Measuring the adoption of internet and communication technologies among practitioners in routine disability services: a stepped inclusive approach.

PURPOSE: Existing measurements of the use of information and communication technologies (ICTs) among practitioners in disability services often treat ICT adoption as a monolithic concept, overlooking its multifaceted nature within the disability field. This study introduces a stepped, inclusive approach to capturing this complexity, elucidating disparities in the utilization of various ICT dimensions, the present vs. anticipated use, and variations among different clinical-demographic groups. MATERIALS AND METHODS: A cross-sectional survey was conducted in Hong Kong, gathering valid data from 324 practitioners spanning diverse disciplines and disability services. RESULTS: Data analysis produced a three-factor model categorizing ICT tools into (1) information and communication tools, (2) screening and monitoring tools, and (3) treatment and rehabilitation tools. The first category was identified as the predominant ICT utilized currently, with significant projected growth in the latter two categories' usage. Variances in current ICT adoption were influenced by practitioners' roles, clientele, positions, affiliating agencies, and educational attainments. CONCLUSIONS: This research provides a deeper understanding of the key dimensions of ICT adoption within disability services. It underscores the importance of devising specific and customized strategies for the effective integration of ICTs, ensuring a more tailored approach to meeting the unique demands of the disability field.

Future studies focusing on information and communication technologies (ICTs) adoption or relevant concepts, such as e-health and telerehabilitation may consider employing similar methodological approaches accustomed to one's local context.Future attention and investment in ICT adoption in disability services should focus more on domains directly relevant to clinical and rehabilitation practice, tailoring strategies to the specific needs of the field.There exists an urgent imperative to enhance ICT training, especially for psychosocial and medical professionals, while also increasing investments in non-governmental organizations.Such support needs to be gender- and age-inclusive, ensuring it meets the diverse needs of practitioners at all organizational levels.

Potential of V-Si72, V-C72, and V-Al36N36 as catalysts for oxygen reduction reaction.

CONTEXT: The capacities of V-Si72, V-C72, and V-Al36N36 nanocages to catalyze the ORR processes have been investigated. The acceptable pathways of ORR processes on V-Si72, V-C72, and V-Al36N36 nanocages have been examined by DSD-PBEPBE-D3/aug-cc-pVDZ, PW91PW91/aug-cc-pVDZ, and COSMO model in the gas phase and water. The ΔGreaction values of reaction steps of ORR pathways on V-Si72, V-C72, and V-Al36N36 nanocages are calculated. The Eadoption and Eformation of V-Si72, V-C72, and V-Al36N36 nanocages are negative values and these nanostructures are stable materials. The H2O has the lowest Eadsorption on V-Si72, V-C72, and V-Al36N36 nanocages. The *OH formation, creation of *OH-OH*, and formation of O* are rate-determining steps of ORR mechanisms. The overpotential values of ORR processes on V-Si72, V-C72, and V-Al36N36 nanocages are 0.41, 0.37, and 0.30 V, respectively. The V-Al36N36 nanocage have lower overpotential for ORR processes than V-Si72 and V-C72 nanocages by DSD-PBEPBE-D3/aug-cc-pVDZ, PW91PW91/aug-cc-pVDZ, and COSMO model in the gas phase and water. The V-Al36N36 nanocage have more negative ∆Greaction for reaction steps of ORR than V-Si72 and V-C72 nanocages. The V-Al36N36 nanocage with lower overpotential is proposed as an effective catalyst for ORR processes via studied pathways. METHODS: The DSD-PBEPBE-D3/aug-cc-pVDZ method has been used to optimize and calculate the frequencies of V-Si72, V-C72, and V-Al36N36 nanocages in GAMESS software. The complexes of O, OH, OOH, and H2O with V-Si72, V-C72, and V-Al36N36 nanocages are optimized and frequencies are determined by the DSD-PBEPBE-D3/aug-cc-pVDZ method. The Gactivation and ∆Greaction of ORR pathways on V-Si72, V-C72, and V-Al36N36 nanocages are calculated by DSD-PBEPBE-D3/aug-cc-pVDZ, PW91PW91/aug-cc-pVDZ, and COSMO model in the gas phase and water.

Mesomelia-synostoses syndrome: contiguous deletion syndrome, SULF1 haploinsufficiency or enhancer adoption?

