Towards a smart pervasive conversational agent for COVID-19 psychological assistance based on NLP

Diverse countries throughout the world were quar-antined due to the novel pandemic known as COVID-19, even after vaccination,. As a result of this grim circumstance, most socioeconomic and political spheres have encountered deep crisis and from there people have experienced stress, anxiety, depression, and even suicide, In this paper, we propose a smart pervasive conversational agent for psychological assistance during and after COVID-19 quarantine, which could converse with a regular citizen to raise awareness of the genuine threat of the outbreak and the importance of vaccination. Our proposed conversational agent could be able to recognize and manage stress and anxiety using natural language understanding (NLU) and international stress and anxiety scales. The messages given by our agent and its mode of communication may help to alleviate anxiety following the world's lockdown. Our agent's comment threads and management styles may be able to soothe people's worry during the world's lockdown. Our proposed approach is a mobile healthcare service with three interdependent units: an input processing (IP) that performs natural language understanding (NL), a Storage that stores every interaction, and a response manager (RM) that controls the responses of our conversational agent. © 2022 IEEE.

Prototype of a Device for the Automatic Measurement of Physiological Signals to Assist the Diagnosis and Monitoring of Patients with Covid-19

This article describes the design, construction and preliminary results of a device to automate the mea-surement of physiological signals to assist in the diag-nosis and monitoring of COVID-19. The device uses a system to controlling linear actuators to turn on/off certified biomedical instruments, in addition to algo-rithms for image recognition of displays with measure-ments of temperature, oxygen saturation, pressure and heart rate. The system also includes a mobile ap-plication, which receives data in real time and creates a database for medical evaluation. Results obtained with the device have demonstrated to provide a high percentage of efficiency in the data acquisition. After several trials with users, SUS and PSSUQ tests were applied to allow verifying the users' feedback regard-ing the satisfaction and usability of the prototype, with high score, showing the good acceptance of the device from the users.

Disruptive digital innovations in healthcare: Knowing the past and anticipating the future

The twin focus on healthcare and digital transformation during the past two decades, which was intensified by the COVID-19 pandemic to an unanticipated level, has resulted in the mushrooming of literature in the area. While this has enriched the available insights, it has also created a certain amount of confusion, and there is now a need to make sense of what has been achieved before undertaking research that contributes more meaningfully to theory and practice in the area. Motivated by this need, we systematically analyze and evaluate the existing empirical research on the topic of disruptive digital innovations in healthcare. We followed a five-step approach to identify and analyze 42 congruent studies spread across domains, publishers, and geographies to achieve our objective. The outcome of our review is a conceptual framework that could serve to motivate and support future research. First, we presented a bibliographic sketch of the literature to clarify the milieu and descriptives. Next, we performed content analysis to organize the existing evidence into meaningful streams. Towards this end, we followed a structured approach to the review by defining the scope through a matrix–form conceptual framework to guide thematic analysis. Accordingly, we reported on the findings from three perspectives—theoretical, enabler, and barrier—anchoring them in four innovation implementations/outcomes: products, services, processes, and business models. Our analysis suggests that existing scholarship has drawn upon various interdisciplinary theories to map the enablers as well as the barriers that may inhibit the adoption and usage of these disruptive innovations. Based on the findings of our structured approach, we offer useful recommendations to advance research and practice in this field.

Enhancing COVID-19 tracking apps with human activity recognition using a deep convolutional neural network and HAR-images.

