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1.
JMIR Res Protoc ; 11(11): e40286, 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2109567

ABSTRACT

BACKGROUND: Colombia has a long history of an armed conflict that has severely affected communities with forced internal displacement and violence. Victims of violence and armed conflicts have higher rates of mental health disorders, and children and adolescents are particularly affected. However, the mental health needs of this population are often overlooked, especially in low- and middle-Income countries, where scarcity of resources exacerbates the problem that has been further compounded by the global COVID-19 pandemic. Thus, special attention should be paid to the development of interventions that target this population. OBJECTIVE: Our research aims to adapt an existing patient-centered digital intervention called DIALOG+ from a clinical setting to an educational setting using stakeholders' (teachers' and students') perspectives. We aim to evaluate the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for the identification and mobilization of personal and social resources to mitigate the impact of social difficulties and to promote mental well-being. METHODS: We will conduct an exploratory mixed methods study in public schools of postconflict areas in Tolima, Colombia. The study consists of 3 phases: adaptation, exploration, and consolidation of the DIALOG+ tool. The adaptation phase will identify possible changes that the intervention requires on the basis of data from focus groups with teachers and students. The exploration phase will be an exploratory cluster randomized trial with teachers and school counselors to assess the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in school settings. Adolescents' data about mental health symptoms and wellness will be collected before and after DIALOG+ implementation. During this phase, teachers or counselors who were part of the intervention group will share their opinions through the think-aloud method. Lastly, the consolidation phase will consist of 2 focus groups with teachers and students to discuss their experiences and to understand acceptability. RESULTS: Study recruitment was completed in March 2022, and follow-up is anticipated to last through November 2022. CONCLUSIONS: This exploratory study will evaluate the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in postconflict school settings in Colombia. The use of this technology-supported tool aims to support interactions between teachers or counselors and students and to provide an effective student-centered communication guide. This is an innovative approach in both the school and the postconflict contexts that could help improve the mental health and wellness of adolescents in vulnerable zones in Colombia. Subsequent studies will be needed to evaluate the effectiveness of DIALOG+ in an educational context as a viable option to reduce the gap and inequities of mental health care access. TRIAL REGISTRATION: ISRCTN Registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374?q=ISRCTN14396374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40286.

2.
BMC Prim Care ; 23(1): 277, 2022 11 08.
Article in English | MEDLINE | ID: covidwho-2108744

ABSTRACT

BACKGROUND: Chagas is a public health problem, especially in Latin America, exacerbated by migratory movements and increasing urbanization. Argentina is among the countries with the highest estimated prevalence in the region, with 1,500,000 people infected, with mother to child as the main mode of transmission. Vertical transmission has been significantly reduced by treating women of childbearing age; several guidelines in the region recommend treatment as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Despite recommendations, women of childbearing age are not always treated, and children do not receive timely diagnosis and treatment. The objective of this research was to design an implementation strategy to improve using Chagas guidelines focused on attending women of childbearing age and children at the primary healthcare level and pilot it in three primary health care centers in Argentina. METHODS: We conducted a pilot feasibility study using the Consolidated Framework for Implementation Research. A qualitative process evaluation was conducted using semi-structured interviews with health care providers and observations in primary health care centers. RESULTS: We developed a multifaceted implementation strategy including training, flowcharts and reminders, a register of suspected and confirmed cases, and the selection of a management facilitator. The pilot study took place between September 2019 and May 2020. The implementation level was heterogeneous and varied depending on the components, being the facilitating factors, the simplicity of the intervention, professionals' willingness to expand the indication of serologic tests, and staff commitment to the adoption of intervention components. The main barriers found were the change of authorities at the local level, some professionals´ reluctance to administer etiological treatment, staff shortages, lack of diagnostic supplies, and the health emergency caused by the COVID-19 pandemic. CONCLUSIONS: Behavioral change strategies should be applied to improve implementation to address some of the main barriers, including support actions offered by opinion leaders, medical experts, and local health authorities. Rapid diagnostic tests should be readily available to maintain behavior changes. We suggest further refinement of the strategy and its implementation in more centers to assess outcomes prospectively with a hybrid implementation research design.


