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1.
Cyberpsychol Behav Soc Netw ; 24(2): 79-85, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33577414

RESUMEN

The persistence of the coronavirus-caused respiratory disease (COVID-19) and the related restrictions to mobility and social interactions are forcing a significant portion of students and workers to reorganize their daily activities to accommodate the needs of distance learning and agile work (smart working). What is the impact of these changes on the bosses/teachers' and workers/students' experience? This article uses recent neuroscience research findings to explore how distance learning and smart working impact the following three pillars that reflect the organization of our brain and are at the core of school and office experiences: (a) the learning/work happens in a dedicated physical place; (b) the learning/work is carried out under the supervision of a boss/professor; and (c) the learning/work is distributed between team members/classmates. For each pillar, we discuss its link with the specific cognitive processes involved and the impact that technology has on their functioning. In particular, the use of videoconferencing affects the functioning of Global Positioning System neurons (neurons that code our navigation behavior), mirror neurons, self-attention networks, spindle cells, and interbrain neural oscillations. These effects have a significant impact on many identity and cognitive processes, including social and professional identity, leadership, intuition, mentoring, and creativity. In conclusion, just moving typical office and learning processes inside a videoconferencing platform, as happened in many contexts during the COVID-19 pandemic, can in the long term erode corporate cultures and school communities. In this view, an effective use of technology requires us to reimagine how work and teaching are done virtually, in creative and bold new ways.


Asunto(s)
Educación a Distancia , Relaciones Interpersonales , Vías Nerviosas , Conducta Espacial , Atención , Infecciones por Coronavirus , Humanos , Aprendizaje , Memoria Episódica , Neuronas Espejo , Neuronas , Pandemias , Navegación Espacial , Estudiantes , Comunicación por Videocoferencia
2.
Medicine (Baltimore) ; 100(6): e24141, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578519

RESUMEN

BACKGROUND: The global neo-coronary pneumonia epidemic has increased the workload of healthcare institutions in various countries and directly affected the physical and psychological recovery of the vast majority of patients requiring hospitalization in China. We anticipate that post-total knee arthroplasty kinesiophobia may have an impact on patients' postoperative pain scores, knee function, and ability to care for themselves in daily life. The purpose of this study is to conduct a micro-video intervention via WeChat to verify the impact of this method on the rapid recovery of patients with kinesiophobia after total knee arthroplasty during neo-coronary pneumonia. METHODS: Using convenience sampling method, 78 patients with kinesiophobia after artificial total knee arthroplasty who met the exclusion criteria were selected and randomly grouped, with the control group receiving routine off-line instruction and the intervention group receiving micro-video intervention, and the changes in the relevant indexes of the two groups of patients at different time points on postoperative day 1, 3 and 7 were recorded and analyzed. RESULTS: There were no statistical differences in the scores of kinesiophobia, pain, knee flexion mobility (ROM) and ability to take care of daily life between the two groups on the first postoperative day (P > .05). On postoperative day 3 and 7, there were statistical differences in Tampa Scale for kinesiophobia, pain, activities of daily living scale score and ROM between the two groups (P < .01), and the first time of getting out of bed between the two groups (P < .05), and by repeated-measures ANOVA, there were statistically significant time points, groups and interaction effects of the outcome indicators between the 2 groups (P < .01), indicating that the intervention group reconstructed the patients' postoperative kinesiophobiaand hyperactivity. The level of pain awareness facilitates the patient's acquisition of the correct functional exercises to make them change their misbehavior. CONCLUSIONS: WeChat micro-video can reduce the fear of movement score and pain score in patients with kinesiophobia after unilateral total knee arthroplasty, shorten the first time out of bed, and improve their joint mobility and daily living ability. ETHICS: This study has passed the ethical review of the hospital where it was conducted and has been filed, Ethics Approval Number: 20181203-01.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/psicología , Trastornos Fóbicos/psicología , Neumonía/epidemiología , Actividades Cotidianas , Anciano , Artroplastia de Reemplazo de Rodilla/efectos adversos , /diagnóstico , Estudios de Casos y Controles , China/epidemiología , Femenino , Humanos , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/psicología , Neumonía/virología , Periodo Posoperatorio , Estudios Prospectivos , Rango del Movimiento Articular , Recuperación de la Función , Rehabilitación/métodos , Rehabilitación/psicología , Comunicación por Videocoferencia/instrumentación , Comunicación por Videocoferencia/estadística & datos numéricos
3.
Ann Clin Psychiatry ; 33(1): 27-34, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33529285

