Improvement in intubation success during COVID-19 pandemic with a simple and low-cost intervention: A quasi-experimental study / Mejoría del éxito en la intubación durante la pandemia covid-19 con una intervención simple y de bajo costo: estudio cuasi-experimental

Objectives: primary objective: to improve the FPS rates after an educational intervention. Secondary objective: to describe variables related to FPS in an ED and determine which ones were related to the highest number of attempts.Design it was a prospective quasi-experimental study. Setting done in an ED in a public Hospital in Argentina. Patients there were patients of all ages with intubation in ED. Interventionsin the middle of the study, an educational intervention was done to improve FPS. Cognitive aids and pre- intubation Checklists were implemented. Main variables of interest the operator experience, the number of intubation attempts, intubation judgment, predictors of a difficult airway, Cormack score, assist devices, complications, blood pressure, heart rate, and pulse oximetry before and after intubation All the intubations were done by direct laryngoscopy (DL). Results data from 266 patients were included of which 123 belonged to the basal period and 143 belonged to the post-intervention period. FPS percentage of the pre-intervention group was 69.9% (IC95%: 60.89–77.68) whereas the post-intervention group was 85.3% (IC95%: 78.20–90.48). The difference between these groups was statistically significant (p=0.002). Factors related to the highest number of attempts were low operator experience, Cormack-Lehane 3 score and no training. Conclusions a low-cost and simple educational intervention in airway management was significantly associated with improvement in FPS, reaching the same rate of FPS than in high income countries. (AU)

Objetivos: objetivo principal: mejorar la tasa de éxito de intubación luego de una intervención educativa. Objetivo secundario: describir las variables asociadas con el éxito en el primer intento (EPI) y determinar cuáles se relacionaron con mayor número de intentos. Diseño estudio prospectivo cuasi-experimental. Ámbito: realizado en un SE de un Hospital público de Argentina. Pacientes se incluyeron todos aquellos pacientes intubados en el SE en el período de estudio. Intervención en la mitad del estudio, se realizó una intervención educativa, se implementaron ayudas cognitivas y listas de verificación preintubación. Todas las intubaciones se realizaron por laringoscopia directa. Variables de interés principales experiencia del operador, número de intentos de intubación, criterios de intubación, predictores de vía aérea difícil, grado de Cormack, dispositivos facilitadores utilizados, complicaciones y los signos vitales antes y después de la intubación. Resultados se incluyeron datos de 266 pacientes de los cuales 123 pertenecían al período basal y 143al período postintervención. El porcentaje de éxito del grupo preintervención fue del 69,9% (IC95%: 60,89-77,68) mientras que el grupo postintervención fue del 85,3% (IC95%: 78,20-90,48). La diferencia entre estos grupos fue estadísticamente significativa (p=0,002). Los factores relacionados con el mayor número de intentos fueron la baja experiencia del operador, el grado de Cormack-Lehane 3 y la falta de capacitación. Conclusiones una intervención educativa simple y de bajo costo en el manejo de la vía aérea se asoció significativamente con la mejora en el éxito del primer intento de intubación, alcanzando los porcentajes de los países de altos ingresos. (AU)

Improvement in intubation success during COVID-19 pandemic with a simple and low-cost intervention: A quasi-experimental study.

OBJECTIVES: primary objective: to improve the FPS rates after an educational intervention. SECONDARY OBJECTIVE: to describe variables related to FPS in an ED and determine which ones were related to the highest number of attempts. DESIGN: it was a prospective quasi-experimental study. SETTING: done in an ED in a public Hospital in Argentina. PATIENTS: there were patients of all ages with intubation in ED. INTERVENTIONS: in the middle of the study, an educational intervention was done to improve FPS. Cognitive aids and pre- intubation Checklists were implemented. MAIN VARIABLES OF INTEREST: the operator experience, the number of intubation attempts, intubation judgment, predictors of a difficult airway, Cormack score, assist devices, complications, blood pressure, heart rate, and pulse oximetry before and after intubation All the intubations were done by direct laryngoscopy (DL). RESULTS: data from 266 patients were included of which 123 belonged to the basal period and 143 belonged to the post-intervention period. FPS percentage of the pre-intervention group was 69.9% (IC95%: 60.89-77.68) whereas the post-intervention group was 85.3% (IC95%: 78.20-90.48). The difference between these groups was statistically significant (p=0.002). Factors related to the highest number of attempts were low operator experience, Cormack-Lehane 3 score and no training. CONCLUSIONS: a low-cost and simple educational intervention in airway management was significantly associated with improvement in FPS, reaching the same rate of FPS than in high income countries.

