Distribution, Preparedness and Management of Ukrainian Adult Refugees on Dialysis- an International Survey by the Renal Disaster Relief Task Force of the European Renal Association

Introduction: During armed conflicts dialysis patients may experience limitations or interruptions of therapy leading to severe life-threatening complications due to medical and logistical challenges. Before the Russian-Ukrainian war, there were approximately 10,000 adults requiring dialysis in Ukraine. Some patients decided to flee their place of residence and look for opportunities to continue dialysis in another location in Ukraine or abroad. To better understand the needs of conflict-affected kidney failure patients and to provide data which could support equitable and evidence-based prioritization of resources, the Renal Disaster Relief Task Force of the European Renal Association conducted a survey on distribution, preparedness and management of adults requiring dialysis displaced due to the war in Ukraine. Method(s): Cross-sectional online survey was conducted to assess the status of dialysis patients who were displaced across European countries since the beginning of the conflict in February 2022. The survey was sent to all national nephrology societies across Europe with a request to disseminate it to all dialysis centers in their countries. Data were collected between May and August 2022. Fresenius Medical Care (FMC) shared a limited set of aggregated data without direct center participation. Result(s): We received data on 602 patients (290 collected through the survey and 312 from FMC), who were dialyzed in 24 countries. Most patients were dialyzed in Poland (45.0%), followed by Slovakia (18.1%), Czech Republic (7.8%), Romania (6.3%), Germany (4.7%) and Hungary (3.5%). Most patients were originally dialyzed in Kyiv (north-central), Kharkiv (northeast), Odesa (southwest) and Zaporizhzhia (southeast). Before reaching the current reporting center, 34.6% of patients were treated in at least one other center since leaving their regular unit. Mean age was 48.1+/-13.4 years, 43.5% were females. Before patients left Ukraine, 95.7% had been on hemodialysis (HD), 2.5% on continuous ambulatory peritoneal dialysis (PD) and 1.8% on automated PD. HD session frequency was reduced under war conditions in 23.5% of patients. Eighty-eight percent of HD patients had a patent arteriovenous fistula, 7.3% were HBs antigen positive, 16.1% had anti-HCV antibodies, 0.6% anti-HIV antibodies and 27.3% anti-HBc antibodies. In terms of patient preparedness for displacement, 63.9% carried medical records with them, 63.3% had a list of medications, 60.4% had medications themselves and 44.0% had a dialysis prescription. Overall, 26.1% of patients were admitted to the dialysis unit in the possession of all these factors while 16.1% presented with none. After leaving Ukraine, 33.9% of patients were hospitalized. Of the 88.5% of patients tested in the reporting center for COVID-19 1.9% was positive. Communication and language problems were reported by 43.8% of responding physicians. Conclusion(s): Up to the end of August 2022, less than 10% of Ukrainian dialysis patients decided to flee their country since the start of the Russian-Ukrainian conflict and the majority of them chose as their place for dialysis a country neighboring Ukraine. Preparedness for displacement varied and was incomplete in most patients. Results from our survey may inform evidence-based policies and interventions to prepare for and respond to special needs of vulnerable kidney failure populations during armed conflicts and other emergencies. No conflict of interestCopyright © 2023

ICT usage in aphasia rehabilitation-beliefs, biases, and influencing factors from the perspectives of speech and language therapists

Background: The use of digital technology is promoted as an efficient route for the delivery of intensive speech and language therapy in aphasia rehabilitation. Research has begun to explore the views of people with aphasia (PwA) in relation to Information and Communication Technology (ICT) usage in the management of aphasia but there is less consideration of the prescribers' views, i.e., speech and language therapists (SLTs). Aim(s): We aimed to explore SLTs' views of ICT use in aphasia management and identify factors that influence their decisions to accept and integrate ICT in aphasia rehabilitation. In addition, we considered the findings in the context of the Unified Theory of Acceptance and Use of Technology (Venkatesh, Morris, Davis & Davis, 2003). Methods & Procedures: Speech and language therapists (n = 15) from a range of clinical and geographical settings in the Republic of Ireland were invited to participate in one of four focus groups. Focus group discussions were facilitated by an SLT researcher and were audio-recorded and transcribed. Analysis was completed following Braun and Clarke's six phases of thematic analysis (Braun and Clarke, 2006). Outcomes & Results: Four key themes were identified;i. Infrastructure, Resources, and Support, ii. SLT beliefs, biases and influencers, iii. Function & Fit, and iv. ICT and Living Successfully with Aphasia. The SLTs discussed a wide range of factors that influence their decisions to introduce ICT in aphasia rehabilitation, which related to the person with aphasia, the SLT, the broad rehabilitation environment, and the ICT programme features. In addition, several barriers and facilitators associated with ICT-delivered aphasia rehabilitation were highlighted. Conclusion(s): This research highlights a range of issues for SLTs in relation to the use of ICT in aphasia rehabilitation within an Irish context. The potential benefits of using ICT devices in rehabilitation and in functional everyday communication were discussed. However, SLTs also identified many barriers that prevent easy implementation of this mode of rehabilitation.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

