Micromotor-based dual aptassay for early cost-effective diagnosis of neonatal sepsis.

Given the long-life expectancy of the newborn, research aimed at improving sepsis diagnosis and management in this population has been recognized as cost-effective, which at early stages continues to be a tremendous challenge. Despite there is not an ideal-specific biomarker, the simultaneous detection of biomarkers with different behavior during an infection such as procalcitonin (PCT) as high specificity biomarker with one of the earliest biomarkers in sepsis as interleukin-6 (IL-6) increases diagnostic performance. This is not only due to their high positive predictive value but also, since it can also help the clinician to rule out infection and thus avoid the use of antibiotics, due to their high negative predictive value. To this end, we explore a cutting-edge micromotor (MM)-based OFF-ON dual aptassay for simultaneous determination of both biomarkers in 15 min using just 2 µL of sample from low-birth-weight neonates with gestational age less than 32 weeks and birthweight below 1000 g with clinical suspicion of late-onset sepsis. The approach reached the high sensitivities demanded in the clinical scenario (LODPCT = 0.003 ng/mL, LODIL6 = 0.15 pg/mL) with excellent correlation performance (r > 0.9990, p < 0.05) of the MM-based approach with the Hospital method for both biomarkers during the analysis of diagnosed samples and reliability (Er < 6% for PCT, and Er < 4% for IL-6). The proposed approach also encompasses distinctive technical attributes in a clinical scenario since its minimal sample volume requirements and expeditious results compatible with few easy-to-obtain drops of heel stick blood samples from newborns admitted to the neonatal intensive care unit. This would enable the monitoring of both sepsis biomarkers within the initial hours after the manifestation of symptoms in high-risk neonates as a valuable tool in facilitating prompt and well-informed decisions about the initiation of antibiotic therapy.These results revealed the asset behind micromotor technology for multiplexing analysis in diagnosing neonatal sepsis, opening new avenues in low sample volume-based diagnostics.

Personalized Integrated Care Promoting Quality of Life for Older People: Protocol for a Multicenter Randomized Controlled Trial.

BACKGROUND: Alzheimer disease (AD) and Parkinson disease (PD) are the 2 most common neurodegenerative diseases affecting millions of people worldwide. The Personalized Integrated Care Promoting Quality of Life for Older People (PC4L) project proposes an integrated, scalable, and interactive care ecosystem that can be easily adapted to the needs of several neurodegenerative and chronic diseases, care institutions, and end user requirements. OBJECTIVE: The study protocol developed within the framework of the PC4L project aims to iteratively test the integrated platform and its modules, and focuses primarily on assessing the impact of the proposed solution (ie, the PC4L platform) on patients' quality of life, as well as its usability and feasibility on a large-scale sample size in 3 different scenarios (home, neurorehabilitation, and day care centers). METHODS: A prospective multicenter clinical study is conducted in 5 European countries (Germany, Italy, Portugal, Romania, and Spain) at 6 different pilot centers, for 3 months, in patients with PD, Parkinsonism, AD, and other dementias (ODs). Patients were randomized in a ratio of 1:1 to the intervention group (use of the PC4L system) or the control group (no intervention). The PC4L system consists mainly of a wristband for monitoring parameters such as steps and levels of physical activity, and the PC4L app, which includes different engaging functionalities. Both groups are assessed through baseline and end-of-study clinical evaluations, including assessment of quality of life through the EQ-5D-3L scale. RESULTS: The study protocol is part of a project approved and funded by the European Commission Horizon 2020 (grant agreement number 875221). The ethics committees of all involved centers reviewed and approved the study protocol. The study began with the recruitment phase in September 2022, and enrollment ended in February 2023. Recruitment is now closed (April 2023). The results of this study are expected to be published in summer 2023. A total of 558 patients, 279 per study group, were recruited. The results will allow to clarify the impact of PC4L on quality of life, will assess the empowerment of patients and the medical resources use, as well as the usability of the final version of the PC4L system. It will also provide information on the support of the system as a tool to facilitate the decision-making process. CONCLUSIONS: The PC4L project intends to test a technology-based, integrated, scalable, and interactive care platform on patients with neurodegenerative diseases and proposes a good coordinated care model between all involved actors. Future developments of the PC4L solution may involve caregivers and socio-health professionals in the decision-making process in order to facilitate efficient communication between all stakeholders and ensure reliable and protected access to data within Europe. TRIAL REGISTRATION: ClinicalTrials.gov NCT05538455; https://clinicaltrials.gov/study/NCT05538455. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47916.

