In-service training policy during the COVID-19 pandemic: The case of the agents of the farmers, rural people, and nomads social insurance fund.

Introduction: The COVID-19 pandemic has posed the in-service training of agents of the Farmers, Rural People, Nomads Social Insurance Fund (hereafter the Fund) to many problems. In-service training is one of the most effective development factors for organizational goals. This sort of training will increase employees' skills and subsequently improve their job performance. Accordingly, the present research mainly aimed to shed light on the effect of in-service training policy on employees' capabilities and job performance. Methods: The research was conducted among the agents of the Fund in Fars province, Iran (N = 197) out of whom 127 agents were sampled by simple randomization. The research instrument was a standard questionnaire whose face and content validity was confirmed by a panel of experts and its reliability was determined by calculating Cronbach's alpha in a pilot study. The results showed that the indicators used to measure the research variables were acceptably consistent with the factor structure and the theoretical framework of the research. Results and discussion: Based on the findings, in-service training in the Fund during the COVID-19 pandemic has had a positive and significant effect on the agents' capabilities (communication and team-working skills, creativity and problem-solving skills, commitment and responsibility, technical information and knowledge, and technical and practical skills) and job performance at the individual, technical, and general levels. Also, the agents' capabilities have had a positive and significant influence on their job performance. It can be concluded that in-service training can influence the agents' capabilities and job performance and improve organizational performance during the COVID-19 pandemic. Thus, the enhancement of in-service training courses' quantity and quality during the COVID-19 pandemic can influence the job performance of the agents at the individual, general, and technical performance levels.

Assessing knowledge and barriers at the primary care provider level that contribute to disparities in inammatory breast cancer diagnosis and treatment

Background: Although recognized as the most lethal breast cancer, inflammatory breast cancer (IBC), a NCI designated rare cancer and a cancer health disparity, is severely understudied. Given the unique presentation of diffuse tumor spread without a solid mass, not easily detected by selfbreast exams or mammograms, IBC patients often face delays in diagnosis and treatment leading to poor outcomes. Moreover, reproductive risk factors in IBC and high incidence in younger women, minoritized and marginalized populations highlight the significance of primary care providers (PCP) who are often the first point of contact when patients begin to notice symptoms. Method(s): In this study, we evaluated the knowledge gaps and barriers amongst PCP (physicians, physician assistants, nurse practitioners) in their ability to recognize the signs and coordinate care effectively for IBC. To assess PCP experiences with IBC in their practices and overall breast cancer care during COVID, we first conducted semi-structured interviews (n=11) with providers selected from a convenience sample at Duke University and in the local clinics. Based on data from these interviews and additional cognitive interviews, we developed and disseminated a comprehensive online survey (n=78). Result(s): In this study, access to care was identified as the single most important barrier to treating rare cancers. Furthermore, majority of the PCPs in this cohort identified only a moderate ability to recognize IBC in patients (mean = 3.3, range 1-7), thereby limiting early diagnosis. From the semi-structured interviews, PCPs recognized that IBC is not likely to be part of typical differential diagnosis when patients present with mastitis or breast changes, and most had not seen IBC in their practice. Only 31% (n=78) reported ever suspecting IBC in a patient. Delays in referrals to specialized large clinical centers were also reported as a major barrier. In particular, 62.8% (n=49) reported some delay in referrals for diagnostic imaging. In addition, since the COVID-19 pandemic started, 33% reported diagnosing less breast cancer cases and 63% reported that they experienced breast cancer referral delays. When asked what methods providers would find most helpful to learn more about diagnosing and caring for patients with IBC, the top three modes of preferred education were online CME options (53%);lunchtime, or other in-service training (33%);and website for patients and providers (32%). Conclusion(s): We succeeded in developing a survey instrument and to our knowledge first mixed methods study to assess PCP knowledge gaps and barriers to timely diagnosis and care of IBC patients. Results underscore need to develop PCP training modules and care coordination tools to improve guideline-concordant care. This survey instrument also has the potential to serve as a blueprint to design, implement, and evaluate interventions for other rare cancers.

