Staff Expertise Research Articles

A Study on How Libraries Operate as Health Spaces in the United States.

A health space is any physical, social, or virtual space that supports building health literacy skills, promotes health behavior, preventive health, and wellbeing, or provides health care, health information, or health or social services. To move the needle on health, especially preventive health, a focus on non-traditional health spaces is critical. Libraries serve various community needs such as food distribution, health literacy, education, immunization, and health screenings. This study explores the extent to which libraries are equipped to function as a health space. A convergent mixed-methods approach was utilized; 234 library personnel were randomly recruited using data from the 2017 Public Libraries Survey to complete a survey and 24 semi-structured follow-up interviews were conducted. Our findings support that libraries function as a health space in multiple ways including providing important health and social programming and services to patrons. They help meet patron's health information needs by leveraging the expertise of community partners and incorporating valuable input from patrons in programming decisions. However, the capacity of libraries to carry out these health initiatives varies, in particular due to limited staff expertise in health-related topics and structural issues (e.g., funding). Our research emphasizes the need to integrate organizational health literacy attributes into library operations, specifically by (1) streamlining strategic partnerships with community experts in libraries in high-need areas to extend their limited resources, and (2) incorporating health literacy into missions and operations to draw necessary financial and personnel support to overcome salient challenges (i.e., funding and staff training).

Analysis of Factors Affecting Inpatient Satisfaction at RSU Wulan Windy Medan Marelan

Patient satisfaction is a key indicator in assessing the quality of healthcare services provided by hospitals. It reflects the individual experiences of each patient and signifies the effectiveness of the service delivery system. High levels of satisfaction are associated with timely service delivery, environmental comfort, effective communication, and the expertise and friendliness of medical staff. This study analyzes factors influencing inpatient satisfaction at RSU Wulan Windy Medan Marelan. The research employs a quantitative approach through survey methodology with data collected from 355 respondents. Statistical analysis included bivariate chi-square tests and multivariate logistic regression. Results indicate significant impacts of timely service delivery, comfort, and staff competence on patient satisfaction, with p-values of <0.001 for each factor.

Diagnostic challenges in complicated case of glioblastoma

Glioblastoma is the commonest primary malignant brain tumor, with a very poor prognosis and short overall survival. It is characterized by its high intra- and intertumoral heterogeneity, in terms of both the level of single-nucleotide variants, copy number alterations, and aneuploidy. Therefore, routine diagnosis can be challenging in some cases. We present a complicated case of glioblastoma, which was characterized with five cytogenomic methods: interphase fluorescence in situ hybridization, multiplex ligation-dependent probe amplification, comparative genomic hybridization array and single-nucleotide polymorphism, targeted gene panel, and whole-genome sequencing. These cytogenomic methods revealed classical findings associated with glioblastoma, such as a lack of IDH and TERT mutations, gain of chromosome 7, and loss of chromosome 10. At least three pathological clones were identified, including one with whole-genome duplication, and one with loss of 1p and suspected loss of 19q. Deletion and mutation of the TP53 gene were detected with numerous breakends on 17p and 20q. Based on these findings, we recommend a combined approach to the diagnosis of glioblastoma involving the detection of copy number alterations, mutations, and aneuploidy. The choice of the best combination of methods is based on cost, time required, staff expertise, and laboratory equipment. This integrated strategy could contribute directly to tangible improvements in the diagnosis, prognosis, and prediction of the therapeutic responses of patients with brain tumors.

Factors influencing the adoption of extended reality (XR) applications in libraries for sustainable innovative services: a systematic literature review (SLR)

Purpose This study aims to identify the factors influencing the adoption of extended reality (XR) applications in libraries for sustainable innovative services and reveal the challenges of adopting XR technology in libraries. Design/methodology/approach A systematic literature review was applied to address the study’s objectives. The 26 most relevant seminal studies published in peer-reviewed journals were selected to conduct the study. Findings The findings showed that access to digital collections, skill development, marketing, innovation and sustainable development factors influence the adoption of extended reality applications in libraries. The study illustrated that technical challenges, financial challenges, the unavailability of staff expertise and lack of institutional support caused barriers to the adoption of XR in libraries. Originality/value The study has added valuable literature to the existing body of knowledge. It has provided a framework to efficiently adopt extended reality in libraries for the delivery of sustainable, innovative services to library patrons.

