Current provision and HCP experiences of remote care delivery and diabetes technology training for people with type 1 diabetes in the UK during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to the rapid implementation of remote care delivery in type 1 diabetes. We studied current modes of care delivery, healthcare professional experiences and impact on insulin pump training in type 1 diabetes care in the United Kingdom (UK). METHODS: The UK Diabetes Technology Network designed a 48-question survey aimed at healthcare professionals providing care in type 1 diabetes. RESULTS: One hundred and forty-three healthcare professionals (48% diabetes physicians, 52% diabetes educators and 88% working in adult services) from approximately 75 UK centres (52% university hospitals, 46% general and community hospitals), responded to the survey. Telephone consultations were the main modality of care delivery. There was a higher reported time taken for video consultations versus telephone (p < 0.001). Common barriers to remote consultations were patient familiarity with technology (72%) and access to patient device data (67%). We assessed the impact on insulin pump training. A reduction in total new pump starts (73%) and renewals (61%) was highlighted. Common barriers included patient digital literacy (61%), limited healthcare professional experience (46%) and time required per patient (44%). When grouped according to size of insulin pump service, pump starts and renewals in larger services were less impacted by the pandemic compared to smaller services. CONCLUSION: This survey highlights UK healthcare professional experiences of remote care delivery. While supportive of virtual care models, a number of factors highlighted, especially patient digital literacy, need to be addressed to improve virtual care delivery and device training.

Metodologias ativas e o ensino tecnicista na saúde: a prática docente / Active methodologies and technicist teaching in health: the teaching practice

Objetivo: Caracterizar a percepção do docente sobre as metodologias ativas utilizadas na educação profissional da área da saúde, bem como, desenvolver um prospecto de aplicativo para dispositivos móveis com conteúdo voltado ao ensino ativo. Métodos: Trata-se de uma pesquisa de campo-ação, de natureza qualitativa em uma Instituição Escolar Vale do Paraíba, a coleta deu-se em Maio 2019 a amostra foi determinada por conveniência. Resultados: A estratégia que o professor utiliza para desenvolver um conteúdo é o instrumento mais importante para alcançar os objetivos a que se propõe. Entretanto, não existe um método pedagógico universal, e sim uma infinidade de recursos ou ferramentas que o mesmo lança mão para mediar o processo ensino. Conclusão: O papel do professor, enquanto facilitador no processo de ensino-aprendizagem é fundamental no sentido de abrir-se e adequar-se às novas demandas.(AU)

Objective: To characterize the perception of teachers about active methodologies used in professional education in the health area, as well as to develop an application prospectus for mobile devices with content aimed at active teaching. Methods: This is a field-action research, qualitative in nature in a School Institution Vale do Paraiba, the collection took place in May 2019 and the sample was determined by convenience. Results: The strategy that the teacher uses to develop content is the most important instrument to achieve the goals it proposes. However, there is no universal pedagogical method, but an infinity of resources or tools that it uses to mediate the teaching process. Conclusion: The teacher's role, as a facilitator in the teachinglearning process, is fundamental in the sense of opening up and adapting to new demands.(AU)

Objetivo: Caracterizar la percepción de los profesores sobre las metodologías activas y las prácticas pedagógicas utilizadas en la formación profesional en los cursos del área de la salud, así como desarrollar inicialmente un prospecto de una aplicación para dispositivos móviles con contenidos centrados en estrategias de enseñanza activa. Métodos: Se trata de una investigación de campo, de carácter cualitativo. Se elaboró un instrumento de recopilación de datos para las entrevistas con los docentes de una institución privada de enseñanza técnica, amostra determinada por conveniencia. Para elaborar el prospecto de aplicación se utilizó la metodología del Design Thinking. Resultados: La estrategia que el profesor utiliza para desarrollar un contenido es la herramienta más importante para lograr sus objetivos. Sin embargo, no existe un método pedagógico universal, sino una multitud de recursos o herramientas que el profesor utiliza para estimular el aprendizaje del alumno. Conclusión: El papel del profesor, como facilitador en el proceso de enseñanza-aprendizaje, es fundamental para adaptarse a las nuevas exigencias, para estar abierto a nuevas prácticas pedagógicas, para aceptar los retos que imprime la educación de hoy y del futuro, de enseñar a aprender y de aprender a enseñar.(AU)