Formação interprofissional, territorialização e inovação na Gestão em Saúde: experiências vivenciadas no PET-Saúde / Interprofessional training, territorialization and innovation in Health Management: experiences lived in PET-Saúde / Formación interprofesional, territorialización e innovación en Gestión en Salud: experiencias vividas en el PET-Saúde

Objetivo: relatar as vivências de um grupo tutorial do Programa de Educação pelo Trabalho para Saúde (PET-Saúde), no que tange estratégias de formação interprofissional, atividades de territorialização e medidas de intervenção vinculadas à Atenção Básica em Saúde (ABS) da Secretaria Municipal de Feira de Santana-Bahia (SMS-FSA), no período de agosto de 2022 a julho de 2023. Método: Refere-se a um relato de experiência do grupo tutorial IV (Gestão da Atenção Básica e Saúde da Família). As ações foram desenvolvidas em parceria com a (SMS-FSA), com ênfase na ABS e seus programas NASF e SAD. Resultados:as atividades foram divididas em: Eixo 01. Cursos de formação continuada; Eixo 02. Diagnóstico Situacional local; Eixo 3. Criação de propostas de inovação para atuação em saúde. Conclusão:é notória a contribuição do programa para o melhor entendimento dos discentes acerca da interprofissionalidade para entendimento da gestão em saúde e dos recursos utilizados para traçar o perfil epidemiológico que guiam as atividadesde prevenção e promoção à saúde.

Objective: to report the experiences of a tutorial group of the Program of Education through Work for Health (PET-Saúde), regarding interprofessional training strategies, territorialization activities and intervention measures linked to Primary Health Care (PHC) of the Municipal Secretariat of Feira de Santana-Bahia (SMS-FSA), from August 2022 to July 2023. Method:Refers to an experience report of tutorial group IV (Management of Primary Care and Family Health). The actions were developed in partnership with (SMS-FSA), with emphasis on ABS and its NASF and SAD programs. Results:the activities were divided into: Axis 01. Continuing education courses; Axis 02. Local Situational Diagnosis; Axis 3. Creation of innovation proposals for health work. Conclusion:the contribution of the program to the better understanding of students about interprofessionality to understand health management and the resources used to trace the epidemiological profile that guide prevention and health promotion activities is notorious.

Objetivo: relatar las experiencias de un grupo tutorial del Programa de Educación a través del Trabajo para la Salud (PET-Saúde), sobre estrategias de formación interprofesional, actividades de territorialización y medidas de intervención vinculadas a la Atención Primaria de Salud (APS) de la Secretaría Municipal de Feira de Santana-Bahía (SMS-FSA), de agosto de 2022 a julio de 2023. Método:Se refiere a un informe de experiencia del grupo tutorial IV (Gestión de Atención Primaria y Salud de la Familia). Las acciones se desarrollaron en asociación con (SMS-FSA), con énfasis en ABS y sus programas NASF y SAD. Resultados:las actividades se dividieron en: Eje 01. Cursos de educación continua; Eje 02. Diagnóstico Situacional Local; Eje 3. Creación de propuestas de innovaciónpara el trabajo en salud. Conclusión:es notoria la contribución del programa para la mejor comprensión de los estudiantes sobre la interprofesionalidad para comprender la gestión de la salud y los recursos utilizados para trazar el perfil epidemiológico que orienta las actividades de prevención y promoción de la salud.

End Users' and Other Stakeholders' Needs and Requirements in the Development of a Personalized Integrated Care Platform (PROCare4Life) for Older People With Dementia or Parkinson Disease: Mixed Methods Study.

