhD: None, CHRISTOPHER GILLIGAN, MD MBA: Persica: Consulting Fee: Self, Saluda: Consulting Fee: Self, Mainstay Medical: Contracted Research: Self, Sollis Therapeutics: Contracted Research: Self, Iliad Lifesciences, LLC: Owner: individuals with legal ownership in a company:, Vivek Mehta: NoneCopyright © 2023

Keep Calm and Go Out: Urban Nature Exposure, Mental Health, and Perceived Value during the COVID-19 Lockdown

The COVID-19 pandemic has highlighted the importance of incorporating nature-based solutions in urban design, in order to create sustainable and resilient cities. Inspired by these events, the present study aims at exploring the mental health benefits of nature exposure during the outbreak. Secondarily, we investigate changes in use patterns towards urban green spaces (UGS) and urban blue spaces (UBS) and whether extreme conditions, such as these of a lockdown, can lead to an increase in people's appreciation of urban nature. Through an online survey, we observed that the pandemic resulted in a decrease in the frequency of visitation to UGS/UBS (p < 0.001). Significant differences were found for exercise (p < 0.001) and socialization (p < 0.05) as main drivers for visiting urban nature pre- and post-lockdown. Accordingly, visitation rates for forests (p < 0.05), playgrounds (p < 0.001), and the sea (p < 0.001) differed significantly when comparing the two periods. In people's perception, UGS/UBS are important for the urban fabric (89%). Our structural equation model indicated that nature exposure had a beneficial effect on participants' mental health (p < 0.001). Pathways that explain the relationship between nature exposure and post- lockdown value were nature relatedness, motivation, and perceived importance of UGS/UBS. No mediation could be extracted for nature exposure and mental health. Our findings show the positive association between nature exposure and mental health improvement, especially in times of crisis, as well as a shift in the "value domain” towards urban nature.

Young persons and healthcare professionals experience of virtual gastroenterology consultations: a multicentre survey conducted during the COVID-19 pandemic

ObjectiveTo explore Young Persons (YP) and healthcare professionals (HCP) experiences of virtual consultations (VC) and establish whether developmentally appropriate healthcare can be delivered virtually.MethodYP and HCP questionnaire surveys were designed and piloted. Electronic questionnaire links were sent by post, email or text message January–April 2021 to YP aged 13–25 years old, with predefined chronic gastrointestinal conditions, attending a gastroenterology/hepatology VC. HCP undertaking VC were invited to complete staff questionnaire. Results were anonymous and collated using Excel version 2302.ResultsFive UK hospital trusts participated, with 35 HCP responses. Of the 100 YP completing the survey 66% were female and 34% male aged between 13 years and 25 years (median: 18 years). 13% were new appointments and 87% follow ups, 29% were by video, 69% by phone and 2% gave no response. 80% of HCP spoke to YP directly but not privately (69%). 87% of YP and 88% HCP found VC useful. 83% of YP want VC again, although 20% preferred face to face. 43% of HCP required improved phone/internet connection. 77% of YP required hospital appointments for tests following VC.ConclusionsOverall respondents were satisfied with VC, finding them useful, convenient and time saving. Successful VC rely on appropriate patient selection and availability of reliable technology. Patient preference is key which may alter with time.

Accelerating Clinical Trial Design and Operations

Fully-integrated, component-based CDMS offers flexibility, customization, and efficiency Effective and efficient clinical data collection and management is one of the key factors affecting clinical trial success and is of heightened importance during the COVID-19 pandemic.1 Not only have the scope and complexity of clinical trials continued to increase over the past decade, but the volume and diversity of clinical study data grows ever larger. Researchers have accelerated the development of vaccines and therapeutics for COVID-19 as evidenced by the 4,846 trials found on clinicaltrials. gov.2 The COVID-19 pandemic presents a unique opportunity for understanding technologies that can enable trial data management and their effects on streamlining;and expediting clinical trial design and implementation. Specific measurements evaluated in this study were: database build efficiency, velocity of data collection, frequency of protocol amendments on the database, and the time impact of mid-study updates to the database. [...]the ability to execute mid-study updates or post-go live changes with minimal to no downtime (< one hour) allowed the users and sponsors to work in parallel rather than in serial fashion, speeding up trial start dates and implementation of protocol amendments, and accommodating adaptive COVID-19 trial design.

