Phone Messages Research Articles

RISH Assistance: Voice Activated Digital Assistant for Developers

The increasing use of computing devices brings convenience but also challenges. Traditional interfaces can lead to repetitive strain, slow interactions, and accessibility problemsfor software developers, who often find it hard to turn complex ideas into code, especially with unfamiliar APIs. In response, there is a growing interest in automation and smart machines that act like humans. However, a major obstacle remains—the gap in human-machine interaction. Introducing “RISH Assistance,” a voice-activated digital assis- tant designed for developers. RISH enables users to navigate tasks more efficiently, reducing reliance on screens and tra- ditional input methods. Utilizing advanced voice recognition and Natural Language Processing (NLP), RISH transforms the developer experience by providing easy access to resources, seamless code suggestions, and natural troubleshooting—all through voice commands. Additionally, it can manage phone functions, allowing calls and messages directly from the desktop interface, enhancing productivity. Security is ensured with face authentication, and current session chat history tracking allowsusers to revisit previous interactions. RISH boosts productivity through hands-free interaction, en- abling developers to focus on creative problem-solving. It im- proves accessibility by offering an alternative input method and streamlines workflows, reducing cognitive load while fostering a more intuitive development environment. By facilitating natural and efficient engagement with machines, RISH Assistance aims to enhance human-machine collaboration and create a more inclusive software development landscape.

Therapy for Therapists: Design Opportunities to Support the Psychological Well-being of Mental Health Workers

On-demand mental health services-including counseling, crisis hotlines, and peer support programs-are vital to the healthcare system, providing acute and ongoing support through telephone, online chats, and text messaging. Although such services have proven effective at reducing hopelessness, psychological pain, and suicidality, they put the providers of these services at high risk of burnout, secondary traumatic stress, and compassion fatigue. Our interviews with professionals from four mental health organizations revealed that while these workers have a strong motivation to help clients with mental health care needs, they face various challenges themselves, particularly regarding heavy caseloads, difficult crisis clients, and coping with repeated exposure to abuse and harassment. To overcome challenges, participants identify the need to be self-reliant and engage in self-care practices ranging from socializing with coworkers to yoga and meditation. Although organizations spend significant time training workers prior to their involvement with clients, the training typically lacks components on self-compassion and self-care. Designers might see technology as an opportunity to promote such practices; however, while technology is an integral part of their work routine, participants, irrespective of age, had misapprehensions regarding technology use in the mental health care space, including for managing their psychological well-being. We recommend design guidelines for HCI researchers, including developing contextualized just-in-time adaptive interventions to promote self-compassion and educating workers regarding the use of various technologies to manage their well-being.

Harassment from the Perspective of the Current Romanian Criminal Code

Abstract The legislator of the Criminal Code resorted to the criminalization of this deed in response to cases that occurred in everyday reality, in which various persons, especially women, are waited for and followed in the street or other public spaces or are badgered via phone calls or messages, all of which are done in such a way as to create a state of fear for the person in question.

Does Socioeconomic Status Moderate the Association Between Screen Time, Mobile Phone Use, Social Networks, Messaging Applications, and Mental Health Among Adolescents?

The aim of this study was to examine the relationship between different screen time (ST)-related behaviors and mental health conditions such as depression, anxiety, and stress. In addition, this study aimed to determine the moderating role of socioeconomic status (SES). This was a cross-sectional study and included data from 620 adolescents, aged 12-17 years, from the Valle de Ricote, Region of Murcia, Spain. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Overall ST, mobile phone use, social network use, and messaging application use were measured using validated questionnaires. SES was assessed using the Family Affluence Scale-III. The results indicated that overall ST was significantly associated with symptoms of depression at the mean SES (unstandardized beta coefficient [B] = 0.005, p = 0.023) and 1 standard deviation (SD) below the mean (B = 0.007, p = 0.011), and with stress only 1 SD below the mean (B = 0.006, p = 0.011). No significant associations were found for anxiety and stress across all socioeconomic levels. Mobile phone use exhibited a strong positive association with symptoms of depression (B = 0.891, p < 0.001), anxiety (B = 0.530, p = 0.014), and stress (B = 0.790, p < 0.001) at 1 SD below the mean SES. Similar patterns were observed for mean SES, albeit with slightly weaker associations. Conversely, social network use was positively associated with all three DASS-21 scales, particularly at 1 SD below the mean SES, with the strongest associations found for symptoms of depression (B = 0.327, p < 0.001), anxiety (B = 0.325, p < 0.001), and stress (B = 0.318, p < 0.001). Furthermore, messaging application use did not show significant associations with symptoms of depression, anxiety, or stress across any SES levels. In conclusion, social inequalities may influence the associations between various ST-related behavior and symptoms of depression, anxiety, and stress among adolescents. These findings may have implications for the design of effective interventions to improve symptoms of depression, anxiety, and stress in this population.