Hábitos alimentarios y de higiene asociados a la seroprevalencia de Helicobacter pylori en estudiantes universitarios peruanos / Dietary and hygiene habits associated with the Helicobacter pylori seroprevalence in Peruvian university students / Hábitos alimentares e de higiene associados à soroprevalência do Helicobacter pylori em estudantes universitários peruanos

RESUMEN Introducción: La infección por Helicobacter pylori es cada vez más frecuente en los jóvenes peruanos e incrementa su riesgo de padecer neoplasias gástricas. Objetivo: Determinar los hábitos alimentarios y de higiene asociados a la seroprevalencia de infección por Helicobacter pylori en estudiantes universitarios del departamento de Cajamarca, Perú, durante los meses de septiembre a octubre de 2019. Método: Estudio observacional, transversal, prospectivo con un diseño no experimental. La población estuvo conformada por 367 estudiantes de la carrera profesional de Tecnología Médica. El tamaño de la muestra fue de 188 estudiantes de ambos géneros. Se detectaron anticuerpos IgG frente a Helicobacter pylori en suero, mediante el método de inmunocromatografía. Los hábitos alimentarios y de higiene se recopilaron utilizando una encuesta estructurada. Resultados: El 51,1 % de estudiantes presentó anticuerpos IgG frente a Helicobacter pylori. El 31,38 % de los estudiantes que consumía "a veces" alimentos elaborados en la calle resultaron seropositivos a Helicobacter pylori. Aquellos estudiantes que manifestaron lavarse las manos "a veces" (29,79 %) y "siempre" (21,28 %) antes de ingerir los alimentos presentaron anticuerpos IgG contra la bacteria. Además, los estudiantes seropositivos frente a Helicobacter pylori lavaban sus frutas y verduras con el agua del grifo (43,62 %) y consumían agua de grifo no tratada (29,79 %). Conclusión: El consumo de alimentos preparados en la calle, lavado de manos antes de consumir alimentos, tipo de agua para consumo y lavado de frutas y verduras antes de ingerirlas son hábitos alimentarios y de higiene asociados a la seroprevalencia de Helicobacter pylori.

ABSTRACT Introduction: Helicobacter pylori infection is becoming more frequent in the young population of Peru and at the same time increases the risk of gastric neoplasms. Objective: To identify the dietary and higiene habits associated with the seroprevalence of Helicobacter pylori infection in university students at the Cajamarca Department. Assesed period from September throughout October 2019. Method: An observational, cross-sectional, prospective study with a non-experimental design was carried out. A population of 367 students on Medical technology career were involved and 188 of them, in both sex, were selected as trial. It was detected, using the immunochromatography method in serum assay, IgG antibodies against Helicobacter pylori. Dietary and hygiene habits were collected using a well-structed enquiry. Results: It was identified IgG antibodies against Helicobacter pylori infection in 51.1% of students. The 31.38% of those who, not frequently, had consumed food prepared outdoors were seropositive for Helicobacter pylori. Those students who revealed wash their hands, not frequently (29.79%) and frequently (21.28%) before eating, produced antibodies against this bacterial infection. In addition, Helicobacter pylori seropositive students washed their fruits and vegetables with obtained water from the tap (43.62%) and consumed untreated water fom the tap too (29.79%). Conclusions: Food intake outdoors, wash of hands, fruits and vegetables before eating, and the quality of water to be consumption are dietary and hygiene habits associated with the Helicobacter pylori seroprevalence.

RESUMO Introdução: A infecção por Helicobacter pylori é cada vez mais comum em jovens peruanos e aumenta o risco de neoplasias gástricas. Objetivo: Determinar os hábitos alimentares e de higiene associados à soroprevalência da infecção por Helicobacter pylori em universitários do departamento de Cajamarca, Peru, durante os meses de setembro a outubro de 2019. Método: Estudo observacional, transversal, prospectivo com um não experimental. A população foi composta por 367 alunos da carreira de Tecnologia Médica. O tamanho da amostra foi de 188 alunos de ambos os sexos. Os anticorpos IgG contra Helicobacter pylori foram detectados no soro pelo método de imunocromatografia. Os hábitos alimentares e de higiene foram coletados por meio de questionário estruturado. Resultados: 51,1% dos alunos apresentaram anticorpos IgG contra Helicobacter pylori. 31,38% dos alunos que comeram "às vezes" alimentos preparados na rua eram soropositivos para Helicobacter pylori. Os alunos que relataram lavar as mãos "às vezes" (29,79%) e "sempre" (21,28%) antes de comer apresentaram anticorpos IgG contra a bactéria. Além disso, os alunos soropositivos para Helicobacter pylori lavavam frutas e vegetais com água da torneira (43,62%) e consumiam água da torneira não tratada (29,79%). Conclusão: O consumo de alimentos preparados na rua, a lavagem das mãos antes de consumir os alimentos, o tipo de água para consumo e a lavagem de frutas e verduras antes de ingeri-los são hábitos alimentares e de higiene associados à soroprevalência do Helicobacter pylori.

