Facilitating Virtual Visitation in Critical Care Units During a Pandemic.

Presence of support persons enhances patient and family satisfaction. The introduction of the coronavirus disease-2019 (COVID-19) pandemic has impacted hospital operations and has reduced visitation. A virtual visitation program was implemented in critical care units to replicate visitation by video chat to ease stress on patients and family members to improve communication.

Virtual education in neurosurgery during the COVID-19 pandemic.

OBJECTIVE: Neurosurgical education in the US has changed significantly as a consequence of the novel coronavirus (COVID-19) pandemic. Institutional social distancing requirements have resulted in many neurosurgical programs utilizing video conferencing for educational activities. However, it is unclear how or if these practices should continue after the pandemic. The objective of this study was to characterize virtual education in neurosurgery and understand how it should be utilized after COVID-19. METHODS: A 24-question, 3-part online survey was administered anonymously to all 117 US neurosurgical residency programs from May 15, 2020, to June 15, 2020. Questions pertained to the current use of virtual conferencing, preferences over traditional conferences, and future inclinations. The Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) was used. Comparisons were calculated using the Mann-Whitney U-test. Statistical significance was set at 0.05. RESULTS: One-hundred eight responses were recorded. Overall, 38 respondents (35.2%) were attendings and 70 (64.8%) were trainees. Forty-one respondents (38.0%) indicated attending 5-6 conferences per week and 70 (64.8%) attend national virtual conferences. When considering different conference types, there was no overall preference (scores < 3) for virtual conferences over traditional conferences. In regard to future use, respondents strongly agreed that they would continue the practice at some capacity after the pandemic (median score 5). Overall, respondents agreed that virtual conferences would partially replace traditional conferences (median score 4), whereas they strongly disagreed with the complete replacement of traditional conferences (median score 1). The most common choices for the partial replacement of tradition conferences were case conferences (59/108, 55%) and board preparation (64/108, 59%). Lastly, there was a significant difference in scores for continued use of virtual conferencing in those who attend nationally sponsored conferences (median score 5, n = 70) and those who do not (median score 4, n = 38; U = 1762.50, z = 2.97, r = 0.29, p = 0.003). CONCLUSIONS: Virtual conferences will likely remain an integral part of neurosurgical education after the COVID-19 pandemic has abated. Across the country, residents and faculty report a preference for continued use of virtual conferencing, especially virtual case conferences and board preparation. Some traditional conferences may even be replaced with virtual conferences, in particular those that are more didactic. Furthermore, nationally sponsored virtual conferences have a positive effect on the preferences for continued use of virtual conferences.

Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study.

BACKGROUND: Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. OBJECTIVE: The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. METHODS: We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. RESULTS: We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. CONCLUSIONS: The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. TRIAL REGISTRATION: ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621.

Hearing Aid Compatibility Standards. Final rule; announcement of effective date.

In this document, the Commission announces that the Office of Management and Budget (OMB) has approved, for a period of three years, the information collection associated with rules adopted in the Commission's document Access to Telecommunication Equipment and Services by Persons with Disabilities; Amendment of the Commission's Rules Governing Hearing Aid-Compatible Mobile Handsets et. al., Report and Order and Order on Reconsideration (Order). This document is consistent with the Order, which stated that the Commission would publish a document in the Federal Register announcing the effective date of those rules.

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users.

BACKGROUND: Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users. OBJECTIVE: We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions. METHODS: Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS). RESULTS: Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001). CONCLUSIONS: Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality.

Measurement and mapping of the GSM-based electromagnetic pollution in the Black Sea region of Turkey.

Electromagnetic pollution caused by mobile communication devices, a new form of environmental pollution, has been one of the most concerning problems to date. Consequences of long-term exposure to the electromagnetic radiation caused by cell phone towers are still unknown and can potentially be a new health hazard. It is important to measure, analyze and map the electromagnetic radiation levels periodically because of the potential risks. The electromagnetic pollution maps can be used for the detection of diseases caused by the radiation. With the help of the radiation maps of different regions, comparative analysis can be provided and distribution of the diseases can be investigated. In this article, Global System for Mobile communication (GSM)-based electromagnetic pollution map of the Rize Providence, which has high cancer rates because of the Chernobyl nuclear explosion, is generated. First, locations of the GSM base stations are identified and according to the antenna types of the base stations, safety distances are determined. Subsequently, 155 measurements are taken during November 2014 from the nearest living quarters of the Rize city center in Turkey. The measurements are then assessed statistically. Thenceforth, for visual judgment of the determined statistics, collected measurements are presented on the map. It is observed that national limits are not exceeded, but it is also discovered that the safety distance is waived at some of the measurement points and above the average radiation levels are noted. Even if the national limits are not exceeded, the long-term effects of the exposition to the electromagnetic radiation can cause serious health problems.

