Logbook Entries Research Articles

Characterising indoor air quality in private vehicle cabins under unprecedented traffic conditions during COVID-19 lockdown

Air pollution negatively impacts human health, yet it is rarely studied inside vehicles. This study aimed to characterise indoor air quality (IAQ) in vehicle cabins, focusing on the concentrations of key pollutants and the influence of various factors on IAQ including vehicle-specific characteristics (self-pollution), traffic intensity, ventilation type, and enclosed spaces like parking garages. It addressed a significant literature gap by using real-world driving data, a multipollutant approach, real-time monitoring, and a detailed log of influencing factors. Additionally, part of the study was conducted during the COVID-19 lockdown, providing an unprecedented opportunity to gather real-world data with reduced traffic emissions. Forty trips were conducted with four diesel vehicles of different ages and emission standards. Concentrations of VOCs, CO, CO₂, NO₂, SO₂, O₃, and PM₁, PM₂.₅, PM₁₀, and TSP were monitored, alongside detailed logbook entries. This study evidenced the formation of O₃ inside vehicle cabins under conditions of high NO₂ and/or VOC concentrations and direct sunlight, a phenomenon not previously reported. Results also showed that IAQ inside vehicle cabins depended largely on vehicle-specific factors, the surrounding environment, and indoor-outdoor air exchange. CO, NO₂, SO₂, and PM levels varied mainly with the external environment and air exchange, while CO₂ levels were influenced primarily by ventilation settings. The concentrations of certain pollutants exceeded reference levels for indoor environments, potentially posing health risks to occupants. Further research is needed to study the pioneer evidence of O3 formation and to develop a comprehensive health risk assessment, thereby contributing to developing specific IAQ guidelines for vehicles.

Formative assessment in physical education: teachers’ experiences when designing and implementing formative assessment activities

Formative assessment (FA) is an effective educational approach for optimising student learning and is considered as a promising avenue for assessment within physical education (PE). Nevertheless, implementing FA is a complex and demanding task for in-service PE teachers who often lack formal training on this topic. To better support PE teachers in implementing FA into their practice, we need better insight into teachers’ experiences while designing and implementing formative strategies. However, knowledge on this topic is limited, especially within PE. Therefore, this study examined the experiences of 15 PE teachers who participated in an 18-month professional development programme. Teachers designed and implemented various formative activities within their PE lessons, while experiences were investigated through logbook entries and focus groups. Findings indicated various positive experiences, such as increased transparency in learning outcomes and success criteria for students as well as increased student involvement, but also revealed complexities, such as shifting teacher roles and insufficient feedback literacy among students. Overall, the findings of this study underscore the importance of a sustained, collaborative, and supported approach to implementing FA.

The Role of Wonder in Students’ Conception of and Learning About Evolution

Learning about evolution can be challenging for students, as a full understanding may require them to see the world in new ways, to master a disciplinary language and to understand complex processes. Drawing on a long line of theoretically grounded arguments of philosophers and researchers for including wonder in science teaching, we report on the results of an empirical study with the primary aim of investigating the role of wonder in students’ learning about evolution. The study was carried out through a formative intervention in which two researchers in science education collaborated with a seventh-grade teacher. Over a period of six weeks, 45 students participated in lessons and workshops aimed at eliciting a sense of wonder in relation to concepts that are known to impact the learning of evolution. We incorporated four ‘triggers’ to elicit students’ wonder in the science class: aesthetic experiences, defiance of expectations, agency and awareness of a mystery within the ordinary. Logbook entries and interviews with student pairs provided empirical material for a qualitative analysis of the role of wonder in the students’ meaning-making about, learning of and engagement in evolution. The results show that it is possible to design science teaching that triggers students’ wonder in relation to an intended learning object. The results also reveal that the participating students described their sense of wonder in qualitatively different ways and that they still struggled to make sense of the concept of evolution after six weeks of teaching.

Prevalence of food thermometers usage and temperature control in restaurants in Dammam, Saudi Arabia.

