Specialist Help Research Articles

Assessment and improvement of goals of care discussion by internal medicine residents.

191 Background: End-of-life goals and quality of life are intrinsically connected, focusing on providing care that maximizes comfort, dignity, and personal satisfaction during the final stages of life. Residents are primarily involved in Goals of care (GOC) discussion in hospitalized patients it is an integral component in Internal Medicine (IM) resident education. Literature has shown improved outcomes in delivering bad news by residents and oncology fellows after workshops, lectures, and courses. We aimed to improve Residents' competency in effective GOC discussion. Methods: We devised a questionnaire with the help of palliative care specialists and distributed it via a Google survey to the IM residents. After the survey, a palliative care specialist lectured about understanding the POLST form and components of Code Status Discussions. The same questionnaire was sent again. Five survey questions were used as post-lecture improvement parameters, and residents were stratified among three different classes: Interns, Year 2, and Year 3. Results: Before the lecture, residents were asked about their comfort level on a scale from 1-10, with 10 being the most comfortable conducting GOC discussions with the patient or the patient's family. As per the combined survey of all three classes, 50% of residents scored seven or above. Post lecture, 69.3% of intern year residents and 100% of 2nd and 3rd-year residents scored seven and above, which showed significant improvement in residents' comfort level while conducting GOC discussions. The parameters analyzed were the ability to explain SPIKES protocol for 'Breaking Bad News. Initially, 58.3% of the residents were comfortable explaining it, while 41.7 % answered negatively. After the survey, 84.6% from the intern year, 92.3% in 2nd year, and 77.8% of 3rd-year residents stated being comfortable with explaining SPIKES protocol. Another evaluated paradigm was the residents' ability to determine the patient's prognosis using any given scale/score (like the UCSF prognosis calculator). 33.3 % of the residents said 'yes' while 30.6% answered 'maybe.' Post-intervention, 100% of 3rd-year residents and 61.5% of 2nd-year residents, while 30.8% of intern-year residents said 'yes.' The cumulative mean of all three combined classes was 64.1%, which showed significant improvement compared to pre-intervention 33.3%. Conclusions: The results show that residents' comfort level of conducting GOC discussions improved with a single lecture on the topic. Further interventions and mentorship are needed. Intern-year residents were found to have a lower level of subjective comfort in conducting these discussions, which can be explained by their being relatively new to the work environment. A more integrated approach at the beginning of the residency training regarding GOC discussion training can improve interns' confidence and comfort for ensuing such discussions.

Sleep disorders in cancer patients during systemic therapy

Aim: The aim of this study was to investigate the frequency, quantity and quality of subjective sleep problems, and their correlation with accompanying factors in cancer patients undergoing systemic therapy. Materials and methods: The study included 100 patients – 50 females and 50 males – undergoing oncological treatment who filled out an anonymous questionnaire specifically designed for this research. Results: 88% of the respondents reported the duration of sleep in the range of 5 to 9 hours. 48% of the respondents declared a deterioration in the quality of sleep after the diagnosis of cancer. Following the onset of sleep problems, 66% of respondents did not pursue any treatment. Among the examined patients, symptoms of insomnia were reported by 18%, and symptoms of hypersomnia – by 6%. Mixed sleep disorders were reported by 11% of respondents. The patients undergoing surgical treatment reported a statistically significantly lower quality of sleep compared to the patients not undergoing surgery (median score in the quantitative scale 6 vs. 7 on a scale of 1–10, where 1 indicated the worst quality of sleep and 10 indicated the best quality of sleep; p = 0.04). A very small percentage of patients sought pharmacotherapy or specialist help for sleep disorders, which precludes drawing statistically significant conclusions about the impact of these interventions on sleep quality. Conclusions: Sleep problems are often reported by patients during oncological treatment (48%). The main sleep-related complaints were advanced sleep phase disorders. Due to the frequent occurrence of sleep disorders among patients, it is important to conduct a thorough medical interview to diagnose them and implement appropriate treatment.