With the emergence of COVID-19, mobile health applications have increasingly become crucial in contact tracing, information dissemination, and pandemic control in general. Apps warn users if they have been close to an infected person for sufficient time, and therefore potentially at risk. The distance measurement accuracy heavily affects the probability estimation of being infected. Most of these applications make use of the electromagnetic field produced by Bluetooth Low Energy technology to estimate the distance. Nevertheless, radio interference derived from numerous factors, such as crowding, obstacles, and user activity can lead to wrong distance estimation, and, in turn, to wrong decisions. Besides, most of the social distance-keeping criteria recognized worldwide plan to keep a different distance based on the activity of the person and on the surrounding environment. In this study, in order to enhance the performance of the COVID-19 tracking apps, a human activity classifier based on Convolutional Deep Neural Network is provided. In particular, the raw data coming from the accelerometer sensor of a smartphone are arranged to form an image including several channels (HAR-Image), which is used as fingerprints of the in-progress activity that can be used as an additional input by tracking applications. Experimental results, obtained by analyzing real data, have shown that the HAR-Images are effective features for human activity recognition. Indeed, the results on the k-fold cross-validation and obtained by using a real dataset achieved an accuracy very close to 100%.

Will they or won't they? Understanding New Zealand adults' attitudes towards using digital interventions.

Background: Digital interventions deliver healthcare via the internet or smartphone application to support people's well-being and health. Yet uptake is relatively poor. Furthermore, several studies exploring attitudes towards digital interventions have found inconsistent attitudes. In addition to this, regional and cultural nuances may further influence attitudes to digital interventions. Objective: This study aimed to understand New Zealand adults' attitudes towards digital interventions and their influences. Results: A mixed-method design consisting of a cross-sectional survey and semi-structured interviews found that New Zealand adults hold varied and complex attitudes towards digital interventions. Attitudes were found to be influenced by group membership and the scenarios in which digital interventions are made available. In addition, beliefs about the benefits and concerns surrounding digital interventions, knowledge, perceived views of others, and previous experience and confidence influenced these attitudes. Conclusions: Findings indicated that digital interventions would be acceptable if offered as part of the healthcare service rather than a standalone intervention. Key modifiable factors that could positively influence attitudes were identified and could be leveraged to increase the perceived acceptability of digital interventions.

Virtual fall program assessment for frail Canadian community-dwelling older adults: Examining equitable accessibility.

Objective: In response to COVID-19, the fall prevention program (FPP) at Sunnybrook Health Sciences Centre was modified to be delivered virtually. We compared patient populations assessed for the FPP virtually versus in-person to explore equitable accessibility. Methods: A retrospective chart review was performed. All patients assessed virtually from the beginning of the COVID-19 pandemic until the end of abstraction (April 25, 2022) were compared to a historic sample of patients assessed in-person beginning in January 2019. Demographics, measures of frailty, co-morbidity, and cognition were abstracted. Wilcoxon Rank Sum tests and Fisher's Exact tests were used for continuous and categorical variables, respectively. Results: Thirty patients were assessed virtually and compared to 30 in-person historic controls. Median age was 80 years (interquartile range 75-85), 82% were female, 70% were university educated, the median Clinical Frailty Score was 5 out of 9, and 87% used >5 medications. Once normalized, frailty scores showed no difference (p = 0.446). The virtual cohort showed significantly higher outdoor walking aid use (p = 0.015), reduced accuracy with clock drawing (p = 0.020), and nonsignificant trends toward using >10 medications, requiring assistance with >3 instrumental activities of daily living (IADLs), and higher treatment attendance. No significant differences were seen for time-to-treat (p = 0.423). Conclusion: Patients assessed virtually were similarly frail as the in-person controls but had increased use of walking aids, medications, IADL assistance, and cognitive impairment. In a Canadian context, frail and high socioeconomic status older adults continued to access treatment through virtual FPP assessments during the COVID-19 pandemic highlighting both the benefits of virtual care and potential inequity.

Analysis of Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and eHealth literacy: an online survey for digital experience design.

