Difficulties In Use Research Articles

IMPROVING WATER QUALITY MONITORING AND PARTICIPATORY MONITORING OF THE AQUA PROJECT APPLICATION

Introduction Water quality monitoring plays a key role in promoting environmental sustainability. Water is a vital resource for life and its availability and quality are intrinsically linked to human well-being and health. Through constant monitoring, it is possible to identify and mitigate pollutants, the Aqua project proposes to present a solution for evaluating and monitoring water quality, using a cell phone application and a very low-cost kit, integrating everything into an online platform. line with the aim of establishing a participatory monitoring network for rivers and water bodies. Results and Discussion The initial version of the Aqua1,2 project application, which is capable of determining: nitrite, organic matter, ortho-phosphate, ammonia and iron, all contaminants of water bodies3, stored the information only on the cell phone itself, and the georeferencing was done in a manual, where the operator himself had to manually record where the sample was taken. Furthermore, it was not available on Google Play, which made it difficult for less skilled people to install it. The application was rewritten, and is no longer local, running exclusively on the cell phone and was migrated to the cloud, now the data is also stored in a public database, where other researchers, or interested entities can have access, the account is no longer be local and is now stored on the internet, georeferencing is also now more accurate, as the application reads the location through the phone's own GPS system, and installation can be done via Google Play, removing one of the difficulties for use of the application. Conclusions With these modifications, the objective of participatory monitoring has now become easier to achieve, as the data of all users can be accessed via the internet, they have become more secure as they are no longer on the device, and the location of the sample location has become much easier. more accurate, in addition to allowing data integration.

The profile of social communication in Dravet syndrome

Dravet syndrome (DS) presents a multifaceted clinical picture marked by epilepsy, cognitive impairments and behavioral disorders that progresses throughout development. Behavioral disorders include impairments in social relationships and communication, with frequent diagnosis of autism spectrum disorder. This study focused on comprehensively evaluating and comparing social communication profiles among a group of 43 children with Dravet syndrome, 30 children with level 1 autism spectrum disorder, 36 with social (pragmatic) communication disorder, and 18 with intellectual disability. Using validated tools like the Childhood Autism Spectrum Test and Children’s Communication Checklist, distinct patterns of social communication deficits were delineated. Our findings indicate that children with Dravet syndrome experience challenges in social relationships, primarily due to difficulties in use of pragmatic language. Areas such as range of interests and social interaction are less affected compared to those with ASD, emphasizing differing profiles between the conditions. While children with DS and ID may have similar intellectual functioning, the different social communication deficits in DS indicate their role in the DS phenotype beyond ID. These results underscore the unique social communication profile of DS and emphasizes the importance of tailored interventions and deep phenotyping efforts for effective DS management.

Analysis of Factors Causing Difficulties in Use of Rice Land in the Irrigation Area of the Tojo Region and West Tojo

In one of the areas in Tojo Una-Una Regency, the rice fields are irrigated rice fields with a surface irrigation system, where the water source comes from a river which flows into the rice fields. However, in the dry season, the water demand for rice fields in these two regions cannot evenly meet the water needs of rice fields in both regions, thus affecting farmers' production results. The aim of this research is to find out what factors make it difficult for farmers to utilize rice fields in the irrigation areas of the Tojo and West Tojo regions and to find out the strategies used by farmers to overcome difficulties in utilizing rice fields in the irrigation areas of the Tojo and West Tojo regions . Respondents in this study were 281 respondents including rice field farmers in the Tojo region and farmers in the West Tojo region. Data analysis uses Factor Analysis. The magnitude of the influence resulting from all these factors reached 62,445%, while the remaining 37,555% was influenced by other factors whose influence was not significant. The strategies implemented by farmers to overcome difficulties in utilizing rice fields in the irrigation areas of Tojo and West Tojo regions include repairing irrigation networks, building groundwater irrigation pumps, improving the quality of farmers' human resources through regular extension activities, arranging planting pattern schedules, changing systems. distributing water during the dry season, and reactivating the P3A (Water User Farmers Association).

