Evaluation of a safety-engineered peripherally inserted intravenous catheter with multiple access blood control: clinician acceptability and ease of use.

AIM: Acceptability of a new safety-engineered peripherally inserted intravenous catheter (PIVC) with multiple access blood control (MBC) was evaluated in this observational study by experienced volunteer clinicians on healthy volunteers. METHODS: Clinicians and healthy volunteers were recruited for this study. Observers documented study procedures, including if there was any blood leakage from the catheter hub at various times during hub connections and disconnections and how many attempts it took a clinician to get a successful stick. Clinicians responded to yes-or-no and Likert-scale questionnaires describing their experiences with PIVC with MBC after each procedure. Questionnaire data were summarized by frequency and percent of responses; analyses were conducted using binomial statistics. RESULTS: Overall, clinicians considered PIVC with MBC to be acceptable (93.6% agreement). Clinicians were able to easily remove the catheter protective cap, insert the catheter, visualize primary and secondary flashbacks, easily remove the needle from the catheter hub and determine if the safety clip was activated after withdrawing the needle. In addition, they were able to connect or disconnect and flush extension sets. Clinicians did not have to change their insertion technique, found the catheter easy to insert, and believed the catheter would protect them from blood exposure during insertion of the catheter and subsequent hub accesses (agreement ranged from 82.3% to 98.9%). CONCLUSIONS: No blood leakage was observed from the catheter hub at any time during the procedures. Overall, clinicians found the new PIVC with MBC to be acceptable, easy to use, and functioned properly. HIGHLIGHTS: Acceptability, usability, and ease of use of a new safety-engineered PIVC with MBC was evaluated. PIVC with MBC was >93% acceptable: prevented blood exposure after multiple insertions/removals. Most clinicians (96%) achieved first stick success when using their product. PIVC with MBC was easy to use, worked properly and allowed clinicians to keep their PIVC technique.

Effects of cueing multiple memories of eating on people's judgments about their diet.

Past research shows that recalling a single positive health-related experience, such as exercising, can encourage people's subsequent healthy behaviours. In contrast, we reasoned that attempting to recall many healthy experiences might elicit a metacognitive experience of difficulty that would lead people to perceive themselves as less healthy, and perhaps to make other health-related judgments based on this perception. In two pre-registered experiments (combined N = 729), participants recalled either "few" or "many" instances of eating either healthily or unhealthily, before rating the healthiness of their diets and completing measures of their eating preferences and choices. Contrary to our predictions, our pre-registered analyses provided minimal evidence that the number of memories people retrieved affected their judgments. However, exploratory mediation analyses suggested that two counteracting effects may have occurred, whereby retrieving more (un)healthy memories led people to identify as more (un)healthy, yet also created a sense of subjective difficulty that partially or wholly negated these effects. These findings suggest that whereas probing people's dietary memories might sometimes lead to healthier self-perceptions and dietary choices, we should also consider the possibility of backfire effects.

Perception of nudge interventions to mitigate medication errors risk in healthcare service delivery.

BACKGROUND: Conventional cognitive interventions to reduce medication errors have been found to be less effective as behavioural change does not always follow intention change. Nudge interventions, which subtly steer one's choices, have recently been introduced. METHODS: Conducted from February to May 2023, this study aimed to determine the relationships between perceived effectiveness and perceived ease of implementation of six nudge interventions to reduce medication errors, i.e., provider champion, provider's commitment, peer comparison, provider education, patient education and departmental feedback, and the moderating effects of seniority of job positions and clinical experience on nudge acceptability. Partial Least Square Structural Equation Modelling was used for data analysis. RESULTS AND DISCUSSION: All six nudge strategies had significant positive relationships between perceived effectiveness and acceptability. In three out of six interventions, perceived ease of implementation was shown to have positive relationships with perceived acceptability. Only seniority of job position had a significant moderating effect on perceived ease of implementation in peer comparison intervention. Interventions that personally involve senior doctors appeared to have higher predictive accuracy than those that do not, indicating that high power-distance culture influence intervention acceptability. CONCLUSION: For successful nudge implementations, both intrinsic properties of the interventions and the broader sociocultural context is necessary.

A critical appraisal of web-based information on shoulder pain comparing biomedical vs. psychosocial information.

