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BACKGROUND: Telehealth and mHealth apps become increasingly popular in health professions such as physiotherapy calling for increased awareness on functionality, privacy, and data security. OBJECTIVES: This work presents a functionality, privacy, and data-security evaluation of four telehealth services commonly used in physiotherapy. METHODS: We examined functionality and features, data protection, privacy implementations and data-security with a questionnaire and performed an in-depth investigation of the services. RESULTS: Privacy and security relevant findings such as use of outdated webservers, problems with certificate renewal as well as questionable GDPR compliance were reported. CONCLUSION: Due to the privacy and security relevant findings in this analysis it can be concluded that there is a need for improvement in design, development, operation as well as regulation of telehealth apps and services.
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Computer Security , Confidentiality , Telemedicine , Humans , Mobile Applications , Surveys and Questionnaires , Physical Therapy Modalities , PrivacyABSTRACT
[This corrects the article DOI: 10.2196/51112.].
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BACKGROUND: The COVID-19 pandemic has highlighted the growing relevance of telehealth in health care. Assessing health care and nursing students' telehealth competencies is crucial for its successful integration into education and practice. OBJECTIVE: We aimed to assess students' perceived telehealth knowledge, skills, attitudes, and experiences. In addition, we aimed to examine students' preferences for telehealth content and teaching methods within their curricula. METHODS: We conducted a cross-sectional web-based study in May 2022. A project-specific questionnaire, developed and refined through iterative feedback and face-validity testing, addressed topics such as demographics, personal perceptions, and professional experience with telehealth and solicited input on potential telehealth course content. Statistical analyses were conducted on surveys with at least a 50% completion rate, including descriptive statistics of categorical variables, graphical representation of results, and Kruskal Wallis tests for central tendencies in subgroup analyses. RESULTS: A total of 261 students from 7 bachelor's and 4 master's health care and nursing programs participated in the study. Most students expressed interest in telehealth (180/261, 69% very or rather interested) and recognized its importance in their education (215/261, 82.4% very or rather important). However, most participants reported limited knowledge of telehealth applications concerning their profession (only 7/261, 2.7% stated profound knowledge) and limited active telehealth experience with various telehealth applications (between 18/261, 6.9% and 63/261, 24.1%). Statistically significant differences were found between study programs regarding telehealth interest (P=.005), knowledge (P<.001), perceived importance in education (P<.001), and perceived relevance after the pandemic (P=.004). Practical training with devices, software, and apps and telehealth case examples with various patient groups were perceived as most important for integration in future curricula. Most students preferred both interdisciplinary and program-specific courses. CONCLUSIONS: This study emphasizes the need to integrate telehealth into health care education curricula, as students state positive telehealth attitudes but seem to be not adequately prepared for its implementation. To optimally prepare future health professionals for the increasing role of telehealth in practice, the results of this study can be considered when designing telehealth curricula.
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Pandemics , Telemedicine , Humans , Cross-Sectional Studies , Students , InternetABSTRACT
BACKGROUND: The acquisition of handwriting skills is essential for a child's academic success, self-confidence, and general school performance. Nevertheless, an estimated 5% to 27% of children face handwriting challenges, where the ability to modulate pressure on the pencil and lead on the paper is a key motor component. OBJECTIVE: We aimed to investigate the experience with and usability of the SensoGrip system, a pressure-measuring pen system with personalized real-time feedback about pressure modulation, in a clinical setting with children and occupational therapists (OTs). METHODS: A multimethods study was conducted, incorporating qualitative interviews and questionnaires with children, user diaries, focus group discussions, and a usability questionnaire with OTs, along with a questionnaire for parents. RESULTS: The study involved OTs (n=8), children with handwriting difficulties (n=16), and their parents (n=16), each of whom used the SensoGrip system in up to 5 therapy sessions. OTs reported that the SensoGrip system helped to focus the child's awareness on handwriting pressure and to measure it objectively. The system received high acceptance and usability ratings from the OTs-usefulness: median score of 4 out of 7; ease of use and ease of learning: median score of 6 out of 7; and satisfaction: median score of 6 out of 7. Participants appreciated that it fosters pressure awareness and motivation to draw and write. CONCLUSIONS: The SensoGrip pressure-sensing system with real-time feedback is a promising tool for pediatric occupational therapy. It supports children with handwriting difficulties to adjust their pressure application during the task. In the future, controlled quantitative trials are warranted to further examine the system's impact.
