Information Support Research Articles

Stress parental e perceção dos cuidados de enfermagem parentais em neonatologia

Introduction: the psychoemotional state of parents is affected when their newborn is hospitalized when facing a new environment, dealing with strangers and delegating their first protective care. Objective: to determine the level of parental stress and theperception of parental nursing care in the neonatology service of a national hospital in Peru. Methodology: quantitative, descriptive-correlational, cross-sectional study. With a sample of 75 parents of babies hospitalized in neonatology. Questionnaires were applied: Parental Stress Scale - PPS:NIICU with α=0.7 and Nursing Parent Support Tool - NPST (α = 0.96). Results: 68.7% of the participants presented moderate level of parental stress, the main sources of stress were: alteration of parental role, impact of appearance, treatment and behavior of the baby. They considered parental nursing care to be low, with deficienciesin emotional, communicational and informational support; however, they recognized good nursing care. Finally, no significant relationship was found between both variables (Tau-b: -0.07; with p < 0.05). Conclusions: there is an urgent need to implement initiatives thatinvolve parents in different processes during the hospitalization of their babies, in addition to the training of nurses to identify and attend to psychoemotional needs.

“Let’s just be human:” kindergarten teachers leveraging collegial supports during the first covid-19 school year

ABSTRACT Although efforts have been made to improve teacher professional development and ongoing supports, limited research has examined how early childhood education (ECE) teachers support each other informally. The present study describes how one type of informal support, collegial support (e.g. instrumental and expressive), enabled ECE teachers to cope with the first full school year during the COVID-19 pandemic. Through qualitative interviews, 14 kindergarten teachers shared the various ways they received and perceived collegial supports, and the system-level resources that enabled them to leverage their colleague’s expertise and assistance. ECE teachers expressed how they cared for their own well-being and shared the desire to continue doing so in the future. Implications for low-cost and nimble teacher supports and professional development are discussed.

Exploring Parents’ Everyday Experiences With Digital Media: Barriers and Opportunities for Digital Inclusion

This article presents qualitative research findings on parents’ digital media practices. Through 32 in-depth interviews with parents of 0–6-year-olds in French-speaking Belgium, the study addresses digital inclusion by exploring the diverse ways parents experience and benefit (or not) from digital media. Our research uncovers the dual nature of digital media use in parenting, presenting both advantageous and problematic outcomes across four dialectical dimensions. Our work sheds light on how digital media can (a) offer informational support or constitute an informational challenge, (b) provide emotional assistance or cause emotional struggles, (c) grant access to social support or contribute to social pressures, and (d) serve as a tool for the daily organisation or complicate daily life. Our article also investigates the factors associated with either positive or negative outcomes. We show the role of personal, situational, social, and normative factors. To conclude, we identify strategies for childcare and parenting support professionals to promote digital inclusion among parents by addressing barriers to positive experiences and outcomes related to the use of digital media. By integrating the outcomes of parents’ experiences with digital media into discussions of digital inclusion, this article contributes to a comprehensive approach to promoting digital equity beyond questions of access and skills. It calls for user-centric strategies that consider the diverse experiences and concrete outcomes associated with digital media use and emphasises the importance of supporting parents and families regarding these tools.

Fostering societal participation of marginalised people in street-outreach services in the Netherlands

Abstract Marginalisation is a multilevel phenomenon in society depriving people from essential rights, resources, and opportunities. Street-outreach services in the Netherlands, like social street work (SSW), support these marginalised people in fostering their participation in society as an answer to their marginalised position in society. We followed 927 clients in SSW over an eight-month period. Clients filled in a questionnaire at three timepoints. We examined whether clients’ perceived belongingness, self-esteem, strengths, and informal support (outcome measures) were associated with the working relationship, over time. Results showed the establishment of a working relationship with clients at all three timepoints. An evolving working relationship was associated with an increase in clients’ perceived belongingness, self-esteem, strengths, and informal support over time. This study showed the ability of workers to establish a working relationship with clients in their living environment and underscored the necessity of establishing a working relationship in street-outreach services to foster clients’ participation in society. This study encourages policymakers to reflect on current street-outreach services, to deviate from demanding short-term and measurable results from professionals’ efforts, and to opt for a better fit between performance and financing conditions and daily practices of street-outreach services.