The COVID-19 Pandemic as a driver of education 5.0 at UAH Faculty of Pharmacy

Introduction: In March 2020, the outbreak of the COVID-19 Pandemic in Madrid province, Spain, forced changes in the teaching and organisational methodologies of University educational centres in order to continue delivering knowledge contents that allowed students to acquire the competences and skills required by current regulations. Method(s): Different surveys were carried out on possible alternative teaching methodologies and strategies to be used by the teachers responsible for the different courses in the face of the pandemic situation. They explained to students how the teaching was going to proceed using different remote channels. Result(s): Different strategies such as the heuristic, discovery or playful method facilitated the teaching-learning process allowing students for the acquisition of useful knowledge, competences and skills for job placement. Innovative teaching methods were used, such as the inverted classroom or flipped classroom, cooperative learning, project-based learning or gamification, depending on the characteristics of the different disciplines. The results achieved so far have been, despite initial concerns and doubts, satisfactory, achieving the objectives and skills set at the beginning of the courses. The students have worked on specific, individual or cooperative projects, in which they have faced real problems in the context of service-learning, stimulating their critical thinking, communication, problem solving abilities, with a more practical and tangible dimension. Conclusion(s): The pandemic has accelerated the implementation of an Education 5.0 project, making teachers use resources that some but not all had used previously to promote effective and quality teaching. Combining the new technological tools with traditional educational methodologies helps teachers to achieve their teaching outcomes in a more effective way without losing sight to prepare students for lifelong learning far beyond the digital.

Teren etnologic În perioadă de criză. Note la o descriere de caz 1

In the first months of 2020, the whole world was affected by the restrictions caused by the authorities' attempts to stop the spread of SarsCov2 as far as possible. Initially, the most effective measure was quarantine, which could slow the spread of the virus. In Romania, the first case of Covid19 was confirmed on 23 February 2020, and after a period of hesitation, the national authorities imposed the quarantine on 15 March, i.e., a series of restrictions on the movement of persons and on participation in events involving more than eight persons. Obviously, the introduction of this special regime for the movement of persons affected all areas of social and economic life, including its vital branches, such as the industrial and educational activity. Of course, under these conditions, the first temptation of any ethnologist was to observe the transformations of the rhythms of life, practicing a kind of armchair ethnography and transforming into the observed "field" even their own home, their own life or the lives of those close to them, but also what came to them from the outside world via online. In contrast to these approaches, this paper studies several cases where, through contractual obligations, the ethnologist had to do the field in the classical sense of the term, i.e. to observe real (not virtual) communities, located far away (even geographically), and to participate in their social and cultural life. The constraints imposed by quarantine practically forced ethnological fieldwork to reinvent itself, making researchers reflect on the criteria for selecting their informants under the new conditions, on the manner of interacting with them, on the logistics involved in producing interviews and, last but not least, on the ethical implications of approaches of this kind. The remote field experiences of two projects were presented and analyzed: Educational and Networking Tools on Development of Authentic Performance for Professional Integration - PAN and Colecţie digitală a patrimoniului alimentar românesc si transfer spre societate - FOODie. Analyzing in particular the interviews conducted in the FOODie project, the paper highlights a number of advantages of remote fieldwork, such as: the possibility to overcome quarantine restrictions, the possibility to make a quality video recording, the openings of a collaborative ethnology. A number of difficulties of this type of remote research are also highlighted, such as: communication difficulties due to lack of direct interaction, internet signal fluctuation problems, difficulties in understanding some aspects due to ignorance of the informant's living space.