BACKGROUND: With what has been known as the "triple-win effect", introducing information and communication technologies (ICTs) in the health care of neurodegenerative diseases is beneficial in delaying the need for institutional care, reducing the associated health care costs, reducing the caregiving burden, and improving individuals' quality of life. Nevertheless, the mismatch between the users' expectations and their actual needs remains one of the main challenges that can reduce the usability of technology solutions. Therefore, the European project Personalized Integrated Care Promoting Quality of Life for Older People (PROCare4Life), which aimed to develop an ICT-based platform for all parties involved in the health care of neurodegenerative diseases, adopted a user-centered design approach, where all users are involved from the inception and throughout the platform development and implementation to integrate their needs and requirements in the proposed platform. OBJECTIVE: This paper presents the results of a study on the needs and requirements of the potential end users (older people with neurodegenerative diseases, caregivers, and health care professionals) and other key stakeholders in the development of the PROCare4Life platform. METHODS: A mixed qualitative and quantitative study design was used, including 2 web-based surveys, 40 interviews, and 4 workshops. The study was conducted between April and September 2020 in 5 European countries: Germany, Italy, Portugal, Romania, and Spain. Both data types were analyzed separately and then merged and interpreted, with greater priority placed on qualitative research. RESULTS: A total of 217 participants were recruited; 157 (72.4%) of them completed the web-based surveys (n=85, 54.1% patients and n=72, 45.9% caregivers), and 60 (27.6%) individuals participated in the qualitative research (20/60, 33% health care professionals; 5/60, 8% patients; 5/60, 8% caregivers; and 30/60, 50% key stakeholders). We identified 3 main themes (T): (T1) experiences associated with illness, (T2) thoughts about the platform technology, and (T3) desired properties. Alerts for adverse events, communication tools, reminders, and monitoring are constantly needed functionalities, whereas ease of use, personalization, and user-friendliness are foreseen as necessary features. CONCLUSIONS: This paper identified the key personal, social, and health factors that influence the daily lives of the potential end users and reflected on their needs and expectations regarding the design of the proposed PROCare4Life platform. The collected data were useful for the development of the PROCare4Life platform. Although the combination and collection of features for diverse user groups are typical for integrated care platforms, it results in exponential complexity for designers, developers, and users. Contradicting opinions and several concerns in this study demonstrate that an ICT-integrated care platform should not promise too much for too many. Instead, selection, focus, and, sometimes, restriction to essentials are necessary. Users and other stakeholders should be involved in these decisions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/22463.

2021 Patient Preferences for Point of Care Testing Survey: More Acceptance and Less Concern.

BACKGROUND: The evolving opinions of our community members provide insights into how end-users perceive the value and identify key point-of-care test (POCT) characteristics. METHODS: We deployed our validated 45-item English-language survey to uncompensated volunteers and compared the results from 1264 respondents in 2021 with those obtained in 2020. RESULTS: Average responses for items regarding the benefits of POCTs demonstrated that the 2021 respondents indicated agreement with all 14 potential benefits. Average responses for items regarding concerns were distinctly different from those for benefits. The only concern item that scored in the agree range was "not having insurance coverage for POCTs." Average responses to the other 13 concern items were in the disagree range. For 8 of these items, the magnitude of disagreement was greater in the 2021 survey than was observed for the 2020 survey. Differences in POCT exposure over time and by US regions suggest that higher levels of exposure to POCTs in the East are associated with stronger public support. CONCLUSIONS: Community members strongly support the development of accurate, convenient, easy-to-use, affordable, equitably available, in-home POCTs that produce immediate results. This empowers patients and home caregivers to diagnose, manage, enhance their adherence to medical treatments, and more efficiently engage their physicians.

Investigating psychological variables for technologies promoting physical activity.

Background: Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications. Objectives: This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA. Methods: We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2. Results: We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity. Conclusions: We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.

