bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Competences of Newly Qualified Professionals
Authors: Tosolini Kim
Published: May 2020

Introduction: Very little research has been done on the transition of newly qualified professionals onto the working field. They often feel vulnerable, due to the differences between them and the experienced professionals. With present study the researcher wanted to investigate whether introducing newly qualified professionals to a specific theoretical model, can help improve their competence in the field of deafblindness and reduce the gap between newly qualified professionals at the start of their careers and expert professionals. The study was specifically aimed at an intervention in applying the Real Space Blend Model to improve competences in the interpretations of gestures of persons with CDB in both groups of professionals. Method: The study used a qualitative design based on individual video-analyses and focus groups. Results: In two of the newly qualified professionals a considerable increase in the number of gestures was seen. Such an increase was also found for one of the expert professionals. Two other expert professionals showed a little change in the overall number of gestures. From the thematic analysis, different themes came forward for each focus group. Newly qualified professionals seemed overall more confident after the intervention, while experienced professionals seemed to have more difficulties grasping the model of Real Space Blends. The expert professionals felt more aware about their identification of gestures in practice. Conclusion and discussion: The training did improve competences in newly qualified professionals. The main effect was an increase in confidence in their abilities. Experienced professionals, on the other hand, experienced more difficulties in learning how to use the model of the Real Space Blends, but found the model very useful in practice to add on the Diagnostic Intervention Model. Some limitations of this study were the small amount of participants and that there were more experienced professionals than newly qualified professionals. More extensive research on the transition of newly qualified professionals is recommended.
Effect Of Health Education About Snack Foods On Snack Food Preferences In Elementary School Students At SDN Jagir 1/393 Surabaya
Authors: Setiyowati Eppy , Alamsyah Selvya
Published: May 2020

Snack food is a type of snack that is very popular with school children and is difficult to separate. School children usually buy snacks without considering their nutritional content. Excessive children's preference for snacks can have a negative impact such as decreased appetite and cause various kinds of diseases due to less hygienic food. The aim of the study was to analyze the effect of health education on snack foods on the preferences (preferences) of snack foods on elementary students at Jagir Elementary School 1/393 Surabaya. Pre-Experimental research design with one group pre-post test design approach. The number of samples is 70 students consisting of grades 4, 5 and 6. Sampling using probability sampling with stratified random sampling technique and using a questionnaire as a measuring instrument. Data were analyzed using Paired T-Test with a significance level of 0.05. The results of the study using Paired T-Test obtained a value of ρ = 0,000 with a significance level of α = 0.05 means ρ <α, then H0 is rejected and H1 is accepted which means that there is an influence of health education on snack foods on snack food preferences elementary school students at SDN Jagir 1/393 Surabaya. The conclusion of this study is that health education has an effect on elementary students on the preference of snack foods. Suggestions, for the school to be taken into consideration in increasing students' knowledge in choosing healthy, safe and nutritious snacks.
The Effect Of Hypnotherapy On Post Traumatic Stress Disorder (PTSD) Decrease In Women Of Sexual Abuse In Tasikmalaya 2019
Authors: Rusman Kharisma Nurul Fazrianti , Mintarsih Wiwin , Nurvita Nita
Published: May 2020

Sexual abuse can have a profound trauma effect on victims, especially women. The effect of trauma experienced by victims of sexual abuse is an aotonomic liability anxiety syndrome from a very painful experience both physically and emotionally called Post Traumatic Stress Disorder or PTSD. One therapy for PTSD is hypnotherapy. Hypnotherapy is one kind of complementary /nonconventional therapy where patients are guided to relax in and naturally. The gate of someone's subconscious mind will be open, thus patients tend to be easier to accept healing suggestions given. The purpose of this study is to determine the effect of hypnotherapy on Post Traumatic Stress Disorder (PTSD) in women victims of sexual abuse 2019 in Tasikmalaya.

This study used a single case experimental design within the A-B-Follow paradigm. A is a baseline measurement, and B is a measurement after administration of therapy and follow-up is the final measurement. This study involved four subjects with the criteria of women who were victims of sexual abuse in Tasikmalaya. Data analysis in this study used quantitative analysis in the form of graphical explanations of research and qualitative analysis in the form of results from observations and interviews during the study. The results of this study found that the level of PTSD women who were sexually abused before hypnotherapy was in the high and medium category. While after hypnotherapy was in the medium and low category. Hence, there is an effect of hypnotherapy on the level of PTSD women victims of sexual abuse.
Characteristics of Mothers Which Affect The Low Coverage of Comprehensive Postpartum Service In The Working Area of Community Health Center of Kayen Kidul in Kediri Regency From January to August 2019
Authors: Ivantarina Dintya , Ratnawati Lina
Published: May 2020