Introduction: Since the enactment of the revised Pharmaceutical Affairs Act in Japan in 2009, self-medication practices have increased in the country. However, studies report that consumers pay little attention to the medication facts and risks indicated on the packages of over-the-counter (OTC) medicines, which could be a potential risk. Since the COVID-19 pandemic, the digital transformation of purchasing OTC medicines has progressed. As an appropriate design for the digital transformation is likely to improve consumers' literacy and them obtaining medical information, this study systematically examines Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and its correlation to eHealth literacy, exploring an appropriate digital experience design in purchasing OTC medicine. Methods: Participants from the Greater Tokyo Area of Japan participated in an online survey. Consumers' current behavior and preferences in accessing OTC medicine, receiving medication guidance, and obtaining medical information were examined. eHealth literacy was assessed using the J-eHEALS. Descriptive statistics, text mining, and thematic analysis were conducted to answer research questions. Results: Over 89% of the respondents who had experience in purchasing OTC medicines preferred local pharmacies or stores rather than online purchasing, p < 0.001. Obtaining medicine guidance in pharmacies or stores was the main preference over other approaches, p < 0.001. Furthermore, most of the participants accepted selecting medicine on shelves and digital screens in-store. However, they were accustomed to using smartphones to obtain additional information at the pharmacy or drug store, p < 0.001; this behavior was positively correlated with eHealth literacy, p < 0.001. Conclusions: Japanese consumers are seeking a combination of conventional and digital behaviors for purchasing OTC medicine rather than opting for a particular method. Most consumers prefer purchasing and receiving instructions in-store while searching for additional decision-making information online. eHealth literacy is positively associated with digital behaviors of OTC medicine information acquisition but less associated with medicine purchases and selections. The hybrid digital experience design may enhance the OTC medicine purchase experience and reduce potential risks by providing appropriate information.

Psychiatric Treatment Conducted via Telemedicine Versus In-Person Modality in Posttraumatic Stress Disorder, Mood Disorders, and Anxiety Disorders: Systematic Review and Meta-Analysis.

BACKGROUND: Telemedicine has played a vital role in providing psychiatric treatment to patients during the rapid transition of services during the COVID-19 pandemic. Furthermore, the use of telemedicine is expected to expand within the psychiatric field. The efficacy of telemedicine is well described in scientific literature. However, there is a need for a comprehensive quantitative review that analyzes and considers the different clinical outcomes and psychiatric diagnoses. OBJECTIVE: This paper aimed to assess whether individual psychiatric outpatient treatment for posttraumatic stress disorder, mood disorders, and anxiety disorders in adults using telemedicine is equivalent to in-person treatment. METHODS: A systematic search of randomized controlled trials was conducted using recognized databases for this review. Overall, 4 outcomes were assessed: treatment efficacy, levels of patient satisfaction, working alliance, and attrition rate. The inverse-variance method was used to summarize the effect size for each outcome. RESULTS: A total of 7414 records were identified, and 20 trials were included in the systematic review and meta-analysis. The trials included posttraumatic stress disorder (9 trials), depressive disorder (6 trials), a mix of different disorders (4 trials), and general anxiety disorder (1 trial). Overall, the analyses yielded evidence that telemedicine is comparable with in-person treatment regarding treatment efficacy (standardized mean difference -0.01, 95% CI -0.12 to 0.09; P=.84; I2=19%, 17 trials, n=1814), patient satisfaction mean difference (-0.66, 95% CI -1.60 to 0.28; P=.17; I2=44%, 6 trials, n=591), and attrition rates (risk ratio 1.07, 95% CI 0.94-1.21; P=.32; I2=0%, 20 trials, n=2804). The results also indicated that the working alliance between telemedicine and in-person modalities was comparable, but the heterogeneity was substantial to considerable (mean difference 0.95, 95% CI -0.47 to 2.38; P=.19; I2=75%, 6 trials, n=539). CONCLUSIONS: This meta-analysis provided new knowledge on individual telemedicine interventions that were considered equivalent to in-person treatment regarding efficacy, patient satisfaction, working alliance, and attrition rates across diagnoses. The certainty of the evidence regarding efficacy was rated as moderate. Furthermore, high-quality randomized controlled trials are needed to strengthen the evidence base for treatment provided via telemedicine in psychiatry, particularly for personality disorders and a range of anxiety disorders where there is a lack of studies. Individual patient data meta-analysis is suggested for future studies to personalize telemedicine. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021256357; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256357.

Acceptance, drivers, and barriers to use eHealth interventions in patients with post-COVID-19 syndrome for management of post-COVID-19 symptoms: a cross-sectional study.