Knowledge, Attitude and Anxiety Levels about COVID-19 among Healthcare Workers at Ankara City Hospital, Türkiye

Introduction: We aimed to assess the present knowledge, attitude and anxiety levels of coronavirus disease 2019 (COVID-19) among healthcare workers at Ankara City Hospital. Materials and Methods: The study was implemented in the form of an online survey, based on voluntary participation and conducted on healthcare workers at the Ministry of Health Ankara City Hospital by using convenience sampling and snowball method between 30 May-2 July 2020. There were 28 questions on knowledge and 8 questions on attitude. The Beck Anxiety Inventory (BAI) was used to measure the anxiety level of the participants. The results were analyzed using the SPSS program. Results: Of the participants, 75% were females, 61.25% were nurses/midwives, and mean age was 34.5 ± 10.1 years. A significant portion of the participants (84.50%) had a moderate or adequate level of knowledge. The highest knowledge score in terms of their professions are doctors, followed by nurses/midwives. The most used resource (71.25%) by our participants was the Ministry of Health’s web page, posters and brochures. The knowledge adequacy of those who have a case algorithm is 1.8 times. Of the participants, 61.0 % demonstrated a positive attitude. 25.25% were gauged to have severe and moderate anxiety. Of the participants, 42.39% stated that anxiety causing reason was the future of their family in case of death in our study. The anxiety score of the female participants was higher than that of the men, young people were higher than the other age groups. There was no significant correlation between the level of knowledge and attitude;whereas a negative, weak correlation was identified between the level of knowledge and anxiety, and between attitude and anxiety. Conclusion: Although the knowledge level of the participants was found to be adequate, in-service training on infection control measures, especially on the use of personal protective equipment should be continued using official information, such as algorithms are designed and other sources by the Ministry of Health. Health workers, especially women and young people, should be monitored psychologically, treated and social support for them should be increased during the pandemic. Increasing knowledge and positive attitudes may be contribute to decrease anxiety scores.

Supporting Families Considering Clinical Trial: A Digital Resource Featuring Parent and Provider Perspective and Guidance

Purpose/Objectives: 1. Describe the clinical trial consideration process from family point of view, so parents know the questions to ask and providers can support them 2. Place consideration in context of life with a child having a rare disease/disorder, to prepare both parties for what lies ahead 3. Illustrate variety of decisions and outcomes that families experience, to emphasize that there is no one right answer Design/Methods: The project is a digital library (unit) of content presented in a variety of media (video, downloadable guide, podcast, blog) and organized around subjects of greatest potential concern and interest to families and providers based on the described experience of families who considered and/or enrolled in a clinical trial. Unit is available online, free, 24/7. Results: The Evaluating the Clinical Trial Option unit was introduced in February 2020. In 12 months, there were 9,640 video views, the guides were viewed 226 times, and the Guided Pathway visited 356 times. (numbers would be updated for the poster). Staff has presented its content to numerous gatherings of providers, patient disease groups, and industry professionals to overwhelmingly positive feedback. Professionals serving the rare disease community, especially patient advocates at biotech companies and patient disease groups, have reached out to CPN for resources from the unit to meet particular needs: e.g. content about informed consent helped a family understand the restrictions around posting to social media and content about inclusion criteria -- including a parent's hope to 'train' towards meeting the criteria, as well as the potential for parents to feel they have failed if their child does not meet that criteria -- helped a parent navigate their stress and worry about COVID-induced disruptions to their child's physical therapy prior to seeking participation in a trial. Companies have reported valuing the unit as a therapy- and industry-neutral, unbiased source of information for families. Companies link to it in their patient support portals and use the videos for in-service training. The patient disease group NTSAD, anticipating multiple clinical trials for its affected families, links to the unit on its website and sends families considering enrollment links to it in email communications. The American Society of Gene and Cell Therapy has recognized the unit for covering the emotional aspects of trial participation that are not covered in their resources and has embedded links to it in their patient- and provider-facing websites. Conclusion/Discussion: The unit was designed as a resource to share with families and for their self-service, but grows in momentum and impact as it is used as a resource for educating colleagues -- including genetic counselors, medical geneticists, doctors working with rare disease patients - and peers striving to better understand the lived family experience.