Subject(s)
COVID-19 , Pandemics , Child , Female , Humans , Pilot Projects , Feasibility Studies , COVID-19/epidemiology , Argentina/epidemiology , Infectious Disease Transmission, Vertical , Primary Health Care
3.
Int Urogynecol J ; 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2103855

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Telemedicine has been recommended for the management of urogynecological conditions during the coronavirus (COVID 19) pandemic. This study aimed to evaluate the feasibility of telemedicine for urogynecology at a Brazilian public hospital. METHODS: A descriptive observational study was performed at a urogynecology outpatient clinic. The primary outcome was the desire to continue with telemedicine. Secondary outcomes were appointment resolvability, technical aspects of the appointment, and patient satisfaction. The participants had in-person appointments that were canceled because of the COVID-19 pandemic. We collected data on sociodemographic characteristics and clinical and technical aspects of the appointments. The participants responded to satisfaction questionnaires 7-15 days post-procedure. The categorical variables were evaluated based on absolute and relative frequency. The continuous variables were described as the mean and standard deviation. A chi-square test was performed to determine the association between variables. RESULTS: In total, 225 patients had appointments canceled due to the COVID-19 pandemic, of which 171 were eligible for the study. Telemedicine appointments were agreed upon by 48% of the participants and 85.5% responded to the satisfaction survey. We found that 57.7% of the participants desired to continue with telemedicine. The appointment resolvability rate was 76.1%, 63.4% of the appointments met the technical criteria, and the satisfaction rate was 93%. The only variable associated with the desire to continue telemedicine was overall patient satisfaction (p=0.02). CONCLUSIONS: Telemedicine in urogynecology is feasible and can be implemented in the studied population. However, actions are essential to adequately support patient preference and improve the acceptance of telemedicine.

4.
Niger Postgrad Med J ; 29(4): 288-295, 2022.
Article in English | MEDLINE | ID: covidwho-2100050

ABSTRACT

Introduction: The challenges posed by the COVID-19 pandemic have necessitated the increasing use of online virtual training platforms. The objectives of the study were to assess the acceptability, appropriateness and feasibility of virtual space in strengthening the research capacity in Nigeria. Materials and Methods: Data were collected through an adapted online questionnaire from participants following a 2-day webinar. Both descriptive and inferential (bivariate and multivariate) analyses were done. Results: The findings of the study revealed that 55.2% of participants (n = 424) were males and 66.0% (n = 424) were early career researchers. Two hundred and thirty-six participants (55.7%) (n = 424) reported very good acceptability, 67.9% (n = 424) reported very good appropriateness while 54.7% (n = 424) reported good feasibility of webinar for research capacity strengthening. The rating of knowledge obtained from the webinar as 'excellent' increased the odds of acceptability (odd ratio [OR] = 38.30; P < 0.001), appropriateness (OR = 15.65; P < 0.05), and feasibility (OR = 20.85; P < 0.05). Furthermore, the preference for zoom and other online platforms for learning increased odds of acceptability of the webinar (OR = 2.29; confidence interval [CI]: 0.97-57.39; P < 0.05), appropriateness (OR = 2.55; CI: 1.10-5.91; P < 0.05) and feasibility (OR = 2.34; CI: 0.96-5.74; P < 0.05). Conclusion: The study concluded that webinar was acceptable, appropriate and feasible for strengthening research capacity, although poor internet connectivity and cost of data were the major challenges in Nigeria. However, a learner-centred approach in contents' delivery that ensures optimal learning has the potential of enhancing research capacity strengthening via virtual space.


Subject(s)
COVID-19 , Male , Humans , Female , Nigeria , Pandemics/prevention & control , Feasibility Studies , Surveys and Questionnaires
5.
JMIR Form Res ; 6(11): e38460, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2098992