Implementation strategies to improve adoption of unmet social needs screening and referrals in care management using enabling technologies: study protocol for a cluster randomized trial.

Background Adverse social determinants of health contribute to health inequities. Practice guidelines now recommend incorporating patient unmet social needs into patient care, and payors increasingly reimburse for screening and providing related referrals to community organizations. Emergent electronic health record (EHR)-based tools can enable clinical-community linkages, but their adoption commonly faces workflow and infrastructure barriers. Targeted implementation support such as training, championship, practice facilitation, and audit and feedback, can enhance such tools' adoption, but no prior research has assessed such strategies' impact on the adoption of 'enabling technologies' supporting clinical-community linkages. This study will test whether providing targeted implementation support to safety-net primary care health center care management teams improves the sustained adoption of EHR-based enabling technologies used to 1) screen for social needs and 2) link patients to community organizations. Methods Formative evaluation of barriers and facilitators to adopting EHR-enabled social needs referrals and ascertainment of services received will include semi-structured interviews and a 'guided tour' of enabling technology used by care managers serving patients with complex health and/or social needs. A modified Delphi process conducted with care management staff and subject matter experts will then inform the development of an intervention targeting adoption of social risk EHR-enabled tools. The intervention will be piloted in three health centers, refined, then tested in a pragmatic stepped-wedge cluster-randomized trial in 20 health centers (five wedges of four health centers) that provide care management to high-risk patients with social needs. Discussion This study is among the first to evaluate an intervention designed to support care management teams' adoption of enabling technologies to increase clinical-community linkages. It was funded in September 2023 by the National Institute of Nursing Research. Formative activities will take place from January to June 2024, the intervention will be developed in July-December 2024, the pilot study will be conducted from January-March 2025, and the cluster-randomized trial will occur from July 2025 -September 2026. Study data will be analyzed and results disseminated in 2027-2028. Study results have the potential to improve clinical-community linkages and in so doing to advance health equity. Trial registration Clinicaltrials.gov registration # NCT06489002. Registered July 5, 2024, https//clinicaltrials.gov/study/NCT06489002?term=NCT06489002&rank=1.

Assessing Retrieval-Augmented Large Language Model Performance in Emergency Department ICD-10-CM Coding Compared to Human Coders.

Accurate medical coding is essential for clinical and administrative purposes but complicated, time-consuming, and biased. This study compares Retrieval-Augmented Generation (RAG)-enhanced LLMs to provider-assigned codes in producing ICD-10-CM codes from emergency department (ED) clinical records. Retrospective cohort study using 500 ED visits randomly selected from the Mount Sinai Health System between January and April 2024. The RAG system integrated past 1,038,066 ED visits data (2021-2023) into the LLMs' predictions to improve coding accuracy. Nine commercial and open-source LLMs were evaluated. The primary outcome was a head-to-head comparison of the ICD-10-CM codes generated by the RAG-enhanced LLMs and those assigned by the original providers. A panel of four physicians and two LLMs blindly reviewed the codes, comparing the RAG-enhanced LLM and provider-assigned codes on accuracy and specificity. RAG-enhanced LLMs demonstrated superior performance to provider coders in both the accuracy and specificity of code assignments. In a targeted evaluation of 200 cases where discrepancies existed between GPT-4 and provider-assigned codes, human reviewers favored GPT-4 for accuracy in 447 instances, compared to 277 instances where providers' codes were preferred (p<0.001). Similarly, GPT-4 was selected for its superior specificity in 509 cases, whereas human coders were preferred in only 181 cases (p<0.001). Smaller open-access models, such as Llama-3.1-70B, also demonstrated substantial scalability when enhanced with RAG, with 218 instances of accuracy preference compared to 90 for providers' codes. Furthermore, across all models, the exact match rate between LLM-generated and provider-assigned codes significantly improved following RAG integration, with Qwen-2-7B increasing from 0.8% to 17.6% and Gemma-2-9b-it improving from 7.2% to 26.4%. RAG-enhanced LLMs improve medical coding accuracy in EDs, suggesting clinical workflow applications. These findings show that generative AI can improve clinical outcomes and reduce administrative burdens. This work was supported in part through the computational and data resources and staff expertise provided by Scientific Computing and Data at the Icahn School of Medicine at Mount Sinai and supported by the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. Research reported in this publication was also supported by the Office of Research Infrastructure of the National Institutes of Health under award number S10OD026880 and S10OD030463. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders played no role in study design, data collection, analysis and interpretation of data, or the writing of this manuscript. A study showed AI models with retrieval-augmented generation outperformed human doctors in ED diagnostic coding accuracy and specificity. Even smaller AI models perform favorably when using RAG. This suggests potential for reducing administrative burden in healthcare, improving coding efficiency, and enhancing clinical documentation.