Mask Mirroring: A Novel Approach to Healthcare Empathy in the COVID-19 Era.

The COVID-19 pandemic has brought forth substantial changes to societal norms and global health infrastructure, one of the most impactful being mask wearing. With varying attitudes toward mask usage in a post-pandemic environment, this paper introduces the concept of "mask mirroring" in healthcare settings. This strategy involves healthcare providers reciprocating the mask-wearing behavior of their patients, intending to respect patients' choices and alleviate their potential concerns and anxieties. It is hypothesized that mask mirroring could serve as a symbol of empathy and solidarity, enhancing the doctor-patient rapport and facilitating effective healthcare delivery. In addition, it could reduce the transmission of respiratory infections, fostering a safer healthcare environment. Importantly, mask mirroring addresses the power dynamics between healthcare providers and patients, allowing patients' preferences and comfort to be prioritized. The implementation of this concept requires clear communication about its purpose and symbolism, striking a balance between reassurance and respect for differing viewpoints. The ultimate aim of mask mirroring is to promote patient-centric care, reflecting our commitment to understanding and empathizing with patients' concerns in a world recovering from COVID-19.

Decentralisation of the Compliance of Anti-tobacco Law in India: The Case of Higher Educational Institutions in New Delhi, India.

Introduction This paper studies the decentralised compliance responsibility of India's tobacco control legislation, called the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act of 2003, with its rules, which the government has outsourced to higher educational institutions, studied through an example of New Delhi. The study looks into the three most important parameters of decentralised compliance. Two of these require the installation of signboards by higher educational institutions, and the third involves imposing and collecting fines against persons found smoking within the educational institutions. Regarding the boards, the first board is about the warning prohibiting the sale within 100 yards of educational institutions, and the second one prohibits smoking in educational institutions. The study also checks with the educational institutions whether there is a presence of cigarette and tobacco product vendors within 100 yards of the institution, where the sale of such products has been banned by law. The study also found educational activities to create awareness in the institutions for tobacco control and cessation. Methods Thirty-six higher educational institutions, including universities, were randomly selected and studied through a unique methodology using India's transparency law, i.e., the Right to Information Act 2005. The portions of the law, which was direct compliance, or related compliance by the higher educational institution was included in the study. This justified the decentralised responsibility of these higher educational institutions. Applications for information under the transparency law were requested and supplied. Out of the 47 institutions, in which information requests were filed, 36 provided the information under the law. Credible information was provided by the higher educational institutions and this information was collated and interpreted to provide insights into the compliance by the higher educational institutions. Results Only 44.4% of the institutions had a board prohibiting the sale of cigarettes and other tobacco products. This was a non-universal compliance by the higher educational institutions. 88.9 per cent had boards prohibiting smoking in the higher educational institutions. Only one out of the 36 had an instance of smoking recorded and collection of fines. While 47.2% reported to not have any instance of smoking and fine collection. Fifty per cent of the institutions had no record of fine collection amounting to defiance of the law. 75 per cent of institutions did some kind of awareness activities which was not a direct statutory requirement, but a recommended guideline. Conclusion The results show that the intent to decentralise the compliance of the tobacco control law in New Delhi by the higher educational institutions has not been universally successful and requires much effort for its on-ground penetration. Such studies have a policy impact as they serve as an example for the generalisability of such statutes, which only work when there is implementation from the bottom-up and when the deterrent is also strong with incentivisation to the educational institutions to implement tobacco control with vigour.

Online group projects in higher education: persistent challenges and implications for practice.