Effectiveness of text message reminders on paediatric appointment adherence: a systematic review and meta-analysis.

Attending health appointments is important for the paediatric population, as it allows for earlier detection of health issues and subsequent necessary treatments. It also ensures timely immunisations while also allowing patients or their parents to raise health concerns. Hence, it is crucial to take steps to ensure that such medical appointments are attended.To evaluate the effectiveness of text message reminders (TMRs) in improving paediatric patients' adherence to their appointments.A systematic review and meta-analysis were conducted. The search spanned across eight online databases from their inception dates to January 2024. The random-effects model was utilised to conduct the meta-analysis, where risk ratio was used as the effect measure. Subgroup analyses were conducted for age, number of TMRs sent, and type of appointments attended.In total, 13 studies were included. Compared to standard care (involving non-text message reminders or no reminders), TMRs were significantly more effective in improving appointment attendance among the paediatric population. Significant subgroup differences were found in the type of appointments attended, where TMRs were more effective for medical appointments compared to vaccination appointments. No differences in adherence to appointments were found across age groups or the number of TMRs sent. Conclusion: Sending TMRs can be a potentially cost-effective way to improve the attendance rate of paediatric medical appointments, given the ease of implementation and the extensive mobile phone usage globally. Future studies should compare TMRs to other modes of automated reminders such as telephone messages or emails, to identify the most optimal method of delivery. Trial registration: PROSPERO (CRD42023464893).

2347 EXPEDITE: a sustainable initiative to improve average length of stay (ALOS) in an acute geriatric Ward in Singapore

Abstract Introduction Prolonged hospitalisation is associated with increased mortality, increased risk of hospital acquired infections, functional decline and institutionalisation in older adults. Baseline data collected for patients admitted to the Acute Geriatric ward of Alexandra Hospital, a tertiary hospital in Singapore, from 28 Feb to 31 Aug 2022 (n = 299, age &amp;gt; 65 years) revealed an average LOS of 12.3 days. Potential contributing factors identified • 98% did not have a documented medical clearance date • 3.54 days required to decide for medical social worker referral • 9 days before discharge plans are communicated to family. Aim: To reduce average length of stay (ALOS) from 12.3 days in Aug 2022 to 9.81 days by Aug 2023. This was a target set at the hospital level on our Geriatric service in the setting of a rising national pressure for inpatients beds. Method The EXPEDITE Huddle was a regular 30 minute huddle introduced, in addition to the existing weekly multidisciplinary meeting. It was developed based on the QI methodology and streamlined from 3x/week frequency to 1x/week following PDSA cycles. A chat group on the secure hospital mobile phone messaging system was also created for ease of communication among stakeholders. Results • ALOS reduced from 12.3 days to 9.1 days (3.4 days) • 91.8% of patients (n = 154) now have a documented medical clearance date • Communication on discharge plans initiated within 3 days from admission • Sustainability: -In light of positive results, a discharge care navigator (DCN) to lead the discharge planning efforts was offered by the hospital to the Geriatric service. -The EXPEDITE huddle (now led by the DCN) continues and ALOS has remained within target. Conclusion(s) Early discharge planning with a focus on system level factors that contribute to delayed discharge can help reduce ALOS in hospitalised older adults.

