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1.
G Ital Cardiol (Rome) ; 23(1): 4-9, 2022 Jan.
Article in Italian | MEDLINE | ID: covidwho-1609117

ABSTRACT

BACKGROUND: The COVID-19 pandemic caused by SARS-CoV-2 has greatly modified outpatient follow-ups. The aim of this retrospective study was to evaluate the organizational modalities and clinical effects of rearrangements of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) outpatient visits performed in our centers at Ravenna and Lugo Hospitals, Italy, during the pandemic outbreak in 2020. METHODS: All scheduled in-person device follow-up visits in March-December 2020 have been considered. On the basis of documented past functioning of each device and of remote monitoring (RM) capabilities, in-person visits were either performed or postponed at variable times. The characteristics of the follow-ups and the device-related clinically relevant events were analyzed, the latter being further divided into serious malfunction and problems to be corrected by device reprogramming. RESULTS: Overall, 27% of in-person visits were postponed (n = 576) (36% of ICDs and 25% of PMs), peaking 62% in March-May 2020. RM compensated nearly all hold-ups in ICDs and just 63% of postponements in PMs. The postponement-caused delay between in-person visits was 5.6 ± 1.1 months for ICDs and 4.7 ± 1.2 months for PMs; in 24% of ICDs the time interval between in-person visits was ≥18 months. Clinically relevant events were 56 (18 [4.4%] in ICDs, 38 [2.1%] in PMs), with no deaths and 21 serious malfunctions (4 [1%] in ICDs, 15 [0.8%] in PMs). RM identified all ICD malfunctions, while it was not available in the affected PMs. In comparison with the year 2019, serious malfunctions increased, though the difference was not significant. Monthly RM transmissions increased by 2.3 fold. CONCLUSIONS: In our single-center experience during the COVID-19 pandemic, numerous in-person PM/ICD follow-up visits were postponed, and delays were well beyond the previously recommended time limits. However, device-related malfunctions did not increase, notably, when RM capabilities were used.


Subject(s)
COVID-19 , Defibrillators, Implantable , Pacemaker, Artificial , Electronics , Follow-Up Studies , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
2.
J Med Internet Res ; 23(12): e25899, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1596879

ABSTRACT

BACKGROUND: The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing. OBJECTIVE: We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters. METHODS: This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits. RESULTS: There was no difference in percentages of positive strep tests between encounter types for any of the McIsaac scores. There were significantly more phone and e-visit encounters with any missing score components compared with f2f visits. For individual score components, there were significantly fewer e-visits missing fever and cough information compared with phone encounters and f2f encounters. F2f encounters were significantly less likely to be missing descriptions of tonsils and lymphadenopathy compared with phone and e-visit encounters. McIsaac scores of 4 had positive GAS rates of 55% to 68% across encounter types. There were 4 encounters not missing any score components with a McIsaac score of 0. None of these 4 encounters had a positive GAS test. CONCLUSIONS: McIsaac scores of 4 collected during non-f2f care could be used to consider empiric treatment for GAS without testing if significant barriers to testing exist such as the COVID-19 pandemic or geographic barriers. Future studies should evaluate further whether non-f2f encounters with McIsaac scores of 0 can be safely excluded from GAS testing.


Subject(s)
COVID-19 , Pharyngitis , Electronics , Humans , Outpatients , Pandemics , Pharyngitis/diagnosis , Retrospective Studies , SARS-CoV-2 , Triage
3.
BMJ Open ; 11(12): e054442, 2021 12 15.
Article in English | MEDLINE | ID: covidwho-1583096