BACKGROUND: Mesomelia-Synostoses Syndrome (MSS)(OMIM 600,383) is a rare autosomal dominant disorder characterized by mesomelic limb shortening, acral synostoses and multiple congenital malformations which is described as a contiguous deletion syndrome involving the two genes SULF1 and SLCO5A1. The study of apparently balanced chromosomal rearrangements (BCRs) is a cytogenetic strategy used to identify candidate genes associated with Mendelian diseases or abnormal phenotypes. With the improved development of genomic technologies, new methods refine this search, allowing better delineation of breakpoints as well as more accurate genotype-phenotype correlation. CASE PRESENTATION: We present a boy with a global development deficit, delayed speech development and an ASD (Asperger) family history, with an apparently balanced "de novo" reciprocal translocation [t(1;8)(p32.2;q13)dn]. The cytogenetic molecular study identified a likely pathogenic deletion of 21 kb in the 15q12 region, while mate pair sequencing identified gene-truncations at both the 1p32.2 and 8q13 translocation breakpoints. CONCLUSIONS: The identification of a pathogenic alteration on 15q12 involving GABRA5 was likely the main cause of the ASD-phenotype. Importantly, the chr8 translocation breakpoint truncating SLCO5A1 exclude SLCO5A1 as a candidate for MSS, leaving SULF1 as the primary candidate. However, the deletions observed in MSS remove a topological associated domain (TAD) boundary separating SULF1 and SLCO5A1. Hence, Mesomelia-Synostoses syndrome is either caused by haploinsufficiency of SULF1 or ectopic enhancer effects where skeletal/chrondrogenic SULF1 enhancers drive excopic expression of developmental genes in adjacent TADs including PRDM14, NCOA2 and/or EYA1.

Could social media be a game-changer in improving agricultural extension delivery in Ghana?

In this study, we set out to investigate the transforming power of social media for agricultural extension delivery services in Ghana. We employed a quantitative research approach and drew insights from 374 farmers. We used descriptive and inferential statistics to analyse the data. Cocoa farmers have some level of awareness of agricultural information on social media (Overall Mean = 1.88). Farmers regard social media platforms as potential sources of agricultural information (Perception Index = 3.38). Majority of farmers own smartphones (53.74 %) and have internet access (53.74 %). About 31.86 % of farmers spend 30 min to 1 h daily time browsing social media for agricultural information. About 57.65 % use social media for accessing agricultural information and implementing farming practices. According to 89.38 % of farmers, social media information helps to improve crop yield and pest management. The main constraint facing farmers in the use of social media is high data costs (Mean = 7.30). We recommend that the government in collaboration with telecommunication companies should explore innovative pricing models to reduce the cost barrier for farmers accessing agricultural content online.

Prevalence of fetal alcohol spectrum disorder in foster care: A scoping review.

The prevalence of fetal alcohol spectrum disorder (FASD) has been reported to be disproportionately high among children in foster care compared with the general population. However, updated prevalence estimates of infants and children with FASD in foster care or the prevalence of placement of children with FASD in foster care make this unclear. This study examines two questions. Firstly, what is the prevalence of FASD among infants and children in foster care? Secondly, what is the likelihood of placement in foster care for infants and children with FASD? This review was designed using PRISMA-SCR and JBI scoping review guidelines. Three databases were searched for the period June 2012 to June 2023: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar for all countries. Overall prevalence estimates were calculated using a complementary log-log link model along with 95% confidence intervals. Firstly, the estimated prevalence of FASD among infants and children in foster care was 18.8%. Secondly, among children diagnosed with FASD 30.5% are placed into foster care, reflecting greatly increased risk of placement of infants and children with FASD in foster care. We conclude that routine screening for FASD is needed to improve the identification of infants and children with FASD. Increased attention is also needed on developing strategies for FASD prevention. Recognition that nearly one of every three children with FASD will enter foster care demonstrates the need for increased funding, enhanced training and greater availability of services for families and children impacted by FASD.

A Deep Learning-Based Rotten Food Recognition App for Older Adults: Development and Usability Study.

