Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial.

BACKGROUND: Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. OBJECTIVE: This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. SETTING: The study will be implemented in a community setting in three Canadian cities. PARTICIPANTS: Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. INTERVENTION: Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75-150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants' training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. MEASUREMENTS: Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. IMPACT STATEMENT: We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.

The sourcing and use of high physical resemblance personal protective equipment to train healthcare workers, improve confidence and conserve medical-grade equipment.

Personal protective equipment (PPE) is essential for healthcare worker (HCW) safety. Conservation of PPE for clinical use during the COVID-19 pandemic reduced its availability for training, necessitating an innovative approach to sourcing high physical resemblance PPE (HPR-PPE). We present a case study of crowd-sourcing of HPR-PPE to train HCWs. Survey results indicated that HPR-PPE enabled high-fidelity practise of PPE application and removal, aided procedure recall, improved user confidence and was sufficiently similar to medical-grade PPE. HPR-PPE provided a novel and cost-effective alternative. We also demonstrated that medical-grade PPE can be sourced from non-medical institutions and businesses during a pandemic.

Social Stigma: The Hidden Threat of COVID-19.

COVID-19 infection has been recognized as a pandemic by the World Health Organization. Efforts to prevent the spread of the disease are threatened by the appearance of disease-associated social stigma in society. In Egypt, a small wave of stigma directed at different groups started to appear. Here we report the features of COVID-19-associated stigma in Egypt and suggest recommendations to overcome this stigma before it grows and have physical and psychological impacts on society.

The Pandemic: Lessons for Bioethics?

Seeking useful ways to respond to the Covid-19 pandemic, bioethicists have been tempted to claim for themselves what Alasdair MacIntyre characterized in After Virtue as the moral fiction of managerial expertise. They have been eager to offer a wide range of policy prescriptions, presenting themselves as bureaucratic managers and suggesting an expertise that bioethics may not in fact be able to offer. This was evident, for example, in the petition published by The Hastings Center in March 2020. The pandemic could foster a more hopeful future for bioethics if it were to focus attention less on policy decisions that belong to all citizens and more on some of the most basic moral questions that life presents and with which bioethics has always dealt-including, surely, the virtues needed in order to live well in a time of pandemic.