ABSTRACT

INTRODUCTION: COVID-19 is a new viral-induced pneumonia caused by infection with a novel coronavirus, SARS-CoV-2. At present, there are few proven effective treatments. This early-phase experimental medicine protocol describes an overarching and adaptive trial designed to provide safety data in patients with COVID-19, pharmacokinetic (PK)/pharmacodynamic (PD) information and exploratory biological surrogates of efficacy, which may support further development and deployment of candidate therapies in larger scale trials of patients positive for COVID-19. METHODS AND ANALYSIS: Define is an ongoing exploratory multicentre-platform, open-label, randomised study. Patients positive for COVID-19 will be recruited from the following cohorts: (a) community cases; (b) hospitalised patients with evidence of COVID-19 pneumonitis; and (c) hospitalised patients requiring assisted ventilation. The cohort recruited from will be dependent on the experimental therapy, its route of administration and mechanism of action. Randomisation will be computer generated in a 1:1:n ratio. Twenty patients will be recruited per arm for the initial two arms. This is permitted to change as per the experimental therapy. The primary statistical analyses are concerned with the safety of candidate agents as add-on therapy to standard of care in patients with COVID-19. Secondary analysis will assess the following variables during treatment period: (1) the response of key exploratory biomarkers; (2) change in WHO ordinal scale and National Early Warning Score 2 (NEWS2) score; (3) oxygen requirements; (4) viral load; (5) duration of hospital stay; (6) PK/PD; and (7) changes in key coagulation pathways. ETHICS AND DISSEMINATION: The Define trial platform and its initial two treatment and standard of care arms have received a favourable ethical opinion from Scotland A Research Ethics Committee (REC) (20/SS/0066), notice of acceptance from The Medicines and Healthcare Products Regulatory Agency (MHRA) (EudraCT 2020-002230-32) and approval from the relevant National Health Service (NHS) Research and Development (R&D) departments (NHS Lothian and NHS Greater Glasgow and Clyde). Appropriate processes are in place in order to be able to consent adults with and without capacity while following the necessary COVID-19 safe procedures. Patients without capacity could be recruited via a legal representative. Witnessed electronic consent of participants or their legal representatives following consent discussions was established. The results of each study arm will be submitted for publication in a peer-reviewed journal as soon as the treatment arm has finished recruitment, data input is complete and any outstanding patient safety follow-ups have been completed. Depending on the results of these or future arms, data will be shared with larger clinical trial networks, including the Randomised Evaluation of COVID-19 Therapy trial (RECOVERY), and to other partners for rapid roll-out in larger patient cohorts. TRIAL REGISTRATION NUMBER: ISRCTN14212905, NCT04473053.


Subject(s)
Biomedical Research , COVID-19 , Clinical Trials, Phase I as Topic , Clinical Trials, Phase II as Topic , Electronics , Humans , Multicenter Studies as Topic , Randomized Controlled Trials as Topic , State Medicine
4.
Med Educ Online ; 26(1): 1876316, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1575921

ABSTRACT

Changes in medical student learning preferences help drive innovation in teaching and require schools and commercial resources to quickly adapt. However, few studies have detailed the relationship of learner preferences to the environment and teaching modalities used in the pre-clerkship years, nor do they incorporate third-party resources. Our study attempts to analyze learner preferences by comparing the use of traditional and third-party resources. In 2017-18, a survey was distributed to medical students and residents at two accredited medical schools. Participants noted preferred styles of learning regarding lecture duration, timing, location, format, third-party resources, learner types and USMLE Step 1 scores. The 'Learning Environment, Learning Processes, and Learning Outcomes' (LEPO) framework [5] was used to examine learner preferences, with responses compared using the Mann-Whitney U and two proportion z-tests. A total of 329 respondents completed the survey: 62.7% medical students and 37.3% residents. The majority of participants identified their learning style by Kolb [6] as converging (33.0%) or accommodating (39.2%). Students preferred lectures 30-40 minutes long (43.3%), during morning hours (54.2%), in their own homes (52.0%), via online lectures with simultaneous drawings (56.0%), and classroom/podcast lectures with PowerPoint® presentations (54.3%). Overall, students rated third-party resource characteristics higher than traditional curricula, including effectiveness of teachers, length, quality, time of day, and venue (p < 0.001), but also preferred small group formats. Students reported animated videos (46.6%) and simultaneous drawings (46.5%) as the most effective means of retaining information. Understanding changing learner preferences is important in creating optimal curricula for today's students. Using the LEPO framework, this study identifies critical preferences in successfully teaching medical students, inclusive of commercial and traditional resources. These results can also help guide changes in pedagogy necessary due to the more recent COVID-19 pandemic.