The utilization of postpartum maternal services in a complete manner in several regions still has not reached the target that has set by the government. Some factors that affect the coverage of comprehensive postpartum service is mother characteristics. The purpose of this research is to determine the characteristics of mothers who affect the low coverage of comprehensive postpartum service in the working area of Community Health Center of Kayen Kidul in Kediri Regency from January to August year 2019. This research was conducted in September 2019 in the working area of Kayen Kidul Community Health Center of in Kediri Regency. The design of the research used is analytical observational with a case control approach. The sampling techniques used are random sampling clusters. The samples in this study were mothers who had finished their postpartum period (more than 6 weeks to 9 months after giving birth). Independent variables are characteristic of mothers while dependent variables are coverage of the comprehensive postpartum service. Collection of data using data collection sheets with structured interview techniques and medical records in the form of maternal and child health books. Then the data is processed and analyzed univariate, bivariate and multivariate. Statistical results of bivariate statistics showed that the work (P = 0.023), pregnancy complications (P = 0.026), labor complications (P = 0.03) and the type of childbirth (P = 0.01) have an influence on the low coverage of comprehensive postpartum service. Multivariate statistical test results using binomial logistic regression obtained results in the omnibus table having P = 0.006 (P<0.05) which means the model is worth analysed. The significance value in the Hosmer and Lemeshow Test table of 0.074 (p>0.05) has the meaning of acceptable models and hypothesis testing can be performed. The value of Nagelkerke R Square 0.278 means the characteristic mother of age (P = 0.047) and the type of childbirth (P = 0.037) has an effect of 27.8% on the low coverage of the comprehensive postpartum service. The public health policy program should aim to improve the coverage of the comprehensive postpartum service by observing the characteristics of mothers in the region, namely the characteristics of maternal age and type of delivery

 
Utilization Of Local Papaya Fruit At Pregnant Women Trimester II On The Quantity Of ASI Association In Kontunaga District, Muna Souteast Sulawesi 2019
Authors: Altahirah Sutrisna
Published: May 2020

Breast milk is the best nutritional intake for infants in infants 0-24 months. Quantity of ASI (Breast Milk) is needed to meet the needs of the baby which is increasing along with the growth and development of the baby. So from this adequate nutritional needs are needed by pregnant women and prepare to give milk to babies. In the second trimester pregnant women the production of breast milk has begun to be prepared in the mother's body. Lactogagum contained in papaya is very useful and increases milk production. Papaya fruit (carica papaya) is an agricultural commodity that is relatively cheap in price so that it can be reached by people in all walks of life. While the processed products produced from papaya fruit (carica papaya) have a very high economic. Papaya fruit (carica papaya) is included in the category of foods that increase breast milk, because it contains 33% vitamins and 50% more potassium than oranges. Papaya fruit (carica papaya) is good for meeting the needs of potassium during lactation. If the lack of potassium is potentially affected by depression.While the mother's condition must be stable when breastfeeding. This raises the idea of researchers whether local papaya (carica papaya) that grows in Muna Regency can increase the quantity of breast milk. This research was conducted in the kontunaga sub-district divided into two groups namely the intervention group and the control group with a total sample of 50 samples. The research method used is quasi experiment with Independent sample t-test analysis test. The results of this study indicate that there is an effect of giving local papaya to second trimester pregnant women on the quantity of breast milk, this is indicated by the value of P <0.05, which is a very significant effect.
Communication Technology Use by Caregivers of Adolescents With Mental Health Issues: Systematic Review
Authors: Jansen Ronelle , Reid Marianne
Published: May 2020

Background

Caregivers of adolescents with mental health issues experience challenges that may result in the caregivers having a variety of unmet needs. There is a growing need to support these caregivers. Effective support to strengthen positive caregiving behavior in caregivers may address their challenges. Communication technologies offer novel opportunities to assist these caregivers and may contribute to strengthening caregiver behavior. However, little is known about the use of communication technologies among caregivers of adolescents with mental health issues.

Objective

The study aimed to answer the question: “What is the best evidence available to strengthen positive behavior of caregivers of adolescents with mental health issues using communication technology.”

Methods

A systematic review of articles published between January 2007 and August 2018 was conducted. Searches included articles of multiple study designs from EBSCO Host and Scopus platforms with prespecified eligibility criteria. Methodological quality was evaluated using the applicable Critical Appraisal Skills Programme and Joanna Briggs Institute assessment tools.