Cognitive Accessibility of Information for Vocational Education, Support and Rehabilitation

Introduction. The article examines the problems of accessibility of professional information and intersectoral research results at three stages. Methodology and Results. At the first stage, the method of a sociological survey of disabled people (5.500 people) was used, when analyzing the results of which it was concluded that they stated the insufficient importance of education as a sphere of life (43 %) and the incomprehensibility of the information provided to them on information resources (40.2 %). The purpose of the practical second stage of the study is to develop and test the diagnosis of the availability of information for professional information (hereinafter referred to as professional information) and the need for support in obtaining advisory services for professional orientation in accessible types of work, socio–psychological, socio-pedagogical, correctional and educational services through determining the degree of cognitive safety as an objective criterion for helping people and accompanying persons with disabilities. Method: adapted questionnaire (MMSE test) as a screening tool for cognitive preservation in people of working age who applied for social services (5.915 people). The results of practical diagnostics of cognitive preservation have determined approaches to differentiating information design for the perception of information as a condition of cognitive accessibility. At the third stage, prognostic modeling of recommendations to increase the accessibility of professional information for vocational training, education and social rehabilitation, and support for the disabled was carried out. Conclusions. Taking into account functional and adaptive reserves, cognitive safety of disabled people determines the design, modeling of the subsequent design of information accessibility by levels of cognitive accessibility, which contributes to improving the quality of professional information, counseling in order to build a route of vocational education and training, including additional education or retraining.

Surgeon and Surgical Trainee Experiences After Adverse Patient Events

Adverse patient events are inevitable in surgical practice. To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.

Barriers and facilitators of self-management of diabetes amongst people experiencing socioeconomic deprivation: A systematic review and qualitative synthesis.

The number of people living with diabetes is rising worldwide and a higher prevalence of diabetes has been linked to those experiencing socioeconomic deprivation. Self-management strategies are vital and known to reduce the risks of long-term complications amongst people living with diabetes. Lack of knowledge about self-care activity required to manage diabetes is a key barrier to successful self-management. Self-management interventions can be less effective in socioeconomically deprived populations which can increase the risk of exacerbating health inequalities. The purpose of this review is to identify and synthesise qualitative evidence on the barriers and facilitators of self-management of diabetes amongst people who are socioeconomically disadvantaged. MEDLINE, EMBASE, AMED, PsycINFO and CINAHL Plus were searched for qualitative studies concerning self-management of multiple long-term conditions amongst socioeconomically disadvantaged populations. Relevant papers which focused on diabetes were identified. Data were coded and thematically synthesised using NVivo. From the search results, 79 qualitative studies were identified after full-text screening and 26 studies were included in the final thematic analysis. Two overarching analytical themes were identified alongside a set of subthemes: (1) Socioeconomic barriers to diabetes self-management; healthcare costs, financial costs of healthy eating, cultural influences, living in areas of deprivation, competing priorities and time constraints, health literacy, (2) facilitators of diabetes self-management; lifestyle and having goals, support from healthcare providers, informal support. Self-management of diabetes is challenging for people experiencing socioeconomic deprivation due to barriers associated with living in areas of deprivation and financial barriers surrounding healthcare, medication and healthy food. Support from healthcare providers can facilitate self-management, and it is important that people with diabetes have access to interventions that are designed to be inclusive from a cultural perspective as well as affordable. A patient advisory group contributed to the research questions and interpretation of the qualitative findings by reflecting on the themes developed.

Exploring the association between post-critical incident intervention preferences and self-reported coping self-efficacy among firefighters.

Critical incident stress debriefing (CISD) is a commonly utilized intervention in the fire service that aims to minimize psychological harm and adverse mental health outcomes after a potentially traumatic incident. This study aimed to explore firefighter preferences regarding CISD and alternative post-critical incident interventions in relation to firefighter coping self-efficacy (FFCSE) and trauma coping self-efficacy (CSE-T). Firefighters (N = 241) completed an online survey and provided complete data. Most participants were White (n = 203, 84.2%), non-Hispanic (n = 221, 91.7%) men (94.2%; n = 227). CISD was the most preferred intervention among firefighters (n = 113, 46.9%) as compared to informal peer support (n = 31, 12.9%), formal one-on-one counseling (n = 29, 12.0%), and no intervention (n = 68, 28.2%). Firefighters who preferred CISD had statistically significant lower levels of FFCSE, R2 =.033-.044, ps =.012-.030, and CSE-T, R2 =.035-.061 ps =.017-.024, compared to those who preferred no intervention. Firefighters who preferred formal one-on-one counseling had statistically significantly lower levels of FFCSE, R2 =.033-.044, ps =.003-.011, and CSE-T, R2 =.035-0.061, p <.001-p =.002, compared to those who preferred no intervention. The findings from this study may guide future research to increase knowledge on firefighter intervention preferences and the association between preference and coping self-efficacy.