Primary Care Telehealth Initiation and Engagement Among Veterans at High Risk, 2019-2022

During the COVID-19 pandemic, the Veterans Health Administration (VHA) expanded telehealth infrastructure. Understanding telehealth initiation and sustained engagement could inform future resource allocation for high-need populations. To describe and examine primary care use, including initiation, use, and engagement factors, of telehealth modalities (telephone, video visits, and secure messaging) from 2020 to 2022. This cohort study was conducted among 1 383 070 patients in the 75th or higher percentile for 90-day risk of hospitalization or mortality (using previously validated Care Assessment Need scores) engaged in VHA primary care from March 11, 2019, to March 10, 2022. Patient sociodemographic characteristics (age, sex, race and ethnicity, and marital and housing status), health characteristics (chronic condition count, military service disability, serious mental illness, or substance use disorder diagnoses), geographic characteristics (driving distance to clinic and rural or urban location), and Federal Communications Commission-reported broadband speed among subgroups of patients at high risk categorized by telehealth use from 2020 to 2022. Primary care utilization by modality. A total of 1 383 070 patients at high risk were engaged in VHA primary care in March 2020 (median age, 73.0 years [IQR, 65-80 years]; 92.4% male; 77.7% regular telehealth users in 2019). With the onset of the COVID-19 pandemic from March 2020 to March 2021, 92.7% of patients at high risk (1 158 804 of 1 250 438 retained in care) became regular telehealth users. The following year, most patients continued as telehealth users (83.4% [942 151 of 1 129 683 retained]), including 38.2% retention of users at high risk newly engaged in 2020. Between 2019 and 2022 among those living and engaged in VHA primary care, adjusted exploratory multinomial logit models estimated that new telehealth users in 2020 (both sustained or only transiently engaged) were more often Black non-Hispanic individuals with greater comorbidity burdens than those who never engaged in telehealth use (Black non-Hispanic with new persistent telehealth use: adjusted relative risk ratio [ARR], 1.18 [95% CI, 1.16-1.20]; Black non-Hispanic with transient telehealth use: ARR, 1.11 [95% CI, 1.08-1.13]; ≥5 chronic conditions with new persistent telehealth use: ARR, 1.92 [95% CI, 1.88-1.96]; ≥5 chronic conditions with transient telehealth use: ARR, 1.43 [95% CI, 1.40-1.46]). This cohort study suggests that primary care telehealth initiation, use and sustained engagement differed among subgroups of patients at high risk throughout the COVID-19 pandemic. Those never or only transiently engaged with telehealth had lower illness burdens and were less likely to identify as members of racial or ethnic minority groups. Variation in telehealth use among subgroups of patients at high risk during this period could inform future resource allocation.

Peripherally administered vasopressors in critically ill adult patients: A survey of UK healthcare professional practices, attitudes and experiences.

Peripherally administered vasopressor infusions are used to support critically ill patients. The Intensive Care Society recently published guidelines supporting their use. Preliminary evidence suggests variability in peripheral vasopressor infusion use. We aimed to characterise current practice in the use of peripheral vasopressor infusions in the UK National Health Service and to capture the views of healthcare professionals caring for critically ill adult patients. We conducted an online survey of healthcare professionals from December 2022 to March 2023. Our survey used Google Forms and was shared via email, X (formerly twitter), and mobile phone messaging within the UK. Health Research Authority approval was sought, and ethical approval was not required. We received 227 responses and our survey showed variation in the use of peripherally administered vasopressor infusions in critically ill patients across UK National Health Service hospitals. About 87.7% of healthcare professionals initiated peripheral vasopressor infusions in their clinical role. Peripheral vasopressor use was limited to low dose, short durations of infusions, however, there was variability. Metaraminol was the most used peripheral vasopressor (90.3%). Only 22.5% of healthcare professionals used peripherally administered noradrenaline in practice. Our respondents agreed that equipoise exists. Our survey found variability in the use of peripheral vasopressors and in care delivered to critically ill patients in the UK. Our survey shows there are ongoing concerns regarding safety, dosing ranges and durations of use. Future research is required to explore the optimal role that peripheral vasopressor infusions can play in the care of critically ill patients.