Assessment of the Diversity and Abundance of Butterfly Fauna in and around Choolanur Peafowl Sanctuary in Palakkad, Kerala, India

This study investigates the diversity and abundance of butterflies in two selected sites, Choolanur (protected area) and Pazhambalakkode (an area close to sanctuary) of Palakkad district of Kerala, India. The study was done only in and around the peafowl sanctuary and Choolanur forest premise and the diversity of butterfly was found to be a little high at Site 1(Choolanur), with Nymphalidae family being most abundant. The number of butterflies from the Papilionidae and Lycaenida family was recorded to be in less numbers as compare to the Nymphalidae. The diversity of butterflies at at Site 2 (Pazhambalakkode) the diversity was almost similar to the diversity of Site 1, which may be due to the immigration of species. The butterflies were sampled by direct search method and photographs were identified with the help of keys and specialists. The species belonging to Nymphalidae family was seen to be high, followed by species of the Lycaenidae family, Pieridae family and the species of the Papilionidae family was recorded to be least. Our results not only confirm the importance of protected sites for protecting biodiversity within a particular area but also highlight their beneficial effects in their surroundings.

The impact of COVID-19 on people with epilepsy: Global results from the coronavirus and epilepsy study.

To characterize the experience of people with epilepsy and aligned healthcare workers (HCWs) during the first 18 months of the COVID-19 pandemic and compare experiences in high-income countries (HICs) with non-HICs. Separate surveys for people with epilepsy and HCWs were distributed online in April 2020. Responses were collected to September 2021. Data were collected for COVID-19 infections, the effect of COVID-related restrictions, access to specialist help for epilepsy (people with epilepsy), and the impact of the pandemic on work productivity (HCWs). The frequency of responses for non-HICs and HICs were compared using non-parametric Chi-square tests. Two thousand one hundred and five individuals with epilepsy from 53 countries and 392 HCWs from 26 countries provided data. The same proportion of people with epilepsy in non-HICs and HICs reported COVID-19 infection (7%). Those in HICs were more likely to report that COVID-19 measures had affected their health (32% vs. 23%; p < 0.001). There was no difference between non-HICs and HICs in the proportion who reported difficulty in obtaining help for epilepsy. HCWs in non-HICs were more likely to report COVID-19 infection than those in HICs (18% vs 6%; p = 0.001) and that their clinical work had been affected by concerns about contracting COVID-19, lack of personal protective equipment, and the impact of the pandemic on mental health (all p < 0.001). Compared to pre-pandemic practices, there was a significant shift to remote consultations in both non-HICs and HICs (p < 0.001). While the frequency of COVID-19 infection was relatively low in these data from early in the pandemic, our findings suggest broader health consequences and an increased psychosocial burden, particularly among HCWs in non-HICs. Planning for future pandemics should prioritize mental healthcare alongside ensuring access to essential epilepsy services and expanding and enhancing access to remote consultations. We asked people with epilepsy about the effects of COVID-19 on their health and healthcare. We wanted to compare responses from people in high-income countries and other countries. We found that people in high-income countries and other countries had similar levels of difficulty in getting help for their epilepsy. People in high-income countries were more likely to say that their general health had been affected. Healthcare workers in non-high-income settings were more likely to have contracted COVID-19 and have the care they deliver affected by the pandemic. Across all settings, COVID-19 associated with a large shift to remote consultations.

Construction and Standardization of Knowledge Test to Measure the Knowledge Level of Farmers on Rice Crop Cultivation

A study was designed to develop a standardized test to measure the knowledge of rice farmers. Pertinent items covering every aspect of rice cultivation were collected with the help of subject matter specialists, progressive farmers, and scientists along with related literature. After getting experts opinion, items were subjected to difficulty index, discrimination index, correlation, reliability and validity. Items with 20-80 of difficulty level, items with 0.20-0.80 discrimination index and significant either at 1 percent or 5 percent level point in biserial correlation were selected and admitted to rice to measure knowledge level on rice cultivation. A total of 47 items were included in the final knowledge test to measure the knowledge level of farmers in rice cultivation.