Developing a Comprehensive Inventory to Define Harm Reduction Housing.

Background The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a "housing first" approach where abstinence is not required and harm reduction services and supports are co-located. Despite the importance of HRH, the specific characteristics and operations of these sites are not well understood. This study sought to address this gap by cataloging the common features of Boston's HRH sites to generate a comprehensive inventory tool for evaluating implementation of harm reduction strategies at transitional housing locations. Methods We collected data between June and September 2023 and included semi-structured qualitative interviews with HRH staff (n = 19), ethnographic observations and photos at six HRH sites. Candidate inventory components were derived through triangulation of the data. Two expert medical staff unaffiliated with data collection reviewed a draft inventory measuring awareness and utility of HRH inventory components. We then pilot tested the inventory with 3 HRH residents across two sites for readability and reliability. Inventory performance was further tested in a survey of 106 residents. Results HRH staff identified best practices, resources, and policies in HRH sites that were further contextualized with ethnographic field notes. Common to all were overdose prevention protocols, behavioral policies, security measures, and harm reduction supplies distribution. The initial 44-item inventory of services, policies and site best practices was further refined with expert and participant feedback and application, then finalized to generate a 32-item inventory. Residents identified and valued harm reduction services; medical supports were highly valued but less utilized. Conclusion The HRH inventory comprehensively assesses harm reduction provision and residents' awareness and perceived helpfulness of HRH operational components. Characterizing the critical components of HRH through this tool will aid in standardizing the concept and practice of HRH for PWUD and may assist other cities in planning and implementing HRH.

Оценка качества образовательной среды в детском саду для детей с РАС: методика ECERS-R

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;When providing comprehensive support for children with autism spectrum disorders (ASD), it is necessary to create a special educational environment. A study was conducted on the quality of the educational environment of a preschool educational organization for children with ASD using the Early Childhood Environmental Assessment Scale (ECERS-R) tool, which was originally designed to assess the environment in preschools for typically developing children.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The ECERS-R diagnostic methodology evaluates the main components of the educational environment in a preschool organization across seven areas: Space and Furnishings; Personal Care Routines; Language &amp;mdash; Reasoning; Activitie; Interaction; Program Structure; Parents and Staff. In 10 groups of children aged 2 to 8 years of special kindergarten for children with ASD &amp;ldquo;WE ARE TOGETHER&amp;rdquo;, quality monitoring of the preschool&amp;rsquo;s work was carried out by both external and internal (staff) experts.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;The strongest aspects of the kindergarten&amp;rsquo;s educational environment for children with ASD were identified as &amp;ldquo;Staff-Child Interaction&amp;rdquo; and &amp;ldquo;Program Structure&amp;rdquo;. Lower scores were obtained in the areas of &amp;ldquo;Language &amp;mdash; Reasoning&amp;rdquo; and &amp;ldquo;Activities&amp;rdquo;. The &amp;ldquo;Space and Furnishings&amp;rdquo; was rated similarly by both external and internal experts (4.5 points), which indirectly indicates the objectivity of the expert assessment. Internal experts rated their own performance in caring for children with ASD lower, at 3.4 points, while external experts rated the difficulty of caring for children with ASD slightly higher, at 3.6 points.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions.&amp;nbsp;&lt;/strong&gt;In general, kindergarten staff, who work with children in this educational environment on a daily basis, rated its quality significantly higher than external experts. This discrepancy is likely due to the specific nature of the educational environment for children with ASD, as well as the individual characteristics of the children themselves. For a qualitative assessment of the educational environment using ECERS-R in a kindergarten with a special focus, the tool needs to be adapted to better meet the special educational needs of the children. Adding subscales for different conditions seems feasible.&lt;/p&gt;

The background and experience of neuroscience teachers in Australian universities: A cross-sectional survey.