Background: Post-COVID-19 syndrome is a new and debilitating disease without adequate treatment options. eHealth could be a reasonable approach for symptom management. Objectives: This study aims to evaluate the acceptance for eHealth interventions for symptom management in individuals with post-COVID-19 syndrome, as well as drivers and barriers influencing acceptance. Design: Cross-sectional study. Methods: This study was conducted from January 19 until 24 May 2022. Recruitment took place with a web-based survey. Acceptance and predictors of eHealth interventions were measured by the extended UTAUT model. Included in the model were the core predictor performance expectancy, social influence, and effort expectancy. Previously diagnosed mental illness was estimated and mental health by using the well-established Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire Depression Scale. The effect of sociodemographic and medical data was assessed. Multiple hierarchical regression analyses as well as group comparisons were performed. Results: 342 individuals with post-COVID-19 syndrome were examined. The acceptance of eHealth interventions for symptom management was moderate to high (M = 3.60, SD = 0.89). Acceptance was significantly higher in individuals with lower/other education, patients with moderate to severe symptoms during initial COVID-19 infection, still significantly impaired patients, and individuals with a mental illness. Identified predictors of acceptance were age (ß = .24, p < .001), current condition including moderate (ß = .49, p = .002) and still significantly impaired (ß = .67, p < .001), digital confidence (ß = .19, p < .001), effort expectancy (ß = .26, p < .001), performance expectancy (ß = .33, p < .001), and social influence (ß = .26, p < .001). Conclusion: Patients with post-COVID-19 syndrome reported a satisfying level of acceptance and drivers and barriers could be identified. These factors need to be considered for the implementation and future use of eHealth interventions.

Rapid transition to telepractice across the lifespan in speech-language pathology: Insight from a survey of clinicians in Canada.

PURPOSE: This study aims to describe the experiences and needs of Canadian speech-language pathologists (SLPs) who conducted communication assessments via telepractice across the lifespan during the first year (2020) of the COVID-19 pandemic. METHOD: The present study consisted of an online survey that aimed to capture both quantitative aspects of telepractice-based communication assessment and the qualitative experience of shifting to telepractice. One hundred sixty-eight practicing SLPs across Canada participated in the survey, between September 2020 and January 2021. Quantitative results were analysed using descriptive statistics while open-ended responses were analysed using thematic analysis. RESULT: SLPs identified challenges and opportunities relating to client and family engagement, access to and knowledge of technology, and the reliability of assessment tools. SLPs also identified a future need for online assessment materials and training, such as materials adapted for different communication needs (e.g. augmentative and alternative communication). CONCLUSION: The present study contributes to a growing understanding worldwide of potential benefits and challenges related to telepractice, fuelled by the necessary shift in practices in our field during the COVID-19 pandemic. The results provide direction for continuing to build a valid and inclusive approach to telepractice in the future.

Preferences for cardiovascular and pulmonary rehabilitation care: A discrete choice experiment among patients in Lebanon.

OBJECTIVE: Patient preferences are important in designing optimal rehabilitation care. The aim of this study is to assess preferences for rehabilitation care among two groups of respondents. DESIGN: An online discrete choice experiment survey was carried out. SETTING: We use data for Lebanon, a country where rehabilitation care is still underdeveloped. PARTICIPANTS: Patients who have undergone or are currently undergoing rehabilitation treatment (users) and those who have not (yet) used rehabilitation care (non-users). INTERVENTION: Patients were asked to repeatedly choose between two hypothetical rehabilitation care packages with seven different attributes: attitude of the staff, travel time to clinic, out-of-pocket costs, medical equipment, rehabilitation plan, additional lifestyle education session, and support during rehabilitation care. MAIN MEASURES: Preference heterogeneity among patients with different characteristics was investigated using random effect binary logistic regression (software package Stata 15). RESULTS: In total, 126 respondents completed the survey. The most preferred attribute was an informal and friendly attitude of the staff followed by modern medical equipment, additional lifestyle education session via eHealth, and support during the rehabilitation program via phone call or SMS. Respondents were less in favor of going to the rehabilitation clinic and paying additional out-of-pocket costs for the rehabilitation treatment. This rank order was similar between users and non-users. CONCLUSION: Preferences of patients regarding the type of program chosen (eHealth or at clinical-based) need to be included in future rehabilitation programs. Improving patient experience with rehabilitation programs by giving the best care based on a patient-centered approach is essential.