Subject(s)
Choice Behavior , Electronics , Learning , Students, Medical/psychology , Adult , COVID-19 , Curriculum , Humans , Pandemics , SARS-CoV-2 , Schools, Medical , Surveys and Questionnaires , Young Adult
5.
J Med Internet Res ; 23(11): e26480, 2021 11 19.
Article in English | MEDLINE | ID: covidwho-1547113

ABSTRACT

BACKGROUND: The need for strategies to encourage user-initiated reporting of results after HIV self-testing (HIVST) persists. Smartphone-based electronic readers (SERs) have been shown capable of reading diagnostics results accurately in point-of-care diagnostics and could bridge the current gaps between HIVST and linkage to care. OBJECTIVE: Our study aimed to assess the willingness of Chinese men who have sex with men (MSM) in the Jiangsu province to use an SER for HIVST through a web-based cross-sectional study. METHODS: From February to April 2020, we conducted a convenience web-based survey among Chinese MSM by using a pretested structured questionnaire. Survey items were adapted from previous HIVST feasibility studies and modified as required. Prior to answering reader-related questions, participants watched a video showcasing a prototype SER. Statistical analysis included descriptive analysis, chi-squared test, and multivariable logistic regression. P values less than .05 were deemed statistically significant. RESULTS: Of 692 participants, 369 (53.3%) were aged 26-40 years, 456 (65.9%) had ever self-tested for HIV, and 493 (71.2%) were willing to use an SER for HIVST. Approximately 98% (483/493) of the willing participants, 85.3% (459/538) of ever self-tested and never self-tested, and 40% (46/115) of unwilling participants reported that SERs would increase their HIVST frequency. Engaging in unprotected anal intercourse with regular partners compared to consistently using condoms (adjusted odds ratio [AOR] 3.04, 95% CI 1.19-7.74) increased the odds of willingness to use an SER for HIVST. Participants who had ever considered HIVST at home with a partner right before sex compared to those who had not (AOR 2.99, 95% CI 1.13-7.90) were also more willing to use an SER for HIVST. Playing receptive roles during anal intercourse compared to playing insertive roles (AOR 0.05, 95% CI 0.02-0.14) was associated with decreased odds of being willing to use an SER for HIVST. The majority of the participants (447/608, 73.5%) preferred to purchase readers from local Centers of Disease Control and Prevention offices and 51.2% (311/608) of the participants were willing to pay less than US $4.70 for a reader device. CONCLUSIONS: The majority of the Chinese MSM, especially those with high sexual risk behaviors, were willing to use an SER for HIVST. Many MSM were also willing to self-test more frequently for HIV with an SER. Further research is needed to ascertain the diagnostic and real-time data-capturing capacity of prototype SERs during HIVST.


Subject(s)
HIV Infections , Sexual and Gender Minorities , China , Cross-Sectional Studies , Electronics , HIV Infections/diagnosis , HIV Infections/prevention & control , Homosexuality, Male , Humans , Internet , Male , Smartphone
6.
Trials ; 22(1): 828, 2021 Nov 22.
Article in English | MEDLINE | ID: covidwho-1528691