BACKGROUND: Websites have become a primary way for patients to access health-related information, which allows patients to not only understand their condition better but also to engage in better decision making with their health care provider. However, this can be a double-edged sword, as information patients access may not be of high quality, easily readable, or could be biased based on website authorship. This study examines the readability and content quality of common websites about shoulder pain, with a specific focus on biomedical vs. psychosocial information. METHODS: The Flesch reading-ease score (FRES) and Flesch-Kincaid grade level (FKGL) instruments were used to assess website readability. Health on the net code of conduct (HONcode) certification and the DISCERN tool were used to evaluate the reliability and quality of information. Lastly, shoulder-specific content quality and focus was gauged using a Shoulder-specific Website Appraisal Tool (SWAT) created for this study. A systematic search protocol was used to identify popular shoulder injury websites. The websites were identified using 5 search terms (shoulder pain, shoulder muscle pain, shoulder impingement, shoulder rotator cuff pain, and shoulder pain diagnosis) across 5 English-speaking regions (United States, Canada, United Kingdom, Australia, and New Zealand) using the Google search engine. The top 10 websites for each term and region combination were included and combined, yielding 41 original websites for appraisal; several (6) websites were omitted as duplicates, behind paywalls, or nontext (video) for a total of 35 websites appraised. RESULTS: On average, the FRES shoulder pain websites readability was 55.37, which is categorized as "fairly difficult" to read, and a seventh- or eighth-grade reading level based on the FKGL. For trustworthiness and bias, 57% (20 of 35) of the websites were HONcode certified. The quality of health care information using the DISCERN score averaged 50.92%. Examining shoulder-specific content quality, the average SWAT score was 10.54 out of 14 possible points, with only 1 website reporting information on psychosocial aspects of shoulder pain. CONCLUSIONS: This study suggests that shoulder pain websites present information that is at too high of a reading level for public consumption, has a strong bias toward biomedical causes of shoulder pain, and would benefit from implementation of website screening tools to improve evidence-based content.

Links between ease of use, perceived usefulness and attitudes towards technology in older people in university: A structural equation modelling approach.

Technological resources have the potential to improve the quality of life in a context in which social pressure for the use of these tools is increasing. In this sense, the adoption of technological resources by the elderly is a highly complex issue because numerous and varied factors are involved. Precisely for this reason, this study aims to analyze the effects that exist between a series of dimensions related to the perception of older people regarding the ease of use, the perceived usefulness of technological tools, attitudes towards technology and their intention to use them in everyday life. To do this, 415 adults (M = 66.27 years) enrolled in a program at the University of Experience in the Spanish context completed an online questionnaire. The application of a Structural Equations Model for data analysis highlights that the perceived ease of use of the technology has a positive effect on the perceived usefulness of these resources. Similarly, an indirect effect of the perceived usefulness of technology on the intention to use these resources is observed through the manifestation of positive attitudes towards the use of digital tools.

Exploring non-linear relationships between perceived interactivity or interface design and acceptance of collaborative web-based learning.

The novelty of this study is in developing a conceptual model for predicting the non-linear relationships between human-computer interaction factors and ease of use and usefulness of collaborative web-based learning or e-learning. Ten models (logarithmic, inverse, quadratic, cubic, compound, power, s-curve, growth, exponential, and logistic) were examined as functions of effects compared to linear relationships to see which was the most appropriate, based on R2, adjusted R2 and SEE values. To answer the addressed questions, the researcher surveyed 103 students from Kadir Has University about the perceived interface and interactivity of e-learning. The results show that most of the hypotheses formulated for this purpose have been proven. Our analysis shows that cubic models (the relationship between ease of use and usefulness, visual design, course environment, learner-interface interactivity, and course evaluation system and ease of use), quadratic models (the relationship between visual design, and system quality and usefulness, course structure and content, course environment, and system quality and ease of use), logarithmic model (the relationship between course evaluation system and usefulness), and s-curve models (learner-interface interactivity, navigation, and course structure and content and usefulness) performed better in the description for the correlations. Supplementary Information: The online version contains supplementary material available at 10.1007/s10639-023-11635-6.

Impact of teacher-student interaction on students' classroom well-being under online education environment.