Results

The search yielded 1746 articles. Altogether, 5 articles met the eligibility criteria and were included in the review for data synthesis. Data analysis and synthesis identified three thematic conclusions reflecting the types of communication technologies used, caregivers as the target population, and strengthening of positive behavior through determinants of the Integrated Model of Behavior Prediction.

Conclusions

The review reported the usefulness of communication technology by caregivers. Caregivers also demonstrated improvement in self-efficacy, knowledge, parent-child communication, and parental skills reflecting positive behavior. Although the use of communication technology is expanding as a supportive intervention to address caregivers’ needs, the evidence for usefulness among caregivers of adolescents with mental health issues is still scarce. More research and information related to preferred methods of communication delivery among caregivers of adolescents is still needed.
Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis
Authors: Chen Lihong , Cheng Lihui , Gao Wei , Chen Dawei , Wang Chun , Ran Xingwu
Published: May 2020

Background

Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management.

Objective

The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management.

Methods

We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints.

Results

A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P<.001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies.

Conclusions

Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.
Reactions to an Online Demonstration of the Effect of Increased Fruit and Vegetable Consumption on Appearance: Survey Study
Authors: Cairns Patrick , Ozakinci Gozde , Perrett David Ian
Published: May 2020

Background

Inadequate fruit and vegetable consumption causes a considerable disease burden and premature mortality. Despite public health promotion of a healthy diet, the average consumption is still below recommended levels. Fruit and vegetable consumption influences human skin color, increasing red/yellow/orange pigment in the skin. Given that this color is deemed attractive and healthy-looking, the appearance benefit may motivate to eat more fruit and vegetables. Such appearance motivation could be particularly useful in young individuals who currently eat the least fruit and vegetables.

Objective

Our objectives were to assess how widely the impact of diet on skin color is known within the UK and to compare the strength of motivation to eat fruit and vegetables based on health and appearance benefits among different demographic groups.

Methods

Four groups of UK residents (N=200 per group) were recruited through the Prolific online platform. Groups comprised younger (aged 18-24) and older adults (aged 40-60) of low and high self-reported socioeconomic status (1-5 and 6-10 on a 10-point rating scale). Facial images simulating the skin color associated with low and high fruit and vegetable diets were shown to participants. Questionnaires were used to assess (1) background knowledge of the health and skin color effects of dietary fruit and vegetables, (2) the specific motivational impact of the skin color illustration, and (3) the relative importance of motivation to consume fruit and vegetables arising from health and skin color appearance benefits.

Results

We found that 61% (n=487) of all participants were unaware of the dietary–skin color association. We also found that 57% (n=457) of participants found the simple demonstration of the dietary impact on skin color positively motivating to eat more fruit and vegetables. The visual demonstration was equally motivating for participants of high and low self-reported socioeconomic status (P=.63) and different ethnic backgrounds (White N=453, Black N=182, Asian N=87, P=.22). Health benefits from a diet high in fruit and vegetables were regarded as more motivating than skin color appearance benefits. The appearance-changing benefits of a high fruit and vegetable diet (compared to the health benefits) were relatively more important for the younger participants (Mann-Whitney U=96,263, P<.001) and for women (N=489) than for men (N=310, U=83,763, P=.01).

Conclusions

These findings indicate that the promotion of the skin color effects of diets high in fruit and vegetables could provide additional motivation for a healthier diet. Our study indicates the broad appeal of appearance benefits from dietary fruit and vegetable (across ethnicity and socioeconomic status) and particularly amongst young adults where an inadequate diet is most prevalent.
Effect of Health Care Provider Delays on Short-Term Outcomes in Patients With Colorectal Cancer: Multicenter Population-Based Observational Study
Authors: Abdulaal Ahmed , Arhi Chanpreet , Ziprin Paul
Published: May 2020

Background

The United Kingdom has lower survival figures for all types of cancers compared to many European countries despite similar national expenditures on health. This discrepancy may be linked to long diagnostic and treatment delays.

Objective

The aim of this study was to determine whether delays experienced by patients with colorectal cancer (CRC) affect their survival.

Methods

This observational study utilized the Somerset Cancer Register to identify patients with CRC who were diagnosed on the basis of positive histology findings. The effects of diagnostic and treatment delays and their subdivisions on outcomes were investigated using Cox proportional hazards regression. Kaplan-Meier plots were used to illustrate group differences.

Results

A total of 648 patients (375 males, 57.9% males) were included in this study. We found that neither diagnostic delay nor treatment delay had an effect on the overall survival in patients with CRC (χ23=1.5, P=.68; χ23=0.6, P=.90, respectively). Similarly, treatment delays did not affect the outcomes in patients with CRC (χ23=5.5, P=.14). The initial Cox regression analysis showed that patients with CRC who had short diagnostic delays were less likely to die than those experiencing long delays (hazard ratio 0.165, 95% CI 0.044-0.616; P=.007). However, this result was nonsignificant following sensitivity analysis.