Rehabilitation in subjects with frozen shoulder: a survey of current (2023) clinical practice of Italian physiotherapists

ObjectiveFrozen Shoulder (FS) is a musculoskeletal pathology that leads to disability, functional decline, and a worsening in quality of life. Physiotherapists are the primary professionals involved in the treatment of FS, and it is essential to determine if their practice aligns with evidence-based suggestions.AimThe aim is to assess the knowledge, skills, and operational strategies of Italian physiotherapists regarding FS and compare them with the existing literature.MethodsA web-based, anonymous, and voluntary cross-sectional survey was developed and administered to Italian physiotherapists to evaluate their clinical practices.ResultsA total of 501 physiotherapists (38.5% female), completed the survey. More than half were under 35 years old (67.8%), declared working in private practice settings or being self-employed (57.1%), and were primarily engaged with musculoskeletal patients (81.8%). For subjects with FS at their first access, 21.4% identified X-rays as the most useful imaging technique to recognize pathologies beyond rehabilitation competence. In terms of general management, the majority reported working with an orthopaedic or physiatrist (47.5%) or in a multidisciplinary team (33.5%). Regarding manual therapy techniques, 63.3% of physiotherapists preferred intense degree mobilization, posterior direction, and moderate pain at the end of the range of motion for low irritable/high stiffness FS; however, there is a lack of consensus for managing very irritable/low stiffness FS. The majority of physiotherapists (57.7%) concurred that stretching improves the balance between metalloproteinase and its inhibitors. Additionally, 48.3% of physiotherapists selected mobile phone videos and messages to improve patients’ compliance with exercises at home and for motivational/educational purposes.Discussion and ConclusionThe clinical practices of Italian physiotherapists in FS subjects sometimes deviate from evidence-based recommendations. While some discrepancies may be attributed to the existing uncertainties in the literature regarding knowledge and management strategies for FS patients, the authors recommend a stronger adherence to evidence-based practice.

Maternal health service utilization in the Jimma Zone, Ethiopia: results from a baseline study for mobile phone messaging interventions

BackgroundOver the last 20 years, global healthcare has placed a major focus on improving the survival rates of mothers and children, recognizing the potential to prevent a significant number of deaths resulting from pregnancy and childbirth. Nevertheless, there remains an ongoing obstacle to the insufficient utilization of critical obstetric services to achieve optimal health outcomes for pregnant women. This study aimed to assess the magnitude and determinants of maternal healthcare use in the Jimma Zone, Ethiopia.MethodsData were obtained from a household survey as part of the baseline assessment of a cluster randomized controlled trial. The study participants comprised 588 women in early pregnancy, specifically those with a gestational age of less than 20 weeks. Logistic regression analysis was employed to identify factors associated with the use of maternal health services. Adjusted odds ratios (AORs) were used to assess the strength of the associations, with significance level set at a p-value ≤ 0.05.ResultsThe overall prevalence of maternal health service utilization was 87.9% (CI: 85.1, 90.4) for antenatal care, 74.7% (CI: 73.2, 79.9) for health facility delivery, and 60.4% (CI: 56.4, 64.3) for postnatal care. Multivariable logistic analysis revealed that maternal health service use was significantly influenced by access to health facilities (AOR: 6.6; 95% CI: 2.39, 18.16), financial hardship (AOR: 3; 95% CI: 1.97, 4.61), perceived respectful care (AOR: 2.3; 95% CI: 1.07, 5.11), perceived privacy of service provisions (AOR: 2.4; 95% CI: 1.47, 4.06), and attitudes toward maternal service use (AOR: 2.2; 95% CI: 1.48, 3.24).ConclusionsThe study revealed slightly higher rates of antenatal care, facility delivery, and postpartum care utilization. However, there was a low proportion of early antenatal care initiation, and high rates of antenatal care dropout. Mobile phone-based messaging intervention may enhance maternal health service use by addressing factors such as lack of access, economic challenges, disrespectful care, no privacy of procedures, and unfavorable attitudes.

The role of a dedicated Oncology Nurse Navigator in the surgical oncology pathways: 1 year experience from a General Surgery Unit in central Italy with follow up.