Impact of a Virtual Behavioural Support Intervention on Improving Behaviour, Mental Health, and Academic Engagement and Motivation for Children with Adhd and Their Families: A Pilot Study

BACKGROUND: Children with ADHD struggle with their academic achievement, well-being, and social functioning. COVID-19 restrictions negatively impacted families of children with ADHD and limited their access to services. This led to the creation of the online ADHD-VIBES program (VIrtual BEhavioural Support Intervention for Children with ADHD). OBJECTIVE(S): To determine the efficacy of the ADHD-VIBES program to support families of children with ADHD in behavioural, mental health, academic motivation, and engagement challenges. DESIGN/METHODS: The ADHD-VIBES program was an online program created to support children with ADHD and their families. It consisted of separate parent and child sessions (1-hour each) for six weeks, targeting the development of self-regulation, positive thinking, communication, problem-solving and executive function skills. To our knowledge, there was no other online program offering the same program content during the pandemic. All children met the following criteria: confirmed ADHD based diagnosis of child on parent ratings on Conners-3 Rating Scale (T-score > 65);IQ score > 80 on the WASI-II abbreviated;and access to technology to join virtual groups. Parents completed the Behavior Assessment System for Children (BASC-3) and the Parenting Stress Index (PSI-4-SF) questionnaires. Children completed the BASC-3, the Executive Skills Questionnaire (ESQ), and the Motivation and Engagement Scale (MES). All questionnaires were completed at three different time-points: pre-intervention, post-intervention, and two-months after intervention. A survey was completed at the end of the intervention to determine level of satisfaction of parents towards the ADHD-VIBES. RESULT(S): A total of 12 boys between the ages of 8 to 11 years old (M = 9.62, SD = 0.94), and their caregivers, took part in this program (summer 2021). On the BASC-3, parents reported significantly lower levels of depression and anxiety (F:5.65, p=.016;F:6.21, p=.012) after completion of the ADHDVIBES program. No significant difference was reported by the children on the BASC-3. On the PSI-4-SF, there was no statistical difference observed (parental distress p=0.244). Improvement associated with executive skills (ESQ) were noticed related to Planning/Preparation (F:4.86, p=.019), Time Management (F:7.08, p=.005) and Goal Directed Persistence (F:5.71, p=.011). On the MES, negative Motivation subscales scores demonstrated a decrease in raw scores (T1=40.78;T2=35.75;T3=30.98;p=.103). Finally, all parents (100%) were satisfied/very satisfied with the ADHD-VIBES intervention. CONCLUSION(S): The ADHD-VIBES online intervention showed promising improvement on some behavioural issues, and executive function skills. However, future randomized controlled studies with a larger sample size are required to better understand the impact of the intervention for children with ADHD and their parents.

Anxiety of Caregivers in Telerehabilitation Sessions during Covid 19

Introduction: Pandemics affect people in a defeatist manner and become stressful for people with relatives which need specific forms of care and attention. The study was conducted to find out if anxiety prevails among caretakers during the Covid-19 Pandemic as according to the literature review caregivers experience burden and fears related to their care-recipients and telerehabilitation. Material and Methods: The study used cross sectional survey and quantitative research.50 care-givers participated in the research where they filled online questionnaires inspired and derived from care-giver burden scale and beck anxiety inventory. Anxiety was clearly evident as most of the care-givers agreed to have feelings of nervousness 19 (38%), feeling anxious 18 (36%), feeling distressed 22 (44%), complaints about emotional burden 23 (43%) and 23 (46%) constant immersion in duties towards care-recipients. Results: SPSS tables depict the analyzed results and their interpretation. The results show 36%of the care-givers agreed that they face anxiety when a situation gets out of control, 44% were distressed about not getting enough help from healthcare team and other family and friends, 55% are apprehensive about their present condition and 46% are emotionally challenged and constantly immersed in duties owing to their family members. Conclusions: Anxiety and depression as a result of caregiving burden is common among care-givers and needs to be addressed as soon as possible. This makes it essential that health professionals pay heed and attention to develop interventions for care-givers and provide them with pertinent knowledge.