Recent daily life burdens associated with neovascular age-related macular degeneration involve difficulties in use of electronic devices

Neovascular age-related macular degeneration (nAMD) is a prevalent cause of permanent vision loss and blindness in the elderly worldwide, with a significant impact on patients’ daily lives. However, burdens related to nAMD from the patients’ perspective have not been well documented. Here we developed a new questionnaire after eliciting nAMD patients’ daily challenges followed by a pilot survey. Seven daily life burden domains were identified, and a quantitative survey was conducted using the questionnaire in the real-world clinic. Of the total 153 participants (mean age, 76.3 ± 8.3 years), 67 (43.8%) had bilateral nAMD, and 79 (52.7%) were classified into severe nAMD according to the best-corrected visual acuity with cut-off value of 0.52 in logMAR. Patients with bilateral and severe nAMD had significantly higher burden scores across all domains. Network models for the bilateral and severe disease subgroups identified the interactions between “activity of daily living” and “hand–eye coordination” and between “use of electronic devices” and “face recognition” domains, which were considered to be important burdens for the patients. These results can advance ophthalmologists’ understanding of the impact of nAMD on patients’ daily lives and the importance of active and continuing treatment for patients with nAMD.

Using the Extended Unified Theory of Acceptance and Use of Technology to explore how to increase users’ intention to take a robotaxi

In recent years, many governments and companies have gradually launched robotaxi projects to help make transportation systems smarter, improve travel efficiency, and reduce travel costs. Robotaxi is a new mode of travel that replaces human driving with machines, freeing up social labour and enriching people’s travel choices. This study employs the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) to understand the influencing factors of users’ adoption and usage of robotaxis in China to facilitate the broader integration of robotaxis into urban transportation systems. This study surveyed the preferences of 2048 respondents and analysed the data through structural equation modelling. The results indicate that performance expectancy, hedonic motivation, and price value are the factors influencing users’ behavioural intentions, while effort expectancy and social influence affect use behaviour. In contrast, habit is an important factor that affect both behavioural intention and actual use behaviour. Based on the findings, we have proposed practical strategies to improve robotaxi services and updated the UTAUT2 model in the context of robotaxi. We suggest that robotaxi operators can promote user acceptance and use by reducing the difficulty of use, improving the cost performance and the ride experience, and making appropriate publicity and guidance.

The Clinical Usability Evaluation of an Attachable Video Laryngoscope in the Simulated Tracheal Intubation Scenario: A Manikin Study.

The aim of this study was to assess the usefulness of an attachable video laryngoscope (AVL) by attaching a camera and a monitor to a conventional Macintosh laryngoscope (CML). Normal and tongue edema airway scenarios were simulated using a manikin. Twenty physicians performed tracheal intubations using CML, AVL, Pentax Airwayscope® (AWS), and McGrath MAC® (MAC) in each scenario. Ten physicians who had clinical experience in using tracheal intubation were designated as the skilled group, and another ten physicians who were affiliated with other departments and had little clinical experience using tracheal intubation were designated as the unskilled group. The time required for intubation and the success rate were recorded. The degree of difficulty of use and glottic view assessment were scored by participants. All 20 participants successfully completed the study. There was no difference in tracheal intubation success rate and intubation time in the normal airway scenario in both skilled and unskilled groups. In the experienced group, AWS had the highest success rate (100%) in the tongue edema airway scenario, followed by AVL (60%), MAC (60%), and CML (10%) (p = 0.001). The time required to intubate using AWS was significantly shorter than that with AVL (10.2 s vs. 19.2 s) or MAC (10.2 s vs. 20.4 s, p = 0.007). The difficulty of using AVL was significantly lower than that of CML (7.8 vs. 2.8; p < 0.001). For the experienced group, AVL was interpreted as being inferior to AWS but better than MAC. Similarly, in the unskilled group, AVL had a similar success rate and tracheal intubation time as MAC in the tongue edema scenario, but this was not statistically significant. The difficulty of using AVL was significantly lower than that of CML (8.8 vs. 3.3; p < 0.001). AVL may be an alternative for VL.