ABSTRACT

BACKGROUND: It is unclear whether screening for sepsis using an electronic alert in hospitalized ward patients improves outcomes. The objective of the Stepped-wedge Cluster Randomized Trial of Electronic Early Notification of Sepsis in Hospitalized Ward Patients (SCREEN) trial is to evaluate whether an electronic screening for sepsis compared to no screening among hospitalized ward patients reduces all-cause 90-day in-hospital mortality. METHODS AND DESIGN: This study is designed as a stepped-wedge cluster randomized trial in which the unit of randomization or cluster is the hospital ward. An electronic alert for sepsis was developed in the electronic medical record (EMR), with the feature of being active (visible to treating team) or masked (inactive in EMR frontend for the treating team but active in the backend of the EMR). Forty-five clusters in 5 hospitals are randomized into 9 sequences of 5 clusters each to receive the intervention (active alert) over 10 periods, 2 months each, the first being the baseline period. Data are extracted from EMR and are compared between the intervention (active alert) and control group (masked alert). During the study period, some of the hospital wards were allocated to manage patients with COVID-19. The primary outcome of all-cause hospital mortality by day 90 will be compared using a generalized linear mixed model with a binary distribution and a log-link function to estimate the relative risk as a measure of effect. We will include two levels of random effects to account for nested clustering within wards and periods and two levels of fixed effects: hospitals and COVID-19 ward status in addition to the intervention. Results will be expressed as relative risk with a 95% confidence interval. CONCLUSION: The SCREEN trial provides an opportunity for a novel trial design and analysis of routinely collected and entered data to evaluate the effectiveness of an intervention (alert) for a common medical problem (sepsis in ward patients). In this statistical analysis plan, we outline details of the planned analyses in advance of trial completion. Prior specification of the statistical methods and outcome analysis will facilitate unbiased analyses of these important clinical data. TRIAL REGISTRATION: ClinicalTrials.gov NCT04078594 . Registered on September 6, 2019.


Subject(s)
COVID-19 , Sepsis , Electronics , Hospitals , Humans , SARS-CoV-2 , Sepsis/diagnosis , Sepsis/therapy
7.
BMC Med Educ ; 21(1): 578, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1526629

ABSTRACT

BACKGROUND: Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. METHODS: Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. RESULTS: A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. CONCLUSIONS: A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.


Subject(s)
Documentation , Hospitals , Data Collection , Electronics , Sierra Leone
8.
BMC Health Serv Res ; 21(1): 1240, 2021 Nov 17.
Article in English | MEDLINE | ID: covidwho-1523308

ABSTRACT

BACKGROUND: The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) - developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents' mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the 'care-as-usual' group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and 'warm hand over' by a 'service navigator' to ensure their needs are met. METHODS: Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the 'care-as-usual' or 'intervention' group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. CONCLUSIONS: Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. TRIAL REGISTRATION: The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819 ) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.


Subject(s)
COVID-19 , Child Development , Child , Electronics , Humans , Mental Health , Parents , Randomized Controlled Trials as Topic , SARS-CoV-2
9.
Sensors (Basel) ; 21(22)2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1512572

ABSTRACT

The authors decided to investigate the impact of the lockdown period and the resulting limitations in informatics education, especially programming, in out-of-school electronics courses using traditional and distance learning modes in primary school COVID-19 pandemic settings. Two extracurricular courses were held successively; the first electronics course was performed in a traditional out-of-school learning mode using Arduino kits, while the other was held using the TinkerCad circuits virtual environment in distance learning mode. A structured questionnaire was administered to students to map their knowledge of programming. The questionnaire consists of three emotional dimensions: enjoyment, satisfaction and motivation. The fourth dimension was dedicated to the students' programming outcomes. Three emotional dimensions were addressed to primary school students, while the fourth dimension was addressed to the tutors' observations toward the students' programming outcomes. The obtained results revealed that learning modes have no significant impact on students perceiving the programming issues. However, three emotional dimensions revealed a significant difference in the students' enjoyment, satisfaction and motivation in favor of the traditional learning mode. Our findings are of particular interest in light of possible crisis-prompted distance education in the future but can also serve to inform government institutions and policymakers seeking to develop effective concepts for successful distance learning.