Specifically designed family communication booklet to help staff to communicate effectively with Intensive Care Unit patients' next of kin

Introduction: Families of patients admitted to the Intensive Care Unit (ICU) experience significant emotional distress.1 Visiting restrictions mandated during the COVID-19 pandemic presented new barriers to family communication, including a shift from regular bedside nursing updates and in-person family meetings to scheduled, clinician-led telephone calls and video calls.2 This resulted in loss of non-verbal clues and feedback during family discussions, difficulties establishing rapport with families and risked inconsistent messages and moral injury to staff.3 Objectives: We aimed to design a system where all ICU family discussions were documented in one place in a standardised format, thereby clarifying information given to families to date and helping staff give families a consistent message. In addition, we aimed to provide practical advice for the staff making family update telephone calls and strategies for managing difficult telephone conversations. Method(s): We designed and implemented an ICU family communication booklet: this was colour-coded blue;separate to other ICU documentation within the patient notes;and included communication aids and schematics to help staff optimise and structure a telephone update. Using Quality Improvement methodology, we completed four Plan-Do-Study-Act (PDSA) cycles and gathered qualitative and quantitative feedback: this occurred prior to the project and at one,12,18 and 21 months post introduction. We implemented suggested changes at each stage. We designed staff surveys with questions in a 5-point Likert scale format plus opportunity for free comments. Twenty-one months post implementation, we designed and delivered an MDT awareness campaign using the 'tea-trolley training' method,4 departmental induction sessions for new ICU doctors and nurses and a 'Message of the Week' initiative. An updated version of the booklet was introduced in February 2022 (Figure 1). Result(s): Staff survey results are shown in Table 1. Forty-six staff participated in tea trolley training, feedback form return rate 100%. Following feedback, the family communication booklet was updated to include the following: a prompt to set up a password;a new communication checklist at the front, including documentation of next of kin contact details, a prompt to confirm details for video calls, confirm primary contact and whether the next of kin would like updates during the night;consent (if the patient is awake) for video calls while sedated;information regarding patient property;prompt to give families our designated ICU email address to allow relatives to send in photographs to display next to patients' beds;prompts to encourage MDT documentation and patient diary entry. Conclusion(s): During unprecedented visiting restrictions in the COVID-19 pandemic, we implemented an ICU family communication booklet which has been so successful that we plan to use it indefinitely. We plan to further develop this tool by encouraging MDT involvement, seek further staff feedback in six months' time, incorporate this structure into our electronic patient information system when introduced and collect feedback from patients and their next of kin at our ICU follow up clinic. This communication booklet would potentially be reproducible and transferable to other ICUs and could be used as part of a national ICU family communication initiative.

Training needs for ECMO nurses: Analysis, results and what,s beyond

Objectives: Nurses attending ECMO patients must have specialized knowledge and skills. At Careggi Teaching Hospital and ECMO center, as well as in other hospitals worldwide, new personnel have been summoned to face the increased number of critical patients due to the COVID pandemic. Therefore, the number of nurses with poor ECMO experience has recently skyrocketed. During the work shifts inexperienced nurses have been coached by experienced ones. This organization has permitted to manage a volume of fifty-nine ECMO patients during the pandemic without significant adverse events. Method(s): We led a survey among the nurses of the ICU and ECMO unit to assess their perceived training status and educational needs. In November 2022 seventy-two nurses received an anonymous questionnaire made of 21 items based on Likert scale. The questionnaire consisted of three parts investigating the general knowledge of ECMO support and maintenance, their perceived level of competency in several conditions and, finally, their expectations for future training. Result(s): The most relevant results are presented in figure 1. From the analysis of the survey we have assessed that in our institution, an educational programme for nurses actually involved in managing ECMO patients is an urgent need and should cover both ordinary management and emergency situations. Real life scenarios and crisis resource management events should be the focus of the programme. Conclusion(s): Training in ECMO is crucial for patient safety. After COVID pandemic, in our ECMO center, capabilities and knowledge of newly recruited nurses treating ECMO patients are suboptimal/unsatisfactory. A questionnaire to analyze the actual level of competence of the personnel involved can help to tailor a more effective educational programme to meet their real needs and to select the appropriate improvement actions. (Figure Presented). (Figure Presented).