A qualitative study of patients’ perceptions of DASH diet apps for dietary self- management of hypertension in Saudi Arabia

Nutrition smartphone apps have become a popular and readily accessible approach to improving dietary behaviour. Hypertension is often associated with a poor diet, and its prevalence is increasing in Saudi Arabia(1). The Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to reduce blood pressure in people with hypertension(2). A previous study identified two high-quality, safe, and potentially effective smartphone apps for managing hypertension: NOOM and DASH To TEN(3). This study aimed to explore the potential of these two DASH diet self- management apps for controlling blood pressure in the Saudi Arabian context.Fifteen patients were recruited at King Abdullah bin Abdulaziz University Hospital in Riyadh, Saudi Arabia. Ten patients had hypertension, and five had prehypertension (mean age = 45). Patients were given the two apps and asked to try each for one week. Focus groups (n=4) were held at the end of the trial to understand the patient perceptions of the apps. Discussions were recorded, and the transcriptions were analysed using a thematic framework analysis(4).The following four themes emerged:1.Managing hypertension through diet was perceived as important. Most patients reported thatadhering to the DASH diet was challenging due to a lack of motivation and willpower,inadequate support from household members, and high prices for healthy food.2.The potential and current reach of dietary apps emerged as a main theme, and manycomments related to patients’ belief that dietary apps could increase their motivation and awareness about the DASH diet. Barriers to the use of apps were also identified including their difficulty of use, a preference for dietetic monitoring, and cost.3.Interactive app functionality was identified as a key theme, as evidenced by comments about a straightforward sign-up process, an extensive food database for dietary self-monitoring, feedback, goal setting, and reminders, considered essential for diet adherence.4.A preference for the NOOM app emerged. Patients perceived the NOOM app more suitable in the Saudi context. Noom was deemed to support DASH self-management because it supports weight reduction, which helps lower blood pressure. NOOM was perceived as highly interactive, offering motivational reminders, feedback, realistic dietary plans, and a comprehensive food database. Patients made several recommendations for app improvement; these included Arabic language support, automatic calculation of sodium and potassium consumption, and lower cost. Patients also expressed a desire for training in the use of the app.This qualitative analysis suggests that the NOOM app could be suitable for use with hypertensive patients in Saudi Arabia. Further research is needed to determine the feasibility and efficacy of long- term use of the NOOM app with a Saudi Arabia population.

The use of standing powered wheelchairs from the perspective of individuals with spinal cord injury

Purpose The aim of this study was to investigate the experiences of standing powered wheelchair (SPWC) users with spinal cord injury (SCI). Materials and methods This cross-sectional study included 20 participants with SCI. SPWC daily usage time (total, in sitting position and standing position) and the frequency of using the SPWC’s standing feature were recorded. Participants’ level of satisfaction and comfort associated with the SPWC were assessed on a five-point Likert scale. If there was a dissatisfaction reason with the SPWC, the issues related to it were recorded. Participants were asked about their positive and adverse experiences with the use of SPWC. Results Mean age of the participants was 41.65 (± 9.35) years. Eighty percent were tetraplegic. Ninety percent of the participants stood for at least 30 minutes at least one day a week, and 55% stood for at least 30 minutes at least four days a week. The most commonly reported perceived benefits were improvement in activities of daily living, bowel movements, and blood pressure regulation, better perception of body image, and feeling better. The most frequently identified reasons for dissatisfaction with the SPWC were its big dimensions, heavy weight, and difficulty of use in indoor environment and on uneven surfaces. Conclusions The findings show positive perceived experiences for SPWC users with SCI in terms of physical, social, and psychological aspects. Prospective controlled studies are needed to explore the benefits of SPWC use regarding secondary complications of SCI.

Актуальные вопросы развития методики анализа финансового состояния по данным бухгалтерской отчётности

The article is devoted to the development and improvement of methods for analyzing the financial condition of organizations. As a result of reviewing and researching the content of existing methods for analyzing the financial condition of organizations, difficulties of use for users were identified, consisting of a large or small number of stages, sections, oversaturation of coefficients, lack of a common conceptual apparatus for all, incompleteness and obsolescence of recommended values of coefficients characterizing financial state, in low demand and the possibility of using the methodology for analyzing financial condition equally for all organizations. Based on the assessment and generalization of current analysis techniques, an optimal structural and logical diagram of the financial condition analysis technique has been developed, highlighting specific areas of analysis in a certain sequence of their implementation. In order to optimize the number of coefficients, a set of calculation indicators has been proposed and justified, which will allow a faster and more comprehensive assessment of the financial condition of organizations, which will increase the interest of users in the use of improved methods, as well as in the use of analysis results to improve the financial condition and increase the efficiency of management of the organization.