The students' classroom well-being of college students has been widely concerned in online education researches. In order to implement effectively online education in colleges and universities, based on person-context interaction theory, this study investigates a theoretical model of the impact of teacher-student interaction, sound richness, sound pleasure, perceived ease of use and perceived usefulness on students' classroom well-being. By surveying 349 college students receiving online education, the research hypotheses are tested by the structural equation model approach. Research results show that: teacher-student interaction, sound richness, sound pleasure, perceived ease of use and perceived usefulness appreciably improve students' classroom well-being, the sound richness and the students' perceived ease of use can moderate the effect of teacher-student interaction on students' classroom well-being. Finally some pedagogical implications are discussed.

An extended hedonic motivation adoption model of TikTok in higher education.

As information technologies develop, social networking services have gradually gained attention from both researchers and practitioners. However, little is known about the technology adoption of social networking from the perspective of hedonic motivation. For this purpose, this study applied the hedonic motivation system adoption model (HMSAM) to TikTok and incorporated two innovative factors, i.e., perceived boredom and personal innovativeness. Via structural equation modeling (SEM), this study used SmartPLS 4.0.8 to analyze 246 valid responses from Chinese university students via an online survey. The results showed that the research model was adequate for the adoption of TikTok. Curiosity and perceived boredom significantly mediated the positive relationships between perceived ease of use and behavioral intention. Additionally, the educational level moderated the relationship between joy and focused immersion. The results of this study provided insights for future researchers and innovative teaching. Supplementary Information: The online version contains supplementary material available at 10.1007/s10639-023-11749-x.

Pilot comparison of the ease of swallowing of single tablet antiretroviral regimens.

Daily adherence to lifelong antiretroviral therapy (ART) is required to achieve long term treatment success. However, patient preferences for ART tablet size have not been well studied. Our study assessed factors associated with the ease of swallowing (EoS) and tolerability of two placebo tablets representing and matching B/F/TAF (BPT) and DTG/ABC/3TC (DPT). Fifty ART-naïve patients were randomized into a two-period cross-over study. Likert scale (1-5) questionnaires were administered to assess patient factors influencing the ease of swallowing, adherence, home medications, medication preferences and perceptions. Comparisons were done using Student t-tests and ordinal regression. Participants were 64% female, 61% white, mean age 43 years, and taking a mean (median) of 4(1) pills/day. BPT was reported to be easier than DPT with ease of swallowability 1.76 vs. 2.42 (p < 0.001) (1 = very easy). DPT tablet was correctly perceived as larger than BPT (p < 0.001); with both tablets perceived as smaller than actual size (p < 0.001). EoS of either tablet was positively associated with the EoS of the largest home tablet medication (p = 0.021, p = 0.03). Patient's perceptions of EoS can affect their medication adherence, especially in HIV, and should be considered in treatment regimens.

Zenker's Diverticulum: Readability and Quality of Online Written Education Materials.

To assess the readability and quality of online materials for Zenker's diverticulum. A Google search of "Zenker's diverticulum" was performed and the first 50 websites were reviewed. Readability was measured by Flesch Reading Ease (FRES), Flesch-Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG) scores using an online calculator. Understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P). Websites were categorized as either patient-targeted or physician-targeted and unpaired t tests were used to compare scores between these two groups. A total of 31 websites (23 patient-oriented sites and 8 physician-oriented sites) were analyzed. The average FRES, FKGL, and SMOG scores were 29.96 ± 14.72, 13.75 ± 2.78, and 12.19 ± 2.02, respectively, for the entire cohort. Readability scores for the patient-oriented sites were better than the physician-oriented sites for each measure (FRES 36.21 ± 8.86 vs 11.96 ± 13.54, FKGL 12.68 ± 1.58 vs 16.85 ± 3.25, and SMOG 11.37 ± 1.26 vs 14.53 ± 1.98; p < 0.001 for all comparisons). PEMAT-P understandability and actionability scores for the entire cohort were 68.20% ± 10.19% and 10.75% ± 16.52% respectively, and did not differ between patient-oriented and physician oriented sites. Though patient-oriented sites had better readability than physician-oriented sites for Zenker's Diverticulum, both categories had readability levels more advanced than what is recommended for medical education materials.

Welcoming ease: Building a concept from nursing practice.