Threats to operating room personnel's occupational safety and health: a qualitative study

Background & Objective: Every operating room has been associated with a variety of occupational hazards, but not many studies have been conducted to assess and address these hazards. We used a qualitative approach to explore operating room personnel's experiences of workplace hazards and how these hazards threaten their occupational safety and health (OSH). Methodology: This qualitative study was conducted in five teaching hospitals in the south-west of Iran from February 2019 to March 2021. The sample was 24 operating room personnel who were selected under convenient sampling technique. Data were collected using semi-structured, individual interviews, document review and non-participant observation. The collected data were analyzed according to the qualitative content analysis method using MAXQDA v. 2020. Results: After prolonged analysis of the data, the researchers extracted 644 codes, 13 subcategories, 4 categories, and 1 main theme. The main theme of the study was working in a context of occupational hazards. Conclusions: Operating rooms are full of potential dangers, which, when combined with the personnel's negligence and management inefficiencies, increase the risk of occupational health and safety. Therefore, making working conditions safe by providing adequate personal protective equipment (PPE), in-service training, and identifying and managing the causes of personnel negligence are recommended. Moreover, strategies should be introduced to manage stress and conflicts among the healthcare personnel, thus controlling psychological hazards.

Introducing online training for health staff: An institutional perspective

Online training has been gaining popularity for its flexibility and cost-efficiency. Its introduction challenges existing practices of in-service training which are mostly in the form of onsite training. Based on a participative, interpretive case study, we conceptualized in-service training as an institution, examining how the introduction of online training affected changes to the in-service training practices. Our research investigates three modes of in-service training;onsite training, self-paced online course, and synchronized online training. Two conflicting institutional logics that are associated with the first two modes of training emerge;onsite training logic and online training logic. The in-service training institution in Indonesia remained stable despite changes in technology used and the covid pandemic. The logic of onsite training continued to be dominant throughout the period, and most training practices in onsite training were carried over to the online training without reflections. © 2022 The Authors. The Electronic Journal of Information Systems in Developing Countries published by John Wiley & Sons Ltd.

Ableton Live professional learning development for secondary school music teachers

There is a gap between secondary school music teacher’s knowledge of digital audio workstations (DAWs) and the phenomena of the digital musician. A digital musician is a student who uses a computer as their primary instrument for composing and performing music. This case study of in-service professional learning development (PLD) was based on the DAW Ableton Live and its integrated hardware controller, the Push. A review of professional learning literature informed the blended learning design (BLD) approach of the study. The analysis used a six-phase inductive approach for interpretive analysis of the themes. Results of this pre-COVID-19 study revealed that time, BLD, facilitation and videos impacted on the learning of the participants. Additionally, the participants underwent two linked paradigm shifts: first to include a computer and DAW in their conception of what music-making could be, and second that Ableton Live and the Push were musical instruments. Findings suggest that future PLD could increase learner readiness for using videos and a BLD in addition to preparing them for a paradigm shift. © 2022 Intellect Ltd Article. English language.

USE OF MASSIVE OPEN ONLINE COURSES IN THE PROFESSIONAL DEVELOPMENT OF UNIVERSITY TEACHERS

The article is devoted to massive open online courses as a type of continuing professional development of university teachers. It is emphasized that massive open online courses are popular for professional development of specialists, in particular teachers, because they provide timely information, offer flexible, accessible and convenient learning options, allow students to choose the time and pace of study, save time and money to improve qualifications. It is determined that at the same time online courses have certain shortcomings and limitations, first of all of the pedagogical component: low level of interactivity and social presence of both listeners and teachers of courses;insufficiently diverse course design and teaching and learning methods;ineffective methods of assessing students' academic achievements;lack of conditions for the development of a higher level of thinking The results of online courses on domestic and foreign platforms for teachers of Borys Grinchenko Kyiv University in 2020, as well as the results of a survey of pedagogical and scientific-pedagogical staff on their attitude to online courses are analyzed. The results of the survey were analyzed and verified with the methods of descriptive statistics. The survey confirmed the global trend of training in massive open online courses of highly qualified specialists in order to gain new knowledge in a particular field of science and discipline and the development of professional competence. One of the important goals of online training was to gain experience in online training, which was especially relevant in the context of quarantine restrictions during the COVID-19 pandemic. The survey proved the positive attitude of the Borys Grinchenko Kyiv University academic staff to massive open online courses as a convenient and affordable type of continuing professional development.