Conclusions

Diagnostic and treatment delays had no effect on the survival of this cohort of patients with CRC. The utility of the 2-week wait referral system is therefore questioned. Timely screening with subsequent early referral and access to diagnostics may have a more beneficial effect.
Acceptability of the Pregnancy, Exercise, and Nutrition Research Study With Smartphone App Support (PEARS) and the Use of Mobile Health in a Mixed Lifestyle Intervention by Pregnant Obese and Overweight Women: Secondary Analysis of a Randomized Controlled Trial
Authors: Greene Ellen M , O'Brien Eileen C , Kennelly Maria A , O'Brien Orna A , Lindsay Karen L , McAuliffe Fionnuala M
Published: May 2020

Background

Dietary interventions can improve pregnancy outcomes among women with increased BMI. Although the interest in mobile health interventions is growing, little is known about the acceptability of smartphone apps to support lifestyle interventions in such a cohort.

Objective

We aimed to assess the acceptability of the pregnancy, exercise, and nutrition research study with smartphone app support (PEARS) and the use of mobile health in a mixed lifestyle intervention delivered to overweight and obese pregnant women.

Methods

PEARS was a randomized controlled trial of a low glycemic index dietary intervention with exercise prescription and a smartphone app, which was delivered to pregnant women who were overweight or obese. Acceptability questionnaires were completed by the intervention group at 28 weeks of gestation (n=149) and at postintervention (n=123). Maternal characteristics were recorded (ie, age, ethnicity, BMI, socioeconomic status). Associations between maternal characteristics and acceptability of the intervention and app were analyzed using two-tailed t tests, Mann-Whitney U tests, chi-square test, and logistic regression. One-on-one semistructured interviews were conducted with a subcohort of the intervention participants (n=28) at 34 weeks of gestation, in which the participants shared their experiences of the PEARS intervention.

Results

The intervention was generally accepted, with respondents agreeing that the diet was easy to follow (98/148, 68.5%), enjoyable (106/148, 74.1%), and affordable (110/148, 76.9%). Qualitative and quantitative results were consistent with each another, both demonstrating that app acceptability was high. The participants agreed that the app was enjoyable (96/120, 80.0%) and easy to use (116/119, 97.5%). Compared to those with tertiary education, those with lower education levels were more likely to enjoy the dietary changes (P=.04). Enjoyment of the app was associated with disadvantaged neighborhood deprivation index (P=.01) and higher BMI (P=.03).

Conclusions

The PEARS intervention and use of a supportive smartphone app were accepted by pregnant women, particularly by those from vulnerable subgroups of this population.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN) 29316280; https://www.isrctn.com/ISRCTN29316280
Evaluation of the Level of Evidence Supporting the Recommendations Constituting the American Academy of Dermatology Clinical Practice Guidelines: Cross-Sectional Analysis
Authors: Cook Courtney , Ottwell Ryan , Rogers Taylor , Checketts Jake , Musuvathy Sanjeev , Vassar Matt
Published: May 2020

Background

Clinical practice guidelines are evidence-based recommendations used by physicians to improve patient care. These guidelines provide the physician with an assessment of the benefits and harms of a treatment and its alternatives. Therefore, it is essential that the clinical practice guidelines be based on the strongest available evidence. Numerous studies in a variety of different fields of medicine have demonstrated that recommendations supported by weak evidence are a common theme in clinical practice guidelines. A clinical guideline based solely on weak evidence has the capability to reduce the quality of care provided by physicians.

Objective

Our primary objective is to evaluate the levels of evidence supporting the recommendations constituting the American Academy of Dermatology clinical practice guidelines.

Methods

Using a cross-sectional study design, authors SM and RO located all current clinical practice guidelines on the American Academy of Dermatology website on June 10, 2017, and December 11, 2019. Each recommendation and its corresponding evidence rating were extracted in a duplicate and blinded fashion. A consensus meeting was planned a priori to resolve disagreements in extractions or stratifications.

Results

In total, 6 clinical guidelines and their subsections were screened and 899 recommendations were identified. Our final data set included 841 recommendations, as 58 recommendations contained no level of evidence and were excluded from calculations. Many recommendations were supported by a moderate level of evidence and therefore received a B rating (346/841, 41.1%). Roughly one-third of the recommendations were supported by a strong level of evidence and were given an A rating (n=307, 36.5%). The clinical practice guideline with the highest overall strength of evidence was regarding the treatment of acne, which had 17 of 35 (48.6%) recommendations supported by strong evidence and only 2 (5.7%) supported by weak evidence. The clinical practice guideline with the fewest recommendations supported by strong evidence was melanoma (13/63, 20.6%).