With the rapid adoption of online learning across higher education, there is an urgent need to identify its challenges and ways of addressing them. Online group projects, in particular, present significant issues for educators. This paper presents the findings of a systematic literature review identifying the key challenges of online group projects, together with strategies to address them. From a corpus of 114 recent papers, the 57 most relevant were analysed, to identify themes related to challenges and strategies. Key challenges were: low and uneven participation by students; a lack of clarity and preparation for students; and poor relationships. Strategies for addressing challenges were: careful design of projects, particularly regarding fair assessment; clear guidance and preparation of students; and practical and emotional support throughout, to encourage confidence and engagement. The findings of this review will enable educators to design and facilitate online group projects which students find rewarding and valuable.

Application of Blended Learning to Veterinary Gross Anatomy Practical Sessions: Students' Perceptions of Their Learning Experience and Academic Outcomes.

The use of blended learning strategies is increasingly common in health sciences, including veterinary medicine; however, there are very few descriptions of these methods being applied to practicals. We describe here the application of blended learning based on the implementation of flipped classrooms with collaborative learning and gamification to the 2020-2021 veterinary medicine gross anatomy practicals at CEU Cardenal Herrera University (Spain). Students prepared for the sessions by pre-viewing videos and taking a quiz before the start. The sessions were conducted in small groups where students learned through collaborative work and reviewed their learning with a card game. A small but significant increase was observed when comparing the scores of practical exams of the locomotor apparatus with those of 2018-2019 (6.79 ± 2.22 vs. 6.38 ± 2.24, p < 0.05), while the scores were similar (7.76 ± 1.99 vs. 7.64 ± 1.92) for the organ system exams. Students' responses in a satisfaction survey were mostly positive (>80%) regarding the motivating and learning-facilitating effect of this educational method. Our work shows that the application of blended learning in anatomy practicals based on a flipped classroom and with elements of gamification and collaborative work can be an effective way to improve the learning experience of students.

Optimizing Primary Healthcare in Hong Kong: Strategies for the Successful Integration of Radiology Services.

The primary healthcare system in Hong Kong plays a crucial role in addressing the healthcare needs of its population. However, the integration of radiology services into primary care settings has not been fully realized, and there is significant potential for improvement. Incorporating radiology services into primary healthcare can enhance patient care, promote cost-effectiveness, and increase the overall efficiency of the healthcare system by enabling earlier diagnosis and intervention for various health conditions. To successfully integrate radiology services, key strategies include the establishment of public-private partnerships, the adoption of teleradiology and telemedicine services, the development of comprehensive regulatory and policy frameworks, and the exploration of innovative financial models and incentives. By embracing these strategies, Hong Kong can optimize its primary healthcare system and ensure more equitable, effective care for its population.

A Novel Scenario-Based, Mixed-Reality Platform for Training Nontechnical Skills of Battlefield First Aid: Prospective Interventional Study.

BACKGROUND: Although battlefield first aid (BFA) training shares many common features with civilian training, such as the need to address technical skills and nontechnical skills (NTSs), it is more highly scenario-dependent. Studies into extended reality show clear benefits in medical training; however, the training effects of extended reality on NTSs, including teamwork and decision-making in BFA, have not been fully proven. OBJECTIVE: The current study aimed to create and test a scenario-based, mixed-reality platform suitable for training NTSs in BFA. METHODS: First, using next-generation modeling technology and an animation synchronization system, a 10-person offensive battle drill was established. Decision-making training software addressing basic principles of tactical combat casualty care was constructed and integrated into the scenarios with Unreal Engine 4 (Epic Games). Large-space teamwork and virtual interaction systems that made sense in the proposed platform were developed. Unreal Engine 4 and software engineering technology were used to combine modules to establish a mixed-reality BFA training platform. A total of 20 Grade 4 medical students were recruited to accept BFA training with the platform. Pretraining and posttraining tests were carried out in 2 forms to evaluate the training effectiveness: one was knowledge acquisition regarding the NTS and the other was a real-world, scenario-based test. In addition, the students were asked to rate their agreement with a series of survey items on a 5-point Likert scale. RESULTS: A battlefield geographic environment, tactical scenarios, scenario-based decision software, large-space teamwork, and virtual interaction system modules were successfully developed and combined to establish the mixed-reality training platform for BFA. The posttraining score of the students' knowledge acquisition was significantly higher than that of pretraining (t=-12.114; P≤.001). Furthermore, the NTS score and the total score that the students obtained in the real-world test were significantly higher than those before training (t=-17.756 and t=-21.354, respectively; P≤.001). However, there was no significant difference between the scores of technical skills that the students obtained before and after training. A posttraining survey revealed that the students found the platform helpful in improving NTSs for BFA, and they were confident in applying BFA skills after training. However, most trainees thought that the platform was not helpful for improving the technical skills of BFA, and 45% (9/20) of the trainees were not satisfied with the simulation effect. CONCLUSIONS: A scenario-based, mixed-reality platform was constructed in this study. In this platform, interaction of the movement of multiple players in a large space and the interaction of decision-making by the trainees between the real world and the virtual world were accomplished. The platform could improve the NTSs of BFA. Future works, including improvement of the simulation effects and development of a training platform that could effectively improve both the technical skills and NTSs of BFA, will be carried out.