Exploring the scope of nursing practices in the care of ECMO supported patients in Israel

Objectives: The growing implementation of extracorporeal membrane oxygenation (ECMO) for patients with COVID19 has led to increased involvement of nurses in treating ECMO-supported patients (ECMO-SP). In June 2021, the Israeli Ministry of Health;s Nursing Administration published the first director;s circular in the world to detail the nursing scope of practice in caring for ECMO-SP. This study aimed to examine how often nurses perform various activities while caring for adult ECMO-SP. Method(s): A cross-sectional study. A convenience sample consisted of 76 registered ICU nurses (mean age 41.3+/-8.7 years;71% female). A 20-item Nursing Activities in the Care of ECMO-SP instrument was developed based on the Israeli Ministry of Health;s procedure on Nursing Practice in the Care of ECMO-SP and a literature review. The instrument examined how often nurses perform various activities on a Likert scale ranging from 1 (Never) to 5 (Always). Exploratory and confirmatory factor analyses (EFA and CFA), as well as descriptive statistics and Pierson;s correlations were performed. Result(s): When examined in EFA and CFA, the instrument yielded acceptable fit indices. The instrument contains four subscales with the following mean +/- SD scores: Factor 1. Nursing care of ECMO-SP not related to the ECMO device (7 items, a=0.90), M+/-SD=4.66+/-0.61;Factor 2. Activities on the ECMO device during emergencies (5 items, a=0.82), M+/-SD=2.1+/-0.91;Factor 3. ECMO device calibrating and monitoring (4 items, a=0.72), M+/-SD=3.26+/-1.0;and Factor 4. Medication and blood administration through the ECMO device (4 items, a=0.73), M+/-SD=1.52+/-0.60. Of the 20 nursing activities, 10 (50%) were reported as "never" or "rarely" performed. Nine out of 20 items (45%) were reported as "very often" or "always" performed. Conclusion(s): Ten out of 20 (50%) activities while caring for ECMO-SP listed in the scope of practice as permissible for nurses to perform were reported as not performed at all or performed rarely. Policymakers need to act so that the activities listed in the nursing scope of practice are carried out by nurses in practice.

Should COVID-19 pandemic mitigations in the myeloma clinic continue? A summary of patient opinions

Introduction: The COVID-19 pandemic necessitated multiple changes to the format of myeloma clinics to minimise the risk of infection among patients and staff. These included changing in-person clinic appointments to telephone appointments when there was no medical need for face-to- face review and instituting a courier service for delivery of oral or self-administered medications. As COVID-19 restrictions relaxed, we sought to investigate the acceptability of these changes to our patients and to determine which, if any, of the new arrangements should continue. Method(s): Patients who attended the Myeloma Clinic at The Royal Marsden Hospital, both in-person and by telephone, on four separate dates in August and September 2022 were asked to complete a questionnaire to provide their opinions using a combination of multiple-choice, Likert scale and free-text questions. These covered the main domains of change outlined above along with questions about blood test location and attendance with family and friends. Result(s): Questionnaires were returned by 59 patients, 11 relating to in-person appointments and 48 to telephone appointments. 86.0% of patients were in favour of continuing the option of telephone appointments, with many highlighting their convenience and the avoidance of long travel and waiting times, with some also mentioning their COVID-19 security. However, a number of patients expressed concerns including communication difficulties, the inability to effectively assess physical health with an examination and a lack of reassurance. Furthermore, those who attended in-person appointments felt they were very COVID-secure, assigning them a mean of score of 4.5, where 1 was very insecure and 5 very secure. Several suggested that the optimum schedule would include regular telephone appointments with occasional in-person meetings. Interestingly, only 25.5% of patients wanted a video calling option. Patients were also very positive about receiving medications by courier, with 94.1% of patients receiving their medications within two working days of their clinic appointment. 81.8% of patients expressed a wish for this option to continue, highlighting the increased convenience and reduction in waiting times. Conclusion(s): These results suggest that changes made to the Myeloma Clinic in response to the COVID-19 pandemic have improved the patient experience. A mixture of telephone and in-person appointments may be preferable for this cohort of patients, many of whom require regular appointments for chemotherapy approval but are medically stable, and whose frailty makes long travel and waiting times challenging. These findings have implications for the planning of myeloma clinics across the UK.