Conclusions

Clinical practice guidelines that lack strong supporting evidence could negatively affect patient care, and dermatologists should be mindful that not all recommendations are supported by the strongest level of evidence. An increased quantity of quality research needs to be performed in the field of dermatology to improve the evidence supporting the American Academy of Dermatology clinical practice guidelines.
Comparison of Older and Younger Adults’ Attitudes Toward the Adoption and Use of Activity Trackers
Authors: Kim Sunyoung , Choudhury Abhishek
Published: May 2020

Background

Activity tracking devices have significant potential in assisting older adults’ health care and quality of life, but this population lags behind in the adoption of these devices. While theoretical frameworks have been introduced to explain and increase the adoption of this technology by older adults, little effort has been made to validate the frameworks with people in other age groups.

Objective

The goal of this study was to validate the theoretical framework of technology acceptance by older adults that we previously proposed through a direct comparison of the attitudes to and experiences of activity trackers in older and younger users.

Methods

Semistructured interviews were conducted with 2 groups of 15 participants to investigate their experiences of using activity trackers. The recruitment criteria included age (between 18 years and 24 years for the younger participant group or 65 years and older for the older participant group) and prior experiences of using mobile devices or apps for activity tracking for 2 months and longer.

Results

Our findings showed that the phase of perceived ease of learning as a significant influencer of the acceptance of activity trackers existed only in the older participant group, but this phase never emerged in the younger participant group. In addition, this study confirmed that other phases exist in both age groups, but 2 distinct patterns emerged according to age groups: (1) the social influence construct influenced the older participants positively but the younger participants negatively and (2) older participants’ exploration in the system experiment phase was purpose-driven by particular needs or benefits but for younger participants, it was a phase to explore a new technology.

Conclusions

This study confirms the validity of the proposed theoretical framework to account for the unique aspect of older adults’ technology adoption. This framework can provide theoretical guidelines when designing technology for older adults as well as when generating new investigations and experiments for older adults and technology use.
Improving the Quality of Antenatal Care Using Mobile Health in Madagascar: Five-Year Cross-Sectional Study
Authors: Benski Anne Caroline , Schmidt Nicole C , Viviano Manuela , Stancanelli Giovanna , Soaroby Adelia , Reich Michael R
Published: May 2020

Background

Despite many efforts, maternal mortality remains a major burden in most developing countries. Mobile health (mHealth) has the potential to improve access to obstetric care through apps that help patients and providers.

Objective

This study aimed to use mHealth to provide antenatal care (ANC) to 1446 pregnant women in a rural area in Madagascar and evaluate the quality of ANC provided by an mHealth system designed to change the behaviors of providers and patients.

Methods

We included 1446 women who attended ANC visits in rural Madagascar from 2015 to 2019 using an mHealth system called Pregnancy and Newborn Diagnostic Assessment (PANDA). This cross-sectional study used data from different participants, with information collected over several years, to analyze the outputs related to the quality of ANC over time. Specifically, we examined the timing of the first ANC visit, the relationship between the visit duration and the risk factors among pregnant women, and the number of ANC visits per woman.

Results

Following the implementation of the mHealth system in 2015, we observed that women started to come earlier for their first ANC visit; more women attended their first ANC visit in the second trimester of pregnancy in 2019 than in the previous years (P<.001). In 2019, fewer women attended their first ANC visit in the third trimester (57/277, 20.6%) than in 2015 (147/343, 42.9%). There were statistically significant associations between the ANC visit durations and the risk factors, including age (>35 years; 25.0 min, 95% CI 24.0-25.9), educational level (longer visit for women with lower than primary education and for women who attended university and shorter for women with primary school–level education; 40.7 min, 95% CI 30.2-51.3 and 25.3 min, 95% CI 24.4-26.3 vs 23.3 min, 95% CI 22.9-23.8; P=.001), experience of domestic violence during pregnancy, gravidity, parity, infectious diseases (HIV, malaria, and syphilis), and level of anemia. Statistically significant associations were observed for all quality indicator variables. We observed a statistically significant increase in the number of ANC visits per woman over time from 2015 to 2017; the number of ANC visits per woman then became stable after the third year of implementing the PANDA mHealth system.