The Saudi Ministry of Municipal and Rural Affairs is planning to initiate a hazard analysis critical control point (HACCP) system in restaurants and cafeterias to manage issues of food safety in Saudi Arabia. One of the most important elements in the HACCP system is the monitoring temperature of cooked and stored food. The present study aimed to investigate the prevalence and use of refrigerators/freezers and food thermometers among food handlers in local and international restaurants in Dammam, Saudi Arabia. A cross-sectional study was conducted in municipality-licensed restaurants. The temperatures of refrigerator and freezer were checked, and the survey form was completed by the researcher according to logbook entries. We then checked for the presence of a food thermometer, and if a functional thermometer was present, the chef was asked to complete an online questionnaire using Survey Monkey website on a tablet. The response rate of the survey was 68% (238/350 restaurants). We found that 88.1% of restaurants used a thermometer to check the temperature of their refrigerators and freezers. Thirty-one restaurants (13.0%) had a regular temperature-monitoring record available for both the refrigerator and freezer. International restaurants had significantly greater temperature-monitoring data than local restaurants (88.1% vs 63.3%; p= .0001). The prevalence of food thermometers in restaurants was 53.4% (127/238 restaurants), with significantly higher prevalence in international restaurants than in local restaurants (96.6% vs 10.8%; p= .0001). The practice of using food thermometer "always" when meat turned brown was significantly associated with the chef's age and education level. The study results showed poor monitoring and documentation of refrigerator and freezer temperatures along with a low prevalence of food thermometer use. The study result provides an insight into one of the barriers to the implementation of the HACCP system in Dammam.

Towards Finding the Impact of Deep Learning in Educational Time Series Datasets – A Systematic Literature Review

Besides teaching in the education system, instructors do a bunch of background processes such as preparing study material, question paper setting, managing attendance, log book entry, student assessment, and the result analysis of the class. Moreover, Learning Management System(LMS) is mandatory if the course is online. The Massive Open Online Course (MOOC) is an example of the worldwide online education system. Nowadays, educators are using Google to efficiently formulate study material, question papers, and especially for self-preparation. Also, student assessment and result analysis tools are available to get instant results by feeding student data. Artificial Intelligence (AI) is driving behind these applications to deliver the most precise outcome. To accomplish that, AI requires historical data to train the model, and this sequential (year-wise, month-wise, etc) information is called time series data. This Systematic Literature Review (SLR) is conducted to find the contribution of time series algorithms in Education. There are enormous changes in algorithm architecture analogized to the traditional neural network to endure all kinds of data. Though it significantly raises the performance, it expands the complexity, resources, and execution time as well. Due to this, comprehending the algorithm architecture and the method of the execution process is a challenging phase before creating the model. But it is essential to have enough knowledge to select the suitable technique for the right solution. The first part reviews the time series problems in educational datasets using Deep Learning(DL). The second part describes the architecture of the time series model, such as the Recurrent Neural Network (RNN) and its variants called Long-Short Term Memory (LSTM) and Gated Recurrent Unit (GRU), the differences between each other, and the classification of performance metrics. Finally, the factors affecting the time series model accuracy and the significance of this work are summarized to incite the people who desire to initiate the research in educational time series problems.

Analysis of 983 civilian blast and ballistic casualties and the generation of a template of injury burden: An observational study.