Effects of two-phase treatment with functional appliances versus one-phase treatment with pre-molar extraction in Class II div 1 monozygotic twins: A case study

The aim of the study was to compare the skeletal, dental, or soft-tissue outcomes of a one-phase camouflage treatment with pre-molar extraction versus a two-phase treatment with combined twin-block high-pull headgear followed by fixed orthodontic treatment in monozygotic twins. 12-year-old male monozygotic twins presented to the dental clinic with complaints about their anterior teeth. Cephalometric analysis of the patients revealed skeletal Class II malocclusion and a long facial type. Extraoral examination of the patients revealed incompetence of lip seal and a convex profile. In Patient 1, the use of a high pull headgear combined with a twin block to correct skeletal anteroposterior and vertical malocclusions with growth modification and then fixed orthodontic treatment was planned. Patient 2 did not comply with the treatment, complaining that the use of the device could cause esthetic problems and difficulties in use. Therefore, camouflage treatment with extraction of four pre-molars was planned as another treatment option for Class II patients in Patient 2. With the camouflage treatment, the patient continued to grow normally. The combined treatment with twin block and a high pull occipital headgear resulted in inhibition of maxillary growth and a reduction in the severity of the skeletal Class II malocclusion, but the mandibular changes were similar in both patients at the end of treatment. Despite the different treatment modalities, both twins achieved a Class I canine-molar relationship and ideal overjet and overbite. Patients can close their lips with improved soft-tissue profiles. The criteria for the choice of treatment depend entirely on the requirements of the patient.

Micromirror Array with Adjustable Reflection Characteristics Based on Different Microstructures and Its Application.

The conventional reflective optical surface with adjustable reflection characteristics requires a complex external power source. The complicated structure and preparation process of the power system leads to the limited modulation of the reflective properties and difficulty of use in large-scale applications. Inspired by the biological compound eye, different microstructures are utilized to modulate the optical performance. Convex aspheric micromirror arrays (MMAs) can increase the luminance gain while expanding the field of view, with a luminance gain wide angle > 90° and a field-of-view wide angle close to 180°, which has the reflective characteristics of a large gain wide angle and a large field-of-view wide angle. Concave aspheric micromirror arrays can increase the luminance gain by a relatively large amount of up to 2.66, which has the reflective characteristics of high gain. Industrial-level production and practical applications in the projection display segment were carried out. The results confirmed that convex MMAs are able to realize luminance gain over a wide spectrum and a wide range of angles, and concave MMAs are able to substantially enhance luminance gain, which may provide new opportunities in developing advanced reflective optical surfaces.

Manual Dexterity Predictors of Artificial Urinary Sphincter Success

ObjectiveTo determine better in-office measures for artificial urethral sphincter outcomes, we investigated the ability of preoperative timed peg-transfer, pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand Outcome questionnaire in predicting postoperative satisfaction, confidence, and ease of use of artificial urethral sphincter placement for stress urinary incontinence. Materials and MethodsA timed 9-hole peg test, pinch and grip strength assessment, and upper extremity questionnaire were administered during the preoperative visit before sphincter placement. In addition to standard preoperative workup, short form International Consultation of Incontinence Questionnaire and physician handshake were recorded. Activation occurred 6 weeks after surgery along with assessment of adequacy of pump placement. Three months from surgery a repeat incontinence questionnaire and a survey measuring satisfaction, difficulty of use, and confidence were given. Correlation between preoperative assessment variables and the postoperative questionnaire was assessed. ResultsThirty-nine patients were included. Average age and body mass index were 68.8 years and 28.8 kg/m2 respectively. Prior prostatectomy accounted for 92.3% of patients, and 46.2% had prior pelvic radiation. Postoperatively 59.0% of patients were very satisfied; 64.1% of patients reported no difficulty of use; 53.8% felt confidence within one day; and 66.7% had much better bladder control. Average pad improvement count was 5.3. Pinch test was associated with satisfaction (p= 0.011) while peg test was associated with confidence (p = 0.049). Handshake and upper extremity questionnaire were not significant. ConclusionsThe pinch and 9-hole peg transfer tests are cost-effective and easily performed adjuncts that could be used during artificial urethral sphincter evaluation for patients with unclear manual functional status.