Conclusions

This study shows the potential of an mHealth system to improve the quality of ANC, change provider behavior by standardizing ANC visits, and change patient behavior by increasing the willingness to return for subsequent visits and encouraging ANC attendance early in pregnancy. As this is an exploratory study, further studies are necessary to better understand how mHealth can change behavior and identify the conditions required for behavioral changes to persist over time.
Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study
Authors: Ho Hanley J , Zhang Zoe Xiaozhu , Huang Zhilian , Aung Aung Hein , Lim Wei-Yen , Chow Angela
Published: May 2020

Background

In early 2020, coronavirus disease (COVID-19) emerged and spread by community and nosocomial transmission. Effective contact tracing of potentially exposed health care workers is crucial for the prevention and control of infectious disease outbreaks in the health care setting.

Objective

This study aimed to evaluate the comparative effectiveness of contact tracing during the COVID-19 pandemic through the real-time locating system (RTLS) and review of the electronic medical record (EMR) at the designated hospital for COVID-19 response in Singapore.

Methods

Over a 2-day study period, all admitted patients with COVID-19, their ward locations, and the health care workers rostered to each ward were identified to determine the total number of potential contacts between patients with COVID-19 and health care workers. The numbers of staff-patient contacts determined by EMR reviews, RTLS-based contact tracing, and a combination of both methods were evaluated. The use of EMR-based and RTLS-based contact tracing methods was further validated by comparing their sensitivity and specificity against self-reported staff-patient contacts by health care workers.

Results

Of 796 potential staff-patient contacts (between 17 patients and 162 staff members), 104 (13.1%) were identified by both the RTLS and EMR, 54 (6.8%) by the RTLS alone, and 99 (12.4%) by the EMR alone; 539 (67.7%) were not identified through either method. Compared to self-reported contacts, EMR reviews had a sensitivity of 47.2% and a specificity of 77.9%, while the RTLS had a sensitivity of 72.2% and a specificity of 87.7%. The highest sensitivity was obtained by including all contacts identified by either the RTLS or the EMR (sensitivity 77.8%, specificity 73.4%).

Conclusions

RTLS-based contact tracing showed higher sensitivity and specificity than EMR review. Integration of both methods provided the best performance for rapid contact tracing, although technical adjustments to the RTLS and increasing user compliance with wearing of RTLS tags remain necessary.
Changes in Gaze Behavior during the Learning of the Epidural Technique with a Simulator in Anesthesia Novices (Preprint)
Authors: Capogna Emanuele , Salvi Francesco , Delvino Lorena , Di Giacinto Andrea , Del Vecchio Angelica , Capogna Giorgio
Published: May 2020

BACKGROUND

Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to medical and surgical training to improve performance.

OBJECTIVE

The aim of this study was to evaluate the changes in gaze behavior in anesthesia novice trainees when performing a simulated epidural technique before and after a hands-on training on the epidural simulator.

METHODS

We enrolled 48 novice trainees who had never previously performed an epidural block. After a standardized learning module, each trainee practiced the epidural procedure on the epidural simulator while wearing a pair of eye tracking glasses (Tobii Pro Glasses 50 Hz wearable wireless eye tracker). After this baseline recording, each trainee spent two hours practicing with the epidural simulator and afterwards once again performed the eye tracking epidural procedure.
Eye tracking metrics and epidural learning (duration of the procedure and number of attempts) before and after the simulated practice were recorded.

RESULTS

The duration of the epidural procedure was shorter and the number of epidural attempts reduced after the tutorial. Before the tutorial, during needle insertion. the eye tracking metrics showed more visit counts of shorter duration and after the tutorial less visit counts (P=.05) but of longer duration (P=.03). A significant correlation was observed between the number of epidural needle insertions (additional attempts) and the number (OR=2.02 (0.23-1.27; P=.008)) and duration (OR=0.65 (-0.93-0.02; P=.05)) of visits.

CONCLUSIONS

In novice anesthesia trainees who had never previously performed an epidural block, we observed significant changes in gaze behavior associated with increased performance during the initial phase of epidural technique learning with a simulator.
These results may create a prototype for future studies on eye tracking technique as a teaching and evaluating tool in simulation.

CLINICALTRIAL

Not necessary
eHealth Literacy of German Physicians in the Pre–COVID-19 Era: Questionnaire Study (Preprint)
Authors: Kirchberg Johanna , Fritzmann Johannes , Weitz Jürgen , Bork Ulrich
Published: May 2020

BACKGROUND

Digitalization is a disruptive technology that changes the way we deliver diagnostic procedures and treatments in medicine. Different stakeholders have varying interests in and expectations of the digitalization of modern medicine. Many recent digital advances in the medical field, such as the implementation of electronic health records, telemedical services, and mobile health apps, are increasingly used by medical professionals and patients. During the current pandemic outbreak of a novel coronavirus-caused respiratory disease (COVID-19), many modern information and communication technologies (ICT) have been used to overcome the physical barriers and limitations caused by government-issued curfews and workforce shortages. Therefore, the COVID-19 pandemic has led to a surge in the usage of modern ICT in medicine. At the same time, the eHealth literacy of physicians working with these technologies has probably not improved since our study.