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought many challenges to patient care delivery. The need for social distancing and relaxing of federal and state telemental health regulations paved the way for widespread adoption of direct-to-consumer (DTC) ambulatory mental health video visits. METHODS: We present cases that demonstrate the use of video visits across 6 clinical areas, each serving a unique population of patients, in a large behavioral health system. The benefits and limitations of this modality are illustrated in children, adults, and older adults with mood disorders, anxiety disorders, intellectual disability, substance use disorders, neurocognitive disorders, and schizophrenia. RESULTS: Although telephone visits were acceptable and necessary to serve some patients, there are many advantages to video visits in providing best patient care. Education and support for telemental health-delivered to both patients and clinicians-is critical to the success of the DTC model. CONCLUSIONS: DTC telemental health is a widespread clinical tool used during the COVID-19 pandemic. Because this model has many strengths and advantages compared with traditional telemental health delivered in a clinic, regulators and insurers should be open to its continued use postpandemic when clinically appropriate.


Asunto(s)
Trastornos Mentales/terapia , Servicios de Salud Mental , Telemedicina , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Servicios de Salud Mental/organización & administración , Servicios de Salud Mental/normas , Persona de Mediana Edad , Telemedicina/organización & administración , Telemedicina/normas , Teléfono , Comunicación por Videocoferencia , Adulto Joven
5.
BMC Musculoskelet Disord ; 22(1): 18, 2021 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-33402136

RESUMEN

BACKGROUND: Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy. METHODS: An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated. RESULTS: 72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future. CONCLUSION: Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.


Asunto(s)
Neoplasias Óseas/terapia , Comunicación Interdisciplinaria , Oncología Médica/organización & administración , Neoplasias de los Músculos/terapia , Grupo de Atención al Paciente/organización & administración , Sarcoma/terapia , Telemedicina/organización & administración , Comunicación por Videocoferencia/organización & administración , Actitud del Personal de Salud , Actitud hacia los Computadores , Neoplasias Óseas/diagnóstico , Toma de Decisiones Clínicas , Prestación Integrada de Atención de Salud/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Humanos , Neoplasias de los Músculos/diagnóstico , Sarcoma/diagnóstico , Centros de Atención Terciaria
6.
Cochrane Database Syst Rev ; 1: CD013040, 2021 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-33511633