SummaryBackgroundTerrorism and armed conflict cause blast and ballistic casualties that are unusual in civilian practice. The immediate surgical response to mass casualty events, with civilians injured by these mechanisms, has not been systematically characterised. Standardising an approach to reacting to these events is challenging but is essential to optimise preparation for them. We aimed to quantify and assesses the surgical response to blast and ballistic injuries managed in a world-class trauma unit paradigm.MethodsThis was an observational study conducted at the UK-led military Medical Treatment Facility, Camp Bastion, Afghanistan from original theatre log-book entries between Nov 5, 2009, and Sept 21, 2014; a total of 10,891 consecutive surgical cases prospectively gathered by surgical teams were catalogued. Patients with combatant status/wearing body-armour to various degrees including interpreters were excluded from the study. Civilian casualties that underwent primary trauma surgery for blast and ballistic injuries were included (n=983). Surgical activity was analysed as a rate per 100 casualties, and patients were grouped according to adult vs. paediatric and ballistic vs. blast injury mechanisms to aid comparison.FindingsThe three most common surgical procedures for civilian blast injuries were debridement, amputation, and laparotomy. For civilian ballistic injuries, these were debridement, laparotomy and vascular procedures. Blast injuries generated more amputations in both adults and children compared to ballistic injuries. Blast injuries generated more removal of fragmentation material compared to ballistics injuries amongst adult casualties. Ballistic injuries lead to more chest drain insertions in adults. As a rate per 100 casualties, adults injured by blast underwent significantly more debridement (63·5); temporary skeletal stabilisation (13·2) and vascular procedures (12·8) compared to children (43·4, z=4·026, p=0·00007; 5·7, z=2·230, p=0·022; 4·9, z=2·468, p=0·014). Adults injured by ballistics underwent significantly more debridement (63·4); chest drain (12·3) and temporary skeletal fixation procedures (11·4) compared to children (50·0, z=2·058, p=0.040, p<0·05; 2·9, z=2·283, p=0.0230; 2·9, z=2·131, p=0.034 respectively). By comparison, children injured by ballistics underwent significantly more removal of fragmentation and ballistic materials (20·6) when compared to adults (7·7, z=−3·234; p=0.001).InterpretationThis is the first evidence-based, template of the immediate response required to manage civilians injured by blast and ballistic mechanisms. The template presented can be applied to similar conflict zones and to prepare for terror attacks on urban populations.FundingThe work was supported in part by a grant to LM from School of Medicine, University of St Andrews.

Remote Follow-up of Self-isolating Patients With COVID-19 Using a Patient Portal: Protocol for a Mixed Methods Pilot Study (Opal-COVID Study).

BackgroundPeople with COVID-19 are instructed to self-isolate at home. During self-isolation, they may experience anxiety and insufficient care. Patient portals can allow patients to self-monitor and remotely share their health status with health care professionals, but little data are available on their feasibility.ObjectiveThis paper presents the protocol of the Opal-COVID Study. Its objectives are to assess the implementation of the Opal patient portal for distance monitoring of self-isolating patients with COVID-19, identify influences on the intervention’s implementation, and describe service and patient outcomes of this intervention.MethodsThis mixed methods pilot study aims to recruit 50 patient participants with COVID-19 tested at the McGill University Health Centre (Montreal, Canada) for 14 days of follow-up. With access to an existing patient portal through a smartphone app, patients will complete a daily self-assessment of symptoms, vital signs, and mental health monitored by a nurse, and receive teleconsultations as needed. Study questionnaires will be administered to collect data on sociodemographic characteristics, medical background, implementation outcomes (acceptability, usability, and respondent burden), and patient satisfaction. Coordinator logbook entries will inform on feasibility outcomes, namely, on recruitment, retention, and fidelity, as well as on the frequency and nature of contacts with health care professionals. The statistical analyses for objectives 1 (implementation outcomes), 3 (service outcomes), and 4 (patient outcomes) will evaluate the effects of time and sociodemographic characteristics on the outcomes. For objectives 1 (implementation outcomes) and 4 (patient outcomes), the statistical analyses will also examine the attainment of predefined success thresholds. As for the qualitative analyses, for objective 2 (influences on implementation), semistructured qualitative interviews will be conducted with 4 groups of stakeholders (ie, patient participants, health care professionals, technology developers, and study administrators) and submitted for content analysis, guided by the Consolidated Framework for Implementation Research to help identify barriers to and facilitators of implementation. For objective 3 (service outcomes), reasons for contacting health care professionals through Opal will also be submitted for content analysis.ResultsBetween December 2020 and March 2021, a total of 51 patient participants were recruited. Qualitative interviews were conducted with 39 stakeholders from April to September 2021. Delays were experienced owing to measures taken at the McGill University Health Centre to address COVID-19. The quantitative and qualitative analyses began in May 2022. As of June 2022, a total of 2 manuscripts (on the implementation and the patient outcomes) were being prepared, and 3 conference presentations had been given on the study’s methods.ConclusionsThis protocol is designed to generate multidisciplinary knowledge on the implementation of a patient portal–based COVID-19 care intervention and will lead to a comprehensive understanding of feasibility, stakeholder experience, and influences on implementation that may prove useful for scaling up similar interventions.Trial RegistrationClinicalTrials.gov NCT04978233; https://clinicaltrials.gov/ct2/show/NCT04978233International Registered Report Identifier (IRRID)DERR1-10.2196/35760

