Nationwide, large-scale implementation of an online system for remote entry of patient-reported outcomes in rheumatology: characteristics of users and non-users and time to first entry.

AIMS: In May 2020, a nationwide, web-based system for remote entry of patient-reported outcomes (PROs) in inflammatory rheumatic diseases was launched and implemented in routine care (DANBIO-from-home). After 1.5 years of use, we explored clinical characteristics of patients who did versus did not use the system, and the time to first entry of PROs. METHODS: All patients followed in DANBIO were informed about DANBIO-from-home by electronic invitations or when attending their clinic. Characteristics of patients who did/did not use DANBIO-from-home in the period after implementation were explored by multivariable logistic regression analyses including demographic and clinical variables (gender, age group, diagnosis, disease duration, use of biological disease-modifying agent (bDMARD), Health Assessment Questionnaire (HAQ), Patient Acceptable Symptom Scale (PASS)). Time from launch to first entry was presented as cumulative incidence curves by age group (<40/40-60/61-80/>80 years). RESULTS: Of 33 776 patients, 68% entered PROs using DANBIO-from-home at least once. Median (IQR) time to first entry was 27 (11-152) days. Factors associated with data entry in multivariate analyses (OR (95% CI)) were: female gender (1.19 (1.12 to 1.27)), bDMARD treatment (1.41 (1.33 to 1.50)), age 40-60 years (1.79 (1.63 to 1.97)), 61-80 years (1.87 (1.70 to 2.07), or age >80 years (0.57 (0.50 to 0.65)) (reference: age <40 years), lower HAQ (0.68 (0.65 to 0.71)) and PASS 'no' (1.09 (1.02 to 1.17). Diagnosis was not associated. Time to first entry of PROs was longest in patients <40 years of age (119 (24-184) days) and shortest in the 61-80 years age group (25 (8-139) days). CONCLUSION: A nationwide online platform for PRO in rheumatology achieved widespread use. Higher age, male gender, conventional treatment and disability were associated with no use.

Pilot trial comparing COVID-19 publication database to conventional online search methods.

BACKGROUND AND OBJECTIVES: Literature review using search engines results in a list of manuscripts but does not provide the content contained in the manuscripts. Our goal was to evaluate user performance-based criteria of concept retrieval accuracy and efficiency using a new database system that contained information extracted from 1000 COVID-19 articles. METHODS: A sample of 17 students from the University of Vermont were randomly assigned to use the COVID-19 publication database or their usual preferred search methods to research eight prompts about COVID-19. The relevance and accuracy of the evidence found for each prompt were graded. A Cox proportional hazards' model with a sandwich estimator and Kaplan-Meier plots were used to analyse these data in a time-to-correct answer context. RESULTS: Our findings indicate that students using the new information management system answered significantly more prompts correctly and, in less time, than students using conventional research methods. Bivariate models for demographic factors indicated that previous research experience conferred an advantage in study performance, though it was found to be independent from the assigned research method. CONCLUSIONS: The results from this pilot randomised trial present a potential tool for more quickly and thoroughly navigating the literature on expansive topics such as COVID-19.

Chilean spanish transcultural adaptation of CAP-II and SIR scales in an online format for parents of children with hearing aids or cochlear implants / Adaptación transcultural al español chileno de las escalas CAP-II y SIR en formato online para padres de niños(as) con audífonos o implantes cocleares