RESUMEN

BACKGROUND: Pulmonary rehabilitation is a proven, effective intervention for people with chronic respiratory diseases including chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and bronchiectasis. However, relatively few people attend or complete a program, due to factors including a lack of programs, issues associated with travel and transport, and other health issues. Traditionally, pulmonary rehabilitation is delivered in-person on an outpatient basis at a hospital or other healthcare facility (referred to as centre-based pulmonary rehabilitation). Newer, alternative modes of pulmonary rehabilitation delivery include home-based models and the use of telehealth. Telerehabilitation is the delivery of rehabilitation services at a distance, using information and communication technology. To date, there has not been a comprehensive assessment of the clinical efficacy or safety of telerehabilitation, or its ability to improve uptake and access to rehabilitation services, for people with chronic respiratory disease. OBJECTIVES: To determine the effectiveness and safety of telerehabilitation for people with chronic respiratory disease. SEARCH METHODS: We searched the Cochrane Airways Trials Register, and the Cochrane Central Register of Controlled Trials; six databases including MEDLINE and Embase; and three trials registries, up to 30 November 2020. We checked reference lists of all included studies for additional references, and handsearched relevant respiratory journals and meeting abstracts. SELECTION CRITERIA: All randomised controlled trials and controlled clinical trials of telerehabilitation for the delivery of pulmonary rehabilitation were eligible for inclusion. The telerehabilitation intervention was required to include exercise training, with at least 50% of the rehabilitation intervention being delivered by telerehabilitation. DATA COLLECTION AND ANALYSIS: We used standard methods recommended by Cochrane. We assessed the risk of bias for all studies, and used the ROBINS-I tool to assess bias in non-randomised controlled clinical trials. We assessed the certainty of evidence with GRADE. Comparisons were telerehabilitation compared to traditional in-person (centre-based) pulmonary rehabilitation, and telerehabilitation compared to no rehabilitation. We analysed studies of telerehabilitation for maintenance rehabilitation separately from trials of telerehabilitation for initial primary pulmonary rehabilitation. MAIN RESULTS: We included a total of 15 studies (32 reports) with 1904 participants, using five different models of telerehabilitation. Almost all (99%) participants had chronic obstructive pulmonary disease (COPD). Three studies were controlled clinical trials. For primary pulmonary rehabilitation, there was probably little or no difference between telerehabilitation and in-person pulmonary rehabilitation for exercise capacity measured as 6-Minute Walking Distance (6MWD) (mean difference (MD) 0.06 metres (m), 95% confidence interval (CI) -10.82 m to 10.94 m; 556 participants; four studies; moderate-certainty evidence). There may also be little or no difference for quality of life measured with the St George's Respiratory Questionnaire (SGRQ) total score (MD -1.26, 95% CI -3.97 to 1.45; 274 participants; two studies; low-certainty evidence), or for breathlessness on the Chronic Respiratory Questionnaire (CRQ) dyspnoea domain score (MD 0.13, 95% CI -0.13 to 0.40; 426 participants; three studies; low-certainty evidence). Participants were more likely to complete a program of telerehabilitation, with a 93% completion rate (95% CI 90% to 96%), compared to a 70% completion rate for in-person rehabilitation. When compared to no rehabilitation control, trials of primary telerehabilitation may increase exercise capacity on 6MWD (MD 22.17 m, 95% CI -38.89 m to 83.23 m; 94 participants; two studies; low-certainty evidence) and may also increase 6MWD when delivered as maintenance rehabilitation (MD 78.1 m, 95% CI 49.6 m to 106.6 m; 209 participants; two studies; low-certainty evidence). No adverse effects of telerehabilitation were noted over and above any reported for in-person rehabilitation or no rehabilitation. AUTHORS' CONCLUSIONS: This review suggests that primary pulmonary rehabilitation, or maintenance rehabilitation, delivered via telerehabilitation for people with chronic respiratory disease achieves outcomes similar to those of traditional centre-based pulmonary rehabilitation, with no safety issues identified. However, the certainty of the evidence provided by this review is limited by the small number of studies, of varying telerehabilitation models, with relatively few participants. Future research should consider the clinical effect of telerehabilitation for individuals with chronic respiratory diseases other than COPD, the duration of benefit of telerehabilitation beyond the period of the intervention, and the economic cost of telerehabilitation.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Trastornos Respiratorios/rehabilitación , Telerrehabilitación/métodos , Sesgo , Enfermedad Crónica , Ensayos Clínicos Controlados como Asunto/estadística & datos numéricos , Disnea/rehabilitación , Tolerancia al Ejercicio/fisiología , Humanos , Internet/estadística & datos numéricos , Ensayos Clínicos Controlados no Aleatorios como Asunto/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Teléfono/estadística & datos numéricos , Telerrehabilitación/estadística & datos numéricos , Comunicación por Videocoferencia/estadística & datos numéricos , Prueba de Paso/estadística & datos numéricos
7.
BMC Health Serv Res ; 21(1): 85, 2021 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-33485327

RESUMEN

BACKGROUND: Due to regional, professional, and resource limitations, access to mental health care for Canada's Indigenous peoples can be difficult. Telemental health (TMH) offers the opportunity to provide care across vast distances and has been proven to be as effective as face-to-face services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study. METHODS: Using a qualitative descriptive design, the entire staff of a TMH clinic was recruited, comprising of four psychiatrists and four support staff. Individual semi-structured interviews were conducted through videoconferencing, and results were thematically analyzed. RESULTS: To address the mental health gap in Northern communities, all psychiatrists believe in the necessity of in-person care and note the synergistic effect of combining in-person care and TMH services. This approach to care allows psychiatrists to maintain both an insider and outsider identity. However, if a patient's condition requires hospitalization, then the TMH staff face a new set of information sharing and communication challenges with the inpatient staff. TMH staff believe that the provision of culturally sensitive care to Northern patients at the inpatient unit is progressing; however, more work needs to be done. Despite the strong collegial atmosphere within the clinic and collective efforts to provide quality TMH services, all participants express a sense of frustration with the paper-based and scattered documentation system. CONCLUSION: The TMH team works in cohesion to offer TMH services to Indigenous peoples; yet, automatization is needed to improve the workflow efficiency within the clinic and collaboration with the Northern clinics. More research is needed on the functioning of TMH teams and the separate but important roles of each team member.