Information and Communication Technology (ICT) Standards and Guidelines. Final rule.

We, the Architectural and Transportation Barriers Compliance Board (Access Board or Board), are revising and updating, in a single rulemaking, our standards for electronic and information technology developed, procured, maintained, or used by Federal agencies covered by section 508 of the Rehabilitation Act of 1973, as well as our guidelines for telecommunications equipment and customer premises equipment covered by Section 255 of the Communications Act of 1934. The revisions and updates to the section 508-based standards and section 255-based guidelines are intended to ensure that information and communication technology covered by the respective statutes is accessible to and usable by individuals with disabilities.

How to teleconference effectively.

Teleconferencing, whereby a meeting is conducted over the telephone, is a convenient way of getting clinical, management or research business done for people residing in different locations, saving travelling time and costs, and reducing carbon emissions. Despite the convenience, teleconferences are often run poorly, due to inadequate planning or lack of understanding of the technology. Non-engaged participants typing emails, loud background noises and failure of the chair to bring in all participants and sum up are common problems. This Perspectives article seeks to offer some simple practical guidance to those hosting and participating in teleconferences in order to improve effective communication and efficient decision making.

Time-to-reperfusion in STEMI undergoing interhospital transfer using smartphone and WhatsApp messenger.

OBJECTIVE: The objective of this study is to assess the efficacy of WhatsApp application as a communication method among the emergency physician (EP) in a rural hospital without percutaneous coronary intervention (PCI) capability and the interventional cardiologist at a tertiary PCI center. BACKGROUND: Current guidelines recommend that patients with ST-segment elevation myocardial infarction (STEMI) receive primary PCI within 90 minutes. This door-to-balloon (D2B) time has been difficult to achieve in rural STEMI. METHODS AND RESULTS: We evaluated 108 patients with STEMI in a rural hospital with emergency department but without PCI capability to determine the impact of WhatsApp triage and activation of the cardiac catheterization laboratory on D2B time. The images were obtained from cases of suspected STEMI using the smartphones by the EP and were sent to the interventional cardiologist via the WhatsApp application (group 1, n=53). The control group included concurrently treated patients with STEMI during the same period but not receiving triage (group 2, n=55). The D2B time was significantly shorter in the intervention group (109±31 vs 130±46 minutes, P<.001) with significant reduction in false STEMI rate as well. CONCLUSION: This study demonstrates that use of WhatsApp triage with activation of the cardiac catheterization laboratory was associated with shorter D2B time and results in a greater proportion of patients achieving guideline recommendations. The method is cheap, quick, and easy to operate.

Optimal sharpening of compensated comb decimation filters: analysis and design.

Comb filters are a class of low-complexity filters especially useful for multistage decimation processes. However, the magnitude response of comb filters presents a droop in the passband region and low stopband attenuation, which is undesirable in many applications. In this work, it is shown that, for stringent magnitude specifications, sharpening compensated comb filters requires a lower-degree sharpening polynomial compared to sharpening comb filters without compensation, resulting in a solution with lower computational complexity. Using a simple three-addition compensator and an optimization-based derivation of sharpening polynomials, we introduce an effective low-complexity filtering scheme. Design examples are presented in order to show the performance improvement in terms of passband distortion and selectivity compared to other methods based on the traditional Kaiser-Hamming sharpening and the Chebyshev sharpening techniques recently introduced in the literature.

A parametric study of nonlinear seismic response analysis of transmission line structures.