Understanding Digital Health Technologies Using Mind Maps.

PURPOSE: The purpose of this project was to explore digital health technologies in the healthcare environment through the use of concept and mind mapping tools in a graduate level informatics practicum course. DESIGN: This descriptive course evaluation project was conducted at a large university school of nursing during the 2019-2020 academic year and included a convenience sample of 163 doctor of nursing practice students. METHODS: Students completed four major deliverables exploring digital health technologies and data sources using mind maps. Project goals were evaluated using detailed rubrics and data from a course evaluation questionnaire (CEQ) then analyzed using descriptive statistics. Comments from the CEQ and reflection documents were reviewed for themes and validated by two experts. FINDINGS: The variety and creativity of the mind maps along with student comments indicated their ability to apply critical thinking skills to the specific content and technologies being examined. Overall CEQ mean scores were high (M = 4.35), indicating that the mind mapping deliverables were logical, relevant, appropriate, and meaningful to learning. CONCLUSIONS: Nurse educators and healthcare professionals should consider using mind mapping techniques because this venue allows for expanded understanding of the complexities of the healthcare environment and integration of related digital health technologies. CLINICAL RELEVANCE: The recent pandemic highlighted the necessity for new technologies to continue providing patient care services. Mind maps are a fast and economical tool for understanding and prioritizing the needs of an organization as well as a unique teaching strategy to promote critical thinking and sharing of ideas related to digital health technologies.

Outcomes of European Basic Laparoscopic Urological Skills (EBLUS) Examinations: Results from European School of Urology (ESU) and EAU Section of Uro-Technology (ESUT) over 6 Years (2013-2018).

BACKGROUND: The European School of Urology (ESU) and EAU Section of Uro-Technology (ESUT) started hands-on-training (HOT) sessions in 2007 along with structured European Basic Laparoscopic Urological Skills (EBLUS) examinations in 2013. EBLUS includes an online theoretical course, HOT by expert tutors on a set of dry-lab exercises, and finally a standardised examination for skill assessment and certification. OBJECTIVE: To analyse the results and predictors of success from the EBLUS examinations that were conducted during the European Urology Residents Education Programme (EUREP) and other international and national dedicated ESU events. DESIGN, SETTING, AND PARTICIPANTS: ESU has been delivering EBLUS courses and examinations over the past 6 yr (2013-2018) in more than 40 countries worldwide. Trainees were asked about their laparoscopic background (procedures assisted/performed) and about the availability of HOT or simulator/box trainer in their facility. Apart from the online theoretical course, 4 HOT tasks [(1) peg transfer, (2) pattern cutting, (3) single knot tying, and (4) clip and cut] with its quality assessment of depth perception, bimanual dexterity, and efficiency were a part of the assessment and were considered critical to pass the EBLUS examination. RESULTS AND LIMITATIONS: A total of 875 EBLUS examinations were delivered (EUREP, n=385; other ESU events, n=490), with complete data available for 533 (61%) participants among which 295 (55%) passed the examinations. Pass rate increased on a yearly basis from 35% to 70% (p<0.001) and was similar between EUREP (56%) and other ESU/ESUT events (55%). The significant predictors of success were passing tasks 1 [odds ratio (OR): 869.9, 95% confidence interval (CI): 89.6-8449.0, p<0.001] and 2 (OR: 3045.0, 95% CI: 99.2-93 516.2, p<0.001) of the examinations. A limitation of EBLUS was its inability to provide more advanced training such as wet-lab or cadaveric training. CONCLUSIONS: Over the past few years more trainees have passed the European Basic Laparoscopic Urological Skills (EBLUS) examinations. Trainees who spend more time on laparoscopic procedures demonstrated a better performance and pass rate. We found almost no difference between the EBLUS results collected from EUREP and other ESU/ESUT events, which confirms the robustness of the training and examinations conducted worldwide. PATIENT SUMMARY: Training in laparoscopy helps trainees pass the European Basic Laparoscopic Urological Skills (EBLUS) examinations, reflected by an increase in the pass rate over the past 6 yr. Our results also confirm the robustness of EBLUS training and examinations worldwide.