Information and analytical activity in the system of economic security of the enterprise

This article is devoted to understanding the importance of information and analytical support for management decisions in modern conditions, when there are threats of various nature. It has been proven that the selection of reliable necessary information, scientifically based methods of its analysis provide optimal solutions in these conditions, aimed at ensuring the effective operation of the enterprise. Analysis occupies an intermediate place between the selection of information and decision-making. It has been studied that depending on business conditions, different decisions are made, different techniques and methods of analysis are used. The main features that determine the content of analytical activity are highlighted, such as: the study of economic phenomena, objective assessment of the efficiency of the enterprise, scientific substantiation of business plans and identification of reserves at the enterprise. The main tasks of the information and analytical system of enterprises of network structures in modern conditions are highlighted. It is considered that the object of analysis is the economic activity of the enterprise, which can be divided into economic processes and financial results formed under the influence of objective and subjective factors.

Multidimensional impact of sport types on the psychological well-being of student athletes: A multivariate investigation

The correlation between sports participation and psychological well-being is well-documented, revealing a complex interplay influenced by competition level and cultural context. This is particularly relevant in Korea, where the university sports culture significantly impacts student life. This study evaluates how competitive versus non-competitive sports affect Korean university students' psychological well-being using a quantitative approach with SmartPLS 4 for multi-group analysis. Findings reveal that competitive sports significantly enhance mental toughness and stress management through structured coping mechanisms and robust social support, improving coping strategy effectiveness by 34 % compared to non-competitive sports. Conversely, participants in non-competitive sports experience greater general well-being with a 40 % higher use of informal support. These insights suggest that university sports programs could benefit from targeted interventions incorporating specific coping strategies and social support frameworks tailored to the competitive context. This research underscores the need for precise stress management techniques and resilience-building exercises in sports curricula to optimize psychological well-being across different sports environments in Korean universities.

A Research Agenda to Support Families of People With Intellectual and Developmental Disabilities With Intersectional Identities.

Family members provide significant practical and emotional support to people with intellectual and developmental disabilities (IDD) across the lifespan. In September 2022, the State of the Science Conference on Community Living: Engaging Persons With Intellectual and Developmental Disabilities From Underserved Racial, Ethnic, Linguistic, and Cultural Groups in Research was held. This article summarizes the efforts of the workgroup that developed research goals related to supporting families of people with IDD. The focus was on families with intersectional identities and minoritized communities. Recommended areas of future research include exploratory research to better understand the experiences of these families, perspectives of families with intersectional identities about the formal support system, funding for family support and services, and inclusive research strategies.

Tackle Your Feelings: Experience of Help-Seeking for Mental Well-Being Concerns in Professional Rugby Union Players

Limited research into professional rugby union players’ experiences of seeking formal support for their mental health exists, despite comparable rates of mental health issues among elite rugby players with the general population. This qualitative study explored professional players’ actual experiences of accessing Rugby Players Ireland’s mental well-being service, via separate focus group discussions with professional players (n = 5) and player development managers (n = 4) who refer players into the service. An inductive reflexive thematic analysis identified three themes detailing players’ (a) journey to disclosure of their mental health difficulties, (b) their expectations and engagement with the well-being service, and (c) participants’ reflections on mental health experiences in a high-performance environment. Embedding mental health as a key component of player development in high-performance environments, improving mental health literacy, normalizing mental health experiences, and encouraging help-seeking would help promote player well-being and support holistic development alongside sporting performance.

Social support dynamics within parent-AYA cancer survivor dyads in a rural, socioeconomically disadvantaged, majority Hispanic/Latino region.