Asunto(s)
Pueblos Indígenas , Canadá , Comunicación , Servicios de Salud del Indígena , Humanos , Servicios de Salud Mental , Grupos de Población , Psiquiatría , Quebec , Comunicación por Videocoferencia
8.
Curr Oncol ; 28(1): 671-677, 2021 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-33499380

RESUMEN

There has been rapid implementation of virtual oncology appointments in response to the COVID-19 pandemic, particularly in its first wave. Our objective was to assess patterns and perspectives towards virtual oncology appointments during the pandemic among patients with cancer undergoing active treatment. We conducted an international Internet-based cross-sectional survey. Participants were eligible if they (1) were ≥18 years of age; (2) had been diagnosed with cancer (3) were currently undergoing cancer treatment, and (4) spoke English or French. Between 23 April 2020 and 9 June 2020, 381 individuals accessed the survey, with 212 actively undergoing treatment for cancer, including 27% with colorectal, 21% with breast, 7% with prostate and 7% with lung cancer. A total of 52% of respondents were from Canada and 35% were from the United States. Many participants (129, 62%) indicated having had a virtual oncology appointment during the COVID-19 pandemic and most were satisfied with their experience (83%). We found older participants (≥50 years; adjusted OR 0.22, 95% CI 0.06 to 0.85 compared to <50 years) and those with shortest duration of treatment (≤3 months; adjusted OR 0.06; 95% CI 0 to 0.69 compared to >12 months) were less likely to be satisfied with virtual oncology appointments. Virtual health platforms used differed across countries with higher telephone use in Canada (87%) and other countries (86%) as compared to the United States (54%; p-value < 0.05), where there was higher use of video conferencing. Altogether, our findings demonstrate favorable patient perspectives towards virtual oncology appointments experienced during the first wave of the COVID-19 pandemic.


Asunto(s)
/epidemiología , Oncología Médica/organización & administración , Neoplasias/terapia , Telemedicina/tendencias , Adulto , Anciano , Canadá/epidemiología , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Accesibilidad a los Servicios de Salud , Humanos , Cooperación Internacional , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Comunicación por Videocoferencia
9.
JAMA Netw Open ; 4(1): e2033967, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33443581

RESUMEN

Importance: Telehealth has emerged as a means of improving access and reducing cost for medical oncology care; however, use by specialists prior to the coronavirus disease 2019 (COVID-19) pandemic still remained low. Medical oncology professionals' perceptions of telehealth for cancer care are largely unknown, but are critical to telehealth utilization and expansion efforts. Objective: To identify medical oncology health professionals' perceptions of the barriers to and benefits of telehealth video visits. Design, Setting, and Participants: This qualitative study used interviews conducted from October 30, 2019, to March 5, 2020, of medical oncology health professionals at the Thomas Jefferson University Hospital, an urban academic health system in the US with a cancer center. All medical oncology physicians, physicians assistants, and nurse practitioners at the hospital were eligible to participate. A combination of volunteer and convenience sampling was used, resulting in the participation of 29 medical oncology health professionals, including 20 physicians and 9 advanced practice professionals, in semistructured interviews. Main Outcomes and Measures: Medical oncology health professionals' perceptions of barriers to and benefits of telehealth video visits as experienced by patients receiving cancer treatment. Results: Of the 29 participants, 15 (52%) were women and 22 (76%) were White, with a mean (SD) age of 48.5 (12.0) years. Respondents' perceptions were organized using the 4 domains of the National Quality Forum framework: clinical effectiveness, patient experience, access to care, and financial impact. Respondents disagreed on the clinical effectiveness and potential limitations of the virtual physical examination, as well as on the financial impact on patients. Respondents also largely recognized the convenience and improved access to care enabled by telehealth for patients. However, many reported concern regarding the health professional-patient relationship and their limited ability to comfort patients in a virtual setting. Conclusions and Relevance: Medical oncology health professionals shared conflicting opinions regarding the barriers to and benefits of telehealth in regard to clinical effectiveness, patient experience, access to care, and financial impact. Understanding oncologists' perceptions of telehealth elucidates potential barriers that need to be further investigated or improved for telehealth expansion and continued utilization; further research is ongoing to assess current perceptions of health professionals and patients given the rapid expansion of telehealth during the COVID-19 pandemic.