Assessing Participation: Toward Long-Term Experiences, Trajectories and Maturity

Building knowledge on participation successes and failures is essential to enhance the overall quality and accountability of participatory processes. This paper relates to participatory assessment conducted in four cities, where 12 participatory workshops were organized, bringing together more than 230 participants. On-the-spot feedback was collected from the participants and generated 203 logbook entries, which helped define participant-related variables. Those variables in turn unfolded unique participatory trajectories for each participant. Four retrospective focus groups were then organized to bring qualitative, in-depth understanding to the participants’ expectations and (dis)satisfactions all along the participatory processes. On the basis of these empirical data, we developed a contextual, analytical tool to review participation in a longitudinal way. This qualitative tool articulates several intertwined influences: the level of satisfaction, the level of expectations and participatory background from the participants’ perspectives, as well as the participatory maturity from the organizing agency’s perspective. We argue that evaluating participation in the long term and in a transversal way, focusing on agencies’ and participants’ trajectories rather than uniquely on on-the-spot experiences, provides additional meaning to criteria applied to participation evaluation and teaches us more about participation quality and efficiency than repeated assessments of disconnected and isolated initiatives.

Use of an Electronic Medication Management Support System in Patients with Polypharmacy in General Practice: A Quantitative Process Evaluation of the AdAM Trial.

Polypharmacy is associated with a risk of negative health outcomes. Potentially inappropriate medications, interactions resulting from contradicting medical guidelines, and inappropriate monitoring, all increase the risk. This process evaluation (PE) of the AdAM study investigates implementation and use of a computerized decision-support system (CDSS). The CDSS analyzes medication appropriateness by including claims data, and hence provides general practitioners (GPs) with full access to patients’ medical treatments. We based our PE on pseudonymized logbook entries into the CDSS and used the four dimensions of the Medical Research Council PE framework. Reach, which examines the extent to which the intended study population was included, and Dose, Fidelity, and Tailoring, which examine how the software was actually used by GPs. The PE was explorative and descriptive. Study participants were representative of the target population, except for patients receiving a high level of nursing care, as they were treated less frequently. GPs identified and corrected inappropriate prescriptions flagged by the CDSS. The frequency and intensity of interventions documented in the form of logbook entries lagged behind expectations, raising questions about implementation barriers to the intervention and the limitations of the PE. Impossibility to connect the CDSS to GPs’ electronic medical records (EMR) of GPs due to technical conditions in the German healthcare system may have hindered the implementation of the intervention. Data logged in the CDSS may underestimate medication changes in patients, as documentation was voluntary and already included in EMR.

The Effects of Introducing a Mobile App-Based Procedural Logbook on Trainee Compliance to a Central Venous Catheter Insertion Accreditation Program: Before-and-After Study.

