Mobile Teams Research Articles

Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study

Background:Essential workers are at increased risk for SARS-CoV-2 infection. We aimed to estimate the yield, acceptability and cost of systematic workplace-based testing of asymptomatic essential workers for SARS-CoV-2 infection.Methods:From Jan. 27 to Mar. 12, 2021, we prospectively recruited non–health care essential businesses in Montréal, Canada, through email or telephone contact. Two trained mobile teams, each composed of 2 non–health care professionals, visited businesses. Consenting asymptomatic employees provided saline gargle samples under supervision. Samples were analyzed by means of reverse transcription polymerase chain reaction (RT-PCR). At businesses with outbreaks (≥ 2 participants with a positive result), we retested all participants with a negative result on initial testing. Our primary outcomes were yield (proportion of test results that were positive), acceptability (proportion of participants estimated to be present at the business who agreed to participate) and costs (including training, sample collection and analysis, and communicating results). Our secondary outcome was identification of factors associated with a positive test result on multivariable logistic regression.Results:Of the 366 businesses contacted, 69 (18.8%) agreed to participate. Nineteen businesses (28%) were manufacturers or suppliers, 12 (17%) were in auto sales or repair, and 11 (16%) were in childcare; the corresponding number of employees was 1225, 242 and 113. The median number of participants per business was 13 (interquartile range [IQR] 8–22). Of an estimated 2348 employees on site, 2128 (90.6%) participated (808 [38.0%] female, median age 48 [IQR 37–57] yr). Of the 2626 tests performed, 53 (2.0%) gave a positive result. Self-reported nonwhite ethnicity (adjusted odds ratio [OR] 3.7, 95% confidence interval [CI] 1.4–9.9) and a negative SARS-CoV-2 test result before the study (adjusted OR 0.4, 95% CI 0.2–0.8) were associated with a positive test result. Five businesses were experiencing an outbreak; at these businesses, 40/917 participants (4.4%) had a positive result on the initial test. We repeated testing for employees with initially negative results at 3 of these businesses over 2–3 weeks: 8/350 participants (2.3%) had a positive result on the second test, and none had a positive result on the third and fourth tests; no employer reported new positive results after our final visit (up to Mar. 26, 2021). At the remaining 64 businesses, 1211 participants were tested once, of whom 5 (0.4%) had a positive result. The per-person RT-PCR cost was $34, and all other costs, $8.67.Interpretation:On-site saline gargle sampling of essential workers for SARS-CoV-2 testing was acceptable and of modest cost, and appears most useful in the context of outbreaks. This sampling strategy should be evaluated further as a component of efforts to prevent SARS-CoV-2 transmission. Preprint:medRxiv — doi:10.1101/2021.05.12.21256956

Alternative ways to introduce resuscitation at the prehospital stage in emergency conditions

Annotation. Objective – carrying out a comparative assessment of the advantages and disadvantages of intravenous (IV) and intraosseous (IO) resuscitation, which are used by emergency and emergency teams in the Vinnytsia region. The work used statistical data of the Vinnytsia Regional Center for Emergency Medical Care and Disaster Medicine for the period 2019-2021, carry through content analysis of domestic and foreign scientific sources, applied biblio-semantic, analytical, and statistical methods for studying the use of intraosseous and intravenous methods in emergency cases. According to the Vinnytsia Regional Center for Emergency Medical Care and Disaster Medicine for the three years 2019-2021. we observe a low percentage of use of intraosseous access 0,2% - 0,1%, respectively. In the event of an accident in the patient's condition “without changes” a total of 786 injections were carried out both intravenously and intraosseously. In 2019, out of the total number, non-infusion therapy was performed in 71,0% of male patients and 11,1% of female patients, and 11,2% intraosseously only in male patients. Compared to 2020, only 0,3% intraosseously (2 female patients) and in 2021, no intraosseous resuscitation was performed at all. In a state of “deterioration” during an accident (road accident, etc.) for 2019, 87,5% of men and 12,5% of women were injected with drugs intravenously; for 2020, 50% for both males and 50% for females were infused intravenously; for 2021, 87,5% of men and 12,5% of women underwent intravenous resuscitation, intraosseous resuscitation was never performed, provided that the condition of patients worsened. And “death in the presence” occurred during resuscitation for 2019 88,8% (of which 77,7% for men and 11,1% for women) by intravenous access and 11.2 VC (males); for 2020 88,9% intravenously (of which 72,2% for men and 16,7% for women) and 11,1% intraosseously (of which 1 male and 1 female article); in 2021, 65,0% of intravenous access was performed for men and 25,0% for women, while no patient received intraosseous access. In case of a sudden illness, the percentage of intraosseous resuscitation in the state of “deterioration” was as follows: for the period 2019-2021. no intraosseous access was performed. In the state of “death in the presence” for 2019, intraosseous infusion was 3,4%; 2020 – 3,8%; 2021 – 1,9%. Thus, the intraosseous method has several undeniable advantages compared to the intravenous one, but in Ukraine, it is little used in the practice of mobile emergency medical teams with a syringe gun (connector – BLG), both considering the age characteristics: for adults (blue) and children (red color) and prescribed in the fundamental algorithms of clinical/modern protocols for the treatment of circulatory arrest due to insufficient practical and theoretical skills of medical personnel of emergency teams. The analysis of the use of intraosseous methods in emergency medical care gave impetus to conducting theoretical and practical classes for future doctors to master skills and reduce prehospital and early hospital mortality in patients with complement fixation reactions.