Neuroscience is an academic discipline taught within a broad range of university degrees and programs. The expertise and experience of neuroscience teaching staff contribute to the student's learning experience and knowledge acquisition. We undertook a survey to characterize the neuroscience teaching workforce and practices in Australian universities, and to investigate access to and deficiencies in neuroscience teaching resources and training. Two hundred neuroscience teaching staff completed our anonymous online survey. The responses indicated that neuroscience is primarily being delivered by highly qualified (86% with doctoral degrees, 27% with formal qualifications in tertiary teaching), research-active (45% were recently primary supervisors of research students) teaching academics with secure employment (77% in full-time continuing positions). There were more females (61.5%) than males (38.5%) in the sample and most respondents taught neuroscience to students enrolled in a range of degrees/programs. Most survey respondents could access an anatomy laboratory for teaching (87%) but access to specialised online resources, such as augmented reality presentations, customised game-based learning approaches, and/or online brain atlases, was limited. Most survey respondents reported they would benefit from increased access to neuroscience teaching resources and/or peer-tested teaching materials (80%), an informal network of Australian neuroscience teaching peers (64%), and/or training workshops on neuroscience teaching (59%). Approximately half of survey respondents supported the creation of national guidelines for neuroscience teaching curricula. The survey results identify specific gaps in teacher training and resources and inform the development of strategies to support tertiary teachers of neuroscience and student learning.

Family and Staff Cooperation in Early Childhood Special Education

Introduction: Early childhood is a critical period for supporting children's development. The role of families and the staff responsible for the services is crucial in supports to be provided in the development of children with special needs. In this study, stakeholders' cooperation processes were examined in the context of family-staff and staff-staff cooperation. Method: The participants are 12 staff and seven parents at a special education center. The data of the study, which was conducted in the phenomenological design of qualitative research methods, were obtained with the semi-structured interview technique and analyzed with content analysis. Findings: Findings were discussed under the titles cooperation experiences, family participation and needs, early childhood special education, staff, institution features, opinion and suggestions. Six main themes and 18 subthemes were reached. Discussion: The findings of the study were consistent with the findings of the studies examining the cooperation process in special education services in the literature. Physical features of the institution, its operation in accordance with legal regulations and the staff's efficiency are effective in meeting families' needs of information and social support. Families need cooperation with staff expert in different fields in the process of starting education of children with special needs after early diagnosis and evaluation. The role of families and the directors and staff of the special education institutions are critical in maintaining the cooperation. Parents' needs such as information, social and psychological support must be met in line with the family participation. Family participation should be supported through accessible digital-based cooperation programs, professional skills of staff must be developed, and the physical features of institutions must be improved.

It Takes a Village

The introduction of Large Language Models (LLM) to the chatbot landscape has opened intriguing possibilities for academic libraries to offer more responsive and institutionally contextualized support to users, especially outside of regular service hours. While a few academic libraries currently employ AI-based chatbots on their websites, this service has not yet become the norm and there are no best practices in place for how academic libraries should launch, train, and assess the usefulness of a chatbot. In summer 2023, staff from the University of Delaware’s Morris Library information technology (IT) and reference departments came together in a unique partnership to pilot a low-cost AI-powered chatbot called UDStax. The goals of the pilot were to learn more about the campus community’s interest in engaging with this tool and to better understand the labor required on the staff side to maintain the bot. After researching six different options, the team selected Chatbase, a subscription-model product based on ChatGPT 3.5 that provides user-friendly training methods for an AI model using website URLs and uploaded source material. Chatbase removed the need to utilize the OpenAI API directly to code processes for submitting information to the AI engine to train the model, cutting down the amount of work for library information technology and making it possible to leverage the expertise of reference librarians and other public-facing staff, including student workers, to distribute the work of developing, refining, and reviewing training materials. This article will discuss the development of prompts, leveraging of existing data sources for training materials, and workflows involved in the pilot. It will argue that, when implementing AI-based tools in the academic library, involving staff from across the organization is essential to ensure buy-in and success. Although chatbots are designed to hide the effort of the people behind them, that labor is substantial and needs to be recognized.

Barriers to implementation of rapid identification and antimicrobial susceptibility testing technologies in the clinical microbiology laboratory: an American perspective.