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Owing to its cost-efficiency, 24-hour home care is increasing and represents a cornerstone in the care of elder people in Austria. A software solution to support 24-hour caregivers in their daily routine was developed facilitating a user-centered design process. It includes electronic documentation, an e-learning platform, emergency management, and a communication tool. To evaluate the usability and acceptance of the developed software solution, a qualitative survey including focus groups (FG), a group interview (GI), and a usability walkthrough (UW) were conducted. This paper describes the findings of the qualitative survey which indicate that the e-learning platform as well as the e-documentation support 24-hour caregivers in their daily work with their clients. Participants with less technical affinity needed support to use the tool proficiently. 24-hour caregivers appreciate the fact that the solution unites all the needed information in one place.
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Home Care Services , Software , Humans , Aged , Caregivers , Communication , DocumentationABSTRACT
BACKGROUND: Regarding the care of older adults, 24-h home-care represents a cornerstone, with > 32,000 service users in Austria. Our research project 24hQuAALity aimed to develop and evaluate a distributed client-server software solution for the support and quality assurance of this home-care service. In this trial, we investigated the effects of this intervention on the quality of life and professional skills of paid 24h-caregivers in Austria. METHODS: The application used in our study comprises an e-learning platform, an integrated emergency management, networking opportunities, and an electronic care documentation system in the native language of the 24h-caregivers. The trial was conducted using a parallel three-arm study design to evaluate (i) a control group, which performed usual home care, (ii) a partial intervention group, which used the e-learning and networking platforms, and (iii) a full intervention group, which used the entire intervention (e-learning platform, networking platform, and digital care documentation). Primary self-reported outcomes were the standardized ASCOT for Carers score and a score based on responses to project-specific efficacy questions. RESULTS: Among the 110 24h-caregivers who were randomly classified into the three groups, ASCOT for Carers score data were available for 57 and 35 24h-caregivers at 5- and 9-month follow-up examinations, respectively. At 9 months, 24h-caregivers receiving any intervention rated the ASCOT for Carers score (not significantly) better than the controls (p = 0.05, ηp2 = 0.15), mainly in the domain "feeling encouraged and supported". At 9 months, 24h-caregivers receiving any intervention rated the project-specific Efficacy score significantly better than the controls (p = 0.02, ηp2 = 0.20), mainly due to better ratings in the subitems "satisfaction with current docu", "docu supports doing my job", " I'm well prepared for emergencies", "my professional skills are adequate for doing my job", and "communication with contacts". CONCLUSIONS: Providing e-learning and e-documentation devices to 24h-caregivers improved their care-related quality of life, mainly because they felt more encouraged and supported. Moreover, these interventions improved their self-perceived professional skills. As an extrapolation of findings, we found that these interventions could empower 24h-caregivers and improve the quality of home-care services provided by them. TRIAL REGISTRATION: Digital Support for Quality Assurance in 24-h Caregiving at Home was registered and posted on the ClinicalTrials.gov public website (ClinicalTrials.gov Identifier: NCT04581538).
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Caregivers , Home Care Services , Humans , Aged , Quality of Life , Learning , Research DesignABSTRACT
Handwriting learning disabilities, such as dysgraphia, have a serious negative impact on children's academic results, daily life and overall well-being. Early detection of dysgraphia facilitates an early start of targeted intervention. Several studies have investigated dysgraphia detection using machine learning algorithms with a digital tablet. However, these studies deployed classical machine learning algorithms with manual feature extraction and selection as well as binary classification: either dysgraphia or no dysgraphia. In this work, we investigated the fine grading of handwriting capabilities by predicting the SEMS score (between 0 and 12) with deep learning. Our approach provided a root-mean-square error of less than 1 with automatic instead of manual feature extraction and selection. Furthermore, the SensoGrip smart pen SensoGrip was used, i.e., a pen equipped with sensors to capture handwriting dynamics, instead of a tablet, enabling writing evaluation in more realistic scenarios.
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Agraphia , Deep Learning , Child , Humans , Handwriting , Agraphia/diagnosis , Algorithms , Machine LearningABSTRACT
Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders in childhood and adolescence. It is characterized by attention deficit, hyperactivity, and impulsivity as the main symptoms. These can lead to increased stress in everyday life for the entire family. The e-counseling and e-learning application is being developed within the ELSA project to support parents of ADHD-diagnosed children in everyday life. The requirements identified included, for example, advice on children's restlessness or measures against sibling rivalry.