Telehealth in Orthopedic Sports Medicine: A Survey Study on Patient Satisfaction and Experience.

Background: Telehealth has seen breakthroughs in many fields of medicine, but utilization remains limited in orthopedic sports medicine. The purpose of this investigation was to compare patient satisfaction, duration of care, and overall patient experiences with telehealth and in-person clinical visits for sports-related injuries. Methods: A cross-sectional survey study was conducted at an orthopedic sports medicine clinic during the peak of the COVID-19 pandemic between March and November 2020. Anonymous electronic surveys were used to record patient responses and statistical comparisons were drawn through two-sample t-tests. Results: A total of 175 patients (82 telehealth vs. 93 in-person) consented to participate in this investigation, and all were included in the final analysis. The overall composite satisfaction score, when compared between the two groups, did not differ (p = 0.63). Duration of care was significantly longer in the 93 patients who had in-person clinical visits as compared with the 82 patients who had telehealth visits (61/93: >31 min vs. 75/82: <30 min; p < 0.001). Finally, of the 82 patients who had telehealth, 3 respondents said they were "very unlikely" and "unlikely" to request another virtual clinical visit and/or recommend this mode of health care delivery to friends or family. Of the 93 patients had in-person clinical visits, only 15 respondents stated they were uninterested in telehealth under any circumstance. Conclusion: Most patients presenting to an orthopedic sports medicine clinic are open to telehealth, recognize its utility, and believe it to be just as comparable with in-person clinical visits. Level of Evidence: IV.

Mobile heath applications for self-management in chronic lung disease: a systematic review.

Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information: The online version contains supplementary material available at 10.1007/s13721-023-00419-0.

Artificial-Intelligence-Driven Algorithms for Predicting Response to Corticosteroid Treatment in Patients with Post-Acute COVID-19.

Pulmonary fibrosis is one of the most severe long-term consequences of COVID-19. Corticosteroid treatment increases the chances of recovery; unfortunately, it can also have side effects. Therefore, we aimed to develop prediction models for a personalized selection of patients benefiting from corticotherapy. The experiment utilized various algorithms, including Logistic Regression, k-NN, Decision Tree, XGBoost, Random Forest, SVM, MLP, AdaBoost, and LGBM. In addition easily human-interpretable model is presented. All algorithms were trained on a dataset consisting of a total of 281 patients. Every patient conducted an examination at the start and three months after the post-COVID treatment. The examination comprised a physical examination, blood tests, functional lung tests, and an assessment of health state based on X-ray and HRCT. The Decision tree algorithm achieved balanced accuracy (BA) of 73.52%, ROC-AUC of 74.69%, and 71.70% F1 score. Other algorithms achieving high accuracy included Random Forest (BA 70.00%, ROC-AUC 70.62%, 67.92% F1 score) and AdaBoost (BA 70.37%, ROC-AUC 63.58%, 70.18% F1 score). The experiments prove that information obtained during the initiation of the post-COVID-19 treatment can be used to predict whether the patient will benefit from corticotherapy. The presented predictive models can be used by clinicians to make personalized treatment decisions.

Medical Students' and Radiology Technician Trainees' eHealth Literacy and Hygiene Awareness-Asynchronous and Synchronous Digital Hand Hygiene Training in a Single-Center Trial.