OBJECTIVE

This paper describes a representative cohort of German physicians before the COVID-19 pandemic and their eHealth literacy and attitude towards modern ICT.

METHODS

A structured, self-developed questionnaire about user behavior and attitudes towards eHealth applications was administered to a representative cohort of 93 German physicians.

RESULTS

Of the 93 German physicians who participated in the study, 97% (90/93) use a mobile phone. Medical apps are used by 42% (39/93). Half of the surveyed physicians (47/93, 50%) use their private mobile phones for official purposes on a daily basis. Telemedicine is part of the daily routine for more than one-third (31/93, 33%) of all participants. More than 80% (76/93, 82%) of the trial participants state that their knowledge regarding the legal aspects and data safety of medical apps and cloud computing is insufficient.

CONCLUSIONS

Modern ICT is frequently used and mostly welcomed by German physicians. However, there is a tremendous lack of eHealth literacy and knowledge about the safe and secure implementation of these technologies in routine clinical practice.
The Internet of Things: Impact and Implications for Health Care Delivery (Preprint)
Authors: Kelly Jaimon T , Campbell Katrina L , Gong Enying , Scuffham Paul
Published: May 2020

UNSTRUCTURED

The Internet of Things (IoT) is a system of wireless, interrelated, and connected digital devices that can collect, send, and store data over a network without requiring human-to-human or human-to-computer interaction. The IoT promises many benefits to streamlining and enhancing health care delivery to proactively predict health issues and diagnose, treat, and monitor patients both in and out of the hospital. Worldwide, government leaders and decision makers are implementing policies to deliver health care services using technology and more so in response to the novel COVID-19 pandemic. It is now becoming increasingly important to understand how established and emerging IoT technologies can support health systems to deliver safe and effective care. The aim of this viewpoint paper is to provide an overview of the current IoT technology in health care, outline how IoT devices are improving health service delivery, and outline how IoT technology can affect and disrupt global health care in the next decade. The potential of IoT-based health care is expanded upon to theorize how IoT can improve the accessibility of preventative public health services and transition our current secondary and tertiary health care to be a more proactive, continuous, and coordinated system. Finally, this paper will deal with the potential issues that IoT-based health care generates, barriers to market adoption from health care professionals and patients alike, confidence and acceptability, privacy and security, interoperability, standardization and remuneration, data storage, and control and ownership. Corresponding enablers of IoT in current health care will rely on policy support, cybersecurity-focused guidelines, careful strategic planning, and transparent policies within health care organizations. IoT-based health care has great potential to improve the efficiency of the health system and improve population health.
Can Robots Improve Testing Capacity for SARS-CoV-2? (Preprint)
Authors: Cresswell Kathrin , Ramalingam Sandeep , Sheikh Aziz
Published: May 2020

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There is currently increasing interest internationally in deploying robotic applications for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, as these can help to reduce the risk of transmission of the virus to health care staff and patients. We provide an overview of key recent developments in this area. We argue that, although there is some potential for deploying robots to help with SARS-CoV-2 testing, the potential of patient-facing applications is likely to be limited. This is due to the high costs associated with patient-facing functionality, and risks of potentially adverse impacts on health care staff work practices and patient interactions. In contrast, back-end laboratory-based robots dealing with sample extraction and amplification, that effectively integrate with established processes, software, and interfaces to process samples, are much more likely to result in safety and efficiency gains. Consideration should therefore be given to deploying these at scale.
Telemedicine and the Use of Korean Medicine for Patients With COVID-19 in South Korea: Observational Study (Preprint)
Authors: Jang Soobin , Kim Dongsu , Yi Eunhee , Choi Gunhee , Song Mideok , Lee Eun-Kyoung
Published: May 2020

BACKGROUND

COVID-19 was first reported in Wuhan, China, in December 2019, and it has since spread worldwide. The Association of Korean Medicine (AKOM) established the COVID-19 telemedicine center of Korean medicine (KM telemedicine center) in Daegu and Seoul.

OBJECTIVE

The aim of this study was to describe the results of the KM telemedicine center and the clinical possibility of using herbal medicines for COVID-19.

METHODS

All procedures were conducted by voice call following standardized guidelines. The students in the reception group obtained informed consent from participants and they collected basic information. Subsequently, Korean Medicine doctors assessed COVID-19–related symptoms and prescribed the appropriate herbal medicine according to the KM telemedicine guidelines. The data of patients who completed the program by June 30, 2020, were analyzed.