A 3-Year Single Center Experience With Left Atrial Pressure Remote Monitoring: The Long and Winding Road.

Background: Despite continuous advancement in the field, heart failure (HF) remains the leading cause of hospitalization among the elderly and the overall first cause of hospital readmission in developed countries. Implantable hemodynamic monitoring is being tested to anticipate the clinical exacerbation onset, potentially preventing an emergent acute decompensation. To date, only pulmonary artery pressure (PAP) sensor received the approval to be implanted in symptomatic heart failure patients with reduced ejection fraction. However, PAP's indirect estimation of left ventricular filling pressure can be inaccurate in some contexts. Methods: The VECTOR-HF study (NCT03775161) is examining the safety, usability and performance of the V-LAP system, a latest-generation device capable of continuously monitoring left atrial pressure (LAP). In our center, five advanced HF patients have been enrolled. After confirmation of the transmitted data reliability, LAP trends and waveforms have guided therapy optimization. The aim of this work is to share clinical insights from our center preliminary experience with V-LAP application. Results: Over a median follow-up time of 18 months, LAP-based therapy optimization managed to reduce intracardiac pressure over time and no hospital readmission occurred. This result was paralleled by an improvement in both functional capacity (6MWT distance 352.5 ± 86.2 meters at baseline to 441.2 ± 125.2 meters at last follow-up) and quality of life indicators (KCCQ overall score 63.82 ± 16.36 vs. 81.92 ± 9.63; clinical score 68.47 ± 19.48 vs. 83.70 ± 15.58). Conclusion: Preliminary evidence from V-LAP application at our institution support a promising efficacy. However, further study is needed to confirm the technical reliability of the device and to exploit the clinical benefit of left-sided hemodynamic remote monitoring.

Sexo, género y humanización de las tecnologías de cuidados para personas mayores / O sexo, o género e a humanização das tecnologias de cuidados aos idosos / Sex and gender and humanization of care technologies for the elderly

El envejecimiento de la población constituye en los países desarrollados uno de losprincipales desafíos para la salud pública. La innovación tecnológica emerge como una de las 187Cultura de los Cuidados. 3º Cuatrimestre 2021. Año XXV. nº 61respuestas recurrentes y esperanzadoras para abordar este fenómeno de forma sostenible. Serealiza una scoping review sobre el sexo y el género en tecnologías dedicadas a los cuidados quetienen características asimilables a la de los humanos, como la voz, los atributos físicos, lascompetencias sociales y culturales, etc. El resultado aporta veintinueve materiales, once abordanel envejecimiento y/o las relaciones de género en los asistentes de voz, mientras que 18 lo hacensobre tecnología robótica. La revisión crítica de la literatura científica nos permite determinar losprincipales rasgos que caracterizan a los dispositivos vinculándolos con un sexo determinado, yse analizan los dilemas que plantea la perpetuación de los estereotipos de género en relación conestas tecnologías. Por último, se destaca la necesidad de profundizar en las interacciones entrehumanos y tecnologías de los cuidados desde disciplinas como los Science, Tecnology and SocietyStudies o los estudios culturales, para abordar el diseño de tecnologías de asistencia dirigidas apersonas mayores, desde una perspectiva de género.(AU)

Population aging is one of the main challenges to public health in developed countries.Technological innovation is emerging as one of the recurrent and hopeful responses to addressthis phenomenon sustainably. A scoping review is conducted on sex and gender in caretechnologies that have characteristics assimilable to humans, such as voice, physical attributes,social and cultural competencies, etc. The result provides twenty-nine materials. Eleven addressaging and/or gender relations in voice assistants, while 18 address robotic technology. The criticalreview of the scientific literature allows us to determine the main features that characterize thedevices by linking them to a specific sex, and the dilemmas posed by the perpetuation of genderstereotypes concerning these technologies are analyzed. Finally, it highlights the need to deepenthe interactions between humans and care technologies from disciplines such as Science,Technology, and Society Studies or cultural studies, to address the design of assistive technologiesaimed at older people from a gender perspective.(AU)