Science parks: analysis of international experience and development prospects in Ukraine

The object of the research is the issues related to the creation of science parks in Ukraine at a new level in the process of its post-war reconstruction. In this paper, the main focus is on the analysis of the very concept of «science park» and the experience of some international ones, which are most suitable for the domestic plans for the transformation of the Ukrainian economy and its social infrastructure. Also researched the initiative of the Kharkiv city government to create the so-called «science quarter», which would absorb all the best that exists in the world in the field of science parks, and would have its own «highlight». As a result of this study, it was established that the creation and functioning of science parks is an important component of the modern world economy, which should be given serious attention in the process of post-war transformation of the Ukrainian economy. Moreover, the process of developing a strategy for the construction of such science parks should be started now, without waiting for the end of the war. A good example of this is the start of work on the project to create a science park in Kharkiv called «Science Quarter» as part of the development of a city recovery plan with the help of specialists from various international organizations, universities, banks and funds. The article analyses the activities of some similar science parks in Poland, which can be used as a guide in this process, and provides recommendations for the improvement and enhancement of certain basic elements of the future Kharkiv science park. As a result, it was concluded that thanks to the hard work of the city authorities with the support of international institutions, active work is being done to develop a city reconstruction strategy at a fundamentally new level in Kharkiv, within which a significant place is given to the implementation of the «Science Quarter» project. The success of the latter will depend not only on the experienced team of specialists implementing this project and the receipt of the necessary funding, but also, first of all, on the success of our defenders in repelling russian aggression.

Women with acute heart failure receive help from a cardiologist faster than men-gender disparities in acute heart failure

Abstract Funding Acknowledgements None. Introduction Acute heart failure (AHF) is a life-threatening condition that requires quick diagnosis and immediate treatment. Emergency Department (ED) is a major stage for hospitalized patients with AHF. Recent studies have highlighted that the efficacy of any intervention and treatment may be time dependent. Purpose The aim of the study was to analyze the management of patients with AHF depending on gender before treatment in Intensive Cardiac Care Unit (ICCU). Materials and methods In the period from 06/2019 to 01/2021, 767 patients with a diagnosis of acute heart failure (AHF) were urgently admitted to the ED. The most severely unwell 122 patients diagnosed with AHF required treatment in the ICCU . The time of onset of AHF symptoms (SYMPTOMS), first medical contact (FMC) and the time of cardiologist consultation (CC) in the Emergency Department were determined. Results In the study group of 767 patients with AHF presenting to the ED, women constituted 37%.They were less likely to be admitted to the Cardiology Department with a diagnosis of AHF than men (29.5% versus 40.2%) however they died more often in the ED (6.0% versus 2.7%). Among the 122 patients with AHF treated in the ICCU, the majority were men (72%), the mean age was 68 years and the median LVEF = 30% [IQR 20-38%]. In both sexes, the phe.notype of acute decompensated heart failure predominated (68% in women and 82% in men), although acute pulmonary oedema was slightly more common in women (26% versus 15% in men). Women contacted a doctor or called an ambulance faster than men (median time SYMPTOMS to FMC shorter by 1.6 days) and the time from FMC to consultation with a cardiologist was shorter (median time SYMPTOMS to FMC shorter by 0.17th day). Consequently, the delay time from the onset of symptoms to cardiology consultation was twice shorter in women than in men: 3.1 [IQR 0.3-8.4] days vesus 6.9 [IQR1.3-15.3], p=0.05. Conclusion Women with acute heart failure treated in the Intensive Cardiac Care Unit see a doctor faster and also receive specialist help from a cardiologist faster than men.