Clinical microbiology laboratories are responsible for confirming the aetiology of infectious diseases and providing antimicrobial susceptibility testing results. Traditional culture-based testing can be augmented by more rapid testing modalities to provide clinically actionable information as quickly as possible. Despite improvements in patient outcomes, many clinical microbiology laboratories are facing challenges to in-sourcing these technologies. Depending on a multitude of factors, including size, location and patient population served, these barriers may affect some laboratories and hospital systems to greater or lesser extents than others. It will be up to each individual facility to ascertain its ability to overcome barriers. To aid in this self-assessment, we present for thoughtful consideration a discussion of the barriers to implementation of rapid identification and antimicrobial susceptibility testing technologies, with specific attention to matters of financial cost, staff expertise, operational issues and stakeholder buy-in.

Current experience and future potential of facilitating access to digital NHS primary care services in England: the Di-Facto mixed-methods study.

Current National Health Service policy in England encourages enhanced digital access in primary care service provision. In this study, we investigate 'digital facilitation' - that range of processes, procedures and personnel which seeks to support National Health Service primary care patients in their uptake and use of online services. Identify, characterise and explore the potential benefits and challenges associated with different models of digital facilitation currently in use in general practice which are aimed at improving patient access to online services in general practice in England. Use the resulting intelligence to design a framework for future evaluations of the effectiveness and cost effectiveness of such interventions. Explore how patients with mental health conditions experience digital facilitation and gauge their need for this support. Observational mixed-methods study (literature review, surveys, ethnographic observation and interviews); formal synthesis of findings. General practice in four regions of England. Practice survey: 156 staff. Patient survey: 3051 patients. Mental health survey: 756 patients. General practitioner patient survey: 3 million responders. Ethnographic case-studies: 8 practices; interviews with 36 staff, 33 patients and 10 patients with a mental health condition. Stakeholder interviews: 19 participants. Digital facilitation as undertaken in general practice. Patient and practice staff reported use of, and views of, digital facilitation. Surveys, qualitative research; national General Practitioner Patient Survey (2019-22). Scoping-review methodology applied to academic and grey literature published 2015-20. While we did find examples of digital facilitation in routine practice, these often involved using passive or reactive modes of support. The context of COVID, and the necessary acceleration (at that time) of the move to a digital-first model of primary care, shaped the way digital facilitation was delivered. There was lack of clarity over where the responsibility for facilitation efforts lay; it was viewed as the responsibility of 'others'. Patients living with mental health conditions had similar needs and experiences regarding digital facilitation to other patients. The context of the COVID pandemic placed limitations on the project. Fewer practices responded to the practice survey than anticipated; reconfiguration of general practices to support COVID measures was a key consideration during non-participant observation with social distancing and other measures still in place during fieldwork. Digital facilitation, while not a widely recognised concept, is important in supporting the move to a National Health Service with enhanced digital opportunities and enhanced digital access. General practice staff are allocating resources to provide such efforts in general practices in England. The establishment of clear lines of responsibility, the development of digital tools and platforms that work for patients and practice staff, and investment in staff time and training are needed if digital facilitation is to support the intended digital revolution. We did not find one single dominant or preferred model of digital facilitation which might reasonably be considered to form the basis of an intervention to be tested. Rather, there is a need to co-develop such an intervention with patients, general practice staff and relevant policy experts. We outline a framework for a future evaluation of such an intervention. This study is registered as ResearchRegistry6523 (www.researchregistry.com/browse-the-registry#home/?view_2_search=Di-Facto&view_2_page=1) and PROSPERO CRD42020189019 (www.crd.york.ac.uk/prospero/display_record.php?RecordID=189019). This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128268) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 32. See the NIHR Funding and Awards website for further award information.

The influence of care home registration type and size on senior care leader’s confidence to provide palliative and end-of-life care: an explanatory sequential mixed methods study