Role of Psychologist in Adolescent Medicine: An International Perspective.

Adolescent Medicine addresses the health care of adolescents, young adults, and their families. Adolescent psychology constitutes an important part. The COVID-19 pandemic has given insight into adolescent needs, bringing the focus on prevention rather than mere correction. One needs to factor in the unique aspects of adolescence, their need to impress peers and gain acceptance, and their unique information processing, not calculating trade-offs between risk and reward the way adults might, in a linear, rational, logical, and verbal manner. The article focuses on the need for collaborative training among the various stakeholders in Child and Adolescent Mental Health.

Novice nurses' experiences from teamwork in the emergency department: A qualitative content analysis.

BACKGROUND AND AIM: Teamwork is assumed crucial in nursing. Nevertheless, nursing shortages in medical centers have thus far compelled nurse managers to use novice nurses. The present study aimd to explaining the challenges and experiences of novice nurses regarding teamwork in emergency departments. MATERIALS AND METHODS: Using qualitative content analysis, 11 novice nurses working at emergency department, participated in this study. Data were collected with semi structured interview and analyzed by Graneheim and Lundman. RESULTS: The data analysis led to the emergence of four themes of "essential teamwork skills development", "contradictory relationships between team members", "unpleasant feelings and experiences", and, "personal growth and maturation during teamwork". CONCLUSION: Fostering different personal aspects as prerequisites for teamwork, novice nurses will be able to deal with unpleasant feelings and experiences as well as contradictory relationships between team members in an effective manner. This challenging experience will thus give rise to personal growth and maturation during teamwork among them in emergency department.

Training Package for Emergency Medical Teams Deployed to Disaster Stricken Areas: Has 'TEAMS' Achieved its Goals?

In spite of their good intentions, Emergency Medical Teams (EMTs) were relatively disorganized for many years. To enhance the efficient provision of EMT's field team work, the Training for Emergency Medical Teams and European Medical Corps (TEAMS) project was established. The purpose of this study was to assess the effectiveness and quality of the TEAMS training package in 2 pilot training programs in Germany and Turkey. A total of 19 German and 29 Turkish participants completed the TEAMS training package. Participants were asked to complete a set of questionnaires designed to assess self-efficacy, team work, and quality of training. The results suggest an improvement for both teams' self-efficacy and team work. The self-efficacy scale improved from 3.912 (± 0.655 SD) prior to training to 4.580 (± 0.369 SD) after training (out of 5). Team work improved from 3.085 (± 0.591 SD) to 3.556 (± 0.339 SD) (out of 4). The overall mean score of the quality of the training scale was 4.443 (± 0.671 SD) (out of 5). In conclusion, The TEAMS Training Package for Emergency Medical Teams has been demonstrated to be effective in promoting EMT team work capacities, and it is considered by its users to be a useful and appropriate tool for addressing their perceived needs.