O envelhecimento da população é um dos maiores desafios para a saúde pública nospaíses desenvolvidos. A inovação tecnológica está a emergir como uma das respostas recorrentese esperançosas para abordar este fenómeno de uma forma sustentável. É realizada uma revisão deâmbito sobre o género e o sexo nas tecnologias de cuidados que têm características semelhantesàs humanas, tais como voz, atributos físicos, competências sociais e culturais, etc. O resultadofornece vinte e nove materiais, onze dos quais abordam o envelhecimento e/ou as relações degénero nos assistentes de voz, enquanto 18 abordam a tecnologia robótica. A revisão crítica daliteratura científica permite-nos determinar as principais características que caracterizam osdispositivos, ligando-os a um sexo específico, e são analisados os dilemas colocados pelaperpetuação de estereótipos de género em relação a estas tecnologias. Finalmente, destaca anecessidade de aprofundar as interacções entre o ser humano e as tecnologias de cuidados desaúde de disciplinas como Ciência, Tecnologia e Estudos da Sociedade ou estudos culturais, paraabordar a concepção de tecnologias de assistência destinadas a pessoas idosas, a partir de umaperspectiva de género.(AU)

Identifying Enablers of Participant Engagement in Clinical Trials of Consumer Health Technologies: Qualitative Study of Influenza Home Testing.

BACKGROUND: A rise in the recent trend of self-managing health using consumer health technologies highlights the importance of efficient and successful consumer health technology trials. Trials are particularly essential to support large-scale implementations of consumer health technologies, such as smartphone-supported home tests. However, trials are generally fraught with challenges, such as inadequate enrollment, lack of fidelity to interventions, and high dropout rates. Understanding the reasons underlying individuals' participation in trials can inform the design and execution of future trials of smartphone-supported home tests. OBJECTIVE: This study aims to identify the enablers of potential participants' trial engagement for clinical trials of smartphone-supported home tests. We use influenza home testing as our instantiation of a consumer health technology subject to trial to investigate the dispositional and situational enablers that influenced trial engagement. METHODS: We conducted semistructured interviews with 31 trial participants using purposive sampling to facilitate demographic diversity. The interviews included a discussion of participants' personal characteristics and external factors that enabled their trial engagement with a smartphone-supported home test for influenza. We performed both deductive and inductive thematic analyses to analyze the interview transcripts and identify enabler themes. RESULTS: Our thematic analyses revealed a structure of dispositional and situational enablers that enhanced trial engagement. Situationally, clinical affiliation, personal advice, promotional recruitment strategies, financial incentives, and insurance status influenced trial engagement. In addition, digital health literacy, motivation to advance medical research, personal innovativeness, altruism, curiosity, positive attitude, and potential to minimize doctors' visits were identified as the dispositional enablers for trial engagement in our study. CONCLUSIONS: We organized the identified themes for dispositional and situational enablers of trial engagement with a smartphone-supported home test into a research framework that can guide future research as well as the trial design and execution of smartphone-supported home tests. We suggest several trial design and engagement strategies to enhance the financial and scientific viability of these trials that pave the way for advancements in patient care. Furthermore, our study also offers practical strategies to trial organizers to enhance participants' enrollment and engagement in clinical trials of these home tests.

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study.

BACKGROUND: Owing to the shortage of medical professionals, as well as demographic and structural challenges, new care models have emerged to find innovative solutions to counter medical undersupply. Team-based primary care using medical delegation appears to be a promising approach to address these challenges; however, it demands efficient communication structures and mechanisms to reinsure patients and caregivers receive a delegated, treatment-related task. Digital health care technologies hold the potential to render these novel processes effective and demand driven. OBJECTIVE: The goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use. METHODS: We conducted a combination of 19 individual and group interviews with 12 GPs and 14 MAs, seeking to identify relevant technologies for delegation purposes as well as stakeholders' perceptions of their effectiveness. Furthermore, a web-based survey was conducted asking the interviewees to order identified technologies based on their assessed applicability in multi-actor patient care. Interview data were analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize the survey data, leading to a triangulation of the results. RESULTS: Our results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed to improve the development and distribution of innovative technologies and to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultations, portable electrocardiograms, or telemedical stethoscopes, can counteract current challenges in primary care because of its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes. CONCLUSIONS: Technology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance of such innovative approaches increases with the tremendous need for differentiated and effective care, such as during the ongoing COVID-19 pandemic. For the successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role as mediators between GPs and patients, MAs are potentially able to counteract patients' resistance toward using innovative technology and compensate for patients' limited access to technology and care facilities.