BackgroundCare home staff are key providers of palliative and end-of-life care. Yet, little is known about how care home characteristics can influence care leader’s confidence in their ability to provide optimal palliative and end-of-life care.AimTo understand the influence of care home registration type (nursing, residential or dual registered) and size on senior care leader’s confidence to provide palliative and end-of-life care.DesignAn explanatory sequential mixed methods study comprising an online cross-sectional survey (including the Palliative Care Self-Efficacy Scale) and qualitative individual interviews. Analysis of survey data used a multivariate logistic regression and qualitative interview data used Framework Analysis. A ‘Following the Thread’ method was undertaken for data integration.Setting/participantsUK care home senior care leaders, purposively sampled by registration type, size and geographical location.ResultsThe online survey (N = 107) results indicated that nursing home senior care leaders had higher confidence scores on the Palliative Care Self-Efficacy Scale than residential care home leaders (aOR: 3.85, 95% CI 1.20-12.31, p = 0.02). Care home size did not show effect when adjusting for registration type (medium - aOR 1.71, 95% CI 0.59–4.97, p = 0.33; large – aOR 0.65, 95% CI 0.18–2.30, p = 0.5). Interviews (n = 27) identified three themes that promote confidence, (1) ‘feelings of preparedness’ stemming from staff expertise and experience and care home infrastructure, (2) ‘partnership working’ with external services as a valued member of the multidisciplinary team, and (3) a shared language developed from end-of-life care guidance.ConclusionCare home senior care leader’s confidence is influenced by care home characteristics, particularly availability of on-site registered nurses and the infrastructure of large care homes. All care home leaders benefit from training, working with external, multidisciplinary teams and use of guidance. However, mechanisms to achieve this differed by care home type and size. Further exploration is needed on successful integration of palliative care services and interventions to enhance confidence in residential care homes.

Responding to Crisis: A Multiple Case Study of District Approaches for Supporting Student Learning in the COVID-19 Pandemic

Purpose: Prior research shows wide variation in student learning across contexts during the COVID-19 pandemic, but less is known about why such variation occurred or how particular response approaches may help districts navigate future crises. Research methods: Drawing on crisis leadership and organizational theory, we conducted a multiple case study of pandemic response across five school districts in Michigan that performed better-than-predicted on benchmark assessments during the 2020–21 school year. We interviewed 46 district, school, and teacher leaders across district cases and analyzed data using comparative case study methods. Findings: We find that local leaders relied on existing resources such as staff-student relationships, school-family relationships, and curricula and instructional models to address foundational needs stemming from the pandemic. These resources were part of each district's distinct approach to supporting student learning prior to the pandemic and provided a reliable path forward amidst ongoing uncertainty and disruption. When previous approaches were not aligned to external demands, local leaders leveraged staff expertise, staff collaboration, and school-family relationships to develop new teaching and learning approaches. In-person and hybrid districts adapted to create safe in-person learning environments, while remote and hybrid districts adapted to use technology to engage students in distanced learning and personalized academic support. Implications: Our findings shed light on pandemic response approaches that other districts can adopt in future crises and resources that need to be cultivated and distributed across districts to support crisis response. We contribute new insights on the interplay between leadership and organizational capacity during crisis response.

A systematic review of digital transformation technologies in museum exhibition

Museum exhibitions, both temporary and permanent, form an essential link between a society and its cultural, historical, and artistic heritage sites. Curating artifacts and thematic displays in museum exhibitions can promote dialogue, foster cultural appreciation, and contribute to heritage preservation. The traditional way of holding museum exhibitions, heavily reliant on the expertise of designers and curatorial staff, makes them a labor-intensive process, from conceptualization to visitor engagement analysis. This review systematically compiles and examines how the application of digital transformation technologies (DTTs) has revolutionized museum exhibitions and augmented their future potential. DTTs such as artificial intelligence, immersive technologies, additive manufacturing, the Internet of Things, and cloud computing can help create engaging designs, improve accessibility and inclusivity, enhance educational potential, and allow for sophisticated visitor experience data collection and analyses, improving exhibit management. However, despite multiple specialized studies on DTTs and their roles in museum exhibitions, the connections between technology and application scenarios remain underexplored. By addressing this gap, this study is expected to inform and inspire practitioners in the museum and heritage sectors and present new research avenues for scholars.