ABSTRACT

BACKGROUND: Psychiatric inpatients often have limited access to psychotherapeutic education or skills for managing anxiety, a common transdiagnostic concern in severe and acute mental illness. COVID-19-related restrictions further limited access to therapy groups on inpatient psychiatric units. App-based interventions may improve access, but evidence supporting the feasibility of their use, acceptability, and effectiveness in psychiatric inpatient settings is limited. MindShift CBT is a free app based on cognitive behavioral therapy principles with evidence for alleviating anxiety symptoms in the outpatient setting. OBJECTIVE: We aimed to recruit 24 participants from an acute general psychiatric inpatient ward to a 1-month randomized control study assessing the feasibility and acceptability of providing patients with severe and acute mental illness access to the MindShift CBT app for help with managing anxiety symptoms. METHODS: Recruitment, data collection, analysis, and interpretation were completed collaboratively by clinician and peer researchers. Inpatients were randomized to two conditions: treatment as usual (TAU) versus TAU plus use of the MindShift CBT app over 6 days. We collected demographic and quantitative data on acceptability and usability of the intervention. Symptoms of depression, anxiety, and psychological distress were measured in pre- and poststudy surveys for preliminary signals of efficacy. We conducted individual semistructured interviews with participants in the MindShift CBT app group at the end of their trial period, which were interpreted using a standardized protocol for thematic analysis. RESULTS: Over 4 weeks, 33 inpatients were referred to the study, 24 consented to participate, 20 were randomized, and 11 completed the study. Of the 9 randomized participants who did not complete the study, 7 were withdrawn because they were discharged or transferred prior to study completion, with a similar distribution among both conditions. Among the enrolled patients, 65% (13/20) were admitted for a psychotic disorder and no patient was admitted primarily for an anxiety disorder. The average length of stay was 20 days (SD 4.4; range 3-21) and 35% (7/20) of patients were involuntarily admitted to hospital. Small sample sizes limited accurate interpretation of the efficacy data. Themes emerging from qualitative interviews included acceptability and usability of the app, and patient agency associated with voluntary participation in research while admitted to hospital. CONCLUSIONS: Our study benefitted from collaboration between peer and clinician researchers. Due to rapid patient turnover in the acute inpatient setting, additional flexibility in recruitment and enrollment is needed to determine the efficacy of using app-based psychotherapy on an acute psychiatric ward. Despite the limited sample size, our study suggests that similar interventions may be feasible and acceptable for acutely unwell inpatients. Further study is needed to compare the efficacy of psychotherapeutic apps with existing standards of care in this setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT04841603; https://clinicaltrials.gov/ct2/show/NCT04841603.

6.
Int J Environ Res Public Health ; 19(21)2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2090162

ABSTRACT

The COVID-19 pandemic brought negative consequences such as social isolation and limited access to health services, especially for older adults. The objective was to evaluate effects of an online exercise training program and physical fitness and health-related variables on Brazilian older adults during the COVID-19 pandemic and secondarily to assess the feasibility and application of an online program. A study was developed with twenty older adults who participated in a 9-month online exercise program. The physical fitness, depressive symptoms, concern about falling, and quality of life were assessed pre- and post-intervention. One-way repeated measures ANOVA and effect size was used. The feasibility was proven by the adherence to the program, in addition to the absence of identification of adverse effects. The results showed that physical fitness was improved (upper limb strength) or maintained (lower limb strength, lower and upper limb flexibility, cardiorespiratory fitness), as well as for most of the health-related variables (depressive symptoms, concern about falling, and quality of life domains). The study was developed in the first COVID-19 lockdown in Brazil, but positive and important results were obtained. This research supports the feasibility of the online exercise training program and provides a basis for an online exercise program for older adults.


Subject(s)
COVID-19 , Humans , Aged , Feasibility Studies , Brazil/epidemiology , COVID-19/epidemiology , Quality of Life , Pandemics/prevention & control , Communicable Disease Control , Physical Fitness , Exercise , Exercise Therapy/methods
7.
Int J Popul Data Sci ; 6(3): 1711, 2021.
Article in English | MEDLINE | ID: covidwho-2081358

ABSTRACT

Introduction: In summer 2021, as rates of COVID-19 decreased and social restrictions were relaxed, live entertainment and sporting events were resumed. In order to inform policy on the safe re-introduction of spectator events, a number of test events were organised in Wales, ranging in setting, size and audience. Objectives: To design and test a method to assess whether test events were associated with an increase in risk of confirmed COVID-19, in order to inform policy. Methods: We designed a cohort study with fixed follow-up time and measured relative risk of confirmed COVID-19 in those attending two large sporting events. First, we linked ticketing information to individual records on the Welsh Demographic Service (WDS), a register of all people living in Wales and registered with a GP, and identified NHS numbers for attendees. Where NHS numbers were not found we used combinations of other identifiers such as email, name, postcode and/or mobile number. We then linked attendees to routine SARS-CoV-2 test data to calculate positivity rates in people attending each event for the period one to fourteen days following the event. We selected a comparison cohort from WDS for each event, individually matched by age band, gender and locality of residence. As many people attended events in family groups we explored the possibility of also matching on household clusters within the comparison group. Risk ratios were then computed for the two events. Results: We successfully assigned NHS numbers to 91% and 84% of people attending the two events respectively. Other identifiers were available for the remainder. Only a small number of attendees (<10) had a record of confirmed COVID-19 following attendance at each event (14 day cumulative incidence: 36 and 26 per 100,000, respectively). There was no evidence of significantly increased risk of COVID-19 at either event. However, the event that didn't include pre-event testing in their mitigations, had a higher risk ratio (3.0 compared to 0.3). Conclusions: We demonstrate the potential for using population data science methods to inform policy. We conclude that, at that point in the epidemic, and with the mitigations that were in place, attending large outdoor sporting events did not significantly increase risk of COVID-19. However, these analyses were carried out between epidemic waves when background incidence and testing rate was low, and need to be repeated during periods of greater transmission. Having a mechanism to identify attendees at events is necessary to calculate risk and feasibility and acceptability of data sharing should be considered.