[The medical social technology of health preservation of elderly population in conditions of self-isolation].

In Moscow (as of January 1, 2020), the number of population made up to 12,678,079, and out of them the elderly population made up to 2.8 million. Up to the end of 2020, the number of the elderly will reach 3.3 million requiring implementation of corresponding preventive measures due to mass prevalence of coronavirus infection. The COVID-19 pandemic demonstrated that despite restructuring of functioning of industry, social security and health care, quarantine and self-isolation occurred to be exactly the effective measures. The self-isolation regimen also revealed aggravation of harmful effects of stress factors, hypodynamia, hypooxygenation and decreasing of immunological resistance. It is especially important to organize leisure activities and to create the most comfortable conditions for isolated living of the elderly as most susceptible to infection. The experience demonstrated that properly chosen set of activities during self-isolation regimen both disciplines and permits to apply surplus of free time to intensify health potential and to consolidate family relationships.

Investigating Users' and Other Stakeholders' Needs in the Development of a Personalized Integrated Care Platform (PROCare4Life) for Older People with Dementia or Parkinson Disease: Protocol for a Mixed Methods Study.

BACKGROUND: Dementias-including Alzheimer disease-and Parkinson disease profoundly impact the quality of life of older population members and their families. PROCare4Life (Personalized Integrated Care Promoting Quality of Life for Older Adults) is a European project that recognizes the benefit of technology-based integrated care models in improving the care coordination and the quality of life of these target groups. This project proposes an integrated, scalable, and interactive care platform targeting older people suffering from neurodegenerative diseases, their caregivers, and socio-health professionals. PROCare4Life adopts a user-centered design approach from the early stage and throughout platform development and implementation, during which the platform is designed and adapted to the needs and requirements of all the involved users. OBJECTIVE: This paper presents the study protocol for investigating users' needs and requirements regarding the design of the proposed PROCare4Life platform. METHODS: A mixed qualitative and quantitative study design is utilized, including online surveys, interviews, and workshops. The study aimed to recruit approximately 200 participants, including patients diagnosed with dementia or Parkinson disease, caregivers, socio-health professionals, and other stakeholders, from five different European countries: Germany, Italy, Portugal, Romania, and Spain. RESULTS: The study took place between April and September 2020. Recruitment is now closed, and all the data have been collected and analyzed in order to be used in shaping the large-scale pilot phase of the PROCare4Life project. Results of the study are expected to be published in spring 2021. CONCLUSIONS: This paper charts the protocol for a user-centered design approach at the early stage of the PROCare4Life project in order to shape and influence an integrated health platform suitable for its intended target group and purpose. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/22463.

Opportunities and Challenges for Biosensors and Nanoscale Analytical Tools for Pandemics: COVID-19.

Biosensors and nanoscale analytical tools have shown huge growth in literature in the past 20 years, with a large number of reports on the topic of 'ultrasensitive', 'cost-effective', and 'early detection' tools with a potential of 'mass-production' cited on the web of science. Yet none of these tools are commercially available in the market or practically viable for mass production and use in pandemic diseases such as coronavirus disease 2019 (COVID-19). In this context, we review the technological challenges and opportunities of current bio/chemical sensors and analytical tools by critically analyzing the bottlenecks which have hindered the implementation of advanced sensing technologies in pandemic diseases. We also describe in brief COVID-19 by comparing it with other pandemic strains such as that of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) for the identification of features that enable biosensing. Moreover, we discuss visualization and characterization tools that can potentially be used not only for sensing applications but also to assist in speeding up the drug discovery and vaccine development process. Furthermore, we discuss the emerging monitoring mechanism, namely wastewater-based epidemiology, for early warning of the outbreak, focusing on sensors for rapid and on-site analysis of SARS-CoV2 in sewage. To conclude, we provide holistic insights into challenges associated with the quick translation of sensing technologies, policies, ethical issues, technology adoption, and an overall outlook of the role of the sensing technologies in pandemics.