Hybrid deep learning models for the screening of Diabetic Macular Edema in optical coherence tomography volumes

Several studies published so far used highly selective image datasets from unclear sources to train computer vision models and that may lead to overestimated results, while those studies conducted in real-life remain scarce. To avoid image selection bias, we stacked convolutional and recurrent neural networks (CNN-RNN) to analyze complete optical coherence tomography (OCT) cubes in a row and predict diabetic macular edema (DME), in a real-world diabetic retinopathy screening program. A retrospective cohort study was carried out. Throughout 4-years, 5314 OCT cubes from 4408 subjects who attended to the diabetic retinopathy (DR) screening program were included. We arranged twenty-two (22) pre-trained CNNs in parallel with a bidirectional RNN layer stacked at the bottom, allowing the model to make a prediction for the whole OCT cube. The staff of retina experts built a ground truth of DME later used to train a set of these CNN-RNN models with different configurations. For each trained CNN-RNN model, we performed threshold tuning to find the optimal cut-off point for binary classification of DME. Finally, the best models were selected according to sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) with their 95% confidence intervals (95%CI). An ensemble of the best models was also explored. 5188 cubes were non-DME and 126 were DME. Three models achieved an AUROC of 0.94. Among these, sensitivity, and specificity (95%CI) ranged from 84.1–90.5 and 89.7–93.3, respectively, at threshold 1, from 89.7–92.1 and 80–83.1 at threshold 2, and from 80.2–81 and 93.8–97, at threshold 3. The ensemble model improved these results, and lower specificity was observed among subjects with sight-threatening DR. Analysis by age, gender, or grade of DME did not vary the performance of the models. CNN-RNN models showed high diagnostic accuracy for detecting DME in a real-world setting. This engine allowed us to detect extra-foveal DMEs commonly overlooked in other studies, and showed potential for application as the first filter of non-referable patients in an outpatient center within a population-based DR screening program, otherwise ended up in specialized care.

Raising awareness about physical activity’s role in reducing cancer risk: qualitative interviews with immigrant women and community agency managers

ObjectivesTo explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk.Study designQualitative description.MethodsWe conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis.ResultsParticipants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada’s PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes).ConclusionsWe generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.

Exploring the Dietary Supplement Use During COVID-19: Insights from Community Pharmacists, Pharmacy Staff, Academics, and Industry Experts.

Introduction: The increased use of dietary supplements is a consequence of the coronavirus disease 2019 (COVID-19) pandemic. Although their efficacy has not been consistently proven, they have been perceived as a preventive tool against COVID-19. Less strict regulations and debates on their definitions in a regulatory framework raise concerns about safety issues. Apart from dietary supplement use, information demand has increased, and pharmacists have played a key role as accessible health professionals. This study aimed to reveal the opinions of community pharmacists, pharmacy staff, sector representatives, and academicians regarding the sale and use of dietary supplements during the COVID-19 pandemic. Methods: A qualitative study approach was followed, using grounded theory. Data were collected between September 2021 and July 2022, analyzed using MAXQDA 2020 software, and reported according to the Consolidated Criteria for Reporting Qualitative Research. Results: After refining the open codes, two themes emerged: dietary supplements and the effects of the pandemic. It was found that increased dietary supplement use was rooted in COVID-19 fear, promotional activities, and social media influence. The interaction between consumers and the dietary supplement industry is bidirectional. Conclusions: Pharmacies, as access points for these products, played a crucial role in struggling with the effects of the pandemic. Although dietary supplements are considered safe, their potential for adverse reactions poses a public health risk. Flexible regulations, unregulated alternative advertising channels, and a lack of awareness of the safety of these products pose a challenge to public health. In this regard, all stakeholders should work to minimize the risks from undergraduate education to professional life.

Assessment of Knowledge, Attitudes, and Practices of Medical Waste Management for Healthcare Providers in Two of Government Hospitals in Karbala, Iraq

Background: Medical waste is a significant health danger and environmental pollution problem due to its hazardous composition. The expertise and practice of healthcare staff in the proper removal of medical waste is essential for good medical waste management. The purpose of this study was to analyze the knowledge, attitudes, and practices related to medical waste management among healthcare workers in hospitals in Karbala/Iraq. Materials and Methods: descriptive cross-sectional study was conducted using a questionnaire distributed to health care providers in two selected hospitals in Karbala/ Iraq. Results: The results showed the good level of knowledge, attitudes and practices of healthcare providers towards medical waste. There is statistical significance between health care providers' knowledge, attitudes and practices towards medical waste, and their educational level and training courses. In addition to the recording of the statistical significance that were between knowledge with attitudes and practices. The levels can be categorized as positive but it is important to focus on increasing and improving the training of health care providers as it is the basis of the medical waste treatment process. Conclusion: increasing knowledge is one of the best tools to maintain proper workflow in isolating medical waste and maintaining the safety of employees, patients, and the environment.