Intercultural Communication in the Context of Teaching a Foreign Language to Students of Non-linguistic Fields

New requirements for specialist training provide for improving the quality of language education in higher education. The article examines the concept of intercultural communication and its inseparable connection with the teaching of a foreign language to students at non-linguistic universities. To form communicative competence and overcome cultural and linguistic barriers, the help of specialists in the field of intercultural communication is required, since the cultural component turns out to be part of the language.

Investigating the effect of posture correction on the amount of musculoskeletal pain of patient carriers in Bahoner Hospital, Kerman

Introduction: Due to the obviousness of musculoskeletal disorders in health workers, especially patient carriers, we felt it necessary to check the amount of musculoskeletal pain in these workers by correcting the posture. &#x0D; Mateials and Methods:The study is semi-experimental. First, a demographic questionnaire, a self-made questionnaire on the level of awareness and a Nordic questionnaire along with a numerical rating scale to measure the amount of pain related to musculoskeletal disorders were completed for all participants. Then, theoretical and practical interventions were carried out in order to correct posture using occupational medicine, ergonomics, and sports specialists, and again one month and six months later, questionnaires were completed and data were collected. At the end, data analysis was done with SPSS version 24 software.&#x0D; Results: Descriptive statistics show that interventions aimed at correcting posture reduce the average scores of pain for different body parts of patient carriers. And the most obvious musculoskeletal disorder is back pain.&#x0D; Statistical analysis showed that comparing the average score of back pain (p=0.000), neck (p=0.014), shoulder (p=0.006), knee (p=0.006) and leg (p=0.016) in patient carriers before There is a significant difference between postural correction and six months later.&#x0D; However, comparing the average pain score of elbow (p=0.18), wrist (p=0.06), back (p=0.3) and thigh (p=0.08) at the end of six months after correcting the posture, no significant difference was observed.&#x0D; Conclusion: It seems that correcting the posture while carrying and moving the patient with the help of occupational medicine, ergonomics and sports specialists can reduce musculoskeletal pain in medical workers, especially patient carriers. It was also seen that correcting posture has the fastest and greatest effect on reducing back, neck, shoulder, knee and leg pain.

User-Centered Pipeline for Synthetic Augmentation of Anomaly Detection Datasets

Automatic anomaly detection plays a critical role in surveillance systems but requires datasets comprising large amounts of annotated data to train and evaluate models. Gathering and annotating these data is a labor-intensive task that can become costly. A way to circumvent this is to use synthetic data to augment anomalies directly into existing datasets. This far more diverse scenario can be created and come directly with annotations. This however also poses new issues for the computer-vision engineer and researcher end users, who are not readily familiar with 3D modeling, game development, or computer graphics methodologies and must rely on external specialists to use or tweak such pipelines. In this paper, we extend our previous work of an application that synthesizes dataset variations using 3D models and augments anomalies on real backgrounds using the Unity Engine. We developed a high-usability user interface for our application through a series of RITE experiments and evaluated the final product with the help of deep-learning specialists who provided positive feedback regarding its usability, accessibility, and user experience. Finally, we tested if the proposed solution can be used in the context of traffic surveillance by augmenting the train data from the challenging Street Scene dataset. We found that by using our synthetic data, we could achieve higher detection accuracy. We also propose the next steps to expand the proposed solution for better usability and render accuracy through the use of segmentation pre-processing.

Questioning the "Ease" in disease: Was living with HIV a burden or boost during the first wave of Covid-19 in France? A qualitative study (COVIDHIV).