Subject(s)
COVID-19 , Epidemics , COVID-19/epidemiology , Cohort Studies , Data Science , Humans , SARS-CoV-2
8.
J Pediatr Psychol ; 2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2077801

ABSTRACT

OBJECTIVE: To assess the feasibility and acceptability of an online parenting-skills program for caregivers of young children with traumatic brain injury (TBI). Positive parenting contributes to recovery following early TBI and social and emotional development in typically developing children. Yet, few interventions have been designed to support psychosocial recovery and subsequent development after early TBI. METHODS: This study protocol was registered with clinicaltrials.gov (NCT05160194). We utilized an academic hospital's Trauma Registry to recruit caregivers of children, ages 0-4 years, previously hospitalized for TBI. The GROW intervention integrated six online learning modules with videoconference meetings with a coach to review and practice skills while receiving in vivo coaching and feedback. Interactive modules addressed strategies for responsive parenting, stimulating cognition, and managing parenting stress. Enrollment and retention rates served as feasibility metrics and satisfaction surveys assessed acceptability. RESULTS: 18 of 72 families contacted (25%) consented, and 11 of 18 (61%) completed the intervention and follow-up assessments. All participants rated the intervention as helpful and indicated that they would recommend the intervention to others. All endorsed a better understanding of brain injury and how to optimize their child's recovery and development. Both coaches rated intervention delivery as comparable to traditional face-to-face treatment. CONCLUSIONS: Low levels of uptake and initial engagement underscore the challenges of intervening with caregivers following early TBI, which likely were exacerbated due to the COVID-19 pandemic. High levels of acceptability and perceived benefit support the potential utility of GROW while highlighting the need to improve accessibility and early engagement.

9.
Cureus ; 14(9): e29329, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2072213

ABSTRACT

Digital mental health interventions (DMHIs) have the potential to serve a significantly wider portion of the population in need of mental health services. The coronavirus disease 2019 (COVID-19) pandemic has especially highlighted the exacerbation of mental health disparities among minoritized populations. Innovations and research on DMHIs continue to expand, reinforcing the need for a more systemic process of DMHI implementation. In practice, DMHI implementation often skips the fundamental steps of conducting acceptability and feasibility studies. We propose a DMHI implementation framework that identifies an acceptability and feasibility study as an essential first step, simultaneously centering equitable processes that address populations disproportionately affected by mental illness.

10.
Open Forum Infect Dis ; 9(9): ofac459, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2070155

ABSTRACT

Longitudinal virological and serological surveillance is essential for understanding severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) transmission among children but requires increased test capacity. We assessed the uptake of serial at-home testing in children (2-17 years) via mailed SARS-CoV-2 antibody and molecular tests. Completion rates demonstrated the feasibility and sustainability of at-home testing across age groups.

11.
J Clin Med ; 11(19)2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2066172

ABSTRACT

Suicide risk is a multifaceted phenomenon, and many risk factors are involved in its complexity. In the last few decades, mental health apps have spread, providing economic and affordable strategies to prevent suicide. Therefore, the aim of this review is to identify original studies on mobile apps that target suicidal crises. The review follows PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, PsycInfo and Web of Science) for relevant titles/abstracts published from January 2010 to May 2022. It includes original studies that explicitly analyze mobile apps for suicide prevention. A total of 32 studies met the inclusion criteria. Sixteen studies assessed the feasibility and acceptability of mobile apps, ten studies assessed the efficacy of mobile apps in preventing suicide, and six studies described randomized control trial protocols not yet implemented. Generally, the apps were judged by participants to be acceptable and helpful, and several improvements to enhance the functionality of apps were suggested. The efficacy of mobile apps, although limited and assessed with very heterogenous methods, was confirmed by most of the studies. Mobile apps could represent a helpful supplement to traditional prevention tactics, providing real-time monitoring of at-risk persons, personalized tools to cope with suicidal crises, and immediate access to specific support.