542 Mobile Burn Response Teams: A Scoping Review

IntroductionAdvancements in the treatment of burns have reduced morbidity. However, the resources needed to deliver up-to-date care may be overwhelmed by mass casualty disasters. In 2021, the World Health Organization (WHO) recommended that countries prepare teams of deployable burn experts to assist with responding to a mass casualty disaster including burn patients. The aim of this scoping review was to identify existing literature regarding burn management mobile response team organization, describe the reported effectiveness of these teams, identify challenges in adopting the WHO recommendations and consider how the recommendations may be evolved.MethodsWe conducted a scoping review of all literature types published up to February 2021. Searches of MEDLINE, EMBASE, Scopus, and CINAHL databases were conducted to identify reports informing or reporting the use of mobile burn care specialty teams that respond to events resulting in multiple burn-injured victims, including pediatric victims and military response to civilian events.ResultsOf 5,737 identified reports, 24 publications were reviewed. Three distinct types of mobile burn response teams were identified: 1) teams organized by burn care networks; 2) government-organized medical disaster teams with burn-specific experts, and 3) the US Army Burn Flight Team. Teams have responded to events such as terrorist attacks by providing specialized burn supplies and personnel. Mobile burn response teams have demonstrated expert triage and stabilization advantages but are limited by the number of deployable specialists. A challenge in deploying a mobile team is the removal of experts from a burn centre.ConclusionsAlthough the WHO recommends increasing the number of mobile burn response teams available around the world, few countries have implemented this recommendation. A hybrid model where responders on scene communicate with burn centre experts to manage triage may address these challenges.

COVID-19 innovative mobile strategy of test and care among homeless people in Marseille

Homeless people are particularly at risk of becoming infected with COVID-19 because their precarious living conditions make prevention measure difficult. We describe an innovative approach with the aim of implementing testing and monitoring adapted to the needs of the homeless people of Marseille (inhabitants of slums, squats or those living on the street). The intervention included 1) the coordination of 18support organizations for homeless people, 2) the training and the provision of rapid serological and antigenic tests, 3) a mobile outreach team with community mediators in order to provide tests, including COVID-19 PCR on point of care, prevention and monitoring of positive cases. Acceptability of the intervention by participants, field organization was good. The lack of adapted places of accommodation was an important restricting factor for optimal care and support. The emergence of COVID-19 has highlighted discontinuities in health care among homeless people. Specific mobile outreach teams could limit the impact on this high-risk population.