BACKGROUND: Older adults are at greater risk of eating rotten fruits and of getting food poisoning because cognitive function declines as they age, making it difficult to distinguish rotten fruits. To address this problem, researchers have developed and evaluated various tools to detect rotten food items in various ways. Nevertheless, little is known about how to create an app to detect rotten food items to support older adults at a risk of health problems from eating rotten food items. OBJECTIVE: This study aimed to (1) create a smartphone app that enables older adults to take a picture of food items with a camera and classifies the fruit as rotten or not rotten for older adults and (2) evaluate the usability of the app and the perceptions of older adults about the app. METHODS: We developed a smartphone app that supports older adults in determining whether the 3 fruits selected for this study (apple, banana, and orange) were fresh enough to eat. We used several residual deep networks to check whether the fruit photos collected were of fresh fruit. We recruited healthy older adults aged over 65 years (n=15, 57.7%, males and n=11, 42.3%, females) as participants. We evaluated the usability of the app and the participants' perceptions about the app through surveys and interviews. We analyzed the survey responses, including an after-scenario questionnaire, as evaluation indicators of the usability of the app and collected qualitative data from the interviewees for in-depth analysis of the survey responses. RESULTS: The participants were satisfied with using an app to determine whether a fruit is fresh by taking a picture of the fruit but are reluctant to use the paid version of the app. The survey results revealed that the participants tended to use the app efficiently to take pictures of fruits and determine their freshness. The qualitative data analysis on app usability and participants' perceptions about the app revealed that they found the app simple and easy to use, they had no difficulty taking pictures, and they found the app interface visually satisfactory. CONCLUSIONS: This study suggests the possibility of developing an app that supports older adults in identifying rotten food items effectively and efficiently. Future work to make the app distinguish the freshness of various food items other than the 3 fruits selected still remains.

Impacts of Telehealth Adoption on the Quality of Care for Individuals With Serious Mental Illness: Retrospective Observational Analysis of Veterans Affairs Administrative Data.

Background: Telehealth implementation can be challenging for persons with serious mental illness (SMI), which may impact their quality of care and health outcomes. The literature on telehealth's impacts on SMI care outcomes is mixed, necessitating further investigation. Objective: We examined the impacts of facility-level telehealth adoption on quality of care metrics over time among patients with SMI. Methods: We analyzed Veterans Affairs (VA) administrative data across 138 facilities from January 2021 to December 2022. We performed longitudinal mixed-effects regressions to identify the relationships between the proportion of facility-level telehealth visits and SMI specialty care quality metrics: engagement with primary care; access and continuity of care across a range of mental health services including psychotherapy or psychosocial rehabilitation, SMI-specific intensive outpatient programs, and intensive case management; and continuity of mental health care after a high-risk event (eg, suicide attempt). Results: Facilities with a higher proportion of telehealth visits had reduced access and continuity of physical and mental health care for patients with SMI (P<.05). Higher telehealth adoption was associated with reduced primary care engagement (z=-4.04; P<.001), reduced access to and continuity in SMI-specific intensive case management (z=-4.49; P<.001; z=-3.15; P<.002), reductions in the continuity of care within psychotherapy and psychosocial rehabilitation (z=-3.74; P<.001), and continuity of care after a high-risk event (z=-2.46; P<.01). Telehealth uptake initially increased access to intensive outpatient but did not improve its continuity over time (z=-4.47; P<.001). Except for continuity within SMI-specific intensive case management (z=2.62; P<.009), continuity did not improve over time as telehealth became routinized. Conclusions: Although telehealth helped preserve health care access during the pandemic, telehealth may have tradeoffs with regard to quality of care for some individuals with SMI. These data suggest that engagement strategies used by SMI-specific intensive case management may have preserved quality and could benefit other settings. Strategies that enhance telehealth implementation-selected through a health equity lens-may improve quality of care among patients with SMI.

Identifying factors influencing local governments' adoption of comprehensive smoke-free policies: an event history analysis based on panel data from 36 key cities in China (2013-2021).

Introduction: The issue of tobacco control remains a significant concern for public health worldwide. In recent years, remarkable progress has been made toward adopting smoke-free measures in indoor public places. Although China has yet to introduce a national regulation, specifically for smoke-free public places, more than a dozen cities have successively approved and implemented comprehensive smoke-free regulations. Different cities in China have diverse attitudes and behaviors toward smoke-free policies; however, the reasons for these policy differences and the influencing factors have not received sufficient attention and research. Methods: On the basis of the multiple streams framework, this study selects 36 key Chinese cities as research samples and uses a directed dyad-year event history analysis method to analyze the factors influencing the implementation of comprehensive smoke-free policies in cities. Results: Results show that the adoption of such policies is positively influenced by scientific evidence, focal events, media coverage, institutional foundations, economic comparisons, and the influence of health departments and of tobacco control groups. By contrast, policy adoption is negatively affected by the differences in administrative levels, central policy signals, and the influence of the tobacco industry. Discussion: This study contributes to understanding the internal logic behind local governments' adoption of comprehensive smoke-free policies, offering insights for further advocacy at the city and national levels in China and providing experiences that can promote the global tobacco control movement.

Awareness and adoption of farm biosecurity practices in commercial dairy, pig and poultry farms of Uttar Pradesh (India).