12.
Int J Environ Res Public Health ; 19(19)2022 Oct 05.
Article in English | MEDLINE | ID: covidwho-2066044

ABSTRACT

Protective factors that build students' resilience are known. A six-week digital resilience training program was developed on the basis of theory, evidence, and contextual information. The feasibility study sought to evaluate the acceptability, appropriateness, demand, implementation, and limited efficacy of a digital resilience skills enhancement program for undergraduate students. A single group, pre-test, post-test, concurrent mixed methods design among 10 undergraduate students was conducted in one university in Singapore. The content analysis concluded that students accepted and perceived the digital resilience skills enhancement program as appropriate. Students also proposed several improvements, such as the initiation of the program and revisions to the content. The Wilcoxon signed-rank test found significant improvements in resilience (p = 0.02) and meta-cognitive self-regulation (p = 0.01) scores with medium (d = 0.79, 95% CI: -0.15 to 1.74) and very large effect sizes (d = 1.31, 95% CI: 0.30-2.33), respectively. Students found the digital resilience program appropriate and were able to apply their newly acquired skills to promote their resilience and learning. Although, several improvements are proposed to enhance the rigor of the digital resilience program, the findings of this study suggests that digital resilience programs are important for students' well-being.


Subject(s)
Learning , Students , Humans , Program Evaluation , Singapore , Students/psychology , Universities
13.
JMIR Ment Health ; 9(10): e37968, 2022 Oct 07.
Article in English | MEDLINE | ID: covidwho-2065309

ABSTRACT

BACKGROUND: Common mental health disorders (CMDs) are leading causes of disability globally. The ongoing COVID-19 pandemic has further exacerbated the burden of CMDs. COVID-19 containment measures, including lockdowns, have disrupted access to in-person mental health care. It is therefore imperative to explore the utility of digital mental health interventions to bridge the treatment gap. Mobile health technologies are effective tools for increasing access to treatment at a lower cost. This study explores the utility of Inuka, a chat-based app hinged on the Friendship Bench problem-solving therapy intervention. The Inuka app offers double anonymity, and clients can book or cancel a session at their convenience. Inuka services can be accessed either through a mobile app or the web. OBJECTIVE: We aimed to explore the feasibility of conducting a future clinical trial. Additionally, we evaluated the feasibility, acceptability, appropriateness, scalability, and preliminary effectiveness of Inuka. METHODS: Data were collected using concurrent mixed methods. We used a pragmatic quasiexperimental design to compare the feasibility, acceptability, and preliminary clinical effectiveness of Inuka (experimental group) and WhatsApp chat-based counseling (control). Participants received 6 problem-solving therapy sessions delivered by lay counselors. A reduction in CMDs was the primary clinical outcome. The secondary outcomes were health-related quality of life (HRQoL), disability and functioning, and social support. Quantitative outcomes were analyzed using descriptive and bivariate statistics. Finally, we used administrative data and semistructured interviews to gather data on acceptability and feasibility; this was analyzed using thematic analysis. RESULTS: Altogether, 258 participants were screened over 6 months, with 202 assessed for eligibility, and 176 participants were included in the study (recruitment ratio of 29 participants/month). The participants' mean age was 24.4 (SD 5.3) years, and most participants were female and had tertiary education. The mean daily smartphone usage was 8 (SD 3.5) hours. Eighty-three users signed up and completed at least one session. The average completion rate was 3 out of 4 sessions. Inuka was deemed feasible and acceptable in the local context, with connectivity challenges, app instability, expensive mobile data, and power outages cited as potential barriers to scale up. Generally, there was a decline in CMDs (F2,73=2.63; P=.08), depression (F2,73=7.67; P<.001), and anxiety (F2,73=2.95; P=.06) and a corresponding increase in HRQoL (F2,73=7.287; P<.001) in both groups. CONCLUSIONS: Study outcomes showed that it is feasible to run a future large-scale randomized clinical trial (RCT) and lend support to the feasibility and acceptability of Inuka, including evidence of preliminary effectiveness. The app's double anonymity and structured support were the most salient features. There is a great need for iterative app updates before scaling up. Finally, a large-scale hybrid RCT with a longer follow-up to evaluate the clinical implementation and cost-effectiveness of the app is needed.