PURPOSE: The purpose of this paper is to describe the building of the concept welcoming ease for its use in further knowledge development in research. METHOD: A published concept building process was used to guide creation. Development of the concept welcoming ease occurred through a 10-phase approach that included taking a story from practice and identifying key phenomena of interest. Core qualities were lifted with careful attention to theoretical grounding and thorough review of the literature. With this foundation in place, a reconstructed story was created, and mini-saga and mini-synthesis fashioned. IMPLICATIONS: The theory-research-practice triad is seen when concepts are built upon knowledge gained through practice. Theory and developing concepts are used to query phenomena of interest. Future research focus centers on integrating aromatherapy into care for those in treatment for substance use disorder (SUD). Insights gained through future study are expected to support knowledge development in nursing vital to caring in the human health experience.

The roles of individual differences in time perspective, promotion focus, and innovativeness: Testing technology acceptance model.

The goal of this study is to examine the roles of Zimbardo's time perspective along with other individual differences such as promotion focus and innovativeness in perceived ease of use, perceived usefulness, and attitude toward SNSs (social networking sites) in the technology acceptance model (TAM). A total of 234 participants joined this online study in South Korea. As predicted, past positive time perspective (TP) positively affected promotion focus and innovativeness, whereas past negative TP negatively affected them. Present hedonic TP positively affected innovativeness, and present fatalistic TP negatively affected promotion focus each. Future TP also positively related to promotion focus and innovativeness. In addition, simple and serial mediation effects of perceived ease of use and perceived usefulness independently and sequentially mediated the impact of TP on attitude toward SNSs. By considering TP along with promotion focus and innovativeness in conjunction with beliefs in the TAM, this study identifies psychological underpinnings of how individual differences affect technology adoption attitude and behavior. Research implications and future research suggestions will be discussed in detail.

Defining and characterizing task-shifting medical devices.

BACKGROUND: Task shifting could help address limited human resources available for the delivery of quality health care services in low-resource settings. However, the role of medical devices in supporting task shifting is not fully understood. This study aimed to 1) define "task-shifting medical devices" and 2) identify product characteristics to guide the design and development of task-shifting medical devices. A three-part survey questionnaire comprising open-ended, rank-ordering, and multiple-choice questions was disseminated to healthcare professionals worldwide. The survey included questions to capture stakeholders' general understanding of and preferences for task shifting in medicine and public health, and questions to define task-shifting medical devices and identify desirable product characteristics of task-shifting medical devices. RESULTS: Task-shifting medical devices were defined by respondents as "devices that can be used by a less specialized health worker". Aside from safe and effective, both essential characteristics for medical devices, easy to use was the most cited product characteristic for a task-shifting medical device. Responses also emphasized the importance of task-shifting medical devices to enable local agency, such as peer-to-peer training and local maintenance. Several additional frequently mentioned attributes included low cost, contextually appropriate, maintainable, capable of using an alternative power source, easy to understand, easy to learn, reusable, and easy to manage throughout its use cycle. CONCLUSION: This study defines and characterizes task-shifting medical devices based on healthcare professionals' responses. Ease of use was identified as the most important characteristic that defines a task-shifting medical device, alongside safe and effective, and was strongly associated with enabling peer-to-peer training and maintainability. The findings from this study can be used to inform technology product profiles for medical devices used by lower-level cadres of healthcare workers in low-resource settings.

Investigating the ease-of-retrieval effect in an eyewitness context.

The way in which individuals think about their own cognitive processes plays an important role in various domains. When eyewitnesses assess their confidence in identification decisions, they could be influenced by how easily relevant information comes to mind. This ease-of-retrieval effect has a robust influence on people's cognitions in a variety of contexts (e.g., attitudes), but it has not yet been applied to eyewitness decisions. In three studies, we explored whether the ease with which eyewitnesses recall certain memorial information influenced their identification confidence assessments and related testimony-relevant judgements (e.g., perceived quality of view). We manipulated the number of reasons participants gave to justify their identification (Study 1; N = 343), and also the number of instances they provided of a weak or strong memory (Studies 2a & 2b; Ns = 350 & 312, respectively). Across the three studies, ease-of-retrieval did not affect eyewitnesses' confidence or other testimony-relevant judgements. We then tried - and failed - to replicate Schwarz, N., Bless, H., Strack, F., Klumpp, G., Rittenauer-Schatka, H., & Simons, A. (1991. Ease of retrieval as information: Another look at the availability heuristic. Journal of Personality and Social Psychology, 61(2), 195-202. doi:10.1037/0022-3514.61.2.195) original ease-of-retrieval finding (Study 3; N = 661). In three of the four studies, ease-of-retrieval had the expected effect on participants' perceived task difficulty; however, frequentist and Bayesian testing showed no evidence for an effect on confidence or assertiveness ratings.