Clinical research has focused on risk factors and treatment for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), particularly in people with a comorbidity including the human immunodeficiency virus (HIV), but little attention has been paid to the care pathway. This article aims to show how living with HIV may have been a biopsychosocial burden or boost in care pathways for Covid-19. People living with HIV (PLHIV) from 9 clinical centers were invited to participate in this qualitative study. The sampling was purposive with a maximum variation in their sociodemographic profiles. Semi-structured interviews were conducted until data saturation, then coded for thematic analysis, using an inductive general approach. We interviewed 34 PLHIV of which 20 had SARS-COV-2 once. They were 24 males, 26 born in France; median age: 55. Twenty had a CD4 number above 500, and all were on antiretroviral therapy (ART). HIV appeared as a burden when Covid-19 symptoms reminded HIV seroconversion, fear of contamination, and triggered questions about ART effectiveness. HIV was not considered relevant when diagnosing Covid-19, caused fear of disclosure when participants sought SARS-COV-2 testing, and its care in hospitals was disrupted by the pandemic. ART-pill fatigue caused avoidance for Covid-19 treatment. As a boost, living with HIV led participants to observe symptoms, to get advice from healthcare professionals, and screening access through them. Some participants could accept the result of screening or a clinical diagnosis out of resilience. Some could consider ART or another drug prescribed by their HIV specialist help them to recover from Covid-19. Living with HIV could function as a burden and/or a boost in the care pathways for Covid-19, according to patients' relationship to their HIV history, comorbidities and representation of ART. Covid-19 in PLHIV needs further qualitative study to gain a more comprehensive assessment of the pandemic's consequences on their lives and coping strategies.

(227) Vaginismus - Current State of Knowledge

Abstract Introduction Vaginismus is defined as a penetration disorder in which any form of vaginal penetration is often painful or impossible. It has traditionally been referred to as an involuntary contraction of the pelvic floor muscles due to actual or anticipated pain associated with vaginal penetration. Vaginismus is predominantly unknown among clinicians and women. Vaginismus causes women to feel pain, fear and anxiety with penetration attempts. It is a poorly understood and underdiagnosed condition, for which many women do not gain support. This is due to the lack of knowledge of the condition, for the shame and embarrassment felt by vaginismus sufferers which means many do not discuss the issue. Objective Vaginismus is commonly experienced medical issue, affecting about 1–7% of the female population worldwide. Female pain is often viewed not as a medical fact, but as a misimpression or misinterpretation of bodily events. Vaginismus is not the only condition that has been placed in context of neglect. Other sexual pain disorders, such as vestibulodynia, vulvodynia and dyspareunia, have also been met with doubt and disbelief. An examination of the disbelief surrounding female reportage of their own bodily events will not only be beneficial in terms of perception of vaginismus, but also for general women’s health. Methods This systematic review will provide an assessment of the current state of vaginismus. The following databases has been searched from the study inception to July 2023: the Cochrane Central Register of Controlled Trials (Cochrane Library), PubMed, MEDLINE, Embase, Scopus, Web Of Science, ProQuest, ScienceDirect, UpToDate, Polish Medical Bibliography and consultations of Polish specialists and discussion forums of patients have been used. Results Vaginismus influences the quality of life, in the most serious form it can result in unconsumated marriage, sterility and thus can lead to the separation of a couple. When adequately approached, the problem can mostly be solved. Treatment often involves multimodal approaches such as education, medication, cognitive behavioral therapy, physical therapy and possibly surgery. Conclusions Vaginismus is a common and significant sexual problem that causes distress and frustration for both partners. There are women for whom vaginismus is a serious problem and who are not able to cope with the situation without professional help of specialists. Deepening the specialists knowledge in this field is essential for successful treatment. Vaginismus is a well recognized clinical condition associated with non-consummation and considerable distress in women. It has received little scientific attention, and further well designed studies are needed. Disclosure No.

Specialist help at hand.

Specialist help at hand.

Role of museums as a resource in learning of history at elementary level

The purpose of this research was to highlight the importance of museums as a resource in learning history at the elementary level. Museums are institutions used as evidence of historical activities. It was recognized in the 15th century to describe the concept of evidence in a form of a permanent non-profit institute. They reveal the diversity of the culture and society. Museums are the authentic source to interpret historical indications. They are used to educate people about their diversity in cultural traits, science, and history. How the museums are utilized as educational institutions. They preserved the historical happenings to explain the real picture of history. The study targets the role of museums as a resource in learning history at the elementary level. The objective of the study was to explore the academic performance of elementary school students before and after using museums as a resource. The public elementary school students were the population of research. One public school was chosen to conduct the research. The researcher adopted a quantitative approach to collect the parametric data. The research procedure consisted of three phases i.e. planning, development, and implementation phase. One group pretest-posttest design was used to conduct research. The researcher prepared a subject-based test with the help of subject specialists working in the Punjab School Education Department. A pretest was conducted before visiting the museum and a posttest was conducted after visiting the museum. Paired t-test was used to measure the academic performance of the participants. The results of the pretest-posttest indicated that museums can be utilized as a resource in learning history at the elementary level.