Asunto(s)
Actitud del Personal de Salud , Oncólogos , Satisfacción del Paciente , Relaciones Médico-Paciente , Telemedicina , Comunicación por Videocoferencia , Adulto , Femenino , Gastos en Salud , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Oncología Médica , Persona de Mediana Edad , Enfermeras Practicantes , Percepción , Examen Físico , Asistentes Médicos , Relaciones Profesional-Paciente , Investigación Cualitativa , Revelación de la Verdad
10.
Adv Physiol Educ ; 45(1): 53-58, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33464193

RESUMEN

Programming is an important skill for different areas of knowledge. While in the past, programming skills were much more related to fields of computer sciences and engineering, today, professionals from different areas benefit from the ability to write codes for different applications. Furthermore, programming stimulates logical thinking, which impacts other personal abilities. Health science students have limited exposure to programming during their studies. Aware of this and considering the prolonged time in social distancing in Brazil due to the SARS-COV2 pandemic in 2020, we organized an outreach course dedicated to teaching introductory concepts of programming for health science students. The activity was developed fully online using the Zoom web conference agent, lasting 12 wk (8 synchronous classes, 15 synchronous hours in total), and attended by 27 undergraduate and graduate students from two different universities. A collaborative problem-based learning and group-learning methodology were developed through asynchronous homework and mainly online synchronous activities. In this article, we describe our approach and provide some suggestions for replicating the course in other universities. We observed that the activities of the outreach course improved programming skills and confidence for most of the students. More importantly, it piqued their interest enough to motivate them to continue to practice writing and testing their programs. We concluded that an outreach course dedicated to programming promoted improvements in programming skills in health science students. Furthermore, the program was an opportunity to keep the students active in science while working from their homes during the pandemic.


Asunto(s)
Disciplinas de las Ciencias Biológicas/educación , Educación a Distancia , Informática/educación , Pandemias , Programas Informáticos , Estudiantes/psicología , Comunicación por Videocoferencia , Adulto , Brasil , Curriculum , Femenino , Humanos , Masculino , Aprendizaje Basado en Problemas , Interfaz Usuario-Computador , Adulto Joven
11.
JCO Oncol Pract ; 17(1): e26-e35, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33434451

RESUMEN

PURPOSE: Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer. METHODS: This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only. RESULTS: There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group (P = .028 and r = 0.16) and distress by group interactions (P = .014 and r = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%). CONCLUSION: Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.


Asunto(s)
Trastornos de Ansiedad/psicología , Cuidadores/psicología , Neoplasias/psicología , Adulto , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/patología , Trastornos de Ansiedad/terapia , /patología , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/patología , Neoplasias/terapia , Oncólogos , Calidad de Vida , Encuestas y Cuestionarios , Comunicación por Videocoferencia/normas
12.
J Med Internet Res ; 23(1): e24098, 2021 01 27.
Artículo en Inglés | MEDLINE | ID: mdl-33468448

RESUMEN

Remote approaches for dementia research are required in the era of COVID-19, but moving a research program from in person to remote involves additional considerations. We recommend using outcome measures that have psychometric properties for remote delivery, and we recommend against adapting in-person scales for remote delivery without evidence for psychometric equivalency. We suggest remote research designs that maximize benefit for participants, which could have implications for control groups. Researchers should plan for flexibility in their methods for remote research and must not assume all participants will be able to videoconference; telephone-only research is possible. We recommend performing an assessment of information communication technology infrastructure and prior exposure to this technology with each participant before making a final choice on remote methods for research. In general, researchers should adapt their methods for remote research to each participant rather than requesting participants to adapt to the researchers. Screening for sensory loss should be conducted, and the impact of this on the use of technology for remote research should be considered. In this viewpoint, we detail how individualized training is required prior to engaging in remote research, how training plans interact with cognitive impairments and, finally, the steps involved in facilitating technology-based remote data collection.