Participatory Action Research (PAR) - to better understand the experiences of nurse academics working in a team.

BACKGROUND: There is considerable literature outlining the high levels of occupational stress nurse academics experience, and the potential effect of workplace pressure on mental health and wellbeing. OBJECTIVES/AIMS/HYPOTHESES: To support the notion that to succeed in an academic environment, academics are more successful when working in a team, two academics conducted a Participation Action Research study. DESIGN: The PAR study was developed in line with a Clinical Skill Project to better understand the experiences of nurse academics working in a team. The Clinical Skills Project involved the write up of 40 nursing skills for publication. Twenty-seven academics were recruited into the project and allocated skills to write, in teams of 2-3, according to clinical expertise and interest. The Participatory Action Research (PAR) approach formed the framework for the project, as well as, provided an opportunity for the nurse academics to 'come together' at fortnightly team meetings to discuss the project and talk about their experience working in a team. METHODS: Using the PAR cyclical process of observing, reflecting, planning, and acting there was ongoing opportunity for the academic nurses to discuss, question and share knowledge about academic practices. These Interactive reflections were recorded in a team reflective diary during the meetings. Participants were also asked to reflect on their individual experience of working in the team, before, during and after the project. At the completion of the project all reflective comments were transcribed to form a combined narrative. RESULTS: Thematic and content analysis was then undertaken to identify any similarities and or differences in academic staff experience. CONCLUSIONS: The analysis revealed the following key themes. Working in a team creates better staff relationships, Working in a team can change workplace culture and Working in a team can Improve staff health and well-being.

Overcoming challenges in implementing measures across multiple centers of a chain of hospitals to combat COVID-19 pandemic.

PURPOSE: Coronavirus outbreak was first reported towards the end of 2019 and has now been declared a pandemic by the World Health Organization. Post declaration, India announced lockdown and various guidelines were issued by Health authorities worldwide for the organizations to function in this emergency aeon. Different organizations strategized differently to respond to COVID 19 pandemic. The aim was to implement COVID 19 guidelines across all the centres of a chain of Eye hospitals in India in short span of time overcoming the challenges. METHODS: A SMART strategy was confabulated within the team. There were numerous challenges like lack of time, rapidly changing guidelines, no travelling scenarios, training and educating the staff in huge numbers, rapidly evolving situation, change management, need of increased vigilance, and language barrier at certain centres, sustaining quality assurance and motivating the staff in stressful times. The challenges were surpassed using a power packed strategy, dedicated efforts and team work grasping the available tools and technology from a single location. This template can serve us and other hospitals to respond in a better way for similar future challenges. RESULTS: The COVID 19 protocols were implemented across all the centres successfully. The entire Quality assurance system drifted to online platform and education and awareness methods took the digital thread. Teamwork synergized with the aforementioned things and we came out with flying colours achieving the goals in short span of time overcoming all the barriers. CONCLUSION: Difficult times bring challenges and challenges teach us the innovative ways to convert them into opportunities. A well planned strategy, best utilization of available resources, team work and continuous monitoring can bring the best outcomes forward.

Simulation based team training in surgery - a review.

The healthcare environment in surgery is complex, dynamic and often ambiguous. Besides subject knowledge and technical skills, other competencies, such as team work, communication skills and situation awareness, are required to ensure better patient-related outcome. Teams that demonstrate poor non-technical skills make more technical errors, often resulting in patient morbidity or mortality. Different hospital-based locations, such as operating rooms, intensive care units, emergency rooms and surgical wards, are the areas where poor team dynamics prevail. Simulation-based team training is a strategy to provide inter-professional training and experiential learning opportunities for surgeons, anaesthetists and allied health professionals. It helps them to effectively respond in complex situations in complex surgical environment. Simulation-based team training has 3 components; didactics, simulation itself, and debriefing. Literature has shown that simulation-based team training in surgery improves identification of team-based behaviours, improves team performance and overall patient safety.

Exercise-Based Injury Prevention in High-Level and Professional Athletes: Narrative Review and Proposed Standard Operating Procedure for Future Lockdown-Like Contexts After COVID-19.