Readability of online patient education materials for juvenile dermatomyositis.

In this study, we sought to analyze the readability of online patient education materials (PEMs) related to juvenile dermatomyositis (JDM). We analyzed the top 100 Google results and using six different readability scores, found 53 PEMs which had an average grade reading level of 17.4 (graduate level). PEMs by health care providers were written at higher grade levels than those by non-health care providers. Our findings demonstrate a clear need for online JDM PEMs that are written at an appropriate reading level and can be comprehended by patients and families of all levels of health literacy.

Human-Technology Interaction Factors Associated With the Use of Electronic Personal Health Records Among Younger and Older Adults: Secondary Data Analysis.

BACKGROUND: An electronic personal health record (ePHR), also known as a personal health record (PHR), has been broadly defined as an electronic application through which individuals can access, manage, and share their health information in a secure and confidential environment. Although ePHRs can benefit individuals as well as caregivers and health care providers, the use of ePHRs among individuals continues to remain low. OBJECTIVE: The current study aims to examine the relationship between human-technology interaction factors and ePHR use among adults and then to compare the different effects of human-technology interaction factors on ePHR use between younger adults (18-54 years old) and older adults (55 years of age and over). METHODS: We analyzed data from the Health Information National Trends Survey (HINTS 5 cycle 3) collected from US adults aged 18 years old and over in 2019. Descriptive analysis was conducted for all variables and each item of ePHR use. Bivariate tests (Pearson correlation coefficient for categorical variable and F test for continuous variables) were conducted over 2 age groups. Finally, after adjustments were made for sociodemographics and health care resources, a weighted multiple linear regression was conducted to examine the relationship between human-technology interaction factors and ePHR use. RESULTS: The final sample size of 1363 (average age 51.19) was divided into 2 age groups: 18 to 54 years old and 55 years old and older. The average level of ePHR use was low (mean 2.76, range 0-8). There was no significant difference in average ePHR use between the 2 age groups. Including clinical notes was positively related to ePHR use in both groups: 18 to 54 years old (ß=.28, P=.005), 55 years old and older (ß=.15, P=.006). Although accessing ePHRs using a smartphone app was only associated with ePHR use among younger adults (ß=.29; P<.001), ease of understanding health information in ePHRs was positively linked to ePHR use only among older adults (ß=.13; P=.003). CONCLUSIONS: This study found that including clinical notes was positively related to ePHR use in both age groups, which suggested that including clinical notes as a part of ePHRs might improve the effective use of ePHRs among patients. Moreover, accessing ePHRs using a smartphone app was associated with higher ePHR use among younger adults while ease of understanding health information in ePHRs was linked to higher ePHR use among older adults. The design of ePHRs should provide the option of being accessible through mobile devices to promote greater ePHR use among young people. For older adults, providers could add additional notes to explain the health information recorded in the ePHRs.

Factors affecting calving ease in Egyptian buffalo.

Calving ease (CE) is a trait of economic importance that affects animal welfare and farm profitability. The objective of present study was to investigate genetic and environmental factors affecting CE among Primiparous (PP) and multiparous (MP) buffaloes. A total of 9,627 records from 1999 MP and 2,110 PP recorded during the period from 1988 to 2018 were considered. Herd, season of calving, year of calving, birth weight, parity order and gestation length significantly affected CE rate, while age at first calving and sex of calf had no significant effects. Direct and maternal heritabilities of CE in PP and MP were 0.06 and 0.01, respectively. The low heritability of CE indicated that direct selection may not be an effective method to improve CE trait in Egyptian buffalo.

Factors associated with ewe and lamb survival, and subsequent reproductive performance of sheep undergoing emergency caesarean section.