The Resurgence of Candida auris in California during the Novel Coronavirus (COVID-19) Pandemic, May 2020-May 2021

Background. In February 2019, California (CA) experienced its first C. auris outbreak in Orange County (OC). The CA Department of Public Health (CDPH) and OC with the Centers for Disease Control and Prevention (CDC), mounted a successful containment response;by November 2019, cases were limited to low-level spread in OC long-term acute care hospitals (LTACH). In May 2020, C. auris cases began to surge in OC, followed by extensive spread in six other southern CA local health jurisdictions (LHJ). CDPH with LHJ and CDC, initiated an aggressive, interjurisdictional containment response. Methods. We carried out response and preventive point prevalence surveys (PPS), onsite infection prevention and control (IPC) assessments, and in-service trainings at outbreak and interconnected hospitals and skilled nursing facilities in six LHJ. Other regional activities included: epidemiologic investigation, contact and discharge tracking and screening;increasing laboratory testing capacity;screening patients admitted to and from LTACH;statewide healthcare facility (HCF) education and outreach;sending regional outbreak HCF lists to all HCF;and biweekly state-LHJ coordination calls. The Antibiotic Resistance (AR) Lab Network supported testing. Results. From May 2020-May 2021, we conducted screening at 226 HCF, and identified 1192 cases at 93 HCF, mostly through screening (n=1109, 93%) and at LTACH (n=906, 76%);we identified 113 (10%) cases at ACH, including 35 (31%) in COVID-19-burdened units. Cases peaked in August 2020 (n=93) and February 2021 (n=191) and have since declined, with C. auris resurgence mirroring COVID-19 incidence. We conducted 98 onsite IPC assessments, and identified multiple, improper IPC practices which had been implemented in response to COVID-19, including double-gloving and -gowning, extended use of gowns and gloves outside patient rooms, and cohorting according to COVID-19 status only. Figure 1. C. auris and COVID-19 Cases in California through May 2021, and C. auris Cases by Local Health Jurisdiction (LHJ) May 2020-May 2021 Conclusion. The C. auris resurgence in CA was likely a result of COVID-19-related practices and conditions. An aggressive, coordinated, interjurisdictional C. auris containment response, including proactive prevention activities at HCF interconnected with outbreak HCF, can help mitigate spread of C. auris and potentially other novel AR pathogens.

MECC implementation in practice: A mixed method approach to public health interventions in MSK community services

Keywords: MECC, Brief interventions, Behaviour change Purpose: In the UK, 22.2% of adults are classified as inactive, achieving less than 30mins of low to moderate physical activity per week compared to 150 mins per week as recommended by the CMO Guidelines. Physical inactivity costs the UK £7.4 billion annually (Public Health England 2019) and is responsible for one in six UK deaths. Physical inactivity, obesity, smoking, and alcohol consumption are all modifiable lifestyle factors which influence our quality and length of life. With increasing life expectancy and obesity levels, we need to shift our focus to management of long-term musculoskeletal conditions with multi morbidity (NICE Guidelines- Multi Morbidity 2016). We decided to turn the lens inward on our own clinical behaviours, to make every contact count (MECC) considering that obesity is a leading risk factor for osteoarthritis (Pan et al., 2020). Our aim was to upskill the team in MECC conversations to make meaningful behavioural change for the population regionally. This was identified via clinical supervision, notes audits and from minimal MECC change training at both undergraduate and post graduate level. Potential reasons for clinicians not engaging in MECC conversations relate to lack of training, risk of offending patients, prioritisation and/or time pressures. Methods: We looked at Public Health England's local South Tyneside data to shape our MECC vision (PHE Fingertips). Afterwards, we completed public health service mapping, created patient information leaflets on MECC topics and shared these with the team. We prioritised the team undergoing training (11 h per clinician) in motivational interviewing, brief interventions regard healthy eating, smoking and alcohol cessation between July 2020 to March 2021. The team focused on developing relationships with Link workers by delivering in-service training with them and involving them in our pathways. We integrated MECC into clinical templates to ensure data was captured to gauge the training uptake. Results: From September 2020-April 2021, the South Tyneside Community Musculoskeletal (MSK) Service have instigated over 7,000 initial appointment conversations with patients on smoking, alcohol, weight loss and physical activity. This was coupled with 9,000 MECC conversations at follow up appointments with 62.84% of clinicians engaging overall. Our patient related experiential measures had increased to 94.04% over the last quarter (Jan-April 21) with collection rate of 44%. This is a 2% increase in comparison to the same period last year, 3% increase over the year in total despite COVID. Patients and clinicians have engaged with 67% of consultations about exercise and smoking, 66% of consultations about alcohol and weight. Conclusion(s): Lifestyle modification conversations can occur within a MSK Community services setting. Upskilling clinicians to provide brief MECC interventions now is of paramount importance to further reduce the burden of long term MSK conditions. This may be enhanced with utilising patient activation measures pending further research. Impact: Upskilling MSK clinicians with advanced communication skills for MECC brief interventions will enable the identification of unhealthy lifestyle behaviours and offer effective signposting in primary care. This has implications for undergraduate curriculums to better prepare the workforce for evidence based behaviour change thus reducing the cost and healthcare burden. Funding acknowledgements: Work was supported and funded by Connect health.