14.
Sustainability ; 14(19):11890, 2022.
Article in English | ProQuest Central | ID: covidwho-2066376

ABSTRACT

The role of entrepreneurship has transformed to include issues beyond economic growth. This has twisted attention toward the drivers of entrepreneurial intentions across entrepreneurship types, particularly in sustainable entrepreneurship. Sustainable entrepreneurship is essential and a protagonist tool in protecting the environment, economy and society. This ensures employment opportunities, solves environmental problems and facilitates social and economic development. Keeping into consideration, the present study attempts to investigate sustainable entrepreneurial intention through Attitudes toward Sustainability (ATS), Perceived Desirability (PED), Perceived Feasibility (PEF) and Opportunity Recognition (OR) among Saudi Arabia’s university students. We employed the quantitative approach and used a survey questionnaire to obtain the responses from the respondents. We targeted the students of different public sector universities in Saudi Arabia using a random sampling technique. Finally, we utilized 292 valid samples to infer the results. Utilizing the Structural Equation Model (SEM) through analysis of moment structures (AMOS), we found a positive and significant effect of Attitudes towards Sustainability (ATS), Perceived Desirability (PED) and Perceived Feasibility (PEF) on Sustainable Entrepreneurial Intentions (SEI) and Opportunity Recognition (OR). This study provides valuable insights into the entrepreneurship domain and offers guidelines for policymakers and planners in shaping the policies that promote entrepreneurial sustainability and employment in Saudi Arabia. Moreover, the OR factor also significantly and positively affects SEI. Finally, the study’s findings would contribute to the literature review by adding another empirical confirmation from Saudi Arabian students’ viewpoint.

15.
Slovak Journal of Civil Engineering ; 30(3):33-42, 2022.
Article in English | ProQuest Central | ID: covidwho-2065375

ABSTRACT

This study is focused on the feasibility of using energy performance contracting (EPC) for the retrofit of two apartment buildings constructed using precast concrete technologies in Slovakia decades ago. The retrofit packages were defined, and their suitability for EPC was evaluated through discounted payback. The uncertainties in the profitability calculations were covered by designing five possible economic developments and defining input ranges instead of just single inputs. The measures in the technical systems were shown to be more feasible than the retrofit of the building envelopes. The potential to finance the selected measures for technical systems through EPC was further evaluated. It was shown that, for at least one of the two buildings studied, the EPC was recommended only for the economic developments with a notable increase in energy prices compared to the baseline that referred to the situation before the Covid-19 pandemic. In the best case, the payback was four years for one building and seven years for the other;thus, both were potentially suitable for EPC. However, for a complex retrofit, the EPC must be combined with a different funding source to also finance other retrofit measures.

16.
Wireless Communications & Mobile Computing (Online) ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-2064323

ABSTRACT

Contactless authentication is crucial to keep social distance and prevent bacterial infection. However, existing authentication approaches, such as fingerprinting and face recognition, leverage sensors to verify static biometric features. They either increase the probability of indirect infection or inconvenience the users wearing masks. To tackle these problems, we propose a contactless behavioral biometric authentication mechanism that makes use of heterogeneous sensors. We conduct a preliminary study to demonstrate the feasibility of finger snapping as a natural biometric behavior. A prototype-SnapUnlock system was designed and implemented for further real-world evaluation in various environments. SnapUnlock adopts the principle of contrastive-based representation learning to effectively encode the features of heterogeneous readings. With the representations learned, enrolled samples trained with the classifier can achieve superior performances. We extensively evaluate SnapUnlock involving 50 participants in different experimental settings. The results show that SnapUnlock can achieve a 4.2% average false reject rate and 0.73% average false accept rate. Even in a noisy environment, our system performs similar results.