La adquisición de lengua oral representa un desafío para niñas/os sordas/os o con pérdida auditiva (NSPA) que utilizan audífonos o implante coclear (CI). Tomar decisiones a tiempo durante el tratamiento con dispositivos es esencial y requiere de evaluaciones adecuadas. Dos instrumentos usados en la toma de decisiones son las escalas "Categories of Auditory Performance Index II" (CAP-II) y "Speech Intelligibility Rating Scale" (SIR). Estas escalas han mostrado ser útiles para la evaluación continua del desarrollo de habilidades auditivas y de la lengua oral en variados idiomas, pero estas no están disponibles para el español chileno. El objetivo de este estudio es crear traducciones en español chileno de las escalas CAP-II y SIR, las que puedan ser usadas como auto-reporte online por padres y cuidadores con el fin de asistir a profesionales en el monitoreo del progreso de niños/as NSPA, considerando las restricciones impuestas por el COVID-19. El método usado en el proceso comienza con la traducción de una propuesta de auto-reporte de las versiones originales en inglés de las escalas CAP-II y SIR. Finalmente, las versiones en español chileno fueron testeadas en 107 padres-cuidadores de niñas/os NSPA con CI. Los resultados sugieren que estos instrumentos serían adecuados para su uso en el contexto chileno.

Spoken language acquisition is challenging for very young deaf or hard-of-hearing children (DHH) who wear hearing aids or cochlear implants (CI). Timely decision-making for treatment is essential for these children and requires suitable assessments. Two such assessments are the Categories of Auditory Performance Index II (CAP-II) and the Speech Intelligibility Rating Scale (SIR). These have been shown to be helpful for the ongoing evaluation of developing speech perception and spoken language skills in various languages, but they are not available in Chilean Spanish. This study aimed to create a Chilean Spanish translation of the CAP-II and SIR, appropriate for online self-administration by parents-caregivers in Chile, to assist professionals in monitoring DHH children's progress, considering the COVID-19 restrictions. The methods used in the process started with translating a self-report proposal from the original English versions of the CAP-II and SIR scales. Finally, the Chilean Spanish versions were tested in 107 Chilean parents-caregivers of DHH children with CIs. The results suggest these instruments are suitable for use in a Chilean context.

Using group model building to frame the commercial determinants of dietary behaviour in adolescence - proposed methods for online system mapping workshops.

BACKGROUND: Group model building (GMB) is a participatory approach whereby diverse stakeholders can share their views about a problem to create a collective understanding of a complex system. In this article we report our methodological approach to adapt face-to-face GMB processes to an online format to explore the mechanisms by which commercial drivers influence adolescents' dietary behaviour. We use our experiences to make recommendations on how online GMB could be delivered. METHODS: We planned, adapted, piloted, delivered, and evaluated a series of online GMB workshops with adolescents, policymakers and public health practitioners to create a system map of the commercial determinants of dietary behaviour in adolescence. We adapted face-to-face GMB workshops to a series of 3 online GMB workshops with 11 adolescents (16-18 years) living in the Southwest of England, and one GMB workshop with policymakers and public health practitioners. RESULTS: In our experience, adapting, and delivering GMB online is feasible, engaging, cost-saving and an enjoyable experience. Participants gave positive feedback in terms of engagement and enjoyment, and it allowed them to recognise different points of view about the same problem. Participants became familiarised with system thinking and system dynamics concepts, developed a shared understanding of a complex issue and portrayed it in a system map that depicted the most important factors in a causal structure as well as their interactions at various levels. CONCLUSIONS: We recommend using process mapping to understand the overall GMB process in an online environment and piloting the workshops to test the timings and flow between online platforms. For facilitation and delivery, facilitators need to ensure they can create an inviting and engaging online environment, even for participants who decide to have their cameras off. Separating GMB activities into different workshops allowed participants to reflect on the problem being discussed and bring new ideas to subsequent workshops. Evaluating the workshops enabled us to build evidence on the trade-offs between the effectiveness, quality and efficiency of online GMB workshops, and how this might be enhanced to identify leverage points and achieve systemic changes in complex issues. ETHICAL APPROVAL: The research was approved by the University of Bristol's Faculty of Health Sciences Research Ethics Committee (Ref: 99,003) and written consent was received from all participants.

Design of Online Music Education System Based on Artificial Intelligence and Multiuser Detection Algorithm.