The assessment and management of breathing dysfunction in musculoskeletal conditions: A survey of current United Kingdom physiotherapy practice

Keywords: Breathing dysfunction, Evolving musculoskeletal practice, Survey Purpose: The prevalence of breathing dysfunction (BD) is estimated at 10% of the United Kingdom (UK) adult population, and higher in those with asthma (Thomas et al., 2005), while an estimated 20% of adults attend primary care each year with musculoskeletal conditions (Department of Health and Social Care, 2019). Current research indicates a possible relationship between BD and musculoskeletal conditions including alterations in thoracic mechanics, respiratory muscle strength and spirometry, however, there is a lack of evidence regarding the most appropriate BD assessment and management strategies. Therefore, this study investigated physiotherapists’ use of BD assessment and management strategies for patients with musculoskeletal conditions and explored relationships between professional characteristics and current practice variation. Methods: An observational cross-sectional online survey was utilised. UK-based musculoskeletal physiotherapists were invited to participate via social media, professional networks and email. The survey consisted of 28 closed and 16 open questions informed by similar surveys and relevant BD literature. The survey was piloted by five musculoskeletal physiotherapists and was open for eight weeks between 22/05/2020 - 17/07/2020 with a half-way reminder. Data analysis included descriptive statistics and Fishers exact test. Results: 257 questionnaires were completed. 81% (n = 208) of participants worked within the NHS and 31.1% (n = 80) in private practice, with the majority working at an equivalent band 6 (23%, n = 58), band 7 (33%, n = 84) and band 8a (31%, n = 79). 13.2% (n = 34) reported a special interest in BD. 72% (n = 185) of participants did not assess or manage BD, 28% (n = 72) did. In this latter group 100% (n = 72) assessed using subjective indicators and patient observation, while muscle-length testing (69%, n = 50), physical assessment (68%, n = 49), respiratory parameters (26%, n = 19) and BD specific questionnaires (14%, n = 10) were less commonly reported. BD management consistently included breathing retraining (94%, n = 68), general exercise and BD education (89%, n = 64). The inclusion of BD assessment and management in musculoskeletal conditions was statistically significantly associated with BD special interest (p < 0.001), NHS equivalent banding (p = 0.034) and post-graduate BD training including self-directed learning, in-service training, online training, formal lectures, short courses and PhD level study (p < 0.001-0.049). Conclusion(s): This is the first survey of BD assessment and management in musculoskeletal conditions and indicates infrequent assessment and management of BD. For physiotherapists who do assess and manage BD, subjective indicators and observation were the most commonly assessed, while breathing retraining was the most frequent management strategy. BD special interest, relevant post-graduate training and NHS equivalent banding were statistically significantly associated with use of BD assessment and management. Impact: Findings will inform future survey design including international surveys comparing findings across a more diverse sample. Qualitative work or use of vignettes could explore rationales regarding the inclusion of BD assessment and management in musculoskeletal practice. Due to the potentially detrimental clinically important reduced respiratory muscle function associated with mechanical ventilation (Lu et al., 2016;Nassar et al., 2018) and COVID-19 illness (Brosnahan et al., 2020), future quantitative research could investigate whether there is an association between COVID-19 and BD or the effect of long COVID on breathing mechanics. Funding acknowledgements: Project was unfunded.