10071 Background: Childhood cancer survivors and their parents often face psychological, financial, and informational challenges as survivors transition to adolescent/young adult (AYA) age, which can be exacerbated by socioeconomic disparities. Social support can positively impact the trajectory of AYA survivors and their parents by facilitating post-traumatic growth and wellbeing and reducing psychological distress. The aim of this study was to examine social support dynamics within AYA-parent dyads by comparing their support needs and gaps. Methods: This qualitative study was conducted in collaboration with a community-based organization (CBO) serving a predominately socioeconomically disadvantaged, Hispanic/Latino (H/L), and rural population of families affected by childhood cancer in California. English- and Spanish-speaking AYA childhood cancer survivors (≥15 years old, ≥5 years from diagnosis) and parents were interviewed. Transcripts were analyzed qualitatively using applied thematic analysis. Results: Seven AYA-parent dyads (6 H/L) participated in the study. AYAs (6 male, 1 female) were median (min-max) age 19 (16-23) and 14 years post diagnosis (6-17). Parents (1 male, 6 female) were predominantly Spanish-speaking (5/7). Forms of social support fell into emotional, instrumental (i.e. tangible assistance such as financial help), and informational domains. Although family and faith were shared sources of emotional support for parents and AYAs, parents were more likely to discuss fractured family support structures and unmet emotional needs. In contrast AYAs universally identified their parents as consistent sources of emotional support. Parents also more commonly discussed gaps in instrumental support, which were exacerbated by being a single parent and lacking a local extended family network after immigrating to the United States. Parents were frequently the primary source of informational support for their children and AYAs often lacked knowledge regarding their cancer diagnosis and treatment course. Two AYAs expressed ambivalence about receiving more survivorship-focused information due to it bringing up negative emotions around fear of recurrence. Parents frequently expressed worry about their child’s readiness to transition to adult care. Conclusions: Parents experienced gaps in emotional and instrumental social support that were not noted by AYAs, suggesting that parents protected their children from these experiences. Parents continued to serve as primary sources of informational support for AYAs even as they transitioned out of pediatric care. Our findings demonstrate the opportunity to build upon supportive parent-AYA relationships through dyad-focused education and counseling, which may improve readiness to transition to adult-focused survivorship care.

Racial/ethnic distribution of participants in NRG oncology clinical trials: 2014-2023.

e13706 Background: External validity and applicability of clinical research relies upon characteristics of trial participants matching those of the respective disease groups in the general population. Understanding the racial/ethnic distribution of patients enrolled in recent US-based, federally sponsored Phase II and III clinical trials could inform strategies to further align characteristics of trial participants with those of disease group populations. As such, we report the racial/ethnic distribution of participants in NRG Oncology studies during 2014-2023 and compare the distribution to that from the Surveillance, Epidemiology, and End Results (SEER) program data during 2014-2020 (most recent data available). Methods: Proportions of self-reported race/ethnicity were summarized for the 33,370 trial participants enrolled since Mar 1, 2014 (NRG Oncology inception) to therapeutic, symptoms management, and other interventional trials. SEER proportions were used to benchmark NRG trials for representativeness of disease burden in the population. Results: Among NRG trial participants, 71.5% were non-Hispanic (NH) White, 9.7% NH Black, 4.9% Hispanic, and 7.8% N-H Asian (Table). Examining distributions within selected cancer sites relative to cancer proportional incidence in 2014-2020 SEER data, NRG accrual to prostate, lung, cervix, and breast cancer trials is commensurate with observed disease burden for NH Blacks and modestly lower for Asians. For other sites shown, representation was 2 to 5 percentage points lower than SEER frequencies for Blacks and Asians. For all sites, accrual of individuals of Hispanic background was lower than that reported in SEER. As the NRG trials do not reflect sampling across stages and other features of a given cancer in the population, further analysis to be presented will consist of more detailed breakdowns of trial participant disease-specific cancer stage and tumor subtype and comparison to relevant observations from the 2014-2020 SEER database. Conclusions: This high-level comparison of the racial/ethnic distribution of NRG trial participants provides supportive information for population representative enrollment in several cancer sites, but also identifies opportunities to improve enrollment diversity to represent more closely the respective affected population. Areas of success identified merit further investigation to understand if there are best practices which may be applied more broadly towards expanding access to federally funded clinical trials. [Table: see text]

Uniform RIP Bounds for Recovery of Signals with Partial Support Information by Weighted $ℓ_p$-Minimization

Uniform RIP Bounds for Recovery of Signals with Partial Support Information by Weighted $ℓ_p$-Minimization

Hybrid CNN-Transformer Network With Circular Feature Interaction for Acute Ischemic Stroke Lesion Segmentation on Non-Contrast CT Scans.