ЗАХІДНОЄВРОПЕЙСЬКИЙ ФАКТОР ІНДУСТРІАЛЬНОГО РОЗВИТКУ ЛУГАНЩИНИ НАПРИКІНЦІ XVIII – ПЕРШИЙ ПОЛОВИНІ ХІХ СТ.

The article researches the role of foreign specialists – Europeans in the formation of the industrial base of the Luhansk region at the end of the XVIII – the first half of the XIX century. It is noted that despite its political and scientific importance, this topic is practically not researched by representatives of Ukrainian historiography. First of all, are highlighted the activities and results of Charles Gascoigne, who in 1795 created two leading Luhansk enterprises – a coal mine in Lysychansk and a metallurgical plant in Luhansk. Are shown the reasons for the failure of the Gascoigne project, the most important of which is the lack of infrastructure that would allow the supply of industrial products from the Luhansk region to the southern region of modern Ukraine. This problem is tried to overcome with the help of foreign specialists, who proposed the organization of water communication on the Siverskyi Donets River for the transportation of industrial goods. As a result of the conducted research, the authors reached the following conclusions. The development of industry in the Luhansk region, which involved European specialists at the end of the XVIII century failed. The main reason for this failure was the lack of infrastructure to connect the Luhansk region with the southern regions of Ukraine. The proposed projects of European specialists in the organization of the river connection did not bring a positive result. Created by the voluntarist decision of the government of Catherine II, cut off from the places of supply and leading sales markets, the base of heavy industry in the Luhansk region was barely able to support itself in the first half of the XIX century, and could not provide resources and cannons during the war of 1853 – 1856. As is known, the ineffective support of the army became one of the main reasons for the humiliating defeat. The next period of industrial development of the Luhansk region (more successful) began in the 1870s and was associated with the wide involvement of private foreign capital and the active construction of railways. We will consider this aspect in the following scientific articles.

A comprehensive interdisciplinary approach to dyslexia diagnosis and correction

Relevance. Currently, despite the active development of medical technologies, the prevalence of dyslexia still remains at a significantly high level. Within the framework of this article, we propose to consider a comprehensive interdisciplinary approach aimed at solving the identified problem. Purpose: to substantiate the ef fectiveness and feasibility of using this approach in working with children of primary school age in identifying and correcting dyslexia. Methods: The study was conducted using sociological, statistical, comparative, experimental, descriptive, and analytical methods, as well as the method of expert assessments and observation. Research plan and content. During the period from January 15 to March 2, 2023, the authors of the article, together with other 27 specialists, conducted a comprehensive diag nostic examination of children aged 7 to 11 years with disorders in the development of memory, speech, mental calculation skills, and (or) writing in order to identify signs of dyslexia, as well as other developmental features and diseases. Results. Improvements in the correction of dyslexia using a comprehensive interdisciplinary approach within the framework of the authors» «Wizards and Fairies» program were achieved in 92 % of cases, of which a pronounced ef fect was achieved in 47 % (the key reason for seeking specialist help was resolved), and a partial effect — in 45 % of cases. Conclusions. When identifying signs of possible dyslexia in children, it is recommended to use a comprehensive interdisciplinary approach. During the study, this approach showed its high effectiveness: almost all children who participated in the authors» program experienced positive changes in their health, general academic performance, quality and speed of writing, reading and (or) arithmetic by the end of the program.