A pilot to explore if of co-locating Advanced Practice Physiotherapists with Physiotherapists improves clinical knowledge and evidence based practice

Keywords: Improves clinical knowledge and EBP Purpose: The purpose was to explore if having APPs and community physiotherapists co-locating improves: the implementation of EBP, knowledge and clinical reasoning, awareness of useful clinical networks, relationships within the teams and job satisfaction? Methods: Weekly in service training delivered remotely by Microsoft Teams (due to COVID-19) covering assessment, diagnosis and management underpinned by EBP. Discussions around the use of audits and how this may change clinical pathways and improve practice. Reviewing relevant journals and discussions on the local ‘Evidence into Practice Groups’ as a source of where to go for the latest evidence and develop clinical questions. Clinicians provided reflective feedback to show how the pilot was impacting on their practice. The STarT Back Approach was used as an outcome measure to demonstrate evidence into practice. This approach has been shown to be clinically and cost effective method of treating patients with low back pain. It is not routinely used across MPFT physiotherapy departments in the North division and therefore the outcomes were compared to a site that was not involved in the co-locating pilot. A Bespoke training package on the STarT Back Approach was delivered to the pilot site with external speakers from Keele University, IMPACT team (Biopsychosocial approach to management of back pain), Consultant in pain medicine, Activity Coordinator, GP and a Peer support worker on the management of low back pain. Results: Implementation STarT Back Approach: 100% of staff at the pilot site received training and used the tool on all patients with low back pain compared to 31.5% at comparative site. 100% of the medium risk patients at the pilot site were offered follow up compared to 87.5% at comparative site. Psychologically informed treatment was offered to 60% of high risk patients at the pilot site compared to 33.3% at comparative site. Reflective feedback from physiotherapists demonstrating: Improved job satisfaction “My Job satisfaction in regards to personal and team development has improved massively, having the support of more experienced colleagues has been immense” Improved knowledge and skills “Having regular input and better communication links with APPs has improved my knowledge and skills of assessing these pts and has directed the patient into the correct care pathway” Improved use of EBP “Had a patient with a subacute meniscal tear no locking, paid for his own MRI scan privately. I felt much more confident in telling him the evidence of treatment for this with physio and await natural recovery. Thank you, this is what the integration is all about.” Conclusion(s): Sharing knowledge and clinical expertise is key to transforming and improving services and making best use of resources. Co-locating APPs with physiotherapists improves clinical knowledge, helps embeds EBP, improves job satisfaction and ultimately will improve patient care. Impact: This work provides evidence that co-locating of APPs within physiotherapy departments improves clinical practice on a number of levels. These findings should transform how the MSK physiotherapy services across MPFT utilise APPs in the future to ensure evidence based and cost effective care is delivered. Funding acknowledgements: Not funded.

UPSKILLING FOR DIGITAL TRANSFORMATION IN THE 4TH INDUSTRIAL REVOLUTION: A SCOPING REVIEW

The evolution of technology in the manufacturing industry has always been driven by increased production capacity, however, such advances are often accompanied by unanticipated social impact. Throughout the digital revolution in the mid-20th century job markets changed from labour intensive to capital intensive and workers without skills that fit this new paradigm were displaced and forced to upskill or reskill. Today we find ourselves on the brink of the 4th Industrial revolution - modern day society is more self-aware and has the means to avoid the pitfalls of prior technological transformations. That said, we also face a shrinking job market, staggering increases in the cost of higher education and a major shift in technology and human interaction due to the Covid-19 pandemic. Technology is developing at a faster pace than individuals can finish tertiary qualifications, exposing a crucial need for sustainable workforce development to keep up with the surge in technological innovations. In-service training has become a critical endeavour for both the private and public sectors to retain employees in the face of transformation. In this paper, a comprehensive scoping review is presented to assess the current state of in-service training initiatives within the manufacturing industry. Summarizing popular research themes and methodologies, and how interest in such initiatives have changed following the Covid-19 pandemic. The review was conducted according to the PRISMA scoping methodology: three boolean search strings were defined and each was screened over three databases (Scopus, Web of Science, and Engineering Compendex). 42 Studies were identified and assessed via qualitative categorization, and qualitative metrics. The studies were divided into 6 prominent research themes, nl: Learning factories, Gamification & Virtual Reality (VR), Internal company policy and Human resource development (HRD), government policy and economic incentive, High level evaluation of industry 4.0 readiness, and industry impact assessments. Additionally, the most prominent research methods employed throughout were interviews, surveys, literature reviews, case studies, new technology evaluations, and data analytics. The review concluded that though this research avenue is still emerging, it is growing fast. Multiple countries are already at the forefront of research in the sustainable adoption of the 4th industrial revolution into the manufacturing sector, and this review aims to summarize their efforts for ease of repeatability within future research. Copyright © 2021 by Naudé Scribante. Permission granted to IAMOT to publish and use.

