Remote assessment and monitoring with advanced wound therapy to optimise clinical outcomes, access and resources.

OBJECTIVE: Patients in rural communities may have limited access to wound care; however, this may be mitigated by using a shared care approach. This study assessed the impact of a remote assessment and monitoring tool in combination with adjunctive continuous topical oxygen therapy (cTOT) in patients with diabetes and hard-to-heal wounds. METHOD: Patients with hard-to-heal wounds (defined as no visible improvement in the previous four weeks) were enrolled to this 12-week pilot study to validate a shared care approach using an Advanced Digital Wound Care Platform-telehealth (ADWCPt) system (eKare Inc., US) coupled with cTOT. Patient and wound assessments were reviewed by the clinician either remotely, via telehealth calls, or at the clinic, and the number of face-to-face clinic visits was recorded. Patient health status scores were captured before and after the study, along with feedback on usability of the remote platform and cTOT device. RESULTS: The wounds in all eight patients studied reduced in size over 12 weeks (mean percentage area reduction 92.0%), and two wounds were completely re-epithelialised. Another wound almost healed (99.2% wound area reduction). Clinical interactions consisted of self-assessments (n=80, 50.0%), video assessments with the clinician (n=27, 16.9%), and face-to-face interactions in clinic (n=53, 33.1%). Operational efficiencies encompassed a 54.0% increase in the number of clinical interactions, whereas clinical time was reduced by 25.8%. Health status scores improved across all eight patients and feedback on the shared approach and cTOT device was favourable. CONCLUSION: A shared care model with ADWCPt coupled with an innovative cTOT device saved time and resources, improving patient access and engagement, along with a marked improvement in the wound healing trajectory.

Picture This! Bringing joy into Focus and Developing Healthy Habits of Mind: Rationale, design, and implementation of a randomized control trial for young adults.

Research shows that daily experiences of awe, curiosity, gratitude, joy, and love can put the average person on a trajectory of growth, success, and positive social connection, and can also prevent those who are suffering from following a downward spiral. Nonetheless, data show that most people are not functioning at optimal capacity. In fact, just 20% of people may be categorized as "flourishing," with the vast majority of people merely "languishing," at risk for mental health issues, or with clinical levels of mental health concerns. Despite the success of the Positive Psychology movement and the proliferation of Positive Psychology Interventions, the field remains in need of high quality studies that test potential mechanisms of change. The Picture This! intervention, informed by Positive Psychology principles, was designed to improve well-being and decrease depressive symptoms in young adults. This paper details the rationale, design, and implementation of a 4-group randomized control trial (RCT) to test the effectiveness of Picture This!. Specific indices of mental health and well-being (e.g., depressive symptoms, gratitude) were measured at baseline and at the conclusion of the intervention along with potential mechanisms of change (i.e., attentional bias, cognitive style), while positive emotion and general well-being were assessed daily over the 21-day intervention period. If successful, this intervention may provide critical behavioral, cognitive, and attentional tools that, once internalized, can be drawn upon for years to come.