India's livestock sector has been facing significant losses due to episodes of disease outbreaks since time immemorial. Hence, biosecurity measures are very important to maintain and improve animal health along with prevention of disease outbreak. Keeping these facts into consideration, the study was proposed with an objective to assess the existing biosecurity practices adopted by the commercial dairy, pig and poultry farms. The current study was undertaken in the state of Uttar Pradesh as it is the leading state in milk and meat production. A total of 120 farmers were selected randomly including 40 each practicing commercial dairy, pig and poultry farming. An ex-post facto research methodology was used with face-to-face interview and observation to collect data. The biosecurity practices were assessed under seven dimensions such as, location and design of farm, restricted access, isolation and quarantine, cleaning and disinfection, management of feed and water, disposal of carcass, manure and waste, and health management. Results elicited that about 50% of the farmers had medium level of adoption who adopted 18-34 practices out of 51 practices. The average overall adoption score was 34.17 out of 51 (67%) which makes an overall adoption gap of 33%. Maximum adoption gap was seen in case of restricted access (43%) whereas minimum gap in adoption was seen in case of management of feed and water (27%). Pig and poultry farmers showed significantly higher biosecurity measures than dairy farmers (p < 0.05). The more significant contributors to the adoption of biosecurity measures were the level of knowledge of the farmers (p < 0.01). Other factors such as education, income, herd/flock size, Information and Communication Technology utilization, number of trainings also had a significant contribution (p < 0.05) in actual implementation of biosecurity. Hence, better understanding of these measures among the farmers must be ensured by hands on training along with proper demonstration of various procedures involved in maintaining farm biosecurity is need of the hour.

The impact of credit accessibility and information communication technology on the income of small-scale sugarcane farmers in Ndwedwe Local Municipality, KwaZulu-Natal Province, South Africa.

Introduction: Access to credit and information and communication technology (ICT) plays a pivotal role in enhancing the practices of small-scale sugarcane farmers, impacting their financial, social, and economic wellbeing. However, many small-scale farmers need help accessing these resources, thereby affecting their ability to generate sustainable income. This study aimed to assess the factors influencing the adoption of ICT and access to credit and their subsequent impact on small-scale farmers' income. Methods: Employing a multistage sampling technique, 300 small-scale farmers were selected as participants in the study. The recursive bivariate probit regression model was used to assess the factors affecting adoption ICT and a selectivity-corrected ordinary least square regression model was utilized to estimate the synergistic effect of ICT adoption and access to credit on the income of small-scale sugarcane farmers. Results and discussion: The findings revealed that approximately 77% of small-scale farmers had access to credit, while more than 80% had adopted ICT. The results derived from the recursive bivariate probit (RBP) regression model indicated that access to credit, education, and extension support positively and significantly influenced the adoption of ICT. Conversely, marital status and non-farm income exhibited a negative and significant influence on the adoption of ICT. Gender and marital status were positively and significantly associated with access to credit, whereas age, education, and non-farm income showed a negative and significant relationship on access to credit. Subsequently, a selectivity-corrected ordinary least square regression model analysis revealed that factors such as gender, marital status, extension, government support, and transportation costs positively and significantly influenced farmer's income. In contrast, education, employment status, and non-farm income exhibited a negative and significant influence on income. Conclusion and recommendations: The study concludes that socio-demographic factors, such as gender, marital status, extension support, government support, and transportation costs, positively contribute to farmers' income. Small-scale sugarcane farmer involvement in other non-farm activities is associated with reduced farm income. This implies that farmers' livelihoods options are reduced as they can only focus on sugarcane development as a source of income. There is a pressing need to educate small-scale farmers on ICT and provide them with access to agricultural credit. Additionally, extension workers should offer advisory support to small-scale farmers requiring assistance in accessing agricultural credit. There is a need to train sugarcane farmers on different agricultural income generating activities to reduce their over-reliance on sugarcane development. By addressing the identified socio-demographic factors and implementing targeted policy interventions, stakeholders can foster an enabling environment for small-scale farmers to thrive, ultimately contributing to the sustainable development of the sugarcane sector and the broader agricultural landscape in South Africa.

The Information and Communication Technology Maturity Assessment at Primary Health Care Services Across 9 Provinces in Indonesia: Evaluation Study.