Implementing a culturally-appropriate biospecimen collection protocol during the COVID-19 pandemic to address cervical cancer disparities among Native American women

Background: Native American women experience twice the rate and mortality of cervical cancer compared to nonHispanic white women. This cervical cancer disparity is primarily attributed to a lack of screening and unequal access to healthcare. While infection with high-risk HPV genotypes is a well-established risk factor for cervical cancer, there are likely other factors within the local microenvironment that contribute to cervical carcinogenesis. Therefore, the goal of the pilot project is to address the role of the vaginal microbiome (VMB) and inflammation in cervical cancer pathogenesis among Native American women. In 2019, we partnered with the Native Americans for Community Action (NACA) clinic to implement a culturally-appropriate biospecimen protocol. Unfortunately, the COVID-19 pandemic caused NACA and many clinics nation-wide to limit in-patient services or transition to 100% telehealth. As such, preventative care such as breast and cervical cancer screenings were not conducted during the annual well women's exam. Another hurdle in our pilot project included the resignation of the trained nurse in consenting, enrollment, collection and storage at NACA. Therefore, we needed to quickly adapt to accommodate the clinic's COVID-19 restrictions and train a new nurse on the biospecimen collection protocol. Methods: Adjustments to the protocol included vaginal self-collection rather than physician collection of samples. We also provided new clinic staff a “virtual in-service training” to review all required documents (recruitment, consenting, sample collection, gift cards, specimen storage, etc.). Recruitment was slow during the early stage of the COVID-19 vaccine roll out. Therefore, we developed culturally tailored recruitment flyers that were distributed over social media. In addition, we developed a culturally appropriate video on the significance of the well women's exam through collaboration with the NACA clinic and researchers at the partnership for Native American Cancer Prevention (NACP) that will be disseminated in the upcoming weeks. All amendments were approved by the clinic leadership and appropriate institutional review boards (IRBs). Results: As COVID-19 restrictions lifted, the NACA staff was prepared to immediately begin recruitment. Thus far, the NACA staff successfully enrolled (n=25) participants since March 2020 with survey data entered into REDCap. With continued recruitment efforts and launch of the video, we aim to have at least 50% of participants enrolled by Fall 2021. Survey data analyses are in-progress with expected completion by Spring 2022. Conclusion: In summary, the continued efforts by the NACA staff and research team resulted in successful recruitment for the pilot study during the COVID-19 pandemic. This study will set the foundation to evaluate the role of the VMB and HPV-mediated cancer in Native American women.

Preferences of speech and language therapists for telepractice in the COVID-19 pandemic and factors affecting their acceptance of the delivery model

Objectives: With the COVID-19 pandemic, telepractice became a great option in speech-language therapy services, as in many healthcare utilities. However, the transition to this service model did not occur at a similar rate for every clinician. Therefore, this study aimed to determine the experiences, preferences and factors affecting the acceptance of speech-language therapists (SLT) regarding telepractice in Turkey. Methods: Sixty-seven SLTs were presented with a questionnaire that addressed the professional tendencies, experiences and views on telepractice of them. Descriptive statistics regarding the preferences and experiences of SLTs were calculated. Moreover, factors that might be related to the number of sessions they held at the pandemic were examined with the Chi-squared test. Results: The speech-language disorders that SLTs find the most suitable for telepractice were fluency disorders, voice disorders and speech sound disorders. Groups that SLTs deemed most suitable for receiving telepractice in terms of age were 12-21, 22-64 and 7-11, respectively. A significant relationship was found between the frequency of online meetings and telepractice sessions before the pandemic and the number of sessions during the pandemic. Furthermore, a significant relationship also was found between satisfaction with using clinician skills in telepractice and the number of telepractice sessions during the pandemic. Conclusions: The importance of the first experiences of SLTs in the acceptance of the delivery method emerged. The necessity of in-service trainings and exemplary models to improve attitudes emerged. With these trainings, ensuring security, standardizing practices and increasing qualified services will be provided as well.