Musculoskeletal disorders and discomfort for female surgeons or surgeons with small hand size when using hand-held surgical instruments: a systematic review

BackgroundWork-related musculoskeletal disorders (WMSDs), also referred to as work-related musculoskeletal injuries (MSKIs), cause surgeons pain and discomfort. Implementing ergonomics in the operating room has helped reduce such symptoms. However, there are still many issues that surgeons face when dealing with medical instruments, especially among female surgeons or surgeons with smaller hands.MethodsThe Cochrane methodology for performing a systematic review was utilized to search five databases for pertinent literature based on the study question “Do female surgeons or surgeons with smaller hand size, who use surgical instruments have an increased risk of musculoskeletal disorders and discomfort compared to male or larger handed surgeons?”. The literature search strategy was designed around the three conceptual domains of surgeons/surgery, smaller hand size, and instrumentation. We searched PubMed, Embase.com, CINAHL Plus with Full Text (EBSCOhost), Scopus, and Web of Science Core Collection. This exploration identified 2165 research publications, and after specific inclusion and exclusion criteria, 19 studies were included in the systematic review. Risk of bias analysis was conducted to assess the quality of the included studies. After conducting a heterogeneity test, a meta-analysis was not performed due to high heterogeneity.ResultsUsing certain surgical instruments presents challenges in the form of MSKIs for female and smaller-handed surgeons. Studies showed that 77% of females and 73% of surgeons who wear < 6.5 glove size report musculoskeletal issues ranging from difficulty of use to pain. Difficulties using surgical instruments and reported injuries have a greater impact on surgical trainees which might deter interest in surgical fields for future proceduralists. Recommendations for improved ergonomic tool design are suggested by some of the included studies to help tackle the MSKIs that surgeons face when performing operations.ConclusionsThe number of female surgeons has increased substantially in the last decade. Hence, there exists an urgent need to address the major challenges they encounter by focusing on this specific aspect of workplace safety and health to mitigate injury. Doing so will yield a productive environment while simultaneously protecting the health and safety of both surgeons and patients.Systematic review registrationThe study protocol was registered on PROSPERO (ID: CRD42022283378).

Patient barriers and facilitators for making environmental and behavioral modifications for dry eye in the United States.

Managing dry eye disease (DED) is expensive. Often, prescribed treatments improve clinical signs but not patient-reported symptoms. In large surveys, clinicians and patients ranked environmental and behavioral modifications among the most important DED-related research priorities. Our purpose was to investigate the barriers to and facilitators of use of these modifications by patients with DED in the United States and how their use may be impacted by socioeconomic status (SES). Using Qualtrics, we conducted an anonymous online survey of adults with DED living in the United States in August to September 2022. Patients were identified through the Dry Eye Foundation, Sjögren's Foundation, and a DED clinic in Colorado. We used an established index for classifying respondent SES based on education, household income, and employment. Outcomes included use of environmental and behavioral modifications and barriers to and facilitators of their use. We included 754 respondents (SES: 382 low, 275 high, and 97 unclear). Most were aged 18 to 49 years (67%), female (68%), and White (76%) and reported dealing with DED for ≤5 years (67%). The most frequent modifications were taking breaks to rest eyes (68%), increasing water intake (68%), and using hot/cold compresses (52%). For these three, the biggest facilitators were as follows: belief that the modification works (27 to 37%), being recommended it (24 to 26%), and ease of use/performance (21 to 32%). Across modifications, the biggest barriers were difficulty of use (55%), lack of family/employer/social/community support (33%), and lack of awareness (32%). The data do not suggest discernible patterns of differences in barriers or facilitators by SES. Greater emphasis should be placed on explaining to patients how environmental and behavioral modifications might mitigate DED. Employers and members of patients' support systems should be guided regarding how best to support patients in managing DED symptoms.