Knowledge of residents about delirium and its management in the elderly and restless patient

Résumé La confusion est fréquente et grave chez le sujet âgé hospitalisé, alors qu'elle est souvent évitable. Plusieurs études sur les connaissances des infirmier(e)s et des médecins sur la confusion révèlent un manque de formation. En France, l'interne est souvent le prescripteur de première ligne en hospitalisation. Cette enquête nationale réalisée entre juin et décembre 2019 avait pour but d'évaluer les connaissances des internes sur la confusion et la prise en charge de sa forme hyperactive chez le sujet âgé.Pour cela, un auto-questionnaire a été élaboré à partir des recommandations de la Haute Autorité de santé (HAS) sur la confusion puis transmis via les réseaux sociaux aux internes. Ils sont 182 internes de 23 spécialités et de 18 villes différentes à y avoir répondu. Ils déclaraient être impliqués dans 97% des prises en charge alors que 45 % d'entre eux n'avaient pas connaissance des recommandations. La thérapeutique semblait être l'étape la plus difficile et les internes passés par une formation pratique en gériatrie obtenaient de meilleurs résultats.Les enjeux liés à la confusion et les recommandations de prise en charge thérapeutique sont mal connus des internes. La formation théorique mais surtout pratique en stage semble améliorer le niveau de connaissance. Abstract Delirium is frequent and serious, while it is often avoidable. Previous studies revealed a caregivers lack of knowledge about this syndrome concerning diagnosis and therapeutic management. In France, residents are often in first line to manage delirium patients. The purpose of this study is therefore to assess residents' level of knowledge about delirium and its therapeutic management in the elderly.Our study is a national survey carried out between June and December 2019 using a self-administrated survey derived from the 2009 Haute Autorité de santé (HAS) recommendations about delirium. The primary endpoint was the global score obtained by residents. The secondary endpoints were the score in different fields of competence (general knowledge, diagnostic, therapeutic) and the comparison of the resident's score according to their formation. One hundred eighty-two residents from 23 specialties and 18 different cities were represented. Residents were involved in more than 97% of the cases, while 45% of them were unaware of the HAS recommendations. Mean score to the survey was 68/100, and therapeutic management seemed the most difficult step, especially when the symptoms of delirium were severe. Our study highlights the benefit of practical training during internship to improve the level of knowledge on delirium.This study suggests the need for specific teaching on delirium. Training both theoretical and practical seems to be the most effective method. Development of a national educational program about delirium and its management could be proposed to improve residents awareness and develop their skill. Increasing the number of mobile geriatric teams and strengthen their action could also be a concrete option to improve delirium management. Finally, we could imagine the development of a pocket tool to offer a practical bedside help for clinicians. The development of such a tool would require further studies to evaluate its relevance and effectiveness.

Discovery of a Hidden Schistosomiasis Endemic in the Salamat Region of Chad, Africa.

There is currently a severe paucity of rural epidemiologic data on urogenital schistosomiasis in the Republic of Chad in north-central Africa that is hindering national control strategies. Our study describes a mobile medical team's 4-year effort to collect data and provide mass therapeutic and preventive chemotherapy in the Salamat Region of Chad, a previously uninvestigated rural area. To overcome severe limitations in time, resources, support, and infrastructure, the team employed several time- and cost-saving techniques that included: (1) traveling by request and referral to utilize local knowledge to find the areas of highest need, (2) conducting convenience sampling for screening, (3) using simple but validated tools to expedite treatment and data gathering, and (4) working within cultural contexts to find and treat the most school-age children possible. The team managed a total of 11,832 patient encounters and found a 55% rate of hematuria (n=6,495) among school-age children, roughly double previous estimates. Rates of hematuria were higher in males (61%, n=3,955/6,466) than females (48%, n=2,301/4,806) and among adolescents (> 65% in all age groups aged 10 years and older). These methods outline an efficient and effective strategy implemented under real-world conditions to enact therapeutic and preventive chemotherapy campaigns in resource-limited settings by engaging village leadership and developing locally driven solutions. Our data highlight the need for continued local epidemiologic efforts to treat the substantial number of children severely affected with schistosomiasis.