In regular times, implementing exercise-based injury prevention programs into the training routine of high-level and professional athletes represents a key and challenging aspect to decrease injury risk. Barriers to implementing such prevention programs have previously been identified such as lack of resources, logistic issues or motivation. The COVID-19 pandemic associated with restrictions on daily life dramatically impacted sports participation from training to competition. It is therefore reasonable to assume that such lockdown-like context has exacerbated the challenge to implement exercise-based injury prevention programs, potentially leading to a greater musculoskeletal injury risk. In this narrative review, recommendations are proposed for building an expertise- and evidence-based Standard Operating Procedure for injury prevention in lockdown-like contexts for high-level and professional athletes. The following recommendations can be provided: (1) assess the global and sport-specific risks in the light of the ongoing cause of isolation; (2) adapt remote training materials and programs; (3) ensure regular quality communication within the staff, between athletes and the staff as well as between athletes; (4) follow the athlete's mental well-being; and (5) plan for a safe return-to-sports as well as for an ongoing monitoring of the load-recovery balance. These key domains should further be addressed to comply with local policies, which are subject to change over time in each individual country. The use of these recommendations may improve the readiness of athletes, coaches, physicians and all sports stakeholders for future lockdown-like contexts.

The Impact of Cooperative Learning on University Students' Academic Goals.

Cooperative learning encourages the development of interpersonal skills and motivates students to participate more actively in the teaching and learning process. This study explores the impact of cooperative learning on the academic goals influencing university students' behavior and leading to the attainment of a series of academic objectives. To this end, a quasi-experimental pretest-posttest control group design was used, with a sample of 509 university students from Preschool, Primary and Social Education undergraduate degree courses. Using the Academic Goals Questionnaire (AGQ), pretest and posttest measures were taken via self-reports to evaluate three types of academic goals: learning goals, social reinforcement goals and achievement goals. The results show that cooperative learning is an effective tool for encouraging university students to develop academic goals that motivate them to fully engage with the tasks they are set in order to acquire knowledge and skills (learning goals). In addition, when students are asked to work as part of a team on an autonomous basis without the structure and supervision necessary to ensure a minimum standard of cooperation, they display a greater tendency toward social reinforcement goals than toward learning and achievement goals. These findings contribute new knowledge to the conceptual framework on cooperative learning. Goals may be considered one of the most important variables influencing students' learning and the use of cooperative learning techniques in university classrooms creates the necessary conditions for encouraging students to develop goals oriented toward learning.

O PET-Saúde Interprofissionalidade e as ações em tempos de pandemia: perspectivas docentes / El PET-Saúde Interprofesionalidad y las acciones en tiempos de pandemia: perspectivas docentes / PET-Health Interprofessionality and actions in times of pandemic: teachers' perspectives

O Programa de Educação pelo Trabalho para Saúde (PET-Saúde) é uma política indutora que fomenta o aprendizado por vivências problematizadoras nos locais de trabalho em saúde com foco na interprofissionalidade. O objetivo do presente trabalho foi relatar a experiência do PET-Saúde Interprofissionalidade durante a pandemia de Covid-19, na perspectiva docente. Desenvolver o PET-Saúde com estudantes, preceptores, equipes dos serviços e usuários demandou (re)descobrir possibilidades das tecnologias de informação e comunicação e o aprendizado da produção de "novas presenças" sem desistir da ação coletiva, participativa e composta pelos diferentes saberes. Apreendeu-se o desenvolvimento de competências como escuta qualificada para resolução de conflitos, comunicação interprofissional e liderança colaborativa. Este PET-Saúde mostrou-se um disparador na formação em saúde, conectando universidade, rede de saúde e comunidade; e contribuindo para o desenvolvimento de competências colaborativas e um espaço de acolhimento para as situações vivenciadas.(AU)