The Nurse Navigator is a highly specialized nurse with technical and non-technical skills that offers individualized assistance to cancer patients, their family and caregivers to overcome health system barriers and facilitate access to care. This role was introduced in the General Surgery Unit of the Madonna del Soccorso Hospital in San Benedetto del Tronto from 1st January 2023. The primary endpoint is to compare the times taken for each step of the diagnostic-therapeutic pathway comparing the study group followed by Oncology Nurse Navigator (ONN) and the group not followed by this role. The secondary endpoints, only for the study group, were the number of patient contacts with the ONN and the time slots; the number of examinations and consultations organized by ONN; the evaluation of patient satisfaction at discharge; the number and type of problems noted during follow-up contact at 7 and 30days after discharge. A prospective court study with historical control was conducted from 1st January 2023 in Madonna del Soccorso Hospital, Italy. The study group consists of all cancer patients cared for by ONN. The control group was created by selecting the same number of patients as the study group but taken care of in the previous 3years (from 2020 to 2022) and, therefore, without the presence of the Nurse Navigator. The control group data come from clinical documentation. The number and time slots of contact with the ONN were recorded through the use of a company mobile phone active 24/7 through phone calls and messages. The number of examinations and consultations is known through online requests. The satisfaction assessment was carried out through the use of externally validated questionnaire Patient Satisfaction with Cancer Care (PSCC). The follow-up was performed by telephone and recorded on documentation according to established parameters. A total of 200 patients were analyzed. Both the study and control groups included 100 patients each. The average time between the first contact with the patient and the execution of the diagnostic test was 7days in the cases compared to 28days in the control group. The waiting time for the Multi-Disciplinary Team discussion (MDT) was 3 days for the study group compared to 6days in the control group. The average time taken for the first oncological visit was 3days in the study group compared to 18days in the controls. The time from first contact to the operating session was 20days compared to 45 in controls. Each patient had an average of 10 phone calls with the ONN. For all patients accompanied at the first diagnosis, at least 2 radiological and laboratory tests were organized. Oncology appointment for treatment evaluations after delivery of the histological report was communicated within a maximum of 3 working days. A patient satisfaction questionnaire achieved a response rate of 100%, with an average score of 87.0/90. The telephone follow-up had a response rate of 100% of patients and revealed a decrease in problems at the 30-day check-up compared to that of 7days after discharge. (Activity of Daily Living 20% vs 8%; nutritional problems 40% vs 21%, pain 18% vs 2%; surgical wounds 45% vs 1%; mobilization 8% vs 0%). The data demonstrate that ONN service improves the quality and outcomes of surgical oncology patients' pathway. The professional role of the ONN, with predefined technical and non-technical skills, should also be officially recognized by the healthcare system and hospital administration.

The Uncharted Patterns of Antibiotic Prescribing in Urology Ambulatory Practices: A Four-Year Analysis

Background: Urinary tract infections (UTIs) represent a prevalent indication for outpatient antibiotic usage, yet limited data exist regarding antibiotic prescriptions within urology specialties. This study aimed to assess antibiotic prescribing patterns in urology offices over a four-year period, providing insights for potential stewardship interventions. Methods: The analysis focused on antibiotic prescribing trends in adults between 2018 and 2021 during both visit and non-visit (e.g. telephone and chart messages) encounters across 15 ambulatory Urology clinics in an academic medical center in Western New York. Exclusions were made for antivirals, antiparasitics, antifungals, oral suspensions, selected non-UTI antibiotics, duplicate orders on the same day or week, and prescriptions exceeding 28 days. Prescriptions were categorized into single doses administered in the clinic and those prescribed for 2-28 days, with descriptive statistics and trend analyses conducted using SAS v9.14. Results: Over the four-year period, 54,282 prescriptions were analyzed. Of these, 26,944 (49.7%) were single doses administered in the clinic, predominantly for pre-procedure prophylaxis. The most commonly prescribed antibiotics for prophylaxis were fluoroquinolones (FQ) (47.5%), followed by ceftriaxone (19.2%), nitrofurantoin (13.2%), trimethoprim/sulfamethoxazole (8.6%), and gentamicin (4.2%). Among the 27,288 prescriptions for 2-28 days, 72.3% were from non-visit encounters, with 61.6% prescribed by advanced practice providers (APPs) (Figure 1). The mean number of prescriptions per patient was 2.07, with women receiving more prescriptions than men (2.39 vs. 1.88, P &lt; 0.001). FQ remained the most commonly prescribed antibiotics during all encounters (23.7%), followed by nitrofurantoin (23.0%) (Figure 2). The antibiotic duration was longer for visit-based compared to non-visit-based prescriptions (mean 10 vs. 7 days, P &lt; 0.001). Notably, there was a significant decrease in fluoroquinolone use between Q1 2018 and Q4 2019 for both male and female patients, followed by insignificant changes thereafter. Conclusions: Antibiotic use in urology outpatient settings is substantially underestimated if only prescriptions made during visit encounters are considered. More than two-thirds of prescriptions for 2-28 days were from non-visit encounters, with the majority originating from APPs. The average therapy duration exceeded guideline recommendations. Moreover, approximately half of the antibiotics were administered in the office for pre-procedure prophylaxis. To enhance antibiotic prescribing in these specialized clinics, interventions should focus on non-visit prescriptions and provide education for APPs, alongside adjustments to default durations in electronic orders. Further evaluation is essential to assess the appropriateness of single doses for pre-procedure prophylaxis.