Being a member of a novel transitional case management team for patients with unstable housing: an ethnographic study

BackgroundHomeless and unstably housed individuals face barriers in accessing healthcare despite experiencing greater health needs than the general population. Case management programs are effectively used to provide care for this population. However, little is known about the experiences of providers, their needs, and the ways they can be supported in their roles. Connect 2 Care (C2C) is a mobile outreach team that provides transitional case management for vulnerable individuals in a major Canadian city. Using an ethnographic approach, we aimed to describe the experiences of C2C team members and explore their perceptions and challenges.MethodsWe conducted participant observations and semi-structured interviews with C2C team members. Data analysis consisted of inductive thematic analysis to identify themes that were iteratively discussed.ResultsFrom 36 h of field observations with eight team members and 15 semi-structured interviews with 12 team members, we identified five overarching themes: 1) Hiring the right people & onboarding: becoming part of C2C; 2) Working as a team member: from experience to expertise; 3) Proud but unsupported: adding value but undervalued; 4) Team-initiated coping: satisfaction in the face of emotional strain, and; 5) Likes and dislikes: committed to challenges.ConclusionsA cohesive team of providers with suitable personal and professional characteristics is essential to care for this complex population. Emotional support and inclusion of frontline workers in operational decisions are important considerations for optimal care and program sustainability.

Pediatrics of disasters in the structure of professional training of pediatricians of the city children’s polyclinic to work in emergencies and terrorist acts: View from Russia

Introduction: Modern pediatrics of disasters is built on 5 basic principles: integrity, structure, causality, dynamism, and hierarchy. Material and methods: Methodological approaches were used: systemic, complex, integration, functional, dynamic, process, normative, quantitative, administrative, and situational, and methods: historical, analytical, and comparison. Techniques were used: grouping, absolute and relative values, detailing, and generalization. Results: The algorithms of actions of the doctor of the children’s clinic in the event of a fire, the receipt of a call about the laying of explosives and the threat of explosion were considered, the scope of the provision of first qualified aid to the pediatric nursing team was clarified. The issues of the organization of the first qualified and specialized medical care, taking into account the anatomical and physiological characteristics of children and adolescents, as well as medical tactics for small-medium, and large disasters in rural areas and cities are discussed. Conclusion: Pediatrics of disasters is an independent section of organizational and medical work in emergencies and terrorist acts, providing specialized medical care for at least 25% of victims, who are children and adolescents. The training of doctors of a specialized children’s polyclinic is regulated by regulatory documents of the Russian Federation and the Republic of Komi, Orders of the Ministry of Health of the region, a municipal formation, and a medical institution in the field of civil defense and emergency situations. In case of minor emergencies and disasters within the city boundaries with the occurrence of a single or a small number of group losses, medical support repeats that in road traffic accidents, with the exception of the organization and conduct of medical triage. In rural areas, it is required to attract additional medical and nursing teams (emergency medical aid teams), created on the basis of medical institutions of the victim and neighboring areas. At the same time, a forced maneuver by the forces and means of territorial health care is necessary for the medical evacuation of a significant part of the affected children to specialized institutions (departments) located in cities. The provision of psychological and psychiatric assistance to children and adolescents in emergencies is carried out on the basis of its basic modules (departments and offices of psychological and psychiatric assistance, and advisory mobile team of psychological and psychiatric assistance, anonymous psychological and psychiatric assistance by telephone).

Особенности начала заболеваемости COVID-19 в Сузакском районе Джалал-Абадской области (Кыргызстан)

The article reflects the results of studies on the incidence of COVID-19 and community-acquired pneumonia in the Suzak district of Jalal-Abad region during the pandemic of 2020. As a result of the analysis of morbidity, it was shown that the beginning of the incidence of COVID-19 occurred in March 2020, and the beginning of community-acquired pneumonia — in June 2020. The study conducted by the co-authors confirmed that the month of July is the peak of morbidity, and then the highest incidence of COVID-19 and out-of-hospital pneumonia was registered in the autumn period: October-November. According to the results of studies conducted during the global outbreak, it was revealed that the greatest affected age is from 30 to 64 years, 65 years in second place. According to the results of the gender of those who underwent COVID-19, higher rates were women than men. The assessment of prevalence by social groups showed a higher proportion of morbidity among the unemployed population, among the retirement age and medical workers. In the district, out of the number of medical workers who fell ill with COVID-19, the confirmed case was 10.7%, community-acquired pneumonia — 7.9%. According to the epidemiological history, more likely foci of infection and sources of infections have been identified. During the pandemic, in order to prevent coronavirus infection and provide medical care to the population, isolation wards with 295 beds were organized. During the period of operation of the isolators, a total of 1,674 patients were treated. There were also 160 places for observation, where 543 people were under medical supervision. 4 mobile teams were organized, which visited 921 foci and 2721 PCR tests were taken from contact persons. To organize medical care for patients with community-acquired pneumonia during the pandemic in the district, from July, August and October, 5 day hospitals were organized, with 332 beds. The provision of beds per 10 thousand population was 11.3%.