Patient Experience of Using Telehealth Services during COVID-19 in Dubai Health Authority: A Retrospective Cross-Sectional Electronic Survey

Objectives: To examine patients' telehealth usability during COVID-19 in Dubai. Method(s): A cross-sectional retrospective study adopted Telehealth Usability Questionnaire (TUQ). A total of 64,173 participants who used telehealth services during 2020 - 2021 were recruited from the electronic medical record to participate in electronic survey from October to December 2022. The survey was administered through DHA text messaging system. The survey examined participants' characteristics and the six domains of TUQ with a Likert scale. Frequency, percentage, and weighted mean score percentages were used as descriptive statistics to analyze this data. Result(s): A total of 1,535 participants completed the survey. The overall TUQ showed the mean age of users was 43.37 years (+/-11.67 SD). More than half of the users were females (65.21%), the majority were married (74.46%), of a UAE nationality (83.58%), had higher education (56.68%), and were currently working (57.13%). Consultations and COVID-19-related concerns (45.14%), medication refills (19.80%), and laboratory tests (18.24%) were the main reasons for telehealth visits. Weighted means of TUQ six domains were usefulness (87.11%), ease of use and learnability (86.98%), interface quality (85.73%), interaction quality (86.44%), reliability (79.48%), and satisfaction and future use (86.44%). Conclusion(s): Our study revealed high levels of usability and willingness to use telehealth services as an alternative modality to in-person consultations among the participants of the survey. Our results support the implementation of telehealth services in DHA;however, further studies are required to understand the applicability of telehealth after COVID-19 and how to further improve satisfaction.Copyright © 2023

Profiling Inconsistent/Non-Adopters of Infection Prevention Behaviours during the Covid-19 Pandemic for Targeted Public Health Education: A Population Study

Intro: With the relentless waves of coronavirus disease 2019(COVID-19), there is a need for widespread community adoption of infection prevention(IP) measures including hand hygiene, use of face masks, and staying at home when unwell. Understanding the profile of individuals who do not consistently practice IP can help target public health education. Method(s): We conducted a nationally-representative population survey from November 2020 to January 2021. Households were randomly selected from a proportionately stratified national census. The household member with the most recent birthday was invited to complete the survey. Three questions on a 5-point Likert-scale(never-rarely-occasionally-often-always) assessed IP behaviours(hand hygiene, face mask use when having a cough/cold, staying at home when having a cold/flu) before and during the pandemic. A multivariable logistic regression model was constructed to assess factors associated with the non- or inconsistent("never-rarely-occasionally") adoption of any of the three IP behaviours during the pandemic. Finding(s): Mean age of 2004 respondents was 44.5(SD 15.0) years, with 52% females and 65% being highly educated (diploma/degree holders). Although 12% reported consistently("often-always") adopting all 3 IP behaviours pre-pandemic, the majority(n=1752, 87%) reported doing so during the pandemic. After adjusting for age, educational level, and presence of chronic illness, males(AOR 1.71 [95%CI 1.30, 2.25], Chinese(AOR 1.48 [1.07, 2.05]), low-adopters of healthy lifestyle(AOR 1.59 [1.03, 2.45]) and those who did not or inconsistently adopted IP behaviours pre-pandemic(AOR 8.92 [3.28, 24.27]) were more likely not to or inconsistently adopt the 3 IP behaviours during the pandemic. Discussion(s): During the ongoing pandemic, educational messages and information channels on IP measures could be more targeted at males and Chinese. Additionally, the promotion of healthy lifestyle and consistent adoption of IP behaviours during non-pandemic times is critical for consistent adoption of IP behaviours during pandemics. Conclusion(s): Males, Chinese, and low-adopters of healthy lifestyle and IP behaviours pre-pandemic do not consistently practice IP during the pandemic.Copyright © 2023

How Type of Office Visit Influences Attitudes and Preferences for Telemedicine?