BackgroundTo reduce complications associated with central venous catheter (CVC) insertions, local accreditation programs using a supervised procedural logbook are essential. To increase compliance with such a logbook, a mobile app could provide the ideal platform for training doctors in an adult intensive care unit (ICU).ObjectiveThe aim of this paper was to compare trainee compliance with the completion of a logbook as part of a CVC insertion accreditation program, before and after the introduction of an app-based logbook.MethodsThis is a retrospective observational study of logbook data, before and after the introduction of a purpose-built, app-based, electronic logbook to complement an existing paper-based logbook. Carried out over a 2-year period in the adult ICU of the John Hunter Hospital, Newcastle, NSW, Australia, the participants were ICU trainee medical officers completing a CVC insertion accreditation program. The primary outcome was the proportion of all CVC insertions documented in the patients’ electronic medical records appearing as logbook entries. To assess logbook entry quality, we measured and compared the proportion of logbook entries that were approved by a supervisor and contained a supervisor’s signature for the before and after periods. We also analyzed trainee participation before and after the intervention by comparing the total number of active logbook users, and the proportion of first-time users who logged 3 or more CVC insertions.ResultsOf the 2987 CVC insertions documented in the electronic medical records between April 7, 2019, and April 6, 2021, 2161 (72%) were included and separated into cohorts before and after the app’s introduction. Following the introduction of the app-based logbook, the percentage of CVC insertions appearing as logbook entries increased from 3.6% (38/1059) to 20.5% (226/1102; P<.001). There was no difference in the proportion of supervisor-approved entries containing a supervisor’s signature before and after the introduction of the app, with 76.3% (29/38) and 83.2% (188/226), respectively (P=.31). After the introduction of the app, there was an increase in the percentage of active logbook users from 15.3% (13/85) to 62.8% (54/86; P<.001). Adherence to one’s logbook was similar in both groups with 60% (6/10) of first-time users in the before group and 79.5% (31/39) in the after group going on to log at least 3 or more CVCs during their time working in ICU.ConclusionsThe addition of an electronic app-based logbook to a preexisting paper-based logbook was associated with a higher rate of logbook compliance in trainee doctors undertaking an accreditation program for CVC insertion in an adult ICU. There was a large increase in logbook use observed without a reduction in the quality of logbook entries. The overall trainee participation also improved with an observed increase in active logbook users and no reduction in the average number of entries per user following the introduction of the app. Further studies on app-based logbooks for ICU procedural accreditation programs are warranted.

An Investigation on the Learners' Perceptions and Experiences in Engaging with Online Writing Lessons Conducted via Google Classroom

This study aims to examine the learners’ perception and experiences in engaging in writing lesson conducted via Google Classroom among the secondary school learners in Malaysia and China. This study is important for both the teachers and stakeholders to identify the suitable types of writing activities that can be used in a Google classroom platform to motivate the learners to be interested in writing and the ways to solve the problems faced by the learners when it involves writing lesson via e learning. This study focuses on five learners; three learners from Malaysia and two learners from China. This study employed a qualitative approach. The instruments were interview questions and guided logbook journals. The sessions were conducted via Google Meet and the recorded interviews were then transcribed. Hence, researchers used qualitative method to analyse the codes and categories to pen down the findings. As a result, both China and Malaysia learners expressed their affirmative agreement towards their participation in writing classes conducted using Google classroom. Moreover, based on the log book entries, it was discovered that the features embedded in Google classroom platform plays an important role in the teaching and learning process, mainly in submissions and feedbacks. Finally, the learners agree that Google classroom has improved their writing ability to a certain extend. Although the learner faced some hiccups in utilizing this method of e-learning but all participants were affirmative that Google Classroom has instilled confidence and stimulated their motivation to write better essays.