Satisfaction survey of general practitioners calling upon an external mobile geriatric team.

The external mobile geriatric team (équipe mobile de gériatrie extrahospitalière [EMGEH]) at the University Hospital of Grenoble-Alps intervenes with elderly subjects in complex medical and social situations at home at the request of general practitioners (GPs). To evaluate the satisfaction of GPs after EMGEH intervention. The secondary outcomes were the follow-up of recommendations and training requests from community care partners. Retrospective monocentric satisfaction survey of the 124 GPs who used the EMGEH between January 2015 and December 2018. Participation rate of 44%, representative of independent GPs in urban or semi-rural practices. Participants were "satisfied" or "very satisfied" (84.2%) with the responsiveness of the EMGEH, and 85.5% responded favourably to the content of the evaluation. The EMGEH was described as playing an expert and supportive role for GPs. The recommendations were followed by more than 89% of respondents. As many as 83.6% of participants wanted the EMGEH to conduct training sessions, mainly for the management of "behavioural disorders". Following this survey, five recommendations were formulated: decrease the response time by recruiting trained staff, systematically send an e-mail following the report to the requesting doctor, use a platform to exchange information, develop partnerships with the psychiatry team, and create an online resource space. This study contributed towards improving the relationship between the community and the hospital by strengthening links between the GPs within the CHUGA health region and the EMGEH.

Tucson Shares Blueprint for Crisis System Success

Tucson Shares Blueprint for Crisis System Success

Problems and Prospects in Development of Emergency Medical Help Center in OSH, Kyrgyzstan

This article is presenting an analysis of emergency medical center work in Osh city, Kyrgyzstan for a five-year period. Ambulance crew visits indicators from 2016 to 2020 were studied in the Kyrgyz Republic, and in Bishkek and Osh cities, visit numbers monitoring in Emergency Medical Help Center in Osh carried out with a delay of more than 20 minutes, was carried out using statistical test forms from 2016 to 2020 years and proposed measures to improve emergency quality in medical help providing to a population in Osh city. Statistical and analytical methods were used including dynamic analysis of time series, correlation and regression analysis, data processing carried out using application programs. Comparison of average Republican indicator of load on ambulance crews revealed teams load in Osh city 46443 calls, with 68100 calls exceeding the average Republican indicator by 35%, and shows the overload of EMH service mobile teams in Osh. Keywords: emergency medicine, paramedic, mobile teams, trips, optimization, lateness.

New Hampshire crisis units offer new tool in MH treatment

As of this month, there's a new option that mental health advocates in New Hampshire have been asking for for at least a decade: a 24/7 phone line answered by trained mental health staff and, for those who need more, a mobile crisis response team that goes to them. The hope is that a quicker response to the community will spare people emergency room waits and provide them the appropriate level of care, which can often be immediate stabilization and a next‐day appointment with a counselor. Staff from the New Hampshire Department of HHS have said they expect call center staff will resolve 80 % of cases without dispatching a crisis response team. The Rapid Response Access Point, more commonly referred to as mobile crisis response, began Jan. 1 with surprisingly little publicity by the state or the company contracted to run it. In fact, community mental health centers said their two biggest challenges are hiring enough staff and making sure the public knows how to access the new service. Run by Beacon Health Options of Boston, the 24‐hour phone and text line — 1‐833‐710‐6477 — will be staffed by master's‐level clinicians, intake workers and peer support specialists who have lived experience with mental health or substance use disorders, according to its $9.2 million contract with the state. The phone and text line will be replaced with 988, the new national suicide prevention hotline, when it goes live in July. Now, all 10 of the state's community mental health centers will have a crisis response team thanks to a $52.4 million state contract.