Background: Indonesia has rapidly embraced digital health, particularly during the COVID-19 pandemic, with over 15 million daily health application users. To advance its digital health vision, the government is prioritizing the development of health data and application systems into an integrated health care technology ecosystem. This initiative involves all levels of health care, from primary to tertiary, across all provinces. In particular, it aims to enhance primary health care services (as the main interface with the general population) and contribute to Indonesia's digital health transformation. Objective: This study assesses the information and communication technology (ICT) maturity in Indonesian health care services to advance digital health initiatives. ICT maturity assessment tools, specifically designed for middle-income countries, were used to evaluate digital health capabilities in 9 provinces across 5 Indonesian islands. Methods: A cross-sectional survey was conducted from February to March 2022, in 9 provinces across Indonesia, representing the country's diverse conditions on its major islands. Respondents included staff from public health centers (Puskesmas), primary care clinics (Klinik Pratama), and district health offices (Dinas Kesehatan Kabupaten/Kota). The survey used adapted ICT maturity assessment questionnaires, covering human resources, software and system, hardware, and infrastructure. It was administered electronically and involved 121 public health centers, 49 primary care clinics, and 67 IT staff from district health offices. Focus group discussions were held to delve deeper into the assessment results and gain more descriptive insights. Results: In this study, 237 participants represented 3 distinct categories: 121 public health centers, 67 district health offices, and 49 primary clinics. These instances were selected from a sample of 9 of the 34 provinces in Indonesia. Collected data from interviews and focus group discussions were transformed into scores on a scale of 1 to 5, with 1 indicating low ICT readiness and 5 indicating high ICT readiness. On average, the breakdown of ICT maturity scores was as follows: 2.71 for human resources' capability in ICT use and system management, 2.83 for software and information systems, 2.59 for hardware, and 2.84 for infrastructure, resulting in an overall average score of 2.74. According to the ICT maturity level pyramid, the ICT maturity of health care providers in Indonesia fell between the basic and good levels. The need to pursue best practices also emerged strongly. Further analysis of the ICT maturity scores, when examined by province, revealed regional variations. Conclusions: The maturity of ICT use is influenced by several critical components. Enhancing human resources, ensuring infrastructure, the availability of supportive hardware, and optimizing information systems are imperative to attain ICT maturity in health care services. In the context of ICT maturity assessment, significant score variations were observed across health care levels in the 9 provinces, underscoring the diversity in ICT readiness and the need for regionally customized follow-up actions.

Effect of a Structured Multilevel Telehealth Service on Hospital Admissions and Mortality During COVID-19 in a Resource-Limited Region in Brazil: Retrospective Cohort Study.

BACKGROUND: The COVID-19 pandemic represented a great stimulus for the adoption of telehealth and many initiatives in this field have emerged worldwide. However, despite this massive growth, data addressing the effectiveness of telehealth with respect to clinical outcomes remain scarce. OBJECTIVE: The aim of this study was to evaluate the impact of the adoption of a structured multilevel telehealth service on hospital admissions during the acute illness course and the mortality of adult patients with flu syndrome in the context of the COVID-19 pandemic. METHODS: A retrospective cohort study was performed in two Brazilian cities where a public COVID-19 telehealth service (TeleCOVID-MG) was deployed. TeleCOVID-MG was a structured multilevel telehealth service, including (1) first response and risk stratification through a chatbot software or phone call center, (2) teleconsultations with nurses and medical doctors, and (3) a telemonitoring system. For this analysis, we included data of adult patients registered in the Flu Syndrome notification databases who were diagnosed with flu syndrome between June 1, 2020, and May 31, 2021. The exposed group comprised patients with flu syndrome who used TeleCOVID-MG at least once during the illness course and the control group comprised patients who did not use this telehealth service during the respiratory illness course. Sociodemographic characteristics, comorbidities, and clinical outcomes data were extracted from the Brazilian official databases for flu syndrome, Severe Acute Respiratory Syndrome (due to any respiratory virus), and mortality. Models for the clinical outcomes were estimated by logistic regression. RESULTS: The final study population comprised 82,182 adult patients with a valid registry in the Flu Syndrome notification system. When compared to patients who did not use the service (n=67,689, 82.4%), patients supported by TeleCOVID-MG (n=14,493, 17.6%) had a lower chance of hospitalization during the acute respiratory illness course, even after adjusting for sociodemographic characteristics and underlying medical conditions (odds ratio [OR] 0.82, 95% CI 0.71-0.94; P=.005). No difference in mortality was observed between groups (OR 0.99, 95% CI 0.86-1.12; P=.83). CONCLUSIONS: A telehealth service applied on a large scale in a limited-resource region to tackle COVID-19 was related to reduced hospitalizations without increasing the mortality rate. Quality health care using inexpensive and readily available telehealth and digital health tools may be delivered in areas with limited resources and should be considered as a potential and valuable health care strategy. The success of a telehealth initiative relies on a partnership between the involved stakeholders to define the roles and responsibilities; set an alignment between the different modalities and levels of health care; and address the usual drawbacks related to the implementation process, such as infrastructure and accessibility issues.