Asunto(s)
Investigación Biomédica/tendencias , Demencia , Telemedicina , Comunicación por Videocoferencia , Disfunción Cognitiva , Humanos
13.
J Med Internet Res ; 23(1): e23775, 2021 01 26.
Artículo en Inglés | MEDLINE | ID: mdl-33434141

RESUMEN

BACKGROUND: COVID-19 has thrust video consulting into the limelight, as health care practitioners worldwide shift to delivering care remotely. Evidence suggests that video consulting is acceptable, safe, and effective in selected conditions and settings. However, research to date has mostly focused on initial adoption, with limited consideration of how video consulting can be mainstreamed and sustained. OBJECTIVE: This study sought to do the following: (1) review and synthesize reported opportunities, challenges, and lessons learned in the scale-up, spread, and sustainability of video consultations, and (2) identify transferable insights that can inform policy and practice. METHODS: We identified papers through systematic searches in PubMed, CINAHL, and Web of Science. Included articles reported on synchronous, video-based consultations that had spread to more than one setting beyond an initial pilot or feasibility stage, and were published since 2010. We used the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework to synthesize findings relating to 7 domains: an understanding of the health condition(s) for which video consultations were being used, the material properties of the technological platform and relevant peripherals, the value proposition for patients and developers, the role of the adopter system, organizational factors, wider macro-level considerations, and emergence over time. RESULTS: We identified 13 papers describing 10 different video consultation services in 6 regions, covering the following: (1) video-to-home services, connecting providers directly to the patient; (2) hub-and-spoke models, connecting a provider at a central hub to a patient at a rural center; and (3) large-scale top-down evaluations scaled up or spread across a national health administration. Services covered rehabilitation, geriatrics, cancer surgery, diabetes, and mental health, as well as general specialist care and primary care. Potential enablers of spread and scale-up included embedded leadership and the presence of a telehealth champion, appropriate reimbursement mechanisms, user-friendly technology, pre-existing staff relationships, and adaptation (of technology and services) over time. Challenges tended to be related to service development, such as the absence of a long-term strategic plan, resistance to change, cost and reimbursement issues, and the technical experience of staff. There was limited articulation of the challenges to scale-up and spread of video consultations. This was combined with a lack of theorization, with papers tending to view spread and scale-up as the sum of multiple technical implementations, rather than theorizing the distinct processes required to achieve widespread adoption. CONCLUSIONS: There remains a significant lack of evidence that can support the spread and scale-up of video consulting. Given the recent pace of change due to COVID-19, a more definitive evidence base is urgently needed to support global efforts and match enthusiasm for extending use.


Asunto(s)
/epidemiología , Prestación de Atención de Salud/normas , Telemedicina/métodos , Comunicación por Videocoferencia/normas , Humanos , Pandemias , Atención Primaria de Salud/organización & administración , /aislamiento & purificación
14.
Clin Anat ; 34(1): 82-89, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32648289

RESUMEN

COVID-19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID-19 and physical distancing measures disrupt academic activities that previously occurred face-to-face. Restrictions placed on universities due to COVID-19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy-to-use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly-interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID-19 and after.


Asunto(s)
Anatomía/educación , Medios de Comunicación , Educación a Distancia , Investigación , Anatomía/métodos , Control de Enfermedades Transmisibles , Conducta Cooperativa , Educación Médica/métodos , Humanos , Redes Sociales en Línea , Medios de Comunicación Sociales , Interfaz Usuario-Computador , Comunicación por Videocoferencia
15.
Addict Behav ; 113: 106661, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33038682

RESUMEN

For people with current and remitted substance use disorder (SUD), the COVID-19 pandemic increases risk for symptom exacerbation and relapse through added stressors and reduced service access. In response, mutual-help groups and recovery community organizations have increased access to online recovery support meetings. However, rigorous studies examining online recovery support meeting participation to inform best practices have not yet been conducted. In the absence of such studies, a review of relevant literature, considered in context of potential barriers and drawbacks, suggests the risk-to-benefit ratio is favorable. Particularly given limited in-person SUD service access resulting from COVID-19 precautions, online recovery support meetings may help mitigate a key public health problem during an ongoing, public health pandemic.


Asunto(s)
Internet , Grupos de Autoayuda , Trastornos Relacionados con Sustancias/rehabilitación , Telemedicina , Comunicación por Videocoferencia , Alcohólicos Anónimos , Control de Enfermedades Transmisibles , Prestación de Atención de Salud , Humanos , Salud Pública
16.
Public Health Rep ; 136(1): 39-46, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33216679

RESUMEN

Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO's large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.