17.
Archives of Disease in Childhood ; 107(Supplement 2):A395-A396, 2022.
Article in English | EMBASE | ID: covidwho-2064051

ABSTRACT

Aims Due to public health measures, such as social distancing, reductions of patient admissions and resulting lack of teaching opportunities, medical students' time spent on, and intensity of, paediatric placements was severely impacted. A mentorship program at Sheffield Children's Hospital (SCH) was developed in response to restrictions to paediatric medical student placements during the first and second wave of the COVID-19 pandemic. Even in the absence of a pandemic, medical students report high levels of apprehension and anxiety around paediatric patient interactions, therefore, the need to supplement student learning, and to offer teaching opportunities, was paramount. The mentorship program was developed, following a needs assessment of medical students on placement, and delivered by volunteer junior doctors. In its pilot version, 28 took part and returned feedback. The feedback was implemented into a revised mentorship program, and delivered to a further two cohorts. Aims 1. Evaluate the acceptability of the revised mentorship program for medical students on paediatric placement. 2. Evaluate the efficacy of the revised mentorship program for medical students on paediatric placement. 3. Assess feasibility to deliver the mentorship program long-term, without the acute Covid-19 context. Methods Between September and November 2021, 24 medical students were on placement at SCH. All students received an email with an allocated mentor, which they were told to contact. The mentorship program follows a clear pro-forma, with the student and mentor meeting a number of times to complete the tasks in the pro-forma [ range of meetings 1-4, depending on availability]. The scheme was also meant to run in January 2022, with 15 students on placement at SCH, however, there were only four volunteer junior doctors, which meant the scheme was unable to run. At the end of the mentorship program, participants (mentors, mentees) completed an online questionnaire to collect feedback, assess acceptability, ascertain efficacy and feasibility of the mentorship program. Results Out of the 24 students, only nine (38%) returned questionnaires at the end of their placement, and only five mentors completed feedback questionnaires. The program was found to have good acceptability, with 78% of students strongly agreeing that it has been beneficial to have a junior doctor as a mentor. The feedback regarding efficacy was mixed, with some students indicating their felt confident in some areas but not others (especially neonatal medicine). Feasibility of delivering this scheme project is dependent on voluntary participation of mentors. Conclusion Due to medical students' apprehension regarding paediatric student placements, and lack of exposure due to Covid-19, this ongoing mentorship seeks to support medical students during this time. Results indicate good acceptability and moderate efficacy. However, the feasibility of the program is dependent on voluntary participation from paediatric trainees. Ongoing high levels of burnout, staffing pressures and lack of organizational structures encouraging mentor-mentee exchanges especially impacted mentor retention and recruitment. Results are limited due to small numbers of returned feedback, despite implementing easier processes of giving feedback for students.

18.
International Journal of Stroke ; 17(2 Supplement):31-32, 2022.
Article in English | EMBASE | ID: covidwho-2064675

ABSTRACT

Background: Despite similar motor recovery of limbs in research, clinically the lower limb is observed to demonstrate greater recovery than the upper limb (UL). Understanding the relation between the post-stroke rehabilitation experience in the hospital environment and neuroplasticity and motor recovery of the UL may provide insight into how to optimize the hospital and promote recovery. Aim(s): This feasibility study aimed to collect cross-sectional data from inpatients who were clinically receiving UL motor training within a rehabilitation hospital to determine the feasibility of our protocol as well as describe the factors and potential associations between motor performance and therapy participation, fatigue, stress and sleep. Method(s): Inpatients were recruited across two rehabilitation wards;inclusion criteria were broad (stroke diagnosis and clinically identified UL motor impairment). Therapy session duration and frequencies were recorded prior to assessing sleep quality and amount over one night (Actiwatch, Phillips Respironics, USA)). Participants rated their perceived fatigue (Fatigue Severity Scale-FSS) and sleep quality (Leeds Sleep Evaluation Questionnaire-LSEQ), and overnight nursing documentation of sleep was extracted from the medical record. Motor performance was assessed via the box and block test. All data were collected across a 24h period. Result(s): N=14 participants participated (age 71+/-11y) at a mean+/-SD 32+/-23 days post-stroke and 22+/-21 days since admission to rehabilitation. Participants received motor training 10+/-3 times per week, and sessions were 51+/-18min in length. Mean+/-SD sleep duration was 9.5+/-1.9h with 1.1+/-0.7h awake-time during the night. All participants reported fatigue, with mean FSS (37+/-16), and identified issues with respect to getting to sleep as well as quality of sleep on the LSEQ. All data were feasible to collect, however COVID restrictions and bed-numbers influenced recruitment rate. Conclusion(s): Findings provide key feasibility data to better understand targetable factors to optimise the post-stroke rehabilitation experience, neuroplasticity and UL motor recovery after stroke.