A parametric study of nonlinear seismic response analysis of transmission line structures subjected to earthquake loading is studied in this paper. The transmission lines are modeled by cable element which accounts for the nonlinearity of the cable based on a real project. Nonuniform ground motions are generated using a stochastic approach based on random vibration analysis. The effects of multicomponent ground motions, correlations among multicomponent ground motions, wave travel, coherency loss, and local site on the responses of the cables are investigated using nonlinear time history analysis method, respectively. The results show the multicomponent seismic excitations should be considered, but the correlations among multicomponent ground motions could be neglected. The wave passage effect has a significant influence on the responses of the cables. The change of the degree of coherency loss has little influence on the response of the cables, but the responses of the cables are affected significantly by the effect of coherency loss. The responses of the cables change little with the degree of the difference of site condition changing. The effect of multicomponent ground motions, wave passage, coherency loss, and local site should be considered for the seismic design of the transmission line structures.

Evaluation of clipping based iterative PAPR reduction techniques for FBMC systems.

This paper investigates filter bankmulticarrier (FBMC), a multicarrier modulation technique exhibiting an extremely low adjacent channel leakage ratio (ACLR) compared to conventional orthogonal frequency division multiplexing (OFDM) technique. The low ACLR of the transmitted FBMC signal makes it especially favorable in cognitive radio applications, where strict requirements are posed on out-of-band radiation. Large dynamic range resulting in high peak-to-average power ratio (PAPR) is characteristic of all sorts of multicarrier signals. The advantageous spectral properties of the high-PAPR FBMC signal are significantly degraded if nonlinearities are present in the transceiver chain. Spectral regrowth may appear, causing harmful interference in the neighboring frequency bands. This paper presents novel clipping based PAPR reduction techniques, evaluated and compared by simulations and measurements, with an emphasis on spectral aspects. The paper gives an overall comparison of PAPR reduction techniques, focusing on the reduction of the dynamic range of FBMC signals without increasing out-of-band radiation. An overview is presented on transmitter oriented techniques employing baseband clipping, which can maintain the system performance with a desired bit error rate (BER).

Social work, technology, and ethical practices: a review and evaluation of the national association of social workers' technology standards.

Information and communication technologies (ICTs) are becoming essential to social work practice by providing increased treatment possibilities and reducing barriers to service. While recognizing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates.

Clinical social work practice and technology: personal, practical, regulatory, and ethical considerations for the twenty-first century.

The world that social work exists in is no longer defined by traditional physical settings and boundaries, such as schools, agencies, or even offices. With the advent of the Internet and digital communications, social work now exists in a far more complex reality, with clients and social workers engaging across multiple platforms, and sometimes even unintentionally and without one another's awareness. The implications of this can be ethical, practical, regulatory, and personal. This article explores these areas of concern and suggests strategies professionals can use to navigate these complex issues related to technology and clinical practice.

Enhancing long-term stability of the optoelectronic oscillator with a probe-injected fiber delay monitoring mechanism.

Optoelectronic oscillators (OEOs), based on optical fiber loops to act as a high-Q cavity, are capable of generating stable radio-frequencies (RF). The long-term frequency stability of the OEO is then limited by the cavity variation that is mainly induced by temperature sensitivity of the optical fiber. In order to actively stabilize the OEO cavity, we employ the technique of RF transfer over optical fibers. We propose and experimentally demonstrate a dual-loop-OEO scheme to enhance the long-term stability with an injected probe signal to monitor the phase variation in the fiber loops. The experimental results show that the resulting spread-spectrum signal is useful in monitoring the fiber delay without observable interference. The relationships between the measured frequency and the monitored delay are theoretically and numerically discussed. We also estimate the long-term stability of the proposed OEO scheme with the cavity phase correction. The corrected result shows the long-term frequency stability of the proposed OEO is within 8.4×10(-8) at one day.

Getting the message, securely.

Secure messaging is of critical interest to physicians in how they communicate with each other and with their patients. CIOs and other healthcare IT leaders speak about what they are hearing from their clinicians, and what they are doing to meet their requirements.

Secure messaging via the cloud and mobile devices: data security issues emerge with new technologies.

The secure messaging space is alive with new innovations that are moving the industry forward. Key in this space is the push toward moving secure messaging to the cloud and pushing it out to mobile devices. Among the examples are solutions that allow physicians to receive encrypted email on mobile devices, as well as ones that allow doctors to securely text-message each other to coordinate care. However, the security issues around these emerging technologies in this very active space must be further explored.