Understanding unmet needs after young stroke: A codesign project to develop a screening tool

Background & Aims: Young stroke survivors (YSS) report unmet needs related to age and life stage that stroke services often overlook. Researchers, advisers with lived experience, and clinicians collaborated to develop the "Young Stroke Unmet Needs Screening Tool". Method(s): Mixed-method codesign project conducted in three phases: 1. Literature review conducted and workshop held with 12 advisers (8 YSS, 4 clinicians) to develop initial tool content. 2. Online survey conducted to examine YSS preferences for methods of meeting needs, and gain feedback on tool's usability and content. 3. A version was then developed for people with communication or cognitive impairment using Principles of Supported Conversation for Adults with Aphasia, and cognitive strategies. Semi-structured interviews and focus groups held to further develop and test both versions. Result(s): 171 online survey responses (68% female, mean age 45 years, IQR 36-51). Respondents' demographic and stroke-related characteristics influenced preferences for methods of meeting needs, including face-to-face contact with professionals, peer support and succinct tip sheets. Interviews and focus groups were held online due to COVID, with 20 YSS (age 24-53yrs, 60% reported cognitive impairments and 80% had mild to moderate-severe language limitation), and 10 family members. Recruitment of people with more severe language limitations required personal invitation rather than advertising via social media or stroke groups. The tools include six domains (Body and Mind, Emotions, Information, Daily Life, Relationships, Social) covering 53 potential needs. Also included is a distress thermometer. Use of the tool was strongly endorsed for both versions. Conclusion(s): These new unmet needs screening tools could be used to identify service needs for young stroke survivors, including those with cognitive and/or communication difficulties. The tools are now being used in a large study to identify care pathway requirements, to inform the development of a bespoke health service for young stroke survivors.

Extra-analytical Point of Care Testing errors in the pandemic era

Introduction: during the current SARS-CoV-2 pandemic phase, the use of rapid diagnostic devices outside the laboratory has expanded enormously, creating great opportunities but also new risks. Methods: the present observational study evaluated the type and frequency of errors of the extra-analytical phases through an active search on all unclear or ambiguous cases. 252 241 rapid antigenic tests performed outside the laboratory in different health facilities over a 132-day period were considered. The requests, the patient demographics and the results were later entered manually onto the Laboratory Information System (LIS). Results: through a number of data checks and internal reports, 2 556 cases of errors in the pre-examination phase were recorded, with a relative frequency of 12,274 parts per million (ppm). The vast majority of errors were observed in this phase;these were due mainly to computer communication problems induced by human errors that made the loading of results or the issuing of the reports difficult. The remaining cases involving erroneous personal data or patient identification amounted to 16 (64 ppm), confirming the relative safety of this phase in decentralized analysis. The errors identified in the post-examination phase were 540, with a relative frequency of 2140 ppm. The assessment of the severity of the errors with Failure Mode and Effect Analysis (FMEA) allowed us to identify in particular, the attribution of the report to the wrong person (20 ppm) and the manual transcription of an incorrect result (20 ppm). Discussion: this study contributes to the comprehension of the critical issues connected to the Point of Care Testing and made it possible to establish corrective actions: improving staff training, choice of instruments with reading devices and establishing direct computer connection for the entering of the requests and results to the LIS.

Coordinated speech therapy, physiotherapy, and pharmaceutical care telehealth for people with Parkinson disease in rural communities: an exploratory, 8-week cohort study for feasibility, safety, and signal of efficacy.

INTRODUCTION: The potential for coordinated, multidisciplinary telehealth to help connect people with Parkinson disease (PD) in rural areas to PD specialists is crucial in optimizing care. Therefore, this study aimed to test the feasibility, safety, and signal of efficacy of a coordinated telehealth program, consisting of speech therapy, physiotherapy, and pharmaceutical care, for people with PD living in some rural US communities. METHODS: Fifteen individuals with PD living in rural Wyoming and Nevada, USA, participated in this single-cohort, 8-week pilot study. Participants were assessed before and after 8 weeks of coordinated, one-on-one telehealth using the following outcomes: (1) feasibility: session attendance and withdrawal rate; (2) safety: adverse events; and (3) signal of efficacy: Communication Effectiveness Survey, acoustic data (intensity, duration, work (intensity times duration)), Parkinson's Fatigue Scale, 30 second Sit-to-Stand test, Parkinson's Disease Questionnaire - 39, Movement Disorder Society Unified Parkinson's Disease Rating Scale - Part III, and medication adherence. RESULTS: Average attendance was greater than 85% for all participants. There were no serious adverse events and only nine minor events during treatment sessions (0.9% of all treatment sessions had a participant report of an adverse event); all nine cases resolved without medical attention. Although 14 of 16 outcomes had effect sizes trending in the direction of improvement, only two were statistically significant using non-parametric analyses: 30 second Sit-to-Stand (pre-test median=11.0 (interquartile range (IQR)=6.0); post-test median=12.0 (IQR=3.0) and acoustic data work (pre-test median=756.0 dB s (IQR=198.4); post-test median=876.3 dB s (IQR=455.5), p<0.05. CONCLUSION: A coordinated, multidisciplinary telehealth program was safe and feasible for people in rural communities who have PD. This telehealth program also yielded a signal of efficacy for most of the outcomes measured in the study.