Learning, understanding and the use of information technology: a survey study among primary care physician trainees.

BACKGROUND: User understanding of information technology systems (IT-Systems) is a prerequisite for their use. This study aimed to explore how primary care physician trainees learn, understand and use IT-Systems. METHODS: A paper-based survey study among 301 primary care physician trainees in Baden-Wuerttemberg, Germany, was performed. The questionnaire included measures of understanding and use of nine specific system features, five possible learning strategies, a validated scale for affinity for technology interaction, and five individual and three practice characteristics. RESULTS: The sample comprised 94 respondents (31.6% response rate). Between 3.2 and 59.6% said to know specific systems features well; between 13.8 and 42.6% expressed a wish to know more about specific system features. The predominant strategy for learning system features was explanation by others: 51.7 to 66.7% had applied this strategy to learn the features. Between 18.6 and 41.4% had learned the features by trial and error. A better understanding of system features was associated with the use of a trial and error strategy for learning system features (beta = 0.260, p = 0.012). The use of a greater variety of learning strategies was associated with higher affinity for technology interaction (beta = 0.215, p = 0.037). CONCLUSION: The study suggests that many physicians need a better understanding of IT-Systems. The role of manuals, online resources and courses in learning IT-Systems seems limited. The new generation of primary care physicians seem to learn features of IT-Systems through explanation by others and trying in their ambulatory practices. The relevance of IT-Systems in healthcare is high, but physicians need more support in learning to use system features.

Science, Technology, and Human Health: The Value of STS in Medical and Health Humanities Pedagogy.

As the number of medical and health humanities degree programs in the United States rapidly increases (Berry, Lamb and Jones 2016, 2017), it is especially timely to consider the range of specific disciplinary (and multidisciplinary) perspectives that might benefit students enrolled in these programs. This paper discusses the inclusion of one such perspective from the field of Science and Technology Studies (STS.) The author asserts that STS benefits students in the medical and health humanities in four particular ways, by: (1) challenging the "progress narrative" around the advancement of biomedicine as scientific practice, (2) evaluating the meaning of technology, especially in how technology orients us towards sickness and how health technology is in turn shaped by social and cultural values, (3) assessing the plurality of biomedical epistemologies, rather than assuming biomedicine is one, cohesive body of knowledge that does not differ across contexts, and (4) critiquing bias in biomedical practice and science, especially in the marginalization of women's voices and in the racial and postcolonial trajectories of contemporary biomedicine. The paper discusses the theoretical importance of these four trajectories to the medical and health humanities, as well as the venues for inclusion of STS within coursework and programming at Case Western Reserve University. The paper also comments on how programming at other institutions might be adapted to incorporate STS scholarship. By drawing on numerous examples of research in the anthropology, sociology, history, and the philosophy of science, this article seeks to open a conversation about the value of science and technology studies to health humanities pedagogy.

Training on the Use of Technology to Collect Patient-Reported Outcome Data Electronically in Clinical Trials: Best Practice Recommendations from the ePRO Consortium.

Electronic capture of patient-reported outcome (PRO) data has many advantages over paper-based data collection. Regulatory agencies have consistently supported the use of electronic PRO (ePRO) data capture and recommended participant and site staff training on the correct use of electronic data capture systems. The objective of this paper is to outline best practice recommendations for training end users, including site staff and study participants, on the use of ePRO technology in clinical trials to enable consistent, accurate, and complete data collection. Site personnel should be trained on study-specific as well as technology-specific topics and be given instructions on whom to contact to obtain technical support. Optimal training takes place over time using multiple modalities, including hands-on, face-to-face training at an investigator meeting or directly in the clinical site; remote training via webinar or teleconference; interactive on-demand self-paced-training via e-learning modalities; and supplemented by proxy training performed by study clinical research associates. Like site personnel training, study participants should be provided with individual, hands-on training by site staff at the initiation of the trial and in conjunction with interactive electronic training modules that can be accessed on-demand throughout the duration of the trial. The recommendations put forth in this paper provide a structured framework for the training that site personnel and study participants need to optimize the advantages trials can gain from using ePRO data collection systems.

Computing for Medicine: Can We Prepare Medical Students for the Future?