Medical students using the technique of 55-word stories to reflect on a 6-week rotation during the integrated primary care block

Background. Reflection and reflective practice are identified as a core competency for graduates in health professions education. Students are expected to be in a position to process experiences in a variety of ways through reflective learning. In doing so, they can explore the understanding of their actions and experiences, and the impact of these on themselves and others. Objectives. To draw on 5-weekly reflections by final-year medical students during the integrated primary care block placement. These reflections explore the learning that occurred during the rotation and the change in experiences during this period, and illustrate the use of reflection as a tool to support the development of professional practice. Methods. This descriptive qualitative study analysed students’ 55-word reflective stories during a 6-week preceptorship in either a rural or urban primary healthcare centre. The writing technique of short 55-word reflective stories was used to record student experiences. Inductive thematic analysis was conducted using MAXQDA software. This involved identifying the most commonly used words for each week through a word cloud, highlighting each week’s most notable focus for learning to generate themes and sub-themes. Results. Analysis of 127 logbook entries generated 464 stories on a range of experiences that had a significant impact on learning. Students’ reflections in the first 2 weeks were linked to personal experiences and views about the block. In subsequent weeks, reflections focused on the individual responses of students to the learning experiences regarding the curriculum, patient care, ethics, professionalism and the health system. Conclusions. The reflections highlighted the key learning experiences of the medical students and illustrated how meaning is constructed from these experiences. The 55-word stories as a reflection tool have potential to support reflection for students, and provide valuable insight into medical students’ learning journey during their clinical training.

The role of technology in assessment, documentation, and tracking of clinical competencies in radiography education

The role of technology in assessment, documentation, and tracking of clinical competencies in radiography education

621 Impact Of COVID-19 On Surgical Training at A District General Hospital in London

IntroductionCOVID 19 affected surgical training owing to changes in rotations, moving trusts/departments, surgical skills acquisition and new guidelines/protocols during unprecedented times. Aim was to infer how redeployment impacted surgical skills via an objective and subjective study.MethodA retrospective observational study comparing lead surgeons in Laparotomy and Appendectomies between 23rd March- 31st July (2019/2020). A subjective survey was done to elucidate perspectives on skill, academic advancement and trust/deanery support. A focussed group discussion was also done to gain insight on physical and psychological well-being.ResultsLaparotomy 2019 (n = 75) had 59%; 41%; 0% - Consultants/Registrars/ fellows respectively as lead surgeons. 2020 Laparotomies (n = 50) had 40% consultants; 41% registrars; 20% fellowsSimilarly, Appendectomy 2019 (n = 94) had 8.5% consultants; 71.3% registrars; 3.2% clinical fellows, whereas 2020 Appendectomies (n = 67) had 18% consultants; 71.6% registrars and 10.4% fellows.The Likert questionnaire showed 42.86% had mental exhaustion, less confidence/skills due to lesser opportunities/procedures. 57.14% expressed COVID 19 extremely affected surgical training while 28.14% believed in a reduction of 81-100% operative log book entries from before.ConclusionsAlthough, the results were not significant in number of cases managed by trainees; many reported perceived loss of training( log book/portfolio), less teaching/training opportunities and mental exhaustion.

Comparison of home-based pencil push-up therapy and office-based orthoptic therapy in symptomatic patients of convergence insufficiency: a randomized controlled trial.

To assess and compare the effectiveness of home-based pencil push-up therapy (PPT) and office-based orthoptic therapy (OBOT) in patients with convergence insufficiency. In this randomized clinical trial, 176 symptomatic patients with convergence insufficiency, aged between 9 to 30years, were randomly assigned to receive 6weeks of home-based PPT (Group I) or OBOT (Group II) after determining refractive error, near point of convergence (NPC), convergence insufficiency symptom survey (CISS) score, near phoria and positive fusional vergences (PFV) at near. The participants of Group I underwent home-based PPT (pencil push-ups exercises15 minutes per day, daily for 6weeks) and those of Group II OBOT (convergence fusional exercises on synoptophore for 20min per day, 3days a week, for 6weeks) without home reinforcement. Patients were re-examined at 3 and 6weeks after initiation of treatment. NPC and CISS score were the primary and secondary outcome measures, respectively. Statistical analysis was performed with the independent samples t-test, Friedman test and the analysis of variance (ANOVA). Statistical significance was indicated by p-value < 0.05. Participants of both the groups had statistically significant improvement in NPC, CISS score, PFV and near phoria (p < 0.001), but there was no statistically significant difference between the two groups (p > 0.05). However, patients of Group II had significantly better PFV after final visit than those of Group I (p < 0.001). Home-based PPT with good suppression control and with compliance ensured by log book entries, is a simple, cheap, less time consuming and comparably effective alternative to more expensive OBOT for patients suffering from CI. CTRI registration number: REF/2016/11/012,732, Date of registration 25/04/ 2016, Retrospectively Registered.