El Programa de Educación por el Trabajo para Salud (PET-Saúde) es una política inductora que fomenta el aprendizaje por vivencias problematizadoras en los locales de trabajo en salud con enfoque en la Interprofesionalidad. El objetivo fue relatar la experiencia del PET-Saúde Interprofesionalidad durante la pandemia de Covid-19, desde la perspectiva docente. Desarrollar el PET-Saúde con estudiantes, preceptores, equipos de los servicios y usuarios demandó (re)descubrir posibilidades de las tecnologías de información y comunicación, aprendiendo a producir "nuevas presencias", sin desistir de la acción colectiva, participativa, compuesta por los diferentes saberes. Se aprendió a desarrollar competencias tales como escuchar de forma calificada para la resolución de conflictos, la comunicación interprofesional y el liderazgo colaborativo. Este PET-Saúde se mostró un gatillo en la formación en salud, conectando universidad, red de salud y comunidad, contribuyendo al desarrollo de competencias colaborativas y un espacio de acogida para las situaciones vividas.(AU)

The Program 'Education through Work for Health' (PET-Health) is a nudging policy that provides learning through problematizing experiences in health workplaces, with a focus on interprofessionality. The aim was to report the experience of PET-Health Interprofessionality during the Covid-19 pandemic, from the teachers' perspective. The development of PET-Health with students, tutors, teams from the health system and users demanded, (re) discovering possibilities of information and communication technologies, learning to produce "new presences", without giving up the collective, participatory action, composed by different knowledge. There was learning of development of skills such as qualified listening for conflict resolution, interprofessional communication and collaborative leadership. This PET-Health proved to be a triggering event towards health education, connecting university, health network and community, and contributed to the development of collaborative skills and constituted a welcoming space for the situations experienced.(AU)

Construction and Effect of Partnership Model of Rehabilitation for Patients with COVID-2019 in Critical Wards Using International Health Classifications Framework / 中国康复理论与实践

Objective:To construct a teamwork model, Partnership Rehabilitation Therapy (PRT), for therapists in critical wards for patients with Corona Virus Disease 2019 (COVID-19), and observe its effect. Methods:PRT had been developed, in which one therapist (main) implementing therapy and another (assistant) monitoring and supporting in the treatment. Eleven COVID-19 patients from infectious critical ward were treated with PRT. The behavior safety of therapists was recorded during the treatment, and the patients were assessed with Borg Index, Cough Score, Miller Sputum Grading and World Health Organization Disability Assessment Schedule (WHODAS) 2.0 before and after treatment. Results:No physiotherapist was infected by COVID-19. Seven times of infection risks were recorded and avoided, and six times of treatment risks were corrected instantly. All the patients improved in Borg Index (P < 0.01), Cough Score (P < 0.05), Miller Sputum Grading (P = 0.02) and WHODAS 2.0 (P < 0.01) after a 1-week physical therapy. Conclusion:Based on the Family International Classifications, a teamwork model is established, which provides a safe and practicable way for rehabilitation for COVID-19 patients in critical wards.

Degeneracy and Complexity in Neuro-Behavioral Correlates of Team Coordination.

Team coordination-members of a group acting together rather than performing specific actions individually-is essential for success in many real-world tasks such as military missions, sports, workplace, or school interactions. However, team coordination is highly variable, which is one reason why its underlying neural processes are largely unknown. Here we used dual electroencephalography (EEG) in dyads to study the neurobehavioral dynamics of team coordination in an ecologically valid task that places intensive demands on joint performance. We present a novel conceptual framework to interpret neurobehavioral variability in terms of degeneracy, a fundamental property of complex biological systems said to enhance flexibility and robustness. We characterize degeneracy conceptually in terms of a manifold representing the geometric locus of the dynamics in the high dimensional state-space of neurobehavioral signals. The geometry and dimensionality of the manifold are determined by task constraints and team coordination requirements which restrict the manifold to trajectories that are conducive to successful task performance. Our results indicate that team coordination is associated with dimensionality reduction of the manifold as evident in increased inter-brain phase coherence of beta and gamma rhythms during critical phases of task performance where subjects exchange information. Team coordination was also found to affect the shape of the manifold manifested as a symmetry breaking of centro-parietal wavelet power patterns across subjects in trials with high team coordination. These results open a conceptual and empirical path to identifying the mechanisms underlying team performance in complex tasks.