Intensive Intervention on Smoking Cessation in Patients Undergoing Elective Surgery: The Role of Family Physicians.

Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians' clinics in which smokers of both sexes, aged 21-65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32-23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term.

Efficacy of a culturally tailored screening campaign to tackle cervical cancer disparities among Hispanic patients.

e13697 Background: Cultural barriers have been identified as drivers of cervical cancer disparities. Hispanic patients specifically experience a higher incidence of cervical cancer and are more likely to be diagnosed at advanced stages than non-Hispanic White patients, mediated by multiple factors including cultural perceptions. To tackle cultural barriers in cervical cancer screening, this study assessed the efficacy of a community-based media campaign to increase Pap tests within a predominantly Hispanic community in east Los Angeles (LA). Methods: The campaign was implemented through a collaboration of local community members, design and communication experts, and cancer researchers. Prior to campaign design, focus groups were conducted with at-risk Hispanic women aged 18-45. Learnings from these focus groups and additional study of the visual culture of east LA led to selection of the jacaranda tree, which blooms for a short time in LA each spring, as a visual cue to pursue screening. This imagery was accompanied by a scheduling phone number and messaging (“It’s time.” and “You can prevent cervical cancer.”) in Spanish and English. Campaign materials were displayed on bus benches, billboards, and light post banners throughout east LA. To analyze campaign efficacy, intercept surveys were conducted from 2015-2018 by trained interviewers at locations throughout the community. In their preferred language, female participants (n=770) were asked standardized questions assessing campaign recall, message interpretation, and likelihood of scheduling a Pap test after viewing the campaign. Results: Among participants, mean age was 47.4 years, 88.7% primarily spoke Spanish at home, 25.2% were uninsured, 80.6% had not been vaccinated against HPV, and 12.5% had not had a Pap test in the last 3 years. 25.7% of participants recalled having seen campaign materials prior to survey, with 71.7% interpreting the message as a call to prevent and/or get screened for cervical cancer. 89.3% of participants stated that they were Likely or Extremely Likely to schedule a Pap test after viewing the campaign, including 87.2% of those who had not had a Pap test in the last 3 years. Conclusions: These findings support the efficacy of a community-based strategy to increase cervical cancer screening. This campaign showed high screening intent in a sample of participants who were disproportionately uninsured (25.2% v. 8.5% overall in the US in 2018), with similar efficacy among those who were overdue for recommended screenings. These results emphasize the benefit of culturally tailored messaging to improve screening uptake within underserved populations.

Moderation Effects of Daily Behavior on Associations Between Symptoms and Social Participation Outcomes After Burn Injury: A 6-Month Digital Phenotyping Study

ObjectiveTo examine the moderation effects of daily behavior on the associations between symptoms and social participation outcomes after burn injury. DesignA 6-month prospective cohort study. SettingCommunity. ParticipantsTwenty-four adult burn survivors. InterventionsNot applicable. Main Outcome MeasuresSymptoms and social participation outcomes were assessed weekly using smartphone surveys, including symptoms of pain (Patient-Reported Outcomes Measurement Information System [PROMIS] Pain Intensity and Pain Interference), anxiety (PROMIS Anxiety), and depression (Patient Health Questionnaire), as well as outcomes of social interactions and social activities (Life Impact Burn Recovery Evaluation [LIBRE] Social Interactions and Social Activities). Daily behaviors were automatically recorded by a smartphone application and smartphone logs, including physical activity (steps, travel miles, and activity minutes), sleep (sleep hours), and social contact (number of phone calls and message contacts). ResultsMultilevel models controlling for demographic and burn injury variables examined the associations between symptoms and social participation outcomes and the moderation effects of daily behaviors. Lower (worse) LIBRE Social Interactions and LIBRE Social Activities scores were significantly associated with higher (worse) PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Anxiety, and Patient Health Questionnaire-8 scores (P<.05). Additionally, daily steps and activity minutes were associated with LIBRE Social Interactions and LIBRE Social Activities (P<.05), and significantly moderated the association between PROMIS Anxiety and LIBRE Social Activities (P<.001). ConclusionsSocial participation outcomes are associated with pain, anxiety, and depression symptoms after burn injury, and are buffered by daily physical activity. Future intervention studies should examine physical activity promotion to improve social recovery after burns.