Lesion segmentation is a fundamental step for the diagnosis of acute ischemic stroke (AIS). Non-contrast CT (NCCT) is still a mainstream imaging modality for AIS lesion measurement. However, AIS lesion segmentation on NCCT is challenging due to low contrast, noise and artifacts. To achieve accurate AIS lesion segmentation on NCCT, this study proposes a hybrid convolutional neural network (CNN) and Transformer network with circular feature interaction and bilateral difference learning. It consists of parallel CNN and Transformer encoders, a circular feature interaction module, and a shared CNN decoder with a bilateral difference learning module. A new Transformer block is particularly designed to solve the weak inductive bias problem of the traditional Transformer. To effectively combine features from CNN and Transformer encoders, we first design a multi-level feature aggregation module to combine multi-scale features in each encoder and then propose a novel feature interaction module containing circular CNN-to-Transformer and Transformer-to-CNN interaction blocks. Besides, a bilateral difference learning module is proposed at the bottom level of the decoder to learn the different information between the ischemic and contralateral sides of the brain. The proposed method is evaluated on three AIS datasets: the public AISD, a private dataset and an external dataset. Experimental results show that the proposed method achieves Dices of 61.39% and 46.74% on the AISD and the private dataset, respectively, outperforming 17 state-of-the-art segmentation methods. Besides, volumetric analysis on segmented lesions and external validation results imply that the proposed method is potential to provide support information for AIS diagnosis.

Information and support needs of young Black women with early breast cancer to enable self-management and informed decisions during breast cancer treatment.

e12587 Background: Black women with breast cancer are more likely to experience care delays and worse outcomes than White women (Emerson, Cancer ’20). Patient self-management contributes to more timely cancer care delivery and improved outcomes. We interviewed young black women with breast cancer to explore information needs related to their self-management interests and obtain feedback on the independent use of self-management tools developed within the 4R Oncology model. 4R (Right Info/Care/Patient/Time) is an approach to facilitate patient self-management using a Care Sequence plan- a care checklist with a visual depiction of timing and sequence of care, as well as a side effect self-care tool. These tools are typically provided in the clinic, but we aimed to explore if they could be used independently by patients. Methods: The interviewee cohort (N=20) was recruited from the Tigerlily Foundation ANGEL (Advocate Now to Grow, Empower and Lead) patient program. The cohort included Black women, average age 36 (21 to 46), stage I-III breast cancer. The framework approach of qualitative research was used. Results: All women reported information needs not addressed by their providers. Mental wellness and social support information were lacking for 70% (“I never worked with a social worker or anyone to support my mental health”). Most women (65%) wanted more information about breast cancer surgery options and post-surgery drains, bras, pain, and tingling (“before I had my surgery, my doctor didn't tell me all the options I had”). 40% mentioned a lack of reconstructive option information, including how radiation affects implants, “risk of encapsulation” and the long-term impact of having implants “changing them out every 10 years.” A slight majority (55%) desired nutrition and integrative medicine information. About one-third (35%) of women mentioned considerable skin issues during radiation treatment (“I needed skin care, for people with darker skin”). When reviewing a Care Sequence and a side-effect self-care tool, 95% reported they would use them independently if their clinic did not provide them ("I just got general information about breast cancer, I would have preferred a step-by-step process like this"; “This describes what services each role provides, and links to more support”). Most (95%) would have used the side-effect tool ("My chemo education was overwhelming, just a bunch of info thrown at me all at once, having a resource to look at would have been helpful"). Conclusions: In interviews with young Black women with breast cancer we found several information needs and a preference for tools to support self-management during treatment. These indicate considerable improvements are needed in this area. Using the input from the interviews, we are enhancing the 4R Oncology tools to better support the needs of Black patients with breast cancer.

Impact of Urinary Tract and Vaginal Infections on the Physical and Emo-tional Well-being of Women.