The effects of 3D/Full HD and 2D/Ultra HD imaging systems on suturing skills during total laparoscopic hysterectomy: a prospective cohort study.

2D/Ultra HD and 3D/Full HD imaging systems can provide surgeons with more accurate and detailed views of the surgical site. We aimed to compare the effects of 2D/Ultra HD and 3D/Full HD laparoscopy systems on laparoscopic suturing skills during total laparoscopic hysterectomy. In this prospective cohort study, patients were recruited from a tertiary hospital, and demographic data and surgical data were recorded. The primary outcome measures were the durations of the total operation and vaginal cuff closure. Secondary outcome measures were colpotomy duration, total number of sutures placed, duration of first, second, third and fourth sutures, mean suturing duration, total operation duration, the surgeon's perception of difficulty during the vaginal cuff suturing and complications. The 3D/Full HD (n = 39) and 2D/Ultra HD (n = 42) groups were compared in terms of age, BMI, number of previous abdominal surgeries, number of previous cesarean sections, and type of delivery were examined. Both groups were considered homogeneous. The 3D/Full HD group was found to be superior in terms of colpotomy duration, duration of the first, second, and third suture, mean suturing duration, vaginal cuff closure duration, and difficulty of use compared to 2D/Ultra HD group (p < 0.05 for all). In conclusion, the use of 3D/Full HD laparoscopy systems can lead to improved surgical outcomes in terms of colpotomy duration, duration of the first, second, and third suture, mean suturing duration, vaginal cuff closure duration, and difficulty of use compared to 2D/Ultra HD systems.

The effects of umbrella handle shape and grip type on muscle activation and postural variability under windy conditions

This study investigated how different shapes of umbrella handles and grip types influence muscle activation and postural variability under windy conditions. Seventeen adult participants were enrolled in this study, and different handle shapes (cylindrical, ellipsoidal, and triangular prism-shaped), grip types (four- and five-finger grip), and wind strengths were tested. Activation of the forearm and upper arm muscles was recorded using surface electromyography. Postural variability and ratings of (1) perceived difficulty of use and (2) perceived grip-posture variability were measured. The results indicated that activation of the finger flexor muscle increased under windy conditions, whereas postural variability was not affected. Weak wind (3.2–7.5 m/s) conditions caused greater perceived postural variability and activation of the wrist extensor muscle. The ellipsoidal handle shape had lower endpoint postural variability when held with a five-finger grip and also had lower perceived postural variability and difficulty compared to that with the cylindrical shape. Our findings can be used to select appropriate umbrella handle designs based on grip type and wind conditions.

UNLEASHING THE IMPACT OF FINTECH ADOPTION BY COMMERCIAL BANKS: A DYADIC APPROACH THROUGH TECHNOLOGY DRIVEN INNOVATION THEORY

The banking sector has been enduring a rapid evolution with the growth of fintech products. Fintech products (FTPs) are innovative methods that use technology to enhance financial services and provide customers with innovative products and services. There is hardly found any research in aspects of customers and employee perspective. Therefore, this research paper explores impacts of fintech products in financial and non-financial performance in banking industry in Bangladesh on aspects of customers and employee perspective. To conduct the research, Technology Driven Innovation (TDI) theory is employed. Technology Driven Innovation is essential for banking industry as it qualifies banks to develop customer experience, to be competitive and overcome emerging encounters and unveil new opportunity for expansion &amp; growth. To investigate the research, primary data is employed as quantitative method. Smart PLS 4.0 is utilized to run the analysis. In findings, perceived usefulness and perceived difficulty of use of FTPs have significant relation with firm performance. Perceived usefulness of use of FTPs is highly related to customer satisfaction as well as Firm performance. Similarly, perceived difficulty of use of FTPs is related with service quality and work efficiency. KEYWORDS- Customer Satisfaction, Fintech, Fintech Product, Service quality and Work Efficiency.