Patient Preferences for Point-of-Care Testing: Survey Validation and Results.

BACKGROUND: Studies of current opinion of our community members for the characteristics, mode, and location of use, use cases, and overall enthusiasm for point-of-care testing (POCT) diagnosis and management tools are needed. STUDY DESIGN AND METHODS: Qualitative research methods were used to develop, refine, and evaluate hardcopy and electronic versions of a 45-item English language survey. The accuracy of the instrument was measured by recorded structured interview, and its precision was measured by comparison to its administration to a group of uncompensated volunteers. MAIN FINDINGS AND RESULTS: Comparison of survey and structured interview data demonstrated high levels of accuracy. Highly concordant with significant levels of correlation and of direct association indicated favorable precision. Ninety-three percent of respondents believed that POCT could improve their care, and 56% identified having a POCT in their home as a top priority. Accuracy, insurance coverage, immediacy of results, and ease of use were identified as the most important characteristics of a POCT. CONCLUSIONS: Community members strongly support the development of accurate, in-home devices that produce immediate results that can be used to diagnose, manage, and encourage their adherence to treatments for their medical conditions.

The agency of patients and carers in medical care and self-care technologies for interacting with doctors.

People living with Parkinson's disease engage in self-care for most of the time but, two or three times a year, they meet with doctors to re-evaluate the condition and adjust treatment. Patients and (informal) carers participate actively in these encounters, but their engagement might change as new patient-centred technologies are integrated into healthcare infrastructures. Drawing on a qualitative study that used observations and interviews to investigate consultations, and digital ethnography to understand interactions in an online community, we describe how patients and carers living with Parkinson's participate in the diagnosis and treatment decisions, engage in discussions to learn about certain topics, and address inappropriate medication. We contrast their engagement with a review of self-care technologies that support interactions with doctors, to investigate how these artefacts may influence the agency of patients and carers. Finally, we discuss design ideas for improving the participation of patients and carers in technology-mediated scenarios.

Editorial Trends and Challenges in Translation of Point-of-Care Technologies in Healthcare.

Point-of-Care Technologies (POCT) in Healthcare have emerged as a potential pathway in global and resource-limited environments towards improving access to healthcare with emphasis on preventive, personalized and precision medicine. The potential uses for POC technologies by patients or clinicians are many-from home-based monitoring to semi-managed and clinical inpatient healthcare. However, it is yet to be proven precisely what technologies are necessary or how they should be used to make an impact in improving access to quality healthcare. Although there is great potential for the application of new technologies in healthcare, physicians are skeptical about POCT since they fear it will generate large amounts of unreliable and overwhelming information of unknown benefit. Because the benefits and acceptance of POCT are unknown, a necessary first step in its development is performing market research of patients and clinicians to determine what POCT protocols would be most beneficial and acceptable. Research into POCT involves first understanding what the needs are of patients and clinicians, and then researching the best way to apply new technology to improve clinical care based on the understanding of these needs. The conference featured 5 keynote, 8 panel and 4 breakout sessions involving leaders from several stakeholder groups, including technology research, federal funding and regulatory agencies, industry and clinical healthcare. Through numerous presentations and group discussions, the conference participants concluded that the future of POCT depends upon facilitation of collaborative translational research towards development and meaningful validation of POCT in addressing specific healthcare and clinical needs with clear benefits and user acceptance.

Non-Invasive Electromagnetic Skin Patch Sensor to Measure Intracranial Fluid-Volume Shifts.