Clinical records of all 212 ewes undergoing emergency caesarean surgery at a veterinary teaching hospital between January 2008 and December 2019 were evaluated retrospectively. Their age ranged from 1 to 10 years (median = 4 years), with German merino the predominant breed (48.1% of cases). The most frequently diagnosed indications were insufficient cervical dilatation (n = 94, 44.3%), uterine torsion (n = 50, 23.6%), foetopelvic disproportion (n = 31, 14.6%) and vaginal prolapse intra partum (n = 11, 5.2%). Fifty-four (25.5%) of the 212 ewes additionally suffered from one or more concurrent, pre-existing conditions. Overall ewe mortality until hospital discharge was 10.8% (23/212), and 3.8% (n = 6) for the 158 ewes without a history of concurrent disorders. Mortality during hospitalization increased to 31.5% (17/54) for those with pre-existing conditions. Total lamb mortality was 49.1% (173/352) until hospital discharge. Pre-existing conditions (p = .001) and the presence of post-surgical complications (p = .025) were identified as significant factors influencing dam mortality, while delayed presentation for veterinary attention with an observed duration of labour of >12 hr was identified as the most influential factor on total lamb mortality (p = .010). The presence of dead or emphysematous foetuses was not significant for ewe mortality. Follow-up information on further outcomes was available for 156 (82.5%) of the 189 discharged ewes. Eighty-nine animals (57.1%) were re-bred in the following season and achieved a 93.3% (83/89) pregnancy rate, while the remainder had either been slaughtered (n = 56, 35.9%), sold (n = 5, 3.2%) or had died of unknown causes (n = 3, 1.9%). The subsequent incidence of dystocia was 15.6% (n = 12) in the 77 ewes with available information on lambing ease. Adequate management of underlying conditions and timely intervention are important factors for best possible short-term outcomes. In the long term, the subsequent pregnancy rate was good and the incidence of subsequent dystocia was within the normal range.

Patient perceptions of the re-usable Respimatt® Soft Mist™ inhaler in current users and those switching to the device: A real-world, non-interventional COPD study.

PLAIN LANGUAGE SUMMARY: Inhalers are often used to treat patients with chronic obstructive pulmonary disease (COPD). However, there are many available, which can lead to confusion and poor inhaler technique. It is important for a patient to be happy with their inhaler. This study looked at how patients liked the re-usable Respimat® Soft Mist™ inhaler vs. their previous inhaler. It also asked whether they would be willing to continue using the device at the end of the study period.After 4-6 weeks of using the re-usable device, patients reported that they were happy with the inhaler and most would be willing to carry on using it.Overall, these results show that doctors can prescribe Respimat re-usable to patients, even if the patient has not used the inhaler before.

Contested ease: Negotiating contradictory modes of elite distinction in face-to-face interaction.

Research on elites and elite schooling mainly theorize the embodied elite distinction of ease as a dispositional phenomenon, drawing on a Bourdieusian framework. I respond to this by developing an interactionist perspective on embodied elite distinction not as a function of social position, but rather as means of communication used more or less actively to manage others' impressions of one's social position. Drawing on ethnography and interviews, I explore how students at two Swedish upper secondary schools with different elite profiles-an economic elite school and a meritocratic elite school-negotiate what counts as successful performances of their elite position in face-to-face interactions during conferences for "young leaders". The findings suggest that in order for performances to be honored as "confident ease," which is attributed with prestige and moral legitimacy in the peer group, the interacting students had to share the impression that the interaction was a "merit situation". In interactions defined as "privilege situations," similar behavior was labelled as arrogant superiority and seen as illegitimate performances of elite position. While "confident ease" was the hallmark of the male students at the economic elite school, the findings suggests that "confident awareness" may be understood as a contradictory mode of elite distinction characterizing the female students from the meritocratic elite school. They display confidence while simultaneously exploiting the unease they felt in the conference to craft a morally legitimate performance of their elite position. While the findings confirm that students' classed, gendered and moral dispositions are central to navigate elite distinction, they also demonstrate that meanings of such embodied distinctions emerge in relation to how situations are defined and are dependent on the interacting students' combined ability and interest to maintain working consensus on the definition of the situation.