Asunto(s)
/epidemiología , Servicios de Salud Comunitaria/organización & administración , Personal de Salud/educación , Capacitación en Servicio/organización & administración , Tutoría/organización & administración , Población Rural , Servicios de Salud Comunitaria/normas , Agentes Comunitarios de Salud/educación , Práctica Clínica Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Humanos , Área sin Atención Médica , Servicios de Salud Mental/organización & administración , New Mexico/epidemiología , Pandemias , Resiliencia Psicológica , Telemedicina , Población Urbana , Comunicación por Videocoferencia
17.
Ann Clin Transl Neurol ; 8(2): 308-320, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33350601

RESUMEN

OBJECTIVE: The expanding power and accessibility of personal technology provide an opportunity to reduce burdens and costs of traditional clinical site-centric therapeutic trials in Parkinson's disease and generate novel insights. The value of this approach has never been more evident than during the current COVID-19 pandemic. We sought to (1) establish and implement the infrastructure for longitudinal, virtual follow-up of clinical trial participants, (2) compare changes in smartphone-based assessments, online patient-reported outcomes, and remote expert assessments, and (3) explore novel digital markers of Parkinson's disease disability and progression. METHODS: Participants from two recently completed phase III clinical trials of inosine and isradipine enrolled in Assessing Tele-Health Outcomes in Multiyear Extensions of Parkinson's Disease trials (AT-HOME PD), a two-year virtual cohort study. After providing electronic informed consent, individuals complete annual video visits with a movement disorder specialist, smartphone-based assessments of motor function and socialization, and patient-reported outcomes online. RESULTS: From the two clinical trials, 226 individuals from 42 states in the United States and Canada enrolled. Of these, 181 (80%) have successfully downloaded the study's smartphone application and 161 (71%) have completed patient-reported outcomes on the online platform. INTERPRETATION: It is feasible to conduct a large-scale, international virtual observational study following the completion of participation in brick-and-mortar clinical trials in Parkinson's disease. This study, which brings research to participants, will compare established clinical endpoints with novel digital biomarkers and thereby inform the longitudinal follow-up of clinical trial participants and design of future clinical trials.


Asunto(s)
Aplicaciones Móviles , Enfermedad de Parkinson/fisiopatología , Medición de Resultados Informados por el Paciente , Proyectos de Investigación , Teléfono Inteligente , Telemedicina , Comunicación por Videocoferencia , Canadá , Ensayos Clínicos como Asunto , Progresión de la Enfermedad , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Estados Unidos
18.
Phys Ther ; 101(2)2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33313701

RESUMEN

OBJECTIVE: The novel coronavirus 2019 (COVID-19) has impacted acute rehabilitation delivery by challenging the reliance on in-person care and the standard practice of delivering separate physical and occupational therapy services. Health care systems are rapidly developing innovative models of care that provide essential acute rehabilitation services while mitigating viral spread. We present 2 case reports to illustrate how we used technology and COVID-19-specific decision-making frameworks to deliver acute rehabilitation. METHODS: We iteratively developed 2 decision-making models regarding care delivery and discharge planning in the context of the challenges to delivering care in a pandemic. We leveraged use of video communication systems installed in all COVID-19 rooms to reduce the number of in-room providers and frequency of contact. Two patients were admitted to the hospital with symptomatic COVID-19 (males, ages 65 and 40 years). RESULTS: With the use of a video communication system and the decision-making frameworks for care delivery and discharge planning, we avoided 7 in-person sessions. Both patients demonstrated functional gains and were dischargedhome. CONCLUSION: The 2 case reports highlight the innovative use of a technology and COVID-19-specific decision-making processes to provide patient-centered care given the challenges to care delivery during the COVID-19 pandemic. IMPACT: The use of technology and decision-making models allows for delivery of safe acute rehabilitation care that minimizes contact, conserves personal protective equipment, and prepares for COVID-19 surges. The discussion points raised have applicability to patients without COVID-19 and other health care systems. Future research is needed to determine the effectiveness, costs, and downstream effects of our novel approach to acute rehabilitation for patients with COVID-19.


Asunto(s)
/rehabilitación , Prestación de Atención de Salud/métodos , Atención Dirigida al Paciente , Modalidades de Fisioterapia , Adulto , Toma de Decisiones Clínicas , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Comunicación por Videocoferencia
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