Unveiling the interplay between rational, psychological and functional factors in continuous glucose monitoring early adoption: Novel evidence from the Dexcom ONE case in Italy.

BACKGROUND: The escalating prevalence of diabetes, with its multifaceted complications, poses a pressing challenge for healthcare systems globally. In response, the advent of continuous glucose monitoring (CGM) systems, offering technological solutions for daily diabetes management, presents significant opportunities. However, the widespread adoption faces several barriers, linked both to the technological configuration of the devices and to the psychological dimension of patients. Therefore, this study aims to apply and test a theoretical model that investigates the antecedents of the intention to use Continuous Glucose Monitoring systems. METHODS: The research model was built to unveil the impacts of psychological factors, functional components and rational constructs derived from the Technology Acceptance Model (TAM) on CGM systems sustained adoption. To ensure the comparability of results, we have collected data from people who had used Dexcom ONE Dexcom (San Diego, CA) for the first time for at least one month. Employing Structural Equation Modelling (SEM) techniques, the hypothesized relationships among constructs were assessed. RESULTS: The analyses confirmed the positive correlation of rational factors to the Intention to Use. Subjective Norm, intended as the physicians' influence, is positively correlated with the Perceived Usefulness. Trend Arrows, albeit being negatively correlated with Perceived Usefulness, have a positive correlation on Perceived Ease Of Use, reinforcing its mediating effect towards Perceived Usefulness. Among psychological factors, Trust in the CGM technology positively correlates with Intention to Use. Health Literacy is negatively correlated to the Intention to Use. CONCLUSIONS: These findings contribute to theoretical and managerial understanding, providing recommendations to enhance the adoption of CGM systems like Dexcom ONE.

Long-Term Adoption of Televisits in Nursing Homes During the COVID-19 Crisis and Following Up Into the Postpandemic Setting: Mixed Methods Study.

BACKGROUND: There is growing evidence that telemedicine can improve the access to and quality of health care for nursing home residents. However, it is still unclear how to best manage and guide the implementation process to ensure long-term adoption, especially in the context of a decline in telemedicine use after the COVID-19 crisis. OBJECTIVE: This study aims to identify and address major challenges for the implementation of televisits among residents in a nursing home, their caring nurses, and their treating general practitioners (GPs). It also evaluated the impact of televisits on the nurses' workload and their nursing practice. METHODS: A telemedical system with integrated medical devices was introduced in 2 nursing homes and their cooperating GP offices in rural Germany. The implementation process was closely monitored from the initial decision to introduce telemedicine in November 2019 to its long-term routine use until March 2023. Regular evaluation was based on a mixed methods approach combining rigorous qualitative approaches with quantitative measurements. RESULTS: In the first phase during the COVID-19 pandemic, both nursing homes achieved short-term adoption. In the postpandemic phase, an action-oriented approach made it possible to identify barriers and take control actions for long-term adoption. The implementation of asynchronous visits, strong leadership, and sustained training of the nurses were critical elements in achieving long-term implementation in 1 nursing home. The implementation led to enhanced clinical skills, higher professional recognition, and less psychological distress among the nursing staff. Televisits resulted in a modest increase in time demands for the nursing staff compared to organizing in-person home visits with the GPs. CONCLUSIONS: Focusing on health care workflow and change management aspects depending on the individual setting is of utmost importance to achieve successful long-term implementation of telemedicine.

Determinants of land management technology adoptions by rural households in the Goyrie watershed of southern Ethiopia: Multivariate probit modeling estimation.

Land management technology (LMT) adoption is one of Ethiopia's crucial strategies to combat soil depletion and promote agricultural production. However, there is scant information concerning the intensity, interdependent nature, and households' decision to adopt multiple LMTs. Thus, the purpose of this study is to identify factors influencing households' decisions to adopt multiple LMTs and the intensity and interdependency of the technologies in the Goyrie watershed of southern Ethiopia. The data was collected from 291 randomly selected household heads, focus group discussion participants, and key informant interview respondents. The quantitative data was analyzed using descriptive statistics and econometric methods like multivariate probit and ordered probit modeling, while the qualitative data was presented through content analysis. The result indicated that more than half of respondents (67 %) applied one or two LMTs. The highest complementary effects were observed in mixed soil bunds with desho grasses and manure applications. However, soil bunds and fanya-juu, manure application and agroforestry showed interchangeability with one another. Sex, education, family size, landholding size, access to development agents and credit institutions, training, and village membership increased the probability of adopting multiple LMTs, whereas age, land rent, and crop sharing discouraged the likelihood of households' decisions to adopt LMT. The results of the ordered probit model revealed that village membership and contact with extension agents highly encouraged the intensity of LMT adoptions. Thus, policymakers and planners should consider social, institutional, human asset, and technological related factors to increase adoption rates and intensity of land management technologies.