RESULTS

From March 9 to June 30, 2020, 2324 patients participated in and completed the KM telemedicine program. Kyung-Ok-Ko (n=2285) was the most prescribed herbal medicine, and Qingfei Paidu decoction (I and II, n=2053) was the second most prescribed. All COVID-19–related symptoms (headache, chills, sputum, dry cough, sore throat, fatigue, muscle pain, rhinorrhea, nasal congestion, dyspnea, chest tightness, diarrhea, and loss of appetite) improved after treatment (P<.001).

CONCLUSIONS

The KM telemedicine center has provided medical service to 10.8% of all patients with COVID-19 in South Korea (as of June 30, 2020), and it is still in operation. We hope that this study will help to establish a better health care system to overcome COVID-19.
SMAART RAPID Tracker: A Global Policy Informatics tool to track COVID-19 outbreak (Preprint)
Authors: Joshi Ashish , Heisler Zoe , Arora Srishti , Kaur Harpreet , Kaur Kamalpreet , Kandpal Swati , Bhatt Ashruti , Gupta Mansi , Kaur Mahima
Published: May 2020

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In the wake of COVID-19 there has been a large increase of data being generated globally. Basic elements of data, such as incidence, prevalence, and mortality, have already been aggregated to form various dashboard illustrating the spread of COVID-19 across the world. However, it is important to consider not only the rate and trajectory of the virus’s proliferation, but how various countries have responded to the outbreak and the effects of their responses. The SMAART RAPID Tracker integrates information about spread and fatality rates of the disease, but displays them alongside the policies countries have taken in response to the disease. The RAPID Tracker provides comprehensible data visualizations to empower any users to understand the scope of the disease and the different strategies countries are taking. These visualizations are further utilized to highlight insights on a country or state level and allow users to directly compare countries or states. Finally, the RAPID Tracker provides a list of reliable and accurate resources for users to learn more about COVID-19 and how to protect themselves. Policy makers and government agencies can utilize the dashboard as a decision-aid tool to assess the impact of the policies on COVID-19 outbreak to make evidence-based decisions. Especially during a time when testing is scarce and vaccines and treatments are unavailable, it is crucial that policymakers and citizens of the world have access to accurate and meaningful information to inform their behaviors.
Genome-Wide Association Studies of CKD and Related Traits
Authors: Tin Adrienne , Köttgen Anna
Published: May 2020

The past few years have seen major advances in genome-wide association studies (GWAS) of CKD and kidney function–related traits in several areas: increases in sample size from >100,000 to >1 million, enabling the discovery of >250 associated genetic loci that are highly reproducible; the inclusion of participants not only of European but also of non-European ancestries; and the use of advanced computational methods to integrate additional genomic and other unbiased, high-dimensional data to characterize the underlying genetic architecture and prioritize potentially causal genes and variants. Together with other large-scale biobank and genetic association studies of complex traits, these GWAS of kidney function–related traits have also provided novel insight into the relationship of kidney function to other diseases with respect to their genetic associations, genetic correlation, and directional relationships. A number of studies also included functional experiments using model organisms or cell lines to validate prioritized potentially causal genes and/or variants. In this review article, we will summarize these recent GWAS of CKD and kidney function–related traits, explain approaches for downstream characterization of associated genetic loci and the value of such computational follow-up analyses, and discuss related challenges along with potential solutions to ultimately enable improved treatment and prevention of kidney diseases through genetics.
Effects of exercise on symptoms, vestibular/ocular motor screening and postural stability in a college-aged sample
Authors: Moran Ryan N , Murray Nicholas G , Esco Michael R , Dobbs Ward , McAllister-Deitrick Jamie
Published: May 2020

Aim: To examine the effects of maximal exercise on symptoms, vestibular/ocular motor screening (VOMS) and postural stability. Methodology: A total of 17 college-aged individuals completed a symptom scale, VOMS and the modified Clinical Test for Sensory Interaction and Balance (m-CTSIB), followed by a graded maximal exercise treadmill test. Assessments were repeated post exercise, 20 and 40 min post-exercise. Results: Significant increases in total symptoms, symptom severity scores and m-CTSIB scores from baseline to immediate post exercise were reported. Following 20-min recovery, improvements were noted on symptoms, visual motion sensitivity on VOMS and m-CTSIB. Conclusion: Symptoms and postural stability are influenced by exercise and following 20 min of rest, returned to baseline, indicating that a period of 20 min following a suspected concussion may be needed to negate exercise effects.