Elevated intracranial fluid volume can drive intracranial pressure increases, which can potentially result in numerous neurological complications or death. This study's focus was to develop a passive skin patch sensor for the head that would non-invasively measure cranial fluid volume shifts. The sensor consists of a single baseline component configured into a rectangular planar spiral with a self-resonant frequency response when impinged upon by external radio frequency sweeps. Fluid volume changes (10 mL increments) were detected through cranial bone using the sensor on a dry human skull model. Preliminary human tests utilized two sensors to determine feasibility of detecting fluid volume shifts in the complex environment of the human body. The correlation between fluid volume changes and shifts in the first resonance frequency using the dry human skull was classified as a second order polynomial with R² = 0.97. During preliminary and secondary human tests, a ≈24 MHz and an average of ≈45.07 MHz shifts in the principal resonant frequency were measured respectively, corresponding to the induced cephalad bio-fluid shifts. This electromagnetic resonant sensor may provide a non-invasive method to monitor shifts in fluid volume and assist with medical scenarios including stroke, cerebral hemorrhage, concussion, or monitoring intracranial pressure.

Diálogos entre saúde mental e atenção básica: relato de experiência do Pet-Saúde no município de Parnaíba-PI / Dialogues between mental health and primary health care: a Brazilian educational program for health work case report / Diálogos entre salud mental y atención básica: relato de experiencia del Pet-Salud en la ciudad de Parnaíba-PI

O presente artigo pretende apresentar o relato de experiência de integrantes do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) - Rede de Atenção Psicossocial (RAPS), em uma Unidade Básica de Saúde da cidade de Parnaíba-PI. A experiência possibilitou aos participantes observar os desafios na construção de uma atenção integral à saúde mental, na efetivação de linhas de cuidado e de implantação de tecnologias de cuidado, como o Apoio Matricial, bem como as dificuldades dos profissionais da Atenção Básica ao trabalhar a Saúde Mental. Com a observação participante, que supôs visitas domiciliares, rodas de conversa intersetoriais e multiprofissionais, e a corresponsabilização pelos casos, pôde-se conhecer a rede de atenção psicossocial e entender os processos que levam a uma fragilidade e não efetivação das propostas da Reforma Psiquiátrica na realidade local. Percebe-se a necessidade de uma mudança cultural no sentido de incorporar uma visão psicossocial.

The aim of this paper is to report the experience of members of the Educational Program for Health Work (PET-Saúde), Psychosocial Care Network, in a Primary Health care facility in the city of Parnaíba, Brazil. The experience enabled participants to observe the challenges in creating comprehensive mental health care, in the implementation of the effectiveness of care strategies and care technology deployment, such as the Multiprofessional Support, and the difficulties of professionals in primary care when working with Health Mental Care. Through participant observation, which supposed homecare, intersectoral and multidisciplinary meetings, and co-responsibility for the cases, it was possible to know the psychosocial care network and understand the processes which lead to fragility and non-effectiveness of the proposals of the Brazilian psychiatric reform in local reality. There is a need for a cultural change in the sense of incorporating a psychosocial vision.

El presente artículo pretende presentar el relato de la experiencia de los miembros del Programa de Educación por el Trabajo para la Salud (PET-Salud) - Red de Atención Psicosocial, en una Unidad Básica de Salud de la ciudad de Parnaíba-PI. La experiencia ha posibilitado a los participantes observar los desafíos en la construcción de una atención integral a la salud mental, la efectuación de líneas de cuidado e de implantación de tecnologías de cuidado, como el Apoyo Matricial, bien como las dificultades de los profesionales de la Atención Básica al trabajar la Salud Mental. A través de la observación participante, que ha supuesto visitas domiciliares, reuniones intersectoriales y multiprofesionales, y la corresponsabilización por los casos, se pudo conocer la red de atención psicosocial y comprender los procesos que llevan a una fragilidad y no efectuación de las propuestas de la Reforma Psiquiátrica en la realidad local. Se percibe la necesidad de un cambio cultural en el sentido de incorporar una visión psicosocial.