Analysis of a specialist service for non-pregnant women with female genital mutilation: 2008–2019

Background Female genital mutilation affects an estimated 200 million women and girls worldwide. This article examines a midwife-led service that integrates health advocates and counsellors into a model of holistic woman-centred care and was the blueprint for new national clinics opened in 2019. Methods This retrospective case note review examined referral patterns, clinical findings and interventions over 11 years at a UK specialist clinic for non-pregnant women with female genital mutilation. Results More than 2000 consultations were conducted. Two thirds of women had type 3 mutilation. Most were Somali (73.4%) with 18 other ethnic backgrounds represented. Women presented with dysuria, dyspareunia/apareunia, dysmenorrhea, recurrent infections, post-traumatic stress disorder, nightmares, flashbacks and psychosexual issues. Interventions included deinfibulation under local anaesthetic (many as same day walk-in cases), clinical reports for asylum applications and trauma counselling. One in 10 attendees were healthcare professionals/carers. Nearly 5% were refugees/asylum seekers. There were 12 safeguarding referrals, three cases of mandatory reporting duty and two protection orders. Intersectional violence was frequently reported among women of West African origin. Conclusions Significant numbers of non-pregnant women require specialist help. Innovative means to publicise clinics and routine enquiry during gynaecological consultations and GP registration, could ensure earlier signposting to services. Deinfibulation can be safely performed by an expert midwife in a community or outpatient setting.

Effectiveness of Interventions to Improve Digital Health Literacy in Forced Migrant Populations: Protocol for a Mixed Methods Systematic Review

Background Digital health literacy is considered a health determinant that can influence improved health and well-being, health equity, and the reduction of social health inequalities. Therefore, it serves as an asset for individuals to promote their health. However, low digital health literacy is a major problem among forced migrant populations. They do not always have the capacity and skills to access digital health resources and use them appropriately. To our knowledge, no studies are currently available to examine effective interventions for improving digital health literacy among forced migrant populations. Objective This paper presents the protocol for a systematic review that aims to assess the effectiveness of digital health literacy interventions among forced migrant populations. With this review, our objectives are as follows: (1) identify interventions designed to improve digital health literacy among forced migrant populations, including interventions aimed at creating enabling conditions or environments that cater to the needs and expectations of forced migrants limited by low levels of digital health literacy, with the goal of facilitating their access to and use of eHealth resources; (2) define the categories and describe the characteristics of these interventions, which are designed to enhance the abilities of forced migrants or adapt digital health services to meet the needs and expectations of forced migrant populations. Methods A mixed methods systematic review will be conducted according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) checklist. The research will be conducted in an iterative process among the different authors. With the help of a medical information specialist, a specific search strategy will be formulated for the 6 most relevant databases (ie, MEDLINE, Embase, CINAHL, Web of Science, Academic Search Premier, PsycINFO, and the Google Scholar search engine). A literature search covering studies published between 2000 and 2022 has already been conducted. Two reviewers then proceeded, individually and independently, to conduct a double selection of titles, abstracts, and then full texts. Data extraction will be conducted by a reviewer and validated by a senior researcher. We will use the narrative synthesis method (ie, structured narrative summaries of key themes) to present a comprehensive picture of effective digital health literacy interventions among forced migrant populations and the success factors of these interventions. Results The search strategy and literature search were completed in December 2022. A total of 1232 articles were identified. The first selection was completed in July 2023. The second selection is still in progress. The publication of the systematic review is scheduled for December 2023. Conclusions This mixed methods systematic review will provide comprehensive knowledge on effective interventions for digital literacy among forced migrant populations. The evidence generated will further inform stakeholders and aid decision makers in promoting equitable access to and use of digital health resources for forced migrant populations and the general population in host countries. International Registered Report Identifier (IRRID) DERR1-10.2196/50798