Exploring social media adoption for marketing purpose among healthcare professionals in Gondar town, central Gondar zone: A facility-based cross-sectional survey.

Background: Social media has become an integral platform for global information exchange and business interactions, emerging as a crucial tool for promoting products and services in the digital age. Despite its worldwide significance, local businesses, especially in Ethiopia, lag behind in leveraging social media for healthcare marketing. The scarcity of studies on social media adoption among healthcare providers in Ethiopia highlights the imperative for comprehensive research. Objective: This study, conducted in Gondar Town, focused on private healthcare professionals, aiming to identify the determinants of their behavioral intention and usage behavior in adopting social media marketing. Method: A facility-based cross-sectional survey involving 238 health professionals from private healthcare facilities in Gondar Town was conducted between March and June 2023. The study analyzed data using SPSS Version 26 and AMOS Structural Equation Modeling Version 23. Results: All participants reported using social media platforms, with Facebook, Telegram, and YouTube being popular choices. Performance expectancy, social influence, facilitation condition, and behavioral intention significantly influenced healthcare professionals' adoption of social media marketing. Performance expectancy and social influence exhibited the strongest impact on behavioral intention, acting as mediators influencing usage behavior. However, effort expectancy did not significantly influence behavioral intention. Age, gender, experience, and voluntariness showed no significant moderating effects. Conclusion: This study contributes valuable insights into social media marketing adoption in the healthcare sector, emphasizing the critical role of various factors in shaping behavioral intention and usage behavior. The findings offer practical implications for private healthcare providers, policymakers, and marketers, guiding strategies to enhance patient communication and engagement through social media in Gondar Town.

The impact of internet use and cognitive conflict on farmer IPM technology adoption: evidence from China.

BACKGROUND: Integrated pest management (IPM) plays a crucial role in protecting agricultural environments and enhancing the quality of agricultural products. However, a major challenge in China is the conflicting understanding of IPM among farmers, leading to low adoption rates. This undermines farmers' ability to control pests and diseases while increasing risks to agricultural quality and safety. This study aimed to investigate the impact of cognitive conflicts on farmers' adoption of IPM in kiwifruit farms in Shaanxi and Sichuan provinces. Additionally, the study explored the moderating role of internet use in the relationship between cognitive conflicts and farmer adoption of IPM. Data were collected from 686 kiwifruit farms through field surveys in 2018. The binary Probit model and moderating effect models were used to assess the influence of internet use and cognitive conflict on farmer adoption of IPM. RESULTS: The study found that cognitive conflicts significantly hindered farmers' adoption of IPM. Higher levels of cognitive conflict were associated with lower likelihoods of adopting IPM. Internet use and frequency had positive effects on farmer adoption of IPM, promoting its implementation. Moreover, internet use and frequency helped alleviate the inhibitory effect of cognitive conflicts on farmer adoption IPM. CONCLUSION: This research enhances our understanding of cognitive conflicts among farmers when promoting IPM and provides viable strategies to improve the effectiveness of public sector promotion and stimulate farmers' willingness to adopt IPM. It emphasizes the importance of addressing cognitive conflicts and utilizing internet resources to enhance IPM adoption among kiwifruit growers in China. © 2024 Society of Chemical Industry.

Adapting an Efficacious Peer-Delivered Physical Activity Program for Survivors of Breast Cancer for Web Platform Delivery: Protocol for a 2-Phase Study.