Mobile medical teams during the Covid‑19 pandemic: legal aspects and implementation experience

During the pandemic of the new coronavirus infection Covid 19, the healthcare system faced serious challenges, one of which is a shortage of qualified personnel. One of the methods for solving this problem was the creation of mobile multidisciplinary mobile teams on the basis of federal medical institutions. In this article, the authors analyze the legal aspects of the functioning of mobile teams, and also give the experience of the employees of the Federal State Budgetary Educational Institution of Higher Education Bashkir State Medical University in the regions of Russia and abroad.

Outpatient healthcare and clinical trials in the care pathway: Organisational and regulatory aspects and tools

Clinical research in outpatient healthcare, particularly in general practice, which is the first line of contact with the population, is now a public health issue. However, this type of research has specific characteristics that differentiate it from clinical research conducted in a hospital setting and requires an adaptation of its conditions of practice: in terms of organisation, the development of research in outpatient healthcare relies on the appropriation of its fundamentals by the investigators, which implies their presentation, upstream, from the initial cycle, and the participation of practitioners in training modules adapted to research in primary care, such as those already organised by several GIRCI (Groupement Inter régional de la Recherche Clinique et de l'Innovation [French Interregional Clusters for Clinical Research and Innovation]). To compensate for the fragmented nature of their location, on the model of the EMRCs (équipes mobiles de recherche clinique [mobile clinical research teams]) in oncology, mobile research teams should enable general medical practices to participate in clinical trials. This presupposes, on the one hand, the allocation of earmarked funding to ensure the sustainability of a base of dedicated personnel and, on the other hand, the impetus of a national dynamic through the setting up of a multi-organisation thematic institute for "research in primary care" associated, at the operational level, with a national scale investigation network supported by a platform of excellence. The use of digital tools and innovations (telemedicine; data collection via connected tools; e-consent; electronic signature) which make it possible to digitise and relocate all or part of the research procedures for both the participant and the investigation teams. An adaptation of the legal framework in order to bring the place of research closer to the patient and not the other way round, which means moving the equipment and investigations closer to the patient. Taking into account the acceptability of the patient, thus limiting the disruption that may be caused by his or her participation in a research protocol and motivating the practitioner by valuing his or her contribution and providing all the guarantees of scientific relevance and independence of practice. In view of the contextual analysis, positive feedback and the availability of organisational and digital support points facilitating the delocalisation and digitisation of the conduct of research activity as close as possible to the patient and his or her doctor, the round table concluded that opportunities exist today which favour the development of clinical research in general practice. It is important to seize this opportunity and make the most of it without delay.

АДМІНІСТРАТИВНО-ПРАВОВІ ЗАСАДИ ЗАБЕЗПЕЧЕННЯ ДОСТУПНОСТІ МЕДИЧНОЇ ДОПОМОГИ... ДЛЯ НАСЕЛЕННЯ В УМОВАХ ВОЄННОГО СТАНУ

In Ukraine, under the conditions of martial law, the availability of medical care to the population has significantly decreased. This is due to the decrease in the number of medical facilities due to their destruction and damage, the seizure of territories and being under occupation, the decrease in the number of medical workers due to their relocation to safer regions, mobilization, etc., the impossibility of aiding due to interruptions in the supply of electricity and medicines due to with active hostilities, etc. This led to the fact that peaceful plans to reform and develop the medical system became ineffective. The purpose of the article is defined by the author to study the problems of the administrative and legal basis of ensuring the availability of medical care to the population in the conditions of martial law and the formation of scientifically based proposals for the improvement of the administrative and legal regulation of the availability of medical care. The author proposes to implement in Ukraine the activity of mobile brigades for providing medical assistance to the population based on the example of the functioning of such brigades for vaccination and for diagnosing Covid‑19. For this, it is necessary to adopt a separate order by the Ministry of Health of Ukraine, which would determine the order of their organization and activity during the period of martial law, as well as the requirements for their equipment. First, such mobile teams are necessary for the provision of medical services to provide primary medical care (including for children), vaccination, gynecological, emergency dental and psychological care, as well as to provide the minimum necessary medicines to the population through the granting of the right to operate mobile pharmacies.