Introduction: The COVID-19 pandemic caused significant changes in delivery of healthcare. Telemedicine emerged as a popular option. Numerous studies demonstrate a favorable opinion of telemedicine from patient and physician perspectives. What factors make it more efficient and effective This study explores how type of office visit impacts attitudes towards telemedicine and affects patient's preferences for future visits. Method(s): Surveys were delivered by mail or in person to 1,100 randomly selected patients of Sierra Nevada Gastroenterology, a community-based practice in Grass Valley, CA. Each patient (pt) had a telemedicine visit (TMV) from April 2020-October 2021. Three hundred twenty surveys were returned completed. Surveys contained a 5-point Likert scale set of questions rating the quality, communication, compassion, thoroughness and convenience of TMV. In person visits (IPV) were then directly compared to TMV for the same qualities. Demographics were recorded (Table 1). Surveys were separated into 3 categories based on type of visit: new complaint (NC), follow-up of existing problem (FU), procedure-related visit (PRV). Statistical analysis and chi-square test were used to determine statistical significance. Result(s): Quality, communication, thoroughness and compassion during TMV rated high with Likert scores of 4.3-4.7 (= 0 strongly agree) for all groups. Comparing the 3 groups (NC, FU, PRV) with chi-square testing, no statistical difference in ratings was seen. FU pts had the highest Likert scores in all categories. Pts with new complaints preferred IPV over TMV for quality, communication, thoroughness and compassion, which was rated statistically significantly higher (P< 0.05). TMV was favored for convenience in all groups with highest ranking in FU pts (73%). Conclusion(s): This study showed type of office visit did not affect satisfaction or ratings of TMV. However, type of visit did reveal preferences for either IPV or TMV. Pts with NC preferred IPV and felt compassion is important and delivered more effectively in person. This suggests non-verbal communication such as body language, facial expression and tone is conveyed more effectively in person than over phone or video calls. FU or PRV pts rated TMV as more convenient and preferable over IPV for future visits, suggesting that pts with stable or less acute problems prioritize convenience over other factors when selecting type of visit. Further studies are needed to determine what other factors will influence and improve quality of TMV.

Safety Culture in Irish Community Pharmacies: a cross-sectional study using the Community Pharmacy Survey on Patient Safety Culture

Introduction: Safety culture is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organisation's health and safety management.(1) Community pharmacists play a vital role in ensuring optimum medication safety however the study of patient safety culture in this setting is less developed than in secondary care. Aim(s): The study aim was to measure patient safety culture in Irish community pharmacies using the validated Community Pharmacy Survey on Patient Safety Culture (PSOPSC).(2) Methods: The survey consisted of 39 questions based on a 5-point Likert scale, within 11 dimensions. Demographic questions were asked including the pharmacist's role within the pharmacy. A free-text box allowed respondents to give comments on the survey topic. The online questionnaire, hosted on Microsoft Forms, was emailed to all 3943 community pharmacists registered with the Pharmaceutical Society of Ireland in November 2021. A reminder email was sent 14 days later. Data were analysed in Microsoft Excel. Categorical data were presented as frequencies (%). The positive rate response (PRR) of each survey question and dimension was calculated.(2) The PRR is the mean percentage of positive Likert scale responses to each item and each dimension of the survey. A PRR >75% indicated a strong safety culture, while a PRR <50% indicated a dimension that may be improved upon. Free-text responses were explored by thematic analysis. Result(s): The survey was completed by 173 pharmacists, response rate 4.5%. Of these, 33 (19.1%) were superintendent pharmacist, 65 (37.6%) supervising pharmacist, 53 (30.6%) staff pharmacist and 22 (12.7%) locum pharmacist. The mean %PRR across the 11 survey dimensions was 72.3%. Individual statements with highest PRR were Our pharmacists tell patients important information about their new prescriptions (PRR=91.3%) and Staff are treated fairly when they make mistakes (PRR=87.3%). Individual statements with lowest PRR were Interruptions/distractions in this pharmacy (from phone calls, faxes, customers, etc.) make it difficult for staff to work accurately (PRR=6.4%) and We feel rushed when processing prescriptions (PRR=8.1%). The dimension of Organizational Learning-Continuous Improvement demonstrated the highest PRR (81.6%), followed by Response to Mistakes (PRR=81.2%). The dimension of Staffing, work pressure and pace demonstrated the lowest PRR (35.6%). Respondents rated overall patient safety in their pharmacy as excellent/very good/good (88.4%). Differences in perception of patient safety emerged between pharmacists with different levels of responsibility. Patient safety rating was described as fair/poor by 0.0% of superintendent pharmacists, 6.3% of supervising pharmacists, 17.0% of staff pharmacists and 31.8% of locum pharmacists. Fifty-one (29.0%) respondents provided free-text comments. Emergent themes were impact on safety culture of staffing issues;staff training;dispensary workload;and dispensary work pressures. Conclusion(s): The study was limited by low response rate. This may reflect its timing during the COVID-19 pandemic and pharmacists' prioritisation of clinical roles at that time. Respondents reported a broadly positive patient safety culture in the pharmacy in which they work. Differences in perception of safety culture were observed between those with differing levels of responsibility in community pharmacy practice.