Next to the known nosocomial infections, the COVID-19 pandemic was an example for the need for the immediate implementation of functioning hygiene concepts and knowledge transfer. The aim of this study was to evaluate the self-assessment of ehealth literacy in terms of finding, using and critically evaluating health information and theoretical and practical hygiene awareness on a voluntary participation basis at the Jena University Hospital in 2022. The well-established and validated eHEALS and WHO questionnaire on hand hygiene (HH) knowledge for healthcare workers was completely filled by 204 participants (191 medical students; 13 healthcare trainees). In a second step, after the questionnaire, 77 participants completed additional asynchronous, digitally guided self-training using DesiCoach 2Go. In the end, a synchronous hand disinfection was carried out in the hospital using Visirub, by separating it into a group without (n = 191; with and without HH questionnaire) and a group with (n = 31; with HH questionnaire) previously completed self-training. For the eHL, the respondents tended to have a positive self-assessment of finding, using and critically evaluating health information. The voluntary participants of the practical hand disinfection who had received self-training were able to achieve significantly better results (p = 0.0047), resulting in fewer wetting gaps in a subsequent performance with Visirub than those who had not received digital self-training. The survey showed that healthcare-related participants belonging to the "digital native" generation have above-average knowledge on HH and profit by digitally guided self-training.

Lessons for Vietnam on the Use of Digital Technologies to Support Patient-Centered Care in Low- and Middle-Income Countries in the Asia-Pacific Region: Scoping Review.

BACKGROUND: A rapidly aging population, a shifting disease burden and the ongoing threat of infectious disease outbreaks pose major concerns for Vietnam's health care system. Health disparities are evident in many parts of the country, especially in rural areas, and the population faces inequitable access to patient-centered health care. Vietnam must therefore explore and implement advanced solutions to the provision of patient-centered care, with a view to reducing pressures on the health care system simultaneously. The use of digital health technologies (DHTs) may be one of these solutions. OBJECTIVE: This study aimed to identify the application of DHTs to support the provision of patient-centered care in low- and middle-income countries in the Asia-Pacific region (APR) and to draw lessons for Vietnam. METHODS: A scoping review was undertaken. Systematic searches of 7 databases were conducted in January 2022 to identify publications on DHTs and patient-centered care in the APR. Thematic analysis was conducted, and DHTs were classified using the National Institute for Health and Care Excellence evidence standards framework for DHTs (tiers A, B, and C). Reporting was in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS: Of the 264 publications identified, 45 (17%) met the inclusion criteria. The majority of the DHTs were classified as tier C (15/33, 45%), followed by tier B (14/33, 42%) and tier A (4/33, 12%). At an individual level, DHTs increased accessibility of health care and health-related information, supported individuals in self-management, and led to improvements in clinical and quality-of-life outcomes. At a systems level, DHTs supported patient-centered outcomes by increasing efficiency, reducing strain on health care resources, and supporting patient-centered clinical practice. The most frequently reported enablers for the use of DHTs for patient-centered care included alignment of DHTs with users' individual needs, ease of use, availability of direct support from health care professionals, provision of technical support as well as user education and training, appropriate governance of privacy and security, and cross-sectorial collaboration. Common barriers included low user literacy and digital literacy, limited user access to DHT infrastructure, and a lack of policies and protocols to guide the implementation and use of DHTs. CONCLUSIONS: The use of DHTs is a viable option to increase equitable access to quality, patient-centered care across Vietnam and simultaneously reduce pressures on the health care system. Vietnam can take advantage of the lessons learned by other low- and middle-income countries in the APR when developing a national road map to digital health transformation. Recommendations that Vietnamese policy makers may consider include emphasizing stakeholder engagement, strengthening digital literacy, supporting the improvement of DHT infrastructure, increasing cross-sectorial collaboration, strengthening governance of cybersecurity, and leading the way in DHT uptake.

Exploring E-Health Literacy and Technology-Use Anxiety among Older Adults in Korea.