Subject(s)
COVID-19 , Education, Distance , Child , Communicable Disease Control , Electronics , Humans , Informatics , Pandemics , SARS-CoV-2 , Schools , Students
10.
BMC Public Health ; 21(1): 1970, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1496157

ABSTRACT

BACKGROUND: College students are leading an evolution of device use both in the type of device and the frequency of use. They have transitioned from desktop stations to laptops, tablets, and especially smartphones and use them throughout the day and into the night. METHODS: Using a 35-min online survey, we sought to understand how technology daily usage patterns, device types, and postures affect pain and discomfort to understand how knowledge of that pain might help students avoid it. Data were analyzed from 515 students (69.5% male) who completed an internet-delivered survey (81.3% response rate). RESULTS: Participants ranked smartphones as their most frequently used technology (64.0%), followed by laptops and tablets (both 53.2%), and desktop computers (46.4%). Time spent using smartphones averaged over 4.4 h per day. When using their devices, students were more likely to adopt non-traditional workplace postures as they used these devices primarily on the couch or at a chair with no desk. CONCLUSION: Recent trends in wireless academic access points along with the portability of small handheld devices, have made smartphones the most common link to educational materials despite having the least favorable control and display scenario from an ergonomic perspective. Further, the potential impact of transitions in work environments due to COVID-19 may further exacerbate ergonomic issues among millions highlighting the need for such work to be carried out.


Subject(s)
COVID-19 , Electronics , Female , Humans , Male , SARS-CoV-2 , Smartphone , Students
11.
BMJ Open ; 11(10): e053268, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1495473

ABSTRACT

OBJECTIVE: To test the feasibility and acceptability of a short-term reminder and incentives intervention in adolescents with low adherence to asthma medications. METHODS: Mixed-methods feasibility study in a tertiary care clinic. Adolescents recruited to a 24-week programme with three 8-weekly visits, receiving electronic reminders to prompt inhaled corticosteroid (ICS) inhalation through a mobile app coupled with electronic monitoring devices (EMD). From the second visit, monetary incentives based on adherence of ICS inhalation: £1 per dose, maximum £2 /day, up to £112/study, collected as gift cards at the third visit. End of study interviews and questionnaires assessing perceptions of asthma and ICS, analysed using the Perceptions and Practicalities Framework. PARTICIPANTS: Adolescents (11-18 years) with documented low ICS adherence (<80% by EMD), and poor asthma control at the first clinic visit. RESULTS: 10 out of 12 adolescents approached were recruited (7 males, 3 females, 12-16 years). Eight participants provided adherence measures up to the fourth visits and received rewards. Mean study duration was 281 days, with 7/10 participants unable to attend their fourth visit due to COVID-19 lockdown. Only 3/10 participants managed to pair the app/EMD up to the fourth visit, which was associated with improved ICS adherence (from 0.51, SD 0.07 to 0.86, SD 0.05). Adherence did not change in adolescents unable to pair the app/EMD. The intervention was acceptable to participants and parents/guardians. Exit interviews showed that participants welcomed reminders and incentives, though expressed frustration with app/EMD technological difficulties. Participants stated the intervention helped through reminding ICS doses, promoting self-monitoring and increasing motivation to take inhalers. CONCLUSIONS: An intervention using electronic reminders and incentives through an app coupled with an EMD was feasible and acceptable to adolescents with asthma. A pilot randomised controlled trial is warranted to better estimate the effect size on adherence, with improved technical support for the EMD.


Subject(s)
Asthma , COVID-19 , Adolescent , Asthma/drug therapy , Communicable Disease Control , Electronics , Feasibility Studies , Female , Humans , Male , Medication Adherence , Reward , SARS-CoV-2 , Tertiary Healthcare
13.
PLoS One ; 16(9): e0258002, 2021.
Article in English | MEDLINE | ID: covidwho-1448576