Fog-assisted Energy Efficient Cyber Physical System for Panic-based Evacuation during Disasters

Disasters around the world have adversely affected every aspect of life and panic-health of stranded persons is one such category. An effective and on-time evacuation from disaster-affected areas can avoid any panic-related health problems of the stranded persons. Although the nature of disasters differ in terms of how they occur, the evacuation of stranded persons faces approximately same set of issues related to the communication, time-sensitive computation and energy efficiency of the devices operated in the disaster-affected areas. In this paper, a cyber physical system (CPS) is proposed that takes into account various challenges of the disaster evacuation, so an efficient on-time and orderly evacuation of stranded panicked persons could be realized. The system employs fog-assisted mobile and UAV devices for time-sensitive computation services, data relaying and energy-aware computation. The system uses a fog-assisted two-factor energy-aware computation approach using data reduction, which enables the energy-efficient data reception and transmission (DRecTrans) operations at the fog nodes and compensates to extend the period for other functionalities. The data reduction at fog devices employs Novel Events Identification (NEI) and Principal Component Analysis (PCA) for detecting consecutive duplicate traffic and data summarization of high dimensional data, respectively. The proposed system operates in two spaces: physical and cyber. Physical space facilitates real-world data acquisition and information sharing with the concerned stakeholders (stranded persons, evacuation teams and medical professionals). The cyber space houses various data-analytics layers and comprises of two subspaces: fog and cloud. The fog space helps in providing real-time panic-health diagnostic and alert services and enables the optimized energy consumption of devices operate in disaster-affected areas, whereas the cloud space facilitates the monitoring and prediction of panic severity of the stranded persons, using a conditional probabilistic model and seasonal auto regression integrated moving average (SARIMA), respectively. Cloud space also facilitates the disaster mapping for converging the evacuation map to the actual situation of the disaster-affected area, and geographical population analysis (GPA) for the identification of the panic severity-based critical regions. The performance evaluation of the proposed CPS acknowledges its Logistic Regression-based panic-well being determination and real-time alert generation efficiency. The simulated implementation of NEI and PCA depicts the fog-assisted energy efficiency of the DRecTrans operations of the fog nodes. The performance evaluation of the proposed CPS also acknowledges the prediction efficiency of the SARIMA and disaster mapping accuracy through GPA. The proposed system also discusses a case study related to the pandemic disaster of coronavirus disease 2019 (COVID-19), where the system can help in panic-based selective testing of the persons, and preventing panic due to distressing period of COVID-19 outbreak.

The Practice of Face Masking Among Young Adults in South India: An Online Cross-Sectional Survey During Second Wave of COVID-19

Objectives: COVID-19 pandemic urges the need for respiratory protective equipment like face masks as a public health measure to control the spread of infection. This study aimed to investigate the trends followed in the practice of mask-wearing by the South Indian population amid the second wave of COVID-19 outbreak in 2021. Methods: A web-based, online cross-sectional survey was conducted among the young adult population in India in late April 2021. An eight-item questionnaire was designed to assess the social perceptions and attitudes regarding wearing a face mask as a part of universal safety precautions. The social perceptions towards wearing masks were categorized as excellent, good average and poor on a scale (Social Perception Scale -SPS) scored out of 8. The details collected using a predesigned google form are statistically analyzed using the Chi-square test with a p-value of < 0.05 is considered statistically significant. Results: Among the 1283 participants who completed the questionnaire, 57% wore cloth masks followed by 26% wearing N95 masks and 12% wearing surgical masks. Even though the age of the study population varied from 19 – 76 years and with a male preponderance of 56.3% (n = 723), students and recent graduates participated largely in the study (71.8%, n = 922). A mean SPS score of 5.67±1.07 (out of 8) indicates that the social perception of the study population is good. A statistically significant association is observed between the SPS score and the age (p = 0.003), type of mask used (p < 0.001), and economic background of the study population (p <0.001). Breathing difficulty, communication problems, additional cost incurred and dermatologic issues were commonly reported barriers against mask-wearing. Conclusions: Adjunctive public health measures such as mask-wearing are crucial in curbing the COVID-19 transmission. By shaping an appropriate public attitude, policymakers can ensure compliance towards mask-wearing.