The COVID-19 pandemic has increased the importance of health literacy in disseminating information on health in a non-contact society. This study focused on examining the acceptance capacity by older adults of smart devices in Korea and investigating the potential differences between men and women in terms of e-health literacy and technology-use anxiety. The study included 1369 respondents who were adults over 50 years of age and used welfare centers, public health centers, senior citizen centers, and exercise centers in Seoul and Incheon. An online survey was conducted from 1 June 2021 to 24 June 2021. The study found that the older adults' low levels of digital literacy could limit their access to health information and negatively impact their health. The difference between men and women in terms of technology-use anxiety was statistically significant, with the latent mean for men being higher than that for women. The effect sizes of the potential mean differences were found to be at a medium level for e-health literacy and a significant level for technology-use anxiety. With Korea's aging population and the need for the continuous management of chronic diseases among older adults, it is essential to discuss internet-based health information for disease maintenance and treatment.

Virtual hospitals: The future of the healthcare system? An expert consensus.

Today, social and healthcare systems at a global level are facing constant challenges dictated by an increasing mismatch between the demand for care services and the supply of human and economic resources. Such a situation has been exacerbated in the past two years by the Covid-19 pandemic. This has led to an increase in the leverage of digitalisation, which has proved to be a crucial tool for the development and application of new organisational models at both hospital and territorial levels, thus addressing the various criticalities already present in the system. In this sense, the Virtual Hospital has emerged as a potential model for increasing effectiveness and efficiency in delivering sociomedical services. Starting from these premises, an EFTE (estimate, feedback, talk, estimate) approach was used to acquire an expert consensus within a multidisciplinary panel of academics and healthcare managers of the Veneto Region in Italy. This article reports the expert opinion on the possible application of the Virtual Hospital model in the national context, starting from the existing international evidence and good practices, highlighting the potential advantages and barriers to its implementation. Furthermore, the article analyses the most relevant areas of investment for the development of intangible assets and the acquisition of tangible assets necessary for its implementation.

Telehealth and the COVID-19 Pandemic: Making the Pivot from Offline to Online Therapeutic Interventions.

While the global health crisis was not responsible for the creation of virtual environments, the COVID-19 pandemic has spawned increased interest in the use of virtual technologies in the workplace and beyond. The current review highlights some of the methods, modalities, and outcomes of the pivot from in-person (offline) therapeutic interactions to the mode of telehealth (online) strategies. Global social-distancing mandates were especially troubling for mental health clients accustomed to in-person counseling and psychotherapy. Panic, fear, and isolation only compounded the reality of health and financial concerns. Lessons about the advantages of telehealth therapies during the most recent global health crisis, will help prepare us all for the next Disease X event. The primary aim of this brief report is to inform the reader about recent research on the advantages of telehealth modalities. In particular, an examination of online technologies in the midst of a Disease X milieu (i.e., COVID-19) was explored. While the current review is far from exhaustive, research in general should leave us optimistic about the "new normal" of utilizing online communication strategies in mental health and beyond. While a Disease X event did not directly lead to the creation of virtual meetings, emerging research is beginning to enlighten the positive consequences of making the pivot from offline to online therapeutic interventions.

Clinical Sexologists' Perceptions of the Potentials, Downfalls, and Best Practices for Digitally Delivered Therapy: A Lesson from Lockdown Due to COVID-19 in Portugal.

Professionals who work in clinical sexology intervene in situations related to mental health, such as sexual dysfunctions and marital conflicts, often with vulnerable populations, e.g., people with chronic illnesses or trans people. In this work, we wanted to understand the perceptions these professionals have about using Internet interventions and how they perceive-based on their COVID-related experience and the reflections it brought about non-face-to-face interventions-the use of online interventions. During the first lockdown due to COVID-19 in Portugal, we used an online survey and collected answers from 39 Portuguese sexual health professionals to open questions about the use of Internet interventions. The data were analyzed following the summative content analysis procedures. Our results showed that sexual health professionals had several difficulties in clinical practice during the lockdown period, such as the perception that sexuality moved to the backseat in people's lives. Even so, they stated that Internet interventions have several advantages, such as easy accessibility and excellent promotion of social justice. However, disadvantages were also pointed out. The current study allowed us to understand clinicians' perception of the impact of the pandemic on sexual healthcare access and brought recommendations for good practice of sexual medicine with e-health.