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Attention Deficit Disorder with Hyperactivity , Adolescent , Humans , Child , Attention Deficit Disorder with Hyperactivity/diagnosis , Parents/psychology , LearningABSTRACT
INTRODUCTION: Telehealth and its usage strongly depend on regulatory frameworks and user acceptance. During the COVID-19 pandemic, physiotherapists, occupational therapists, speech-language therapists and their patients experienced restrictions regarding the usual face-to-face therapy. Teletherapy has become a highly discussed medium for providing therapy services. This study aimed at assessing Austrian therapists' attitudes towards teletherapy, including perceived barriers, during and before the COVID-19 lockdown. Further interest referred to therapists' technical affinity and experiences with the application of teletherapy. METHODS: Therapists (n = 325) completed an online survey amid the COVID-19 lockdown in 2020. Retrospective indications referred to the time prior to the lockdown. Ratings were opposed across the three therapeutic professions. Subgroup analyses investigated the role of gender and age regarding technical affinity. Measures included custom-made attitudinal statements towards teletherapy and the standardized TA-EG survey. RESULTS: The COVID-19 lockdown caused attitude changes towards teletherapy - for example, in terms of interest (r = 0.57, p > 0.01), perceived skills for performance of teletherapy (r = 0.33, p > 0.01) and perceived need for physical contact with patients (r = 0.35, p > 0.01). Regarding technical affinity, women reported significantly higher values than men did (r = 0.32, p > 0.01). Nearly half of the participants already applied teletherapy, with mainly positive ratings regarding perceived skills and feasibility. Barriers identified were missing or unstable reimbursement policies by insurance companies and therapeutic software with guaranteed data security. DISCUSSION: Austrian therapists indicate a relatively high level of telehealth positivity, with an improvement in the course of the COVID-19 lockdown. However, therapists outline the need for stable reimbursement policies and secure software solutions.
Subject(s)
COVID-19 , Male , Humans , Female , COVID-19/epidemiology , Austria , Pandemics , Retrospective Studies , Communicable Disease Control , Attitude of Health PersonnelABSTRACT
PURPOSE: Problems with handwriting are a common referral to occupational therapy in children and are often associated with inadequate pen grip and tip pressure. Technologies providing immediate feedback on applied forces are currently not available. Therefore, the aim was to identify user's perspectives on the optimal functionality of a pressure-sensitive pen with an integrated feedback system. METHODS: To ensure that the product meets the requirements of the users, user needs of paediatric occupational therapists, elementary or special education teachers and children were collected in two focus groups and a children's workshops before starting the technical development process. Focus group transcripts were analyzed and rephrased as user stories to identify user-centred requirements. In a second step, user stories were merged and ranked regarding importance and feasibility. RESULTS: 120 user story requirements were generated from the focus groups and children's workshops, indicating requirements regarding design and functionality for the pen and mobile application. Visual feedback, appropriate size and weight, customizability, ease of settings and usability of the pen were pivotal. CONCLUSIONS: This study comprehensively researched the requirements for a device that may facilitate children in adjusting their handwriting pressure and can guide further research and evaluation.
Description of a participatory design process for the development of a pressure-sensitive pen.Understand the needs of different stakeholders for an assistive device for children with handwriting difficulties.Inform the further development of a pressure-sensitive pen with immediate pressure-feedback.
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'Robots in healthcare' is a very trending topic. This paper gives an overview of currently and commonly used methods to gather user needs and requirements in research projects in the field of assistive robotics. Common strategies between authors are presented as well as examples of exceptions, which can help future researchers to find methods suitable for their own work. Typical problems of the field are discussed and partial solutions are proposed.
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Home Care Services , Needs Assessment , Robotics , Self-Help Devices , Aged , Equipment Design , Humans , User-Computer InterfaceABSTRACT
The field of "AAL Robotics", combining AAL and robotics as disciplines, has not yet been precisely defined and does not present accepted structures and concepts that would allow to communicate unequivocally its methods, projects, and approaches. The paper presents a method of defining and categorizing AAL robots and presents the resulting classes of robots with regard to the activities they assist. The classification is useful in that it is able to cover the breadth of the field, but a more fine-grained description of functionalities will be needed in further research to establish the potential of robots to assist independent living of older adults.
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Assisted Living Facilities/trends , Man-Machine Systems , Robotics/trends , Self-Help Devices/trends , Telemedicine/trends , Austria , Technology Assessment, BiomedicalABSTRACT
The sterically crowded, highly electron-deficient diazonium salt C6 (CF3 )5 N2 + BF4 - has been synthesized and sample dediazotization reactions were carried out. New compounds, C6 (CF3 )5 I, C6 (CF3 )5 NO2 , and C6 (CF3 )5 NO were isolated and identified. Also, a more convenient route to C6 (CF3 )5 NH2 that gave good yield was achieved.