ABSTRACT

Detecting viruses, which have significant impact on health and the economy, is essential for controlling and combating viral infections. In recent years there has been a focus towards simpler and faster detection methods, specifically through the use of electronic-based detection at the point-of-care. Point-of-care sensors play a particularly important role in the detection of viruses. Tests can be performed in the field or in resource limited regions in a simple manner and short time frame, allowing for rapid treatment. Electronic based detection allows for speed and quantitative detection not otherwise possible at the point-of-care. Such approaches are largely based upon voltammetry, electrochemical impedance spectroscopy, field effect transistors, and similar electrical techniques. Here, we systematically review electronic and electrochemical point-of-care sensors for the detection of human viral pathogens. Using the reported limits of detection and assay times we compare approaches both by detection method and by the target analyte of interest. Compared to recent scoping and narrative reviews, this systematic review which follows established best practice for evidence synthesis adds substantial new evidence on 1) performance and 2) limitations, needed for sensor uptake in the clinical arena. 104 relevant studies were identified by conducting a search of current literature using 7 databases, only including original research articles detecting human viruses and reporting a limit of detection. Detection units were converted to nanomolars where possible in order to compare performance across devices. This approach allows us to identify field effect transistors as having the fastest median response time, and as being the most sensitive, some achieving single-molecule detection. In general, we found that antigens are the quickest targets to detect. We also observe however, that reports are highly variable in their chosen metrics of interest. We suggest that this lack of systematisation across studies may be a major bottleneck in sensor development and translation. Where appropriate, we use the findings of the systematic review to give recommendations for best reporting practice.


Subject(s)
Point-of-Care Systems , Virus Diseases/diagnosis , Electronics , Humans , Virus Diseases/virology
14.
JMIR Public Health Surveill ; 7(9): e26503, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1443942

ABSTRACT

BACKGROUND: True evidence-informed decision-making in public health relies on incorporating evidence from a number of sources in addition to traditional scientific evidence. Lack of access to these types of data as well as ease of use and interpretability of scientific evidence contribute to limited uptake of evidence-informed decision-making in practice. An electronic evidence system that includes multiple sources of evidence and potentially novel computational processing approaches or artificial intelligence holds promise as a solution to overcoming barriers to evidence-informed decision-making in public health. OBJECTIVE: This study aims to understand the needs and preferences for an electronic evidence system among public health professionals in Canada. METHODS: An invitation to participate in an anonymous web-based survey was distributed via listservs of 2 Canadian public health organizations in February 2019. Eligible participants were English- or French-speaking individuals currently working in public health. The survey contained both multiple-choice and open-ended questions about the needs and preferences relevant to an electronic evidence system. Quantitative responses were analyzed to explore differences by public health role. Inductive and deductive analysis methods were used to code and interpret the qualitative data. Ethics review was not required by the host institution. RESULTS: Respondents (N=371) were heterogeneous, spanning organizations, positions, and areas of practice within public health. Nearly all (364/371, 98.1%) respondents indicated that an electronic evidence system would support their work. Respondents had high preferences for local contextual data, research and intervention evidence, and information about human and financial resources. Qualitative analyses identified several concerns, needs, and suggestions for the development of such a system. Concerns ranged from the personal use of such a system to the ability of their organization to use such a system. Recognized needs spanned the different sources of evidence, including local context, research and intervention evidence, and resources and tools. Additional suggestions were identified to improve system usability. CONCLUSIONS: Canadian public health professionals have positive perceptions toward an electronic evidence system that would bring together evidence from the local context, scientific research, and resources. Elements were also identified to increase the usability of an electronic evidence system.


Subject(s)
Artificial Intelligence , Public Health , Canada , Cross-Sectional Studies , Electronics , Humans
15.
BMC Med Res Methodol ; 21(1): 175, 2021 08 21.
Article in English | MEDLINE | ID: covidwho-1443791

ABSTRACT

BACKGROUND: Randomized controlled trials (RCT) are considered the ideal design for evaluating the efficacy of interventions. However, conducting a successful RCT has technological and logistical challenges. Defects in randomization processes (e.g., allocation sequence concealment) and flawed masking could bias an RCT's findings. Moreover, investigators need to address other logistics common to all study designs, such as study invitations, eligibility screening, consenting procedure, and data confidentiality protocols. Research Electronic Data Capture (REDCap) is a secure, browser-based web application widely used by researchers for survey data collection. REDCap offers unique features that can be used to conduct rigorous RCTs. METHODS: In September and November 2020, we conducted a parallel group RCT among Indiana University Bloomington (IUB) undergraduate students to understand if receiving the results of a SARS-CoV-2 antibody test changed the students' self-reported protective behavior against coronavirus disease 2019 (COVID-19). In the current report, we discuss how we used REDCap to conduct the different components of this RCT. We further share our REDCap project XML file and instructional videos that investigators can use when designing and conducting their RCTs. RESULTS: We reported on the different features that REDCap offers to complete various parts of a large RCT, including sending study invitations and recruitment, eligibility screening, consenting procedures, lab visit appointment and reminders, data collection and confidentiality, randomization, blinding of treatment arm assignment, returning test results, and follow-up surveys. CONCLUSIONS: REDCap offers powerful tools for longitudinal data collection and conduct of rigorous and successful RCTs. Investigators can make use of this electronic data capturing system to successfully complete their RCTs. TRIAL REGISTRATION: The RCT was prospectively (before completing data collection) registered at ClinicalTrials.gov; registration number: NCT04620798 , date of registration: November 9, 2020.