19.
International Journal of Stroke ; 17(2 Supplement):11, 2022.
Article in English | EMBASE | ID: covidwho-2064674

ABSTRACT

Background: Cardiac Rehabilitation (CR) is a multidisciplinary approach involving exercise training and health-related education routinely available to cardiac patients, but rarely offered to people with stroke. We have shown people with stroke can be integrated into centre-based CR, but due to access difficulties, opportunities for people with stroke to participate in centre-based CR are limited. Home-based CR is well-established for people with heart disease and offers an alternative for people with stroke who are unable to access centre-based rehabilitation. Aim(s): Investigate the safety and feasibility of home-based, telehealthdelivered, stroke-adapted CR. Method(s): A single-site, prospective-cohort safety and feasibility trial. People with ischaemic stroke were screened for eligibility and invited to participate in a six-week program of exercise and education delivered via telehealth to the participant in their own home following discharge from inpatient rehabilitation (i.e. <6-weeks post-stroke). Safety and feasibility were assessed by incidence of adverse events and measures of participant recruitment, retention, and adherence. Result(s): Ninety-five people with stroke were screened, 67 (70%) were eligible to participate, and 19 (28%) consented. Of the 28 that were ineligible to participate, the main reasons for exclusion were haemorrhagic stroke (53%), nil medical clearance (18%), and nil acute stroke (14%). Of the 48 eligible participants that did not consent, 45% were not included due to the impact of COVID-19, 20% were discharged prior to being approached to participate, and 12% did not consent due to a lack of time. Three participants dropped out of the study prior to commencing the outpatient intervention. The remaining 16 participants completed the six-week intervention. Positive written and verbal feedback was received from participants on the appropriateness of the intervention. Conclusion(s): COVID-19 significantly impacted our capacity to recruit participants to this trial. Preliminary data suggests home-based, telehealthdelivered, stroke-adapted CR is safe and potentially feasible in early subacute stroke.

20.
Clinical Toxicology ; 60(Supplement 2):145-146, 2022.
Article in English | EMBASE | ID: covidwho-2062730

ABSTRACT

Background: The Coronavirus disease 2019 pandemic led to unprecedented changes to medical education as educators adapted to a world necessitating precautions and social distancing. In response to the pandemic, the Emergency Medicine Residents' Association (EMRA) committees' educational programming in association with the American College of Emergency Physicians 2020 Scientific Assembly (ACEP20), initially scheduled to be held in Dallas, TX, between October 26-29, 2020, transitioned to a fully virtual conference. Escape rooms have become popular recreational activities over the last several years. In-person escape rooms are structured around working in teams to solve a series of puzzles in a fictional scenario that allows participants to "escape" the room upon completion. The teamwork and problem-solving skills utilized in escape rooms lend themselves to use in medical education. The traditional in-person escape room format has previously been applied to toxicology for the purposes of providing engaging toxicology education to emergency medicine (EM) residents. Method(s): The researchers developed and led the first nationwide virtual toxicology escape room during ACEP20 using the Zoom platform. The activities consisted of one web-portal linking to a sequence of four Google Forms multiple-choice question quizzes and four games made on Wordwall.net, a virtual educational activity creator. Six teams of 5 residents and medical students from residency programs across the country registered and participated for a total of 30 participants. Teams were split into Zoom breakout rooms, each moderated by at least one medical toxicologist and/or medical toxicology fellow. A survey was sent to participants to assess their overall experience with the activity. Result(s): Every team completed all eight activities within 45 min. This activity demonstrates the feasibility of a large-scale, realtime competitive virtual escape room to engage participants and deliver toxicology education. The lessons learned from exploring virtual sessions like this one will be valuable tools in the future of medical education. Ten participants completed the survey. 80% of respondents reported that the event increased their interest in toxicology. 90% agreed that the format was easy to navigate, instructions were clear, questions were understandable, and toxicologists were well utilized in the event. Conclusion(s): Toxicology-themed escape rooms have potential as virtual activities to educate EM residents on essential toxicology knowledge. While the small survey response rate limits the generalizability of this data, these initial results are promising and suggest that virtual escape rooms may be a viable option for increasing interest in toxicology among resident physicians.

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