With the development of information technology, online music education has become a mainstream education method. Especially after the outbreak of COVID-19, music teachers have to teach through online. Therefore, an online music education system that can improve the quality of teaching is particularly important. Multiuser detection algorithms and artificial intelligence have important applications in many fields, and the field of music online education is no exception. This paper takes the music teaching of the music distance teaching unit as the goal and conducts sufficient research on the educational subjects such as teachers, students, and administrators. And with the help of the SCMA system multiuser detection algorithm and artificial intelligence technology, the system analysis and design method is used to analyze and design the music teaching function system. The system module involves basic information management, student music assignments, online courses, and other levels, providing an excellent educational system design example for music online education. The conclusion analysis shows that the music online education system based on SCMA system multiuser detection algorithm and artificial intelligence designed in this paper can significantly improve the audience's music learning efficiency and has obvious benefits to the student group.

Government influence on e-government adoption by citizens in Colombia: Empirical evidence in a Latin American context.

This study aims to identify government influence in the adoption of e-government by citizens (AEC) through a case study analyzing actions in Antioquia, Colombia, to increase AEC in annual vehicle tax filing and payment services. We classified these actions employing institutional theory, institutional interventions, and legitimation strategies. An analysis correlating AEC actions (including the COVID-19 containment measures) with over 16 million transactions in these two services during 2015-2020 found a strong government influence on AEC. We established coercive pressure and conformance to the environment as important predictors of AEC, but the COVID-19 containment measures only influenced electronic tax payments. Service type was also an essential predictor for these services; however, mobilization was not. Increasing AEC should be considered a necessary objective for public administrations, especially in developing countries that face shortages of resources and facilities.

Reactogenicity and Immunogenicity of the Pfizer and AstraZeneca COVID-19 Vaccines.

Background: The relationships of the coronavirus disease 2019 (COVID-19) vaccination with reactogenicity and the humoral immune response are important to study. The current study aimed to assess the reactogenicity and immunogenicity of the Pfizer and AstraZeneca COVID-19 vaccines among adults in Madinah, Saudi Arabia. Methods: A cross-sectional study, including 365 randomly selected adult Pfizer or AstraZeneca vaccine recipients who received a homologous prime-boost vaccination between February 1st and June 30th, 2021. Data of height and weight were collected to assess the weight status of percipients. An evaluation of seropositivity for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies was assessed using enzyme-linked immunosorbent assay (ELISA). Results: Among the participants, 69% (n = 250) reported at least one vaccine-related symptom. Pain at the injection site was the most frequently reported vaccine-related symptom. The mean total score for vaccine-related symptoms was significantly higher among participants who received the AstraZeneca vaccine, women, and participants with no previous COVID-19 infection (p < 0.05). Spike-specific IgG antibodies were detected in 98.9% of participants after the receipt of two vaccine doses, including 99.5% of Pfizer vaccine recipients and 98.3% of AstraZeneca vaccine recipients. Significantly, higher proportions of participants in the <35-year age group developed a humoral immune response after the first vaccine dose compared with the participants in other age groups. Conclusion: Participants who received the Pfizer COVID-19 vaccine reported fewer vaccine-related complications compared with those who received the AstraZeneca COVID-19 vaccine, but no serious side effects were reported in response to either vaccine. Health status and age were factors that may influence COVID-19 vaccine effectiveness for the generation of antibodies against the SARS-CoV-2 spike protein.

Consumer willingness to pay for plant-based foods produced using microbial applications to replace synthetic chemical inputs.