PROBLEM: Technology can transform health care; future physicians need to keep pace to ensure optimal patient care. Because future doctors are poorly prepared in computer literacy, the authors designed a computer programming certificate course. This Innovation Report describes the course and findings from a qualitative study to understand the ways it prepares medical students to use computing science and technology in medicine. APPROACH: The 14-month Computing for Medicine certificate course (C4M, offered beginning in February 2016), University of Toronto, is comprised of hands-on workshops to introduce programming accompanied by homework exercises, seminars by computer science experts on the application of programming to medicine, and coding projects. Using purposive and maximal variation sampling, 17 students who completed the course were interviewed from April-May 2017. Thematic analysis was performed using an iterative constant comparison approach. OUTCOMES: Participants praised the C4M as an opportunity to achieve computer literacy-including language, syntax, and fundamental computational ideas (and their application to medicine)-and acquire or strengthen algorithmic and logical thinking skills for approaching problems. They highlighted that the course illustrated linkages between computer science and medicine. Participants acknowledged a sometimes-existent chasm between producers and users of technology in medicine, recommending two-way communication between the disciplines when developing technology for use in medicine. NEXT STEPS: We recommend that medical schools consider computer literacy an essential skill to foster future collaborative computing partnerships for improved technology use by physicians and optimal patient care. We encourage further evaluation of future iterations of the C4M and similar courses.

The Next Generation of Physician-Scientists: Adapting to Academic Cardiology in the 21st Century.

More than 3 decades ago, Wyngaarden and Gill first warned of the challenges facing physician-scientists in their seminal papers "The Clinical Investigator as an Endangered Species" and "The End of the Physician-Scientist." In the years since these papers were published, there has been expansion of stage I-II preclinical research focusing on discovery and exploratory studies. Expansion has often come at the expense of physician-scientists whose traditional role has been to bridge the gap between early preclinical research (stage I-II) and clinical trials (stage IV). Consequently, a paradigm shift has occurred, and increasing pressure has been placed on physician-scientists to choose between clinical practice and fundamental research. This shift is particularly concerning in the field of cardiovascular medicine, where the ubiquitous nature and clinical significance of cardiovascular disease make the role of the translational scientist essential. The challenges facing academic cardiologists have then further been amplified by the necessity not only to maintain clinical competence but also to maintain competence in highly technical fields with rapidly advancing technology. Potential solutions to these problems include increasing support from postgraduate training programs, increased participation of trainees in physician-scientist development programs, and recognition of the pivotal role physician-scientists play in translational research by funding agencies. Although the physician-scientist remains an endangered species, multifaceted solutions with a focus on collaboration among institutions, training programs, and funding agencies have the potential to maximize efficiency in biomedical research and successfully translate scientific discoveries from bench to bedside.

Pitfalls and opportunities of teaching veterinary parasitology within an integrated curriculum.

The Faculty of Veterinary Medicine at Utrecht University has seen three major curriculum changes, in 1995, 2001 and 2007. The last change was made because of the European change to a Bachelor-Master system. Almost each time teaching hours tagged for veterinary parasitology have been reduced to currently a minimum of between 46 and 51.5 h, which is much less than the WAAVP-recommended minimum of 70-90 h. This results in a challenge to maintain a qualitatively adequate veterinary parasitology program in a curriculum. Following a brief historic account of previous curricula and implemented curriculum changes, experiences, limitations and opportunities are discussed, including the potential of introducing new teaching materials based, for example, on digital technologies and gaming.

Use of Simulation-Based Training to Aid in Implementing Complex Health Technology.

Clinicians are adult learners in a complex environment that historically does not invest in training in a way that is conducive to these types of learners. Adult learners are independent, self-directed, and goal oriented. In today's fast-paced clinical setting, a practical need exists for nurses and clinicians to master the technology they use on a daily basis, especially as medical devices have become more interconnected and complex. As hospitals look to embrace new technologies, medical device companies must provide clinical end-user training. This should be a required part of the selection process when considering the purchase of any complex medical technology. However, training busy clinicians in a traditional classroom setting can be difficult and costly. A simple, less expensive solution is online simulation training. This interactive training provides a virtual, "hands-on" end-user experience in advance of implementing new equipment. Online simulation training ensures knowledge retention and comprehension and, most importantly, that the training leads to end-user satisfaction and the ability to confidently operate new equipment. A review of the literature revealed that online simulation, coupled with the use of adult learning principles and experiential learning, may enhance the experience of clinical end users.