An Architecture to Facilitate Security Assurance and Legal Compliance for Call Auditing in the Wholesale Electricity Market

The auditability of telephone call records plays an essential governance role in the electricity industry in Australia as non-compliance with the Australian National Electricity Rules can lead to financial charges and result in developing a poor reputation. The existing telephone call recording processes using manual logbook entries or a recording system without verification and auditing capabilities are labour-intensive and prone to human error. This study is motivated to address this real-world problem by designing a system that streamlines telephone call audit processes. This can be verified with digital technologies to meet security requirements as well as legal requirements stipulated by the Australian National Electricity Rules. In meeting security and legal compliance requirements of the Australian National Electricity Rules, this study develops a novel approach using the Clark-Wilson Integrity Model and blockchain technology for an automatic telephone call audit system with security provisions to prevent unauthorized access to and manipulation of telephone call records nationally. Although the application of blockchain has generated great interest in other areas, few studies have been conducted on its application to auditing. This study uses the Clark-Wilson Integrity Model to verify metadata records’ integrity at the systems where metadata are generated. The proposed architectural design not only enhances data integrity and confidentiality but also enables the automatic execution of telephone call audit processes for auditors. The auditing system we propose presents a higher level of security compared to the existing system.

Usefulness of YouTube™ videos in training patients for blood glucose self-monitoring in current coronavirus disease-19 pandemic

Objectives:During the coronavirus disease-19 pandemic, due to restricted health-care access, patients may not get hands-on training for self-monitoring of blood glucose (SMBG) from physicians. YouTube™ is a popular video-sharing web platform that can be used as a source of information for SMBG. This study aimed to assess the usefulness of YouTube™ videos on SMBG.Material and Methods:We searched the keywords “blood glucose self-monitoring,” “home blood glucose monitoring,” “blood glucose test,” and “blood sugar test” on YouTube™. The first 40 videos of each search were listed. After the two-stage screening, 49 videos were included for final data analysis. General characteristics and SMBG-specific characteristics (namely, strip handling, lancing device handling, measurement, and post- measurement action) were observed with pre-defined criteria having “yes” and “no” closed option. Data were tested statistically by the binomial test.Results:Average duration of 49 videos was 244.20 ± 72.61 s and those were online since 35.14 ± 20.52 months on YouTube™. Information about strip handling was mostly deficient, major being checking the expiry date (16.33% videos had the information). The handling of the lancing device was correct in the majority of the videos except for the disinfection of the tip of the lancing device (6.12% videos had the information). The measurement procedure was also correct in the majority of the videos except for the instruction to dry the hands (38.78% videos had the information) after washing. The post-measurement logbook entry was found in 48.98% videos.Conclusion:YouTube™ videos can be used as a potential source of information for patients’ education for SMBG. However, there are various levels of the incompleteness of the tutorials. Primary care physicians may suggest YouTube™ videos after exploring the videos and selecting the most appropriate one for their patients.

Evaluating mandatory reporting of marine turtle bycatch in Atlantic Canadian fisheries