Analysis of consumer preferences and willingness-to-pay (WTP) for sustainable foods produced using new agri-food technologies is required to enhance the uptake of innovations that accelerate the transition towards sustainable food systems. Consumers' willingness to buy new food products, with no or limited consumption experience, mainly depends on their food choice motivational orientations (promotion- vs prevention-orientation). The objective of this study was to elicit consumers' WTP for foods that are produced with microbial applications during the plant production phase with the aim to reduce the use of synthetic chemicals in crop farming, as well as to understand the associations of food choice motives, personal and socio-demographic factors with the WTP. We used contingent valuation to elicit consumers' WTP for three food products (wheat bread, consumer potatoes and tomato sauce) through online surveys. Data were collected from 291 consumers, primarily from Italy, Germany and the Netherlands. Descriptive statistics, latent variable modelling and logistic regression were used to analysis data. Results show that more than two-third of the respondents are willing to pay premiums of at least 0.11 euro per kg of food products for reductions in synthetic chemical use by at least 50% due to microbial applications. The amount of WTP increases with the level of reductions in synthetic chemical use. The majority of the respondents are promotion-oriented consumers in relation to their food involvement, and are more likely to pay premiums for the sustainably produced food products. Environmentally concerned consumers are also more likely to pay premiums, whereas health concerned consumers are not. This study contributes to understanding of consumers' attitude and perceived health risks towards foods obtained using microbial applications, and the heterogeneity of their preferences. Results provide insights for identifying potential buyers of foods produced using microbial applications, and to set prices according to the levels of consumers' WTP.

The Challenges of Managing Pediatric Diabetes and Other Endocrine Disorders During the COVID-19 Pandemic: Results From an International Cross-Sectional Electronic Survey.

Background: Frequency, dimensions, management, and outcomes of the COVID-19 pandemic in children with endocrine disorders and diabetes were assessed. Methods: A cross-sectional electronic survey was distributed to the global network of endocrine societies. Respondents' professional and practice profiles, clinic sizes, their country of practice, and the impact of COVID-19 on endocrine diseases were investigated. Results: Respondents from 131 pediatric endocrine centers in 51 countries across all continents completed the survey. Routine check-ups and education were altered in most pediatric endocrine clinics. Over 20% of clinics experienced a shortage of critical medications or essential supplies. ICU treatment was required for patients with diabetes and COVID-19 in 21.2% of centers. In diabetes, 44% of respondents reported increased diabetic ketoacidosis episodes in newly diagnosed cases and 30% in established cases. Biopsychosocial and behavioral changes were explicitly reported to be occurring among pediatric patients with endocrine disorders. Conclusions: This large global survey conducted during the COVID-19 pandemic highlights that diabetes is more challenging to manage than any other pediatric endocrine disorder, with an increased risk of morbidity. Psychological distress due to COVID-19 needs to be recognized and addressed. The importance of close contact with healthcare professionals should be emphasized, and medical supplies should be readily available to all patients.

Comparative study of the mental health impact of the COVID-19 pandemic on health care professionals in India.

Aims: This study aimed to investigate how the psychological health of health care professionals (HCP) on COVID duty was different from those who were not directly in contact. Methodology: Of 473 (76%) randomly selected respondents (doctors and nurses) to a WhatsApp request message, 450 subjects' data were finally analyzed. Result: The prevalence of stress, anxiety and depression among HCP was 33.8, 38.9 and 43.6%, respectively. Compared with nonexposed professionals, COVID-19-exposed professionals had roughly double the score of these morbidities (t = 6.3, p < 0.001; t = 6.9, p < 0.001; t = 6.0, p < 0.001). Most worry (71.11%) was about the health of their family, followed by themselves (35.55%). Conclusion: The level of exposure, feelings of uncertainty and fear of infection emerged in our study as possible risk factors for psychological morbidities among HCP.

Virtual Interviews in Neurosurgery Resident Selection-A Work in Progress.

INTRODUCTION: Due to the COVID-19 pandemic, the ACGME recommended all interviews for the 2021 residency application cycle be held virtually. Because this is major shift from neurosurgical interviews in past years, this study aims to evaluate both applicant and interviewer satisfaction of conducting interviews virtually. METHODS: For faculty, an 11-question online survey was sent to 116 United States neurosurgery training programs. A 14-question online survey was sent to 255 neurosurgery applicants. The resulting data were analyzed qualitatively and quantitatively. RESULTS: From applicants, 118 responses were received. From faculty, 171 individual responses were received. Thirty-five percent (34.7%) of applicants agreed that they were satisfied with the virtual interview process as a whole. Although 44.5% of faculty disagreed with the statement "I would like to replace in-person interviews with virtual interviews in the future", 57.3% of faculty agreed that they were likely to implement virtual interviews in the future. CONCLUSIONS: Some things might be better assessed through in-person interviews, but there are clear benefits to virtual interviews. Future iterations of the interview process, incorporating virtual interviews, might help determine how and in which situations virtual interviews can be utilized in future residency application cycles.

Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual health of people living in Australia.

INTRODUCTION: Australia recorded its first case of COVID-19 in late January 2020. On 22P March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help 'flatten the curve'. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices. METHODS: An online survey was open from the 23PP April 2020 to 11P May 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (diff) (including 95% CIs) in the proportion of sex practices between time periods. RESULTS: Of the 1187 who commenced the survey, 965 (81.3%) completed it. Overall, 70% were female and 66.3% were aged 18-29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to report sex with a spouse (35.3% vs 41.7%; diff=6.4%; 95% CI 3.6 to 9.2) and less likely to report sex with a girl/boyfriend (45.1% vs 41.8%; diff=-3.3%; 95% CI -7.0 to -0.4) or with casual hook-up (31.4% vs 7.8%; 95% CI -26.9 to -19.8). Solo sex activities increased; 14.6% (123/840) reported using sex toys more often and 26.0% (218/838) reported masturbating more often. Dating app use decreased during lockdown compared with 2019 (42.1% vs 27.3%; diff= -14.8%; 95% CI -17.6 to -11.9). Using dating apps for chatting/texting (89.8% vs 94.5%; diff=4.7%; 95% CI 1.0 to 8.5) and for setting up virtual dates (2.6% vs 17.2%; diff=14.6%; 95% CI 10.1 to 19.2) increased during lockdown. CONCLUSION: Although significant declines in sexual activity during lockdown were reported, people did not completely stop engaging in sexual activities, highlighting the importance of ensuring availability of normal sexual and reproductive health services during global emergencies.

The Virtual Urology Residency Match Process: Moving Beyond the Pandemic.

OBJECTIVES: To define applicant response to the 2021 Urology Residency Match Process in the COVID-19 Pandemic and to extrapolate lessons to optimize the urology resident selection process after the pandemic. METHODS: We emailed an anonymous, de-identified 22-question, multiple choice survey to all applicants to our institution for the 2021 Urology Residency Match, including a summary of the study with a survey link (RedCap). RESULTS: Of the 398 survey recipients, 144 responded (36%). Even if the match process were not limited by COVID-19, 39% of applicants thought interviews should remain in virtual format, 23% said "no," and 30% said "not sure." Nearly all applicants (97%) thought all interview offers should be released on the same day. Regarding the early match, 84% thought this should remain. When asked what factors had the most impact on rank lists, faculty and resident interviews were overwhelmingly favored. Open houses and resident "happy hours" were less important. Most applicants agreed that the faculty and resident interviews and informational talks were adequately replicated on the virtual platform. A majority of applicants (65%) spent under $2000 for the application cycle. CONCLUSION: The COVID-19 pandemic dramatically changed the urology match process. The faculty and resident interviews remained the most important factors in program ranking, and most applicants agreed those were adequately replicated in the virtual format. A plurality of applicants felt that the interview process should remain virtual in a post-COVID-19 environment. The virtual application cycle reduced the cost of applying to residency.

Finding the Next Resident Physicians in the COVID-19 Global Pandemic: An Applicant Survey on the 2020 Virtual Urology Residency Match.