Understanding mobile learning, imagination capacity, and team creativity through people-learn-framework and creativity theory perspective

Though empirically unevidenced assertions posit that m-learning enhances online participation and achieves learning outcomes, instructors continue observing a low rate of students' virtual participation. Such an observation gets instructors sceptical if m-learning achieves learning outcomes. In parallel, employers complain of graduates lacking team creativity skills. This study investigated the m-learning and learning outcomes relationship through the How People Learn framework and comprehended how imagination capacity and team creativity allow digital learning to enhance online participation and facilitate m-learning for achieving learning outcomes, using the creativity theory. Hence, this study proposed a model bearing five hypotheses. This model was tested via an adopted questionnaire and received 307 higher-education students. Multiple regression analysis reveals a partial mediation of m-learning between imagination capacity and team creativity. Such mediation helps achieve the desired learning outcomes, improves online participation, and enhances team creativity. This study also proposes theoretical and practical implications.

Robotic Ad-hoc Networks Connectivity Maintenance based on RF Signal Strength Mapping

Network connectivity preservation is one of the substantial factors in achieving efficient mobile robot teams' maneuverability. We present a connectivity maintenance method for a robot team's communication. The proposed approach augments the Radio Frequency Mapping Recognition (RFMR) method and the signal strength gradient decent approach for an overall goal to create a Proactive Motion Control Algorithm (PMCA). The PMCA algorithm controls and helps strengthen mobile communicating robots' connectivity in the existent Radio Frequency (RF) obstacles. The RFMR method takes advantage of Hidden Markov Models (HMMs) results, which assist in learning electromagnetic environments depending on measurements of RF signal strength. The classification results of HMM lead the robots to resolve whether to continue the current trajectory for avoiding the obstacle shadow or move back to desirable robust Signal Strength (SS) positions. In both cases, the robot will run the gradient approach to determine the signal change trend and drive the robot toward the strong SS direction for maintaining link connectivity. The PMCA, depending on the results of RFMR and gradient approaches, promises to preserve robots' motion control and link connectivity maintenance.

Pose Control of a Spherical Object Held by Deformable Sheet with Multiple Robots

This paper presents a robotic design for transporting a spherical object that is manipulated by a mobile robot team through a deformable sheet. The design goal is to control the position and orientation (i.e., pose) of the object through the collective motion of the robotic team. We first derive a kinematic model to describe the object motion in the deformable sheet. The effect of the mobile robots’ motion on the object is studied and analyzed. We then design a distributed controller for each robot to manipulate the pose of the object. The analysis and experimental results show the controller has the ability to successfully manipulate the object pose to follow a given position and orientation profile.

Impact Of COVID-19 Pandemic Era 2020 on Rashtriya Bal Swasthya Karyakram (RBSK) - National Child Health Program in India-A Cross-Sectional Comparative Research Study

In India because of the elevated birth rate and Brobdingnagian population (globally next to china) Rashtriya Bal Swasthya Karyakram (RBSK) (National Child Health program) is a significant measure by the Government of India, quite vital for public health care provision systems for reducing mortality in children (to achieve SDG goal), particularly within the current COVID-19 pandemic era throughout which most of the essential maternal- kid RCH (Reproductive and Child Health) health services were disrupted globally as well as in India. One of the researchers is a medical doctor who felt that the performance of RBSK during COVID-19 must be investigated to know the status of implementation of services during the pandemic crisis to alert policymakers if there is a disruption of these vital health services due to ongoing pandemic so that proper and timely action should be taken to rectify disruption if any during as well as after pandemic. This analysis study was done to supply significant information to the scientific community and decision-makers with concrete information analysis from authorized HMIS (Health Management data system) of Government - MoHFW (Ministry of Health and Family Welfare)) to provide the COVID-19 impact on RBSK services by public health care facilities across thirty-six states and UTs of India. This novel cross sectional research study revealed that COVID-19 period 2020 had a less number of Male/Female children identified with Disease (6 month to 18 years) screened by RBSK services mobile health teams at Govt and Govt aided schools and Anganwadi centre under RBSK services in India on an all India cumulative basis. This is clearly due to less number of screenings done during the COVID-19 era. The prevalence of Male/Female children identified with Disease (6 month to 18 years) / 1000 screened were 23.49, 31.18 and 29.72 for males and 22.37, 30.27 and 29.31 for females during 2018-2019-2020 respectively, is reduced during COVID-19 era is a good sign.