Urinary Tract Infection (UTI) is a common bacterial infection that can affect var-ious parts of the urinary system, with symptoms including frequent urination, painful urina-tion, and lower back pain. UTIs are more common in women due to their shorter urethra, and they can lead to serious complications if left untreated. Vaginitis is an inflammation or in-fection of the vagina caused by factors like bacteria, fungi (Candida), or protozoa (Trichomo-nas). Symptoms include vaginal itching, abnormal discharge, and discomfort during urina-tion or sexual activity. Treatment depends on the underlying cause and may involve antifun-gal or antimicrobial medications. Vaginal infections, such as bacterial vaginosis, yeast infec-tions, trichomoniasis, cervicitis, and atrophic vaginitis, can have various physical, emotional, sexual, and social impacts on the lives of women. These impacts may include discomfort, embarrassment, reduced sexual satisfaction, social isolation, and emotional distress. Support and resources for managing these infections include healthcare providers who can diagnose and prescribe treatment, pharmacies that provide medications and guidance, telemedicine for remote consultations and prescriptions, support groups for emotional and informational sup-port, and online resources for reliable information. They offer a sense of community, infor-mation sharing, and emotional support, making it easier for individuals to manage their vag-initis and related concerns. Utilizing these resources can contribute to a more informed and empowered approach to vaginal infection prevention and treatment.

How Informal Carers Support Video Consulting in Physiotherapy, Heart Failure, and Cancer: Qualitative Study Using Linguistic Ethnography.

Informal carers play an important role in the everyday care of patients and the delivery of health care services. They aid patients in transportation to and from appointments, and they provide assistance during the appointments (eg, answering questions on the patient's behalf). Video consultations are often seen as a way of providing patients with easier access to care. However, few studies have considered how this affects the role of informal carers and how they are needed to make video consultations safe and feasible. This study aims to identify how informal carers, usually friends or family who provide unpaid assistance, support patients and clinicians during video consultations. We conducted an in-depth analysis of the communication in a sample of video consultations drawn from 7 clinical settings across 4 National Health Service Trusts in the United Kingdom. The data set consisted of 52 video consultation recordings (of patients with diabetes, gestational diabetes, cancer, heart failure, orthopedic problems, long-term pain, and neuromuscular rehabilitation) and interviews with all participants involved in these consultations. Using Linguistic Ethnography, which embeds detailed analysis of verbal and nonverbal communication in the context of the interaction, we examined the interactional, technological, and clinical work carers did to facilitate video consultations and help patients and clinicians overcome challenges of the remote and video-mediated context. Most patients (40/52, 77%) participated in the video consultation without support from an informal carer. Only 23% (12/52) of the consultations involved an informal carer. In addition to facilitating the clinical interaction (eg, answering questions on behalf of the patient), we identified 3 types of work that informal carers did: facilitating the use of technology; addressing problems when the patient could not hear or understand the clinician; and assisting with physical examinations, acting as the eyes, ears, and hands of the clinician. Carers often stayed in the background, monitoring the consultation to identify situations where they might be needed. In doing so, copresent carers reassured patients and helped them conduct the activities that make up a consultation. However, carers did not necessarily help patients solve all the challenges of a video consultation (eg, aiming the camera while laying hands on the patient during an examination). We compared cases where an informal carer was copresent with cases where the patient was alone, which showed that carers provided an important safety net, particularly for patients who were frail and experienced mobility difficulties. Informal carers play a critical role in making video consultations safe and feasible, particularly for patients with limited technological experience or complex needs. Guidance and research on video consulting need to consider the availability and work done by informal carers and how they can be supported in providing patients access to digital health care services.

Integrating Trustworthy Mechanisms to Support Data and Information Security in Health Sensors

An important reason to protect provider and medical care patient information and data is digital terrorism. Patient health records and healthcare provider information are sensitive issues that can affect patients’ health or even national security. Many frequent attacks have carried out breaches on health databases/data sets continuously and on remote servers and local servers with wireless sensor networks (WSNs) in different places. Various modern approaches addressed this issue and were designed to prevent these attacks with the aim of providing the security of patient information and data transmitted and collected by WSNs. However, there are still several signs of weakness in these approaches, which are described in the literature review. This research proposes a new trustworthy approach that supports the provision of data security and information collected by WSN and stored on basestation databases. This approach takes advantage of the integration of several security mechanisms including symmetric cryptography for encryption, asymmetric cryptography for signature and access control, as well as the implementation of the Lesamnta-LW function in the signature mechanism. Solid methodology and careful use of these mechanisms protect and hide users’ information from being exposed to attackers. Security analyses, investigative comparisons and rigorous findings indicate that the proposed approach is superior to previous approaches.