Incidental capture of rare, threatened, and endangered marine species in commercial fisheries has prompted regional, national, and international monitoring and mitigation efforts with varying levels of success. Here we use leatherback sea turtle (Dermochelys coriacea) reports to evaluate federally-mandated Species at Risk Act (SARA) logbooks for reporting commercial fishing interactions with endangered species in Atlantic Canada. 503 leatherbacks were reported in SARA logbooks from 2006 to 2017. The majority of these (93%) corresponded to turtles captured in pelagic longline fisheries targeting swordfish and tunas. The remainder were reported from crab (1.2%), groundfish (1%), lobster (1.6%), mackerel (0.4%), whelk (2.6%), and herring (0.2%) fisheries, although fishing effort, gear configurations, and varying levels of observer coverage introduce biases that obscure conclusions about relative turtle-fishery interaction rates. Of 79 leatherback interactions with pelagic longlines reported by fisheries observers from 2006 to 2017, only 34% were documented in a corresponding SARA logbook entry. This finding, coupled with other sources of data which confirm regular bycatch of leatherbacks in Atlantic Canada, indicates that SARA logbooks, in their present form, underestimate true turtle-fishery interaction rates. Inconsistencies in SARA logbook requirements and reporting formats between management regions may further hinder the efficacy of this reporting tool. Potential improvements to the existing SARA logbook program are suggested; however, given the many limitations inherent in this type of reporting mechanism, alternative approaches to documenting bycatch of not only turtles, but other at-risk species, may ultimately prove more effective.

Is it all about the haul? Pelagic false killer whale interactions with longline fisheries in the central North Pacific

Pelagic false killer whales (Pseudorca crassidens) are killed or seriously injured in the Hawai‘i-based deep-set longline fishery more than any other cetacean, with bycatch regularly exceeding allowable levels. Telemetry data from five satellite-tagged whales (from three groups) and longline logbook entries (4182 sets) from the Hawai‘i-based longline fisheries are used to assess the range of the population and potential interactions with longline gear. A switching state-space model with a 4 -h time step was used to assess the behavior of the tagged whales. Two of the groups remained within the U.S. EEZ surrounding the Northwestern Hawaiian Islands, while one group spent 87.5 % of its time in international waters to the east of the Hawaiian archipelago. Tagged whales came within 100 km of only 26 sets over the 184 days of tag data, with only two of the three groups coming within 50 km of a set. Only twice were whales (from only one group) known to approach closely enough to interact with gear, during two series of three deep-sets, with only one of the six sets recording no catch (indicating probable catch depredation). Movement towards the sets was most dramatic during the haul phase, in one case the tagged whales moved almost 100 km towards the gear in 7 h. During one set in each of the two interactions, whale behavior changed to ‘area restricted search’ (indicative of foraging) during periods that overlapped with hauling of the gear. Overall, our results show that pelagic false killer whales spend a relatively small proportion of their time interacting with U.S. longline gear, and suggest that hauling gear may be an important cue initiating interactions.

Outcome Measurement at a Ugandan Referral Hospital: Validation of the Mbarara Surgical Services Quality Assurance Database.

Five billion people lack access to surgery. Accurate and complete data have been identified as essential to the global scale-up of perioperative care. This study retrospectively validates the Mbarara Surgical Services Quality Assurance Database (SQUAD), an electronic outcomes database at a Ugandan secondary referral hospital. SQUAD data were compared to paper records from August 2013 to January 2017. To assess data entry accuracy, two researchers independently extracted 24 patient variables from 170 charts. To assess completeness of patient capture, SQUAD entries were compared to a sample of charts returned to the Medical Records Department, and to a sample of entries in ward and operating room logbooks. Two-tailed binomial proportions with 95% CI were calculated from the comparative results of patient observations, against a predefined accuracy of 0.85-0.95. Agreement between completed validation observations from charts and SQUAD data was 91.5% (n = 3734/4080 data points). Binomial tests indicated that 15 variables had higher than 95% accuracy. A total 19 of 24 variables had ≥ 85% accuracy. The completeness of SQUAD patient capture was 98.2% (n = 167/170) of charts returned to the Medical Records Department, 97.5% (n = 198/203) of operating logbook entries, and 100% (n = 111/111) of ward logbook entries, respectively. SQUAD closely reflects the primary surgical and anaesthetic data at a Ugandan secondary hospital. Data accuracy of key variables and completeness of population capture were comparable to those of databases in high-income countries and outperformed those of other low- and middle-income countries.