Subject(s)
COVID-19 , Research Design , Electronics , Humans , Randomized Controlled Trials as Topic , SARS-CoV-2 , Surveys and Questionnaires
16.
Int J Environ Res Public Health ; 18(18)2021 09 16.
Article in English | MEDLINE | ID: covidwho-1409569

ABSTRACT

The potential influence of the COVID-19 pandemic has changed the status of school education and further accelerated the revolution of regular teaching method. This study compared the learning effectiveness and learning strategies of vocational high school students in flipped teaching and traditional teaching modes. By adopting flipped teaching on an electronics course throughout the entire academic year, this study aimed to explore the effect of learning strategies of the students under flipped teaching. The subjects of this study were 85 sophomore students majoring in Electrical Engineering. This study randomly selected one class as the control group (n = 43), and adopted the regular teaching method while another class was selected as the experimental group (n = 42), and employed the flipped teaching method. This study used the "Learning strategy scale of students in vocational high schools" as the instrument. The students' scores of the Testing Center for Technological and Vocational Education Test were used to evaluate their learning effectiveness. The results of this study indicate that students under the flipped teaching model made remarkable progress in the electronics course and the learning outcomes remained significant after a long period of time. Moreover, they made notable changes in their learning strategies, including "learning motivation", "reading and exams", "self-testing", and "problem solving strategies".


Subject(s)
COVID-19 , Students, Nursing , Curriculum , Electronics , Humans , Pandemics , Problem-Based Learning , SARS-CoV-2 , Teaching
17.
Health Res Policy Syst ; 19(1): 122, 2021 Sep 07.
Article in English | MEDLINE | ID: covidwho-1406723

ABSTRACT

BACKGROUND: Health systems around the world have been forced to make choices about how to prioritize care, manage infection control and maintain reserve capacity for future disease outbreaks. Primary healthcare has moved into the front line as COVID-19 testing transitions from hospitals to multiple providers, where tracking testing behaviours can be fragmented and delayed. Pooled general practice data are a valuable resource which can be used to inform population and individual care decision-making. This project aims to examine the feasibility of using near real-time electronic general practice data to promote effective care and best-practice policy. METHODS: The project will utilize a design thinking approach involving all collaborators (primary health networks [PHNs], general practices, consumer groups, researchers, and digital health developers, pathology professionals) to enhance the development of meaningful and translational project outcomes. The project will be based on a series of observational studies utilizing near real-time electronic general practice data from a secure and comprehensive digital health platform [POpulation Level Analysis and Reporting (POLAR) general practice data warehouse]. The study will be carried out over 1.5 years (July 2020-December 2021) using data from over 450 general practices within three Victorian PHNs and Gippsland PHN, Eastern Melbourne PHN and South Eastern Melbourne PHN, supplemented by data from consenting general practices from two PHNs in New South Wales, Central and Eastern Sydney PHN and South Western Sydney PHN. DISCUSSION: The project will be developed using a design thinking approach, leading to the building of a meaningful near real-time COVID-19 geospatial reporting framework and dashboard for decision-makers at community, state and nationwide levels, to identify and monitor emerging trends and the impact of interventions/policy decisions. This will integrate timely evidence about the impact of the COVID-19 pandemic related to its diagnosis and treatment, and its impact across clinical, population and general practice levels.