Feasibility randomised controlled trial of face-to-face counselling and mobile phone messages compared to usual care for smokeless tobacco cessation in Indian primary care: Project CERTAIN.

Smokeless tobacco (SLT) use in low- and middle-income countries (LMICs) has adverse health consequences. We hypothesize that it is feasible to test an intervention of mobile phone messages and face-to-face counselling session for SLT cessation in India. We conducted an exploratory, individual parallel two group, randomised controlled trial (RCT), with baseline -and end-point (three months from randomisation) assessments in urban primary health centres in Odisha, India. A total of 250 current (i.e., users in the last three months) SLT users or dual users (i.e., smokers and SLT users) were recruited to the trial (125 in each group). Participants were randomised to either routine care, face-to-face counselling, and reminder mobile messages or routine care only. The primary outcomes were to assess the feasibility of running a full RCT including recruitment, compliance, and retention. A total seven (77.8%) out of nine primary care centres took part in the trial. Out of the 315 SLT users invited to participate, 250 provided consent and were randomised [79.4% (95% CI: 74.5, 83.7)]. Out of the 250 randomised SLT users, 238 [95% (95% CI: 91.8, 97.5)] were followed up at three months (117 in the intervention group and 121 in the control group). Of the participants in the intervention group, 74 (63.8%) reported that they received the mobile messages. This exploratory trial demonstrated the feasibility of delivering and evaluating an intervention of mobile phone messages and face-to-face counselling for SLT users in Indian primary care in a full randomised trial. This study found that combining mobile messages with face-to-face counselling for smokeless tobacco users visiting primary health care settings in India is feasible in terms of recruitment of users, compliance with the intervention, and retention of study participants within the trial.The biochemically verified smokeless tobacco abstinence rate was higher in the intervention group compared with the control groupThere was poor agreement between self-reported tobacco cessation and the measured salivary cotinine in smokeless tobacco users.The findings support the feasibility and acceptability of the intervention signalling the need for a larger clinical trial to test effectiveness of the intervention.

Evaluating the effectiveness of three communication modes in promoting repeat voluntary donation behavior in first-time blood donors at a tertiary care blood center in North India

Abstract: INTRODUCTION: Due to rapid technological advancements, several new methods such as telephone (TP), e-mail, social media, WhatsApp (WA), and Short Message Services are being used as effectively among blood centers worldwide for postdonation communication with blood donors’ education and motivation to recruit and retain them as repeat and regular voluntary nonremunerated blood donors. The present study was aimed at determining the effectiveness of WA, TP, and personal communications (PCs) as modes of communication to recruit and retain first-time replacement blood donors to become repeat and regular voluntary blood donors. MATERIALS AND METHODS: This 1-year observational prospective study was conducted in the Post Graduate Department of Immunohematology and Blood Transfusion in Government Medical College and Hospital, Jammu. Three hundred first-time blood donors selected for the study were divided into three groups comprising 100 blood donors each as per the mode of communication strategy adopted, namely postdonation PC, TP, and WA groups. RESULTS: The repeat donation rate was highest in the TP group (61%), followed by the WA group (47%) and PC group (37%). The mean repeat donation was found to be significant in the TP group (P = 0.007) and WA group (P = 0.021) as compared PC group while there was no significant difference between the TP group and WA groups (0.751). CONCLUSION: In our study, it was found that of the three communication modes, namely personal, TP, and WA, telephonic communication with a repeat donation rate of 61% was the most effective mode of communication in for motivating and converting first-time blood donors into repeat regular voluntary blood donors.