Knowledge and use of ICT-based coordination mechanisms in three regions of Spain

Abstract Background Although there is a consensus on the potential benefits of information and communications technology (ICT) based mechanisms to improve cross-level clinical coordination, their introduction varies greatly among regions and services. The aim is to analyse the knowledge and use of digital coordination mechanisms and the factors related to the use in the health services of three autonomous communities (ACs) of the Spanish national health system. Methods Cross-sectional study based on an on-line survey by means of self-administration of the COORDENA-TICs questionnaire to primary and secondary care doctors of the health services in Catalonia (CAT) (n = 2277), Balearic Islands (BI) (n = 441), Basque Country (BC) (n = 572). Outcome variables: Knowledge and use of digital coordination mechanisms and difficulties of use. Explanatory variables: sociodemographic, labour-related, contextual, organizational, and interactional factors. Descriptive and multivariate analysis were performed to compare the ACs. Results There were some differences between the ACs: the access to and use of ICT-based coordination mechanisms in BI was limited, with the electronic health record (EHR) being the most available but infrequently used, whereas in BC and CAT there was wide access to and use of the EHR and virtual consultations between levels. In all three ACs common difficulties in EHR use emerged such as, technical problems, disorganized and/or insufficient information. Different contextual, organizational, and interactional factors were associated to their use in all three ACs. Conclusions There were differences in the type and level of implementation of ICT-based coordination mechanisms between the ACs that can be related to organizational and contextual factors, that should be further analysed. Addressing the relevant factors in each context should contribute to design effective strategies based on ICT-based coordination mechanisms to improve cross-level clinical coordination. Key messages • Implementation and use of ICT-based coordination mechanisms differed across the three ACs and could be related to differences in contextual and organizational factors in each context. • It is necessary to explore factors and difficulties related to the use of these mechanisms to develop more effective strategies to improve their use and hence impact on clinical coordination.

Comparison of communication interfaces for mechanically ventilated patients in intensive care

ObjectivesThis study aimed to compare the use of a conventional low-tech communication board and a high-tech eye tracking device to improve communication effectiveness of mechanically ventilated patients in intensive care. DesignA prospective randomized crossover was conducted with a mixed method approach (quantitative primary method and qualitative complementary method) to compare the two technologically opposed communication interfaces. SettingThe mechanically ventilated patients were recruited from the general intensive care unit of the Marie Curie Civil Hospital (Charleroi University Hospital, Belgium). Main outcome measuresThe communication exchanges were assessed through effectiveness indicators covering the quantity of messages transmitted, success rate, patient satisfaction, communication content and difficulties of use. ResultsThe sample consisted of 44 mechanically ventilated patients, covering 88 communication exchanges. The intervention effects on the quantity of messages transmitted (two median messages per exchange for the board versus four median messages per exchange for the eye tracking, p < 0.0001), success rate (80 % for the board versus 100 % for the eye tracking, p < 0.05) and patient satisfaction (66 % “not satisfied”, 32 % “satisfied” and 2 % “dissatisfied” for the board versus 52 % “satisfied” and 48 % “very satisfied” for the eye tracking, p < 0.0001) were significant. The communication content covered eight themes for the board compared to nine themes for the eye tracking and the use difficulties included four categories for the board as well as for the eye tracking. ConclusionThe eye tracking device may further improve communication effectiveness of mechanically ventilated patients compared to the conventional communication board, both quantitatively and qualitatively. Implications for clinical practiceThe implementation of high-tech communication devices based on eye tracking in intensive care practice can significantly contribute to patient-centered care by improving communication of mechanically ventilated patients.

에듀테크를 활용한 영어 수업에 대한 교사들의 인식 및 실행 형태에 관한 연구

The purpose of this study is to find out teachers' perceptions and implementation of English class using edutech. An Online survey and a focus group interview were conducted. The results of the study are as follows. First, teachers mentioned that the purpose of using edutech is to improve students' activity and induce interest. Second, regarding the experience of using edutech, they used Classcard and Chatterfix the most, and stated that students' speaking ability and concentration have improved. Third, as a result of examining teachers' perceptions of edutech, the most common response was that more classes using edutech should be increased for future education. Fourth, they responded that the advantage of English class using edutech was to induce interest and achievement. On the other hand, they pointed to environmental restrictions and difficulties of use as disadvantages. Based on these research results, this paper presents several suggestions.