BACKGROUND: Interventions promoting physical activity (PA) among survivors of cancer improve their functioning, reduce fatigue, and offer other benefits in cancer recovery and risk reduction for future cancer. There is a need for interventions that can be implemented on a wider scale than that is possible in research settings. We have previously demonstrated that a 3-month peer-delivered PA program (Moving Forward Together [MFT]) significantly increased the moderate to vigorous PA (MVPA) of survivors of breast cancer. OBJECTIVE: Our goal is to scale up the MFT program by adapting an existing peer mentoring web platform, Mentor1to1. InquistHealth's web platform (Mentor1to1) has demonstrated efficacy in peer mentoring for chronic disease management. We will partner with InquisitHealth to adapt their web platform for MFT. The adaptation will allow for automating key resource-intensive components such as matching survivors with a coach via the web-based peer mentoring platform and collecting key indexes to prepare for large-scale implementation. The aim is to streamline intervention delivery, assure fidelity, and improve survivor outcomes. METHODS: In phase 1 of this 2-phase study, we will interview 4 peer mentors or coaches with experience in delivering MFT and use their feedback to create Mentor1to1 web platform adapted for MFT (webMFT). Next, another 4 coaches will participate in rapid, iterative user-centered testing of webMFT. In phase 2, we will conduct a randomized controlled trial by recruiting and training 10 to 12 coaches from cancer organizations to deliver webMFT to 56 survivors of breast cancer, who will be assigned to receive either webMFT or MVPA tracking (control) for 3 months. We will assess effectiveness with survivors' accelerometer-measured MVPA and self-reported psychosocial well-being at baseline and 3 months. We will assess implementation outcomes, including acceptability, feasibility, and program costs from the perspective of survivors, coaches, and collaborating organizations, as guided by the expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. RESULTS: As of September 2023, phase 1 of the study was completed, and 61 survivors were enrolled in phase 2. Using newer technologies for enhanced intervention delivery, program management, and automated data collection has the exciting promise of facilitating effective implementation by organizations with limited resources. Adapting evidence-based MFT to a customized web platform and collecting data at multiple levels (coaches, survivors, and organizations) along with costs will provide a strong foundation for a robust multisite implementation trial to increase MVPA and its benefits among many more survivors of breast cancer. CONCLUSIONS: The quantitative and qualitative data collected from survivors of cancer, coaches, and organizations will be analyzed to inform a future larger-scale trial of peer mentoring for PA delivered by cancer care organizations to survivors. TRIAL REGISTRATION: ClinicalTrials.gov NCT05409664; https://clinicaltrials.gov/study/NCT05409664. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52494.

A Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study.

Background: Advance care planning (ACP) is a process that involves patients expressing their personal goals, values, and future medical care preferences. Digital applications may help facilitate this process, though their use in older adults has not been adequately studied. Objective: This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults. Methods: Older adults (aged 50 years and older) who had an active Epic MyChart account at an academic health care system in North Carolina were recruited to participate. A total of 2850 electronic invitations were sent through MyChart accounts with an embedded hyperlink to the Koda platform. Participants who agreed to participate were asked to complete pre- and posttest surveys before and after navigating through the Koda Health platform. Primary outcomes were reach, adoption, and System Usability Scale (SUS) scores. Exploratory outcomes included ACP knowledge and readiness. Results: A total of 161 participants enrolled in the study and created an account on the platform (age: mean 63, SD 9.3 years), with 80% (129/161) of these participants going on to complete all steps of the intervention, thereby generating an advance directive. Participants reported minimal difficulty in using the Koda platform, with an overall SUS score of 76.2. Additionally, knowledge of ACP (eg, mean increase from 3.2 to 4.2 on 5-point scale; P<.001) and readiness (eg, mean increase from 2.6 to 3.2 on readiness to discuss ACP with health care provider; P<.001) significantly increased from before to after the intervention. Conclusions: This study demonstrated that the Koda Health platform is feasible, had above-average usability, and improved ACP documentation of preferences in older adults. Our findings indicate that web-based health tools like Koda may help older individuals learn about and feel more comfortable with ACP while potentially facilitating greater engagement in care planning.

Filial Trauma: The Experience of Adoptive Parents of Children with Complex Behavioral and Relational Problems.

Children adopted from out-of-home care may present symptoms of developmental trauma that affect their functioning. This puts their adoptive parents at risk of experiencing secondary trauma. The purpose of this research was to understand the experience of adoptive parents who self-report symptoms of secondary trauma in relation to their child's symptoms of developmental trauma. Individual semi-structured interviews were conducted, transcribed, and analyzed using Braun and Clarke's (Qualitative Research in Psychology, 3(2), 77-101, 2006) thematic analysis method. Ten adoptive parents were recruited from four community organizations providing support for adoptive parents or parents of children with attachment disorder. All participants reported feeling strong emotions related to secondary trauma, as well as physical and mental health issues that appeared after the child's arrival in the family. Participants reported experiencing aggression from their child, which greatly disturbed the parent-child relationship and led to the child being placed in residential care for half of the families involved in the study. Secondary trauma was insufficient to fully capture the experience of these parents as it failed to account for the suffering and distress linked to their efforts to establish a parent-child relationship. Instead, filial trauma was used to describe this experience. The authors conclude that a better understanding of filial trauma can contribute to improving post-adoption services for parents struggling to fulfill one of the most important roles of their lives: being the parent of their child.