OBJECTIVE: To assess interviewing applicant perceptions of a virtual urology residency interview in the setting of changes mandated by COVID-19 and to determine applicant preference for virtual or in person interviews. Applicant perceptions of multiple interview components were queried to identify program specific and interview modality specific strengths or weaknesses in the 2020 to 2021 Urology Match. METHODS: A 12 question multiple choice and free text survey was emailed to 66 virtually interviewed applicants for open residency positions at a metropolitan training program after conclusion of interviews. Items of interest included interview type preference, overall interview impression, and recommendations for improvement. RESULTS: A total of 50 of 66 (76%) applicants completed the survey corresponding to approximately 11% of the 2020 national urology applicant pool. A total of 49 of 50 (96%) respondents assessed faculty interaction and the virtual platform positively. A total of 38 of 50 (76%) was satisfied with their resident interaction and 32 of 50 (64%) applicants stated they were able to satisfactorily evaluate the site and program. Ultimately, 39 of 50 (78%) respondents would have preferred an in person interview to our virtual interview. Respondents cited challenges in assessing program culture and program physical site virtually. CONCLUSION: The majority of survey respondents indicated a preference for in person interviews. A smaller proportion of applicants preferred virtual interviews citing their convenience and lower cost. Efforts to improve the virtual interview experience may focus on improving applicant-resident interaction and remote site assessment.

Feasibility and Acceptability of a "Click & Collect" WIC Online Ordering Pilot.

BACKGROUND: Barriers to shopping for foods in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been reported. Online ordering options may improve the WIC shopping experience but are understudied. OBJECTIVE: The objective of this study was to test feasibility and acceptability of a "Click & Collect" model for WIC online ordering from the perspective of WIC participants. DESIGN: A Click & Collect online ordering model was adapted to the WIC program and implemented at 1 grocery store. In the Click & Collect model, WIC participants placed an online order ("click"), then completed payment and pickup at the store ("collect"). PARTICIPANTS/SETTING: Twenty-five WIC participants in East Tennessee were included. MAIN OUTCOME MEASURES: Feasibility was assessed by examining online order summaries and store receipts to determine whether WIC transactions were completed successfully. Acceptability was assessed by qualitative semi-structured interviews conducted with WIC participants after participating in the pilot. ANALYSES PERFORMED: Descriptive statistics were used to analyze sociodemographic and purchase data in SPSS software, version 27. Qualitative interviews were transcribed and analyzed for themes using directed content analysis in NVivo, version 12.0. RESULTS: All WIC participants in the study placed an online order, and 96% picked up the order, indicating a high degree of feasibility. In follow-up qualitative interviews, WIC participants reported interest in the Click & Collect model, and provided suggestions to improve practicality across the following 4 primary themes: website experience, curbside pickup, online shopping fee, and shopping preferences. CONCLUSIONS: The pilot was successfully implemented at 1 store. Click & Collect online ordering was feasible and acceptable to WIC participants, although additional work is needed to make it practical. Online shopping options for the WIC program should be further explored to expand access to nutritious WIC foods in families with low income.

CASE-based and Guidelines-based Lectures are the Most Preferred Form of Online Webinar Education: Results from the Urology Collaborative Online Video Didactics Series (COViD).

Objective To evaluate the most preferred style of online didactic lectures. The COVID-19 pandemic has had a significant impact on surgical resident education, instigating a major shift towards online webinar didactics as a major of resident teaching. We hypothesize that a case-based format of online didactics are the most preferred format for this style of lecture. Study Design We analyzed viewer evaluations following 82 online hour-long lectures in the Urology Collaborative Online Video Didactics Lecture Series. We categorized each lecture as case-based, guidelines-based, practice updates, or surgical technique-based and assessed viewer responses to survey questions regarding subject area relevance, lecturer knowledgeability, lecturer effectiveness, and usefulness to learning. We performed logistic regression to control for viewer level, instructor level, and lecture topic, and using surgical technique-based lectures as the baseline variable. Results 2176 evaluations were analyzed. Case-based, guidelines-based and practice updates were all scored significantly higher than surgical technique for subject area relevance. Case-based and guideline-based lectures scored significantly higher for usefulness to learning. Case-based lectures scored significantly higher for lecturer effectiveness. There was no significant difference in scoring between any lecture style when rated on lecturer knowledgeability. Conclusion When preparing online webinar based didactics for surgical resident education, case-based lecturers appear to be the most preferred and well received lecture style, followed closely by guidelines-based lectures. Practice updates and surgical technique-based lectures are less preferred formats for this teaching modality.