Bipolar Disorder and Antidepressant Associated Hypomania

The impact of antidepressant associated hypomania on monomanic depression and its relationship to bipolar disorder. This review attempts to investigate and review current research on bipolar disorder diagnosis, the neurobiological mechanisms of antidepressant-associated hypomania, risk factors, and how to manage the occurrence of this condition. Bipolar disorder is a widespread, debilitating, recurrent, variable-severity mental health condition in which the patient exhibits two different states and unpredictable mood switching. Mania, hypomania, mixed states, depression, and depression interspersed with moments of relative health are the stages of the disorder. Early identification of bipolar disorder can improve prognosis. Patients with monophasic episodes are uncommon, as the clinical manifestation of bipolar illness is unpredictable. Throughout their lives, individuals with bipolar disorder alternate between episodes of mania or hypomania and depression. Depressive episodes in bipolar disorder are referred to as bipolar depression, and the underlying core symptom is depressed mood, which are essentially identical to the diagnostic criteria and clinical symptoms of uniphasic depression, so there is a high risk of misdiagnosis during the initial visit. Patients often choose to seek specialist help during depressive episodes, and this can lead to a tendency to overlook whether a patient has bipolar disorder. Antidepressant monotherapy is contraindicated for hypomanic episodes. Antidepressants tend to induce hypomanic and manic episodes, a phenomenon known as antidepressant-associated hypomania (AAH). All antidepressant drugs may cause mania. One is drug induced mania; The other is considered a potential bipolar disorder. There is a high co-occurrence of psychiatric disorders, but only bipolar disorder, monophasic depression, and antidepressant-induced hypomanic episodes are discussed here.

Digital Patient Reported Outcome Measures Platform for Post-COVID-19 Condition and Other Long-Term Conditions: User-Centered Development and Technical Description.

Post-COVID-19 condition (PCC), colloquially known as long COVID, is a multisystem condition characterized by persistent symptoms beyond 4 weeks after the SARS-CoV-2 infection. More than 60 million people with PCC worldwide need prompt assessment, diagnosis, and monitoring, with many requiring specialist help from a multidisciplinary team of health care professionals (HCPs). Consequently, a scalable digital system is required for both people with PCC and HCPs to capture the breadth of symptoms and their impact on health, using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). We aim to develop and implement a novel PCC digital PROM (DPROM) platform for (1) securely collecting PROM and PREM data from people with PCC, (2) enabling users to monitor symptoms longitudinally and assess response to treatment, (3) generating reports for the electronic health records (EHRs), (4) providing summary reports on PCC services based on national requirements, and (5) facilitating the sharing of relevant data with authorized research teams to accelerate our understanding of this new condition and evaluate new strategies to manage PCC. We (1) undertook requirement analysis with people with PCC, HCPs, and researchers to identify the needs of the DPROM platform and determine its required functionalities; (2) designed and developed a clinically useful web portal for staff and a mobile app for patients, with a web-based alternative app to improve patient and staff choice, limit the risk of digital exclusion, and account for variability across services; (3) determined the PROMs and PREMs that PCC services would prefer to use on the platform; and (4) designed the summary report function that can be generated for each user for the EHR and for reporting to national health authorities. A DPROM platform to record PCC symptom profile, condition severity, functional disability, and quality of life, based on the C19-YRS (Yorkshire Rehabilitation Scale) and other PROMs and PREMs, was developed. Individual-level medical information and details on the COVID-19 illness can be captured systematically. The platform generates easy-to-understand scores, radar plots and line graphs for people with PCC to self-monitor their condition and for HCPs to assess the natural course of the condition and the response to interventions. Clinics can configure a suite of PROMs and PREMs based on their local and national service and commissioning requirements and support research studies which require large-scale data collection on PROMs. The DPROM platform enables automatic aggregate data analysis for services to undertake service evaluation and cost-effectiveness analysis. The DPROM platform generated summary report can be uploaded to the EHRs of people with PCC. A multifunctional DPROM platform to assess, grade, and monitor PCC has been developed. Future research will analyze the system's usability in specialist PCC clinical services and other long-term conditions.