Subject(s)
COVID-19 , General Practice , Australia , COVID-19 Testing , Electronics , Humans , Pandemics , Policy , SARS-CoV-2
19.
JCO Clin Cancer Inform ; 5: 615-621, 2021 05.
Article in English | MEDLINE | ID: covidwho-1379810

ABSTRACT

PURPOSE: Among patients receiving chemotherapy, symptom monitoring with electronic patient-reported outcomes (ePROs) is associated with improved clinical outcomes, satisfaction, and compliance with therapy. Standard approaches for ePRO implementation are not established, warranting evaluation in community cancer practices. We present implementation findings of ePRO symptom monitoring across a large multisite community oncology practice network. METHODS: Patients initiating a new systemic therapy at one of the 210 practice sites at Texas Oncology were invited to use the Navigating Cancer ePRO platform, with stepped-wedge implementation from July to December 2020. Participating patients received a weekly prompt by text message or e-mail to self-report common symptoms and well-being. Severe self-reported symptoms triggered a real-time notification to nursing triage to address the symptom. Enrollment and compliance were systematically tracked weekly with evaluation of barriers and facilitators to adoption and sustainability. RESULTS: Four thousand three hundred seventy-five patients planning systemic treatment were enrolled and participated. Seventy-three percent (1,841 of 2,522) of enrolled patients completed at least one ePRO assessment. Among these individuals, 64% (16,299 of 25,061) of available weekly ePRO assessments were completed. Over a 10-week period, compliance declined from 72% to 52%. Barriers currently being addressed include lack of a second reminder text or e-mail prompt, inconsistent discussion of reported ePROs by clinicians at visits, and COVID-related changes in workflow. Facilitators included ease of use and patient and staff engagement on the importance of PROs for symptom management. CONCLUSION: ePROs can be effectively implemented in community oncology practice. Utilization of ePROs is high but diminishes over time without attention to barriers. Ongoing work to address barriers and optimize compliance are underway.


Subject(s)
COVID-19 , Patient Reported Outcome Measures , Electronics , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Texas/epidemiology
20.
Int J Environ Res Public Health ; 18(8)2021 04 09.
Article in English | MEDLINE | ID: covidwho-1378352

ABSTRACT

To provide web services adapted to the users' functional capabilities, diversity must be considered from the conceptualization and design phases of the services' development. In previous work, we proposed a model that allows the provisioning of adapted interfaces based on users' identity and their functional attributes to facilitate this task for software designers and developers. However, these identities and attributes are self-declared by the users, which may impact reliability and usability. In this work, we propose an extension of our model to resolve these deficiencies by delegating the identity and attributes' provision to external certified entities. The European electronic Identification, Authentication and Trust Services (eIDAS) regulation established a solution to ensure the cross-border mutual recognition of Electronic Identification (eID) mechanisms among the European Member States. This research aims to provide an extension of this regulation mentioned above (eIDAS) to support functional attributes and connect our previously proposed model to this extended eIDAS network. Thanks to this proposal, web services can guarantee adapted and personalized interfaces while improving the functionalities offered without any previous configuration by users and, in a reliable way, since the functional attributes belong to the users' official eID. As the attribute set provided by eIDAS nodes only contains citizens' personal and legal ones, we also propose a mechanism to connect the eIDAS network to external attribute providers that could extend the eIDAS profile of users with their functional attributes. We deployed a pilot to validate the proposed model consisting of an identity provider, an eIDAS node supporting the extended reference code, and an attribute provider supporting functional attributes. We also designed and implemented a simple service that supports eID authentication and serves adapted interfaces based on the retrieved extended eIDAS profile. Finally, we developed an experience for getting feedback from a set of real users with different functional capabilities. According to the results, we concluded that the generalized adoption of the proposed solution in the European digital web services will significantly improve their accessibility in terms of ease of use and adaptability to users' capacities.


Subject(s)
Software , Trust , Electronics , Reproducibility of Results
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