Attitudes amidst the pandemic: Virtual delivery of care in an adult cystic fibrosis population

Background: The COVID-19 pandemic has altered how we deliver care to people with cystic fibrosis (CF) across the spectrum of disease severity. Because of lockdowns and avoiding exposure to COVID-19 by limiting inperson clinic visits, clinical care has pivoted from standard practices to virtual care in combination with in-person traditional visits. This approach has allowed patients to be monitored and treated in a timely manner. Such virtual visits have the advantage of reducing the time commitment for clinic visits because the patient does not have to travel to and from the hospital, but virtual care lacks the ability to conduct a physical examination and to obtain objective and standardized testing of key measurements known to be associated with health outcomes in CF. The objective of this study was to evaluate the attitude of patients to virtual delivery of care and their comfort level with such care. Method(s): This is a prospective, cross-sectional survey of adults with CF who are followed at St. Michael's Adult CF Center in Toronto, Canada. An online survey was created using SurveyMonkey to assess attitudes toward and satisfaction with virtual care. The survey was emailed to participants and included the Canadian CF Registry ID;a reminder email sent a week later. Baseline demographic and clinical data were obtained from the Canadian CF Registry and presented as median (range) or proportions as appropriate. Questions using a 3-point Likert scale will be categorized into agree, neutral, and disagree. Result(s): A total of 210 participants (53.0% female) completed the survey (median age 37.8, range 19.2-78.9). Median age of diagnosis was 2.2, 95.7% were Caucasian, 76.0% had completed post-secondary education, 63.0% were employed and 11.0% were students, 75% were pancreatic insufficient, 39.0% had CF-related diabetes, and 12.4% were post lung-transplant. Median percentage predicted forced expiratory volume in 1 second was 65.8% (range 17.9-126.9%), and median body mass index was 23.6 kg/m2 (range 15.5-45.7 kg/m2). Eighty-one percent of respondents had had a virtual visit before completing the survey. Sixty percent of respondents felt that in-person visits were the preferred way of completing a medical assessment, and 27.0% preferred virtual visits. Seventy-three percent felt it was important for the virtual visit to occur at the booked time, 59.0% had concerns that their lung function was not assessed during virtual visits, 46.0% felt they were losing the benefits of allied health team assessments with virtual visits, and 40.0% worried that their health would decline if primarily seen virtually. Just over half of respondents wanted to continue with virtual visits in some capacity after the pandemic. The optimal proportion of in-person visits was felt to be 50.0%. More than 85% of respondents were comfortable with technology (phone or computer) and had reliable access to the Internet to conduct virtual visits. Seventy percent of people would like to have access to a home spirometer, but cost was a barrier. Conclusion(s): From the patient's perspective, in-person visits were still the preferred way to complete a medical assessment, which seemed to be driven by concerns over lack of methods for assessment, particularly lung function, and access to the multidisciplinary team. Home spirometers, if freely available, might increase comfort with virtual appointments.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Development of a Questionnaire on Access to Sickle Cell Disease Care in the Indigenous Tharu Population of Nepal