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A general three-component triple cascade reaction through an iminium-enamine-iminium sequential activation initiated by a hetero-Michael addition to α,ß-unsaturated aldehydes affords [3.2.0]heterobicycles in high diastereoselectivity. The rate and diastereoselectivity of the reaction depended on the (E)-4-heterocrotonate and size of the secondary amine. The enantiomers of the major diastereoisomer of oxa- and azabicyclo[3.2.0]heptane derivatives were separated by enzymatic kinetic resolution with immobilized Candida antarctica Lipase B (CALB), with E values up to 153. The absolute configuration of the nonacylated enantiomer of oxabicyclo[3.2.0]heptane was determined by single crystal X-ray analysis.
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A new methodology was developed for the synthesis of enantiomerically enriched 3,3-disubstituted 3-chlorooxindoles 3 via a Michael addition of 3-chloroxindoles to nitroolefins 2, catalyzed by chiral squaramide 10. Products with adjacent quaternary-tertiary centers were isolated in excellent yields (up to 99%), high diastereoselectivities (up to 11:1), and enantiomeric purities (up to 92%). This is the first example where 3-chloroxoindoles 1 have been used as nucleophiles in a highly stereoselective organocatalytic reaction.
Subject(s)
Hydrocarbons, Chlorinated/chemical synthesis , Indoles/chemical synthesis , Catalysis , Hydrocarbons, Chlorinated/chemistry , Indoles/chemistry , Molecular Structure , StereoisomerismABSTRACT
New 3-azabicyclo[3.2.0]heptane derivatives were synthesized using a multicomponent reaction. Racemic compounds were efficiently resolved by kinetic resolution with immobilized lipase B of Candida antarctica (Novozym 435). The obtained compounds demonstrated greater binding affinity at D(2L) and D(3) dopamine receptors compared to D(1) binding sites, and individual enantiomers of the same compound possessed distinct affinities.
Subject(s)
Fungal Proteins/metabolism , Heptanes/chemical synthesis , Heptanes/metabolism , Lipase/metabolism , Receptors, Dopamine/metabolism , Animals , Biocatalysis , Chemistry Techniques, Synthetic , Heptanes/chemistry , Humans , Kinetics , Ligands , Models, Molecular , Molecular Conformation , RatsABSTRACT
The crystal structure of the title compound, C(15)H(14)N(4), contains chains of coplanar tetra-zole rings with the chain direction along b. These are formed through weak hydrogen bonds, donated by the tetra-zole H atoms and by one of the H atoms of the methyl-ene group, and accepted by two neighbouring N atoms of the adjacent tetra-zole ring. The chains are connected to each other in a staircase-like manner via weak hydrogen bonds, donated from the second H atom of the methyl-ene group and accepted by the N atom next to the C atom in the tetra-zole ring. The resulting layers are parallel to the bc plane.
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The title racemic compound, C(13)H(18)O(3), a common precursor in the total synthesis of terpenes, crystallizes with two molecules in the asymmetric unit. The crystal structure is made up of triple chains, formed by weak inter-molecular C-Hâ¯O contacts, propagating in the a-axis direction.
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In the title compound, C(10)H(22)N(2) (2+)·2Br(-), a precursor in the synthesis of organocatalysts, the bipiperidinium ion is located on a twofold rotation axis which passes through the mid-point of the central C-C bond. The piperidinium ring adopts a chair conformation. In the crystal, the cations are linked together by Br(-) ions through N-Hâ¯Br hydrogen bonds, forming layers parallel to the ab plane.
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In the title compound, {[Cu(C(9)H(15)N(13))(2)](ClO(4))(2)}(n), the Cu(2+) cation lies on an inversion center and is coordinated by the tetra-zole N(4) atoms of six symmetry-equivalent tris-[2-(1H-tetra-zol-1-yl)eth-yl]amine ligands (t(3)z) in the form of a Jahn-Teller-distorted octa-hedron with Cu-N bond distances of 2.0210â (8), 2.0259â (8) and 2.4098â (8)â Å. The tertiary amine N atom is stereochemically inactive. The cationic part of the structure, viz. [Cu(t(3)z)(2)](2+), forms an infinite two-dimensional network parallel to (100), in pockets of which the perchlorate anions reside. The individual networks are partially inter-locked and held together by C-Hâ¯O inter-actions to the perchlorate anions and C-Hâ¯N inter-actions to tetra-zole N atoms.