Purpose of Study Sickle cell disease (SCD) disproportionately affects the Tharu population of Nepal, a marginalized indigenous group concentrated in the Dang district. SCD is a structural hemoglobinopathy resulting in abnormal red blood cells with a tendency to occlude microvasculature. Since 2015, University of British Columbia medical students and a local community partner, Creating Possibilities, have improved access to SCD screening and diagnosis for the Tharu population. However, interviews conducted in 2016- 2017 found that SCD-afflicted community members encounter a number of challenges to obtain treatment once diagnosed. The purpose of this study was to develop a questionnaire on barriers to accessing SCD care in this community. Methods Used The Barriers to Accessing SCD Care Questionnaire was developed from items in existing scales, deductive and inductive item generation, and feedback from expert local partners. Reviewing literature on barriers to accessing healthcare in the Western region of Nepal informed region-specific questionnaire items, while literature on accessing SCD treatment in resource-limited settings informed SCD-specific questionnaire items. We also reviewed the literature on barriers to treatment for various stigmatized chronic health conditions in low-resource settings. Summary of Results Qualitative interviews with SCD-afflicted Tharu individuals in 2016-2017 identified inadequate local medical resources, transportation, financial strain, and limited awareness as barriers to care. Based on the literature review, we organized all survey items under the themes transportation, medical infrastructure, finances, community attitudes, and personal attitudes. The questionnaire includes closed-ended questions using a Likert scale, as well as open-ended interview prompts. It was made in collaboration with local community members to ensure it is culturally appropriate, needs-specific, and easily understandable. The questionnaire received ethics board approval, and interviews will begin once local health authorities lift COVID-19 restrictions. Conclusions Results from the Barriers to Accessing SCD Care questionnaire will guide future community-based interventions.

Access to Sickle Cell Disease Treatment in the Indigenous Tharu Population of Nepal

Purpose of Study: Sickle cell disease (SCD) is a hemoglobinopathy that disproportionately affects the indigenous Tharu population of Nepal, a marginalized ethnic group concentrated in the Dang district. There are significant global disparities in the prognosis of SCD;in low-income countries, which lack screening and management infrastructure, up to 80% of those born with SCD are undiagnosed and less than half survive beyond 5 years of age. Since 2015, University of British Columbia medical student teams have collaborated with a local community partner, Creating Possibilities (CP), to improve SCD awareness, screening, diagnosis, and management for the Tharu population in and around Dang. Community members with SCD have previously expressed numerous challenges in obtaining treatment once diagnosed. This study aims to better understand difficulties in accessing SCD care for this community. Methods Used: The Access to SCD Care Questionnaire was developed from items in existing scales, deductive and inductive item generation, and feedback from expert local partners to ensure it is culturally appropriate, needs-specific, and easily understandable. The questionnaire includes closed-ended questions using a Likert scale and open-ended interview prompts. It centers around five core themes: personal beliefs, community attitudes, finances, transportation, and medical infrastructure. Interviews were conducted in Tharu (local dialect) by CP staff members in January to March 2022. Themes and sub-themes were qualitatively analyzed. Summary of Results: Participants aged from 14 to 42 with an equal sex ratio, a total of 12 interviews were conducted before study saturation was reached. All participants reported at least one minor or major problem with access to SCD care in each of the five core themes of the questionnaire. Inadequate healthcare infrastructure was the most frequently reported barrier, with participants reporting lack of local medication accessibility and low supplies at further district hospitals. Additionally, despite government funding for treatment coverage, participants reported difficulties obtaining the necessary legal documents to prove eligibility. The second largest perceived barrier to care was transportation, which was reported to be costly, time-consuming, and not readily available. Regardless of sub-theme, participants reported that system-wide effects from COVID-19 perpetuated these issues. Conclusion(s): Results from the Access to SCD Care Questionnaire demonstrate that availability and accessibility to medications and transportation services are the primary challenges to receiving SCD care in this indigenous community. Therefore, future interventions for this community should focus on these findings. In contrast with previous literature, community stigma and personal beliefs were not often reported as hindering SCD treatment. This may be attributed to successful education campaigns within this specific community or due to participation bias.