Selfsupport Assistive Device for Visually Impaired People Using Iot

Assistive device tailored for visually impaired individuals to navigate streets, public spaces, and seeking aid independently. It outlines the key components of the system, including a microcontroller board, various sensors, cellular communication, GPS modules, IoT technology, and a Bluetooth instruction provider are showcasing the technological backbone supporting its functionalities. The system primarily employs sensors to track the user's path and detect obstacles, alerting them through sound and wrist vibrations. Notably, it also notifies nearby individuals when assistance is required and sends alerts, alongside the user's location, to registered family members and caregivers via phone messages. Furthermore, registered phones can retrieve the system's location and enable real-time tracking of VIP. The abstract underscores the system's thorough testing and verification process, ensuring its functionality effectiveness. Lastly, it emphasizes the system's superiority over existing solutions and anticipates its significant positive impact on enhancing the quality of life for visually impaired individuals.

An Improvement Project in Reducing After-Visit Phone Calls in a Community Pediatric Neurology Clinic: Too Much Communication?

Physicians strive to provide high-quality clinical care, yet after-visit patient telephone calls create extra demands on a clinician's time. Pediatric neurologists are particularly affected by this challenge given the number of patients with chronic illnesses they serve and the volume of worried parents they support. Added workload coupled with a busy office practice increases the likelihood of early physician burnout, which can have downstream effects on the quality of patient care and patient satisfaction. Using the IHI model for quality improvement (abbreviated QI moving forward), QI methodology was used to determine volume and key drivers of patient/family communications after a visit to a pediatric neurology clinic. Interventions aimed at reducing telephone messages by 15% over a 6-month period were put into place. A baseline audit of clinic phone calls was completed in 2019 to develop an overview of after-visit communications. After-visit telephone calls and web-based portal messages were then tracked for 3-week periods in 2019, 2020, and 2021 to understand key trends. A key driver diagram of patient/family communications after a clinic visit was created, and interventions aimed at reducing telephone messages were discussed. These interventions included optimizing MD-RN workflows, synchronous and asynchronous educational initiatives, and changes to our clinic's voicemail phone tree. Our primary outcome measure was the average monthly telephone call volume, and this measure was tracked monthly from November 2020 through December 2022. Similarly, electronic portal message volume was tracked and served as our balancing measure. Physicians, nurses, and patients were primary drivers of phone call volume. After interventions were in place, the average monthly call volume decreased by 30% from a baseline of 293 calls to 203 calls. This change was sustained for at least 1 year. The average monthly portal message volume remained consistent throughout the study period at 359 messages. Both physicians and nurses agree that after-visit patient communication affects their workload. This study illustrates that QI methodology can be used to plan and implement interventions aimed at decreasing after-visit telephone calls.

Has telemedicine come to fruition? Parents’ and pediatricians’ perceptions and preferences regarding telemedicine

BackgroundTelemedicine has increasingly become a viable option for patient care and may increase access to care. The aim of our study was to evaluate both parent and pediatrician perceptions, preferences, and acceptability regarding the use of different telemedicine modalities.MethodsWe conducted a cross-sectional survey of both parents and pediatricians in Geneva, Switzerland in 2021. The questionnaire focused on digital literacy, preferences, acceptability, advantages, and disadvantages regarding telemedicine (phone, email, video, and instant message). Descriptive statistics and comparisons of preferences and perceptions (Pearson Chi2 and logistic regression) were performed.ResultsTwo hundred and twenty-two parents and 45 pediatricians participated. After face-to-face consultations, parents and pediatricians preferred the phone for simple medical advice, discussion of parameters, acute or chronic problems, and psychological support. Email was preferred for communication of results and prescription renewal. Main reasons for using telemedicine were avoiding travel and saving time. Disadvantages were lack of physical examination, technical problems, and unsuitability of the reason for consultation.ConclusionsUnderstanding the factors that influence acceptance and satisfaction with telemedicine is vital for its successful implementation. Convenience, quality of care, trust, strong pediatrician–parent relationships, technical reliability, user-friendliness, and privacy considerations play significant roles in shaping parent and pediatrician attitudes toward telemedicine.ImpactThe COVID-19 pandemic spurred the expansion of the use of telemedicine in pediatric care. Few studies have addressed parent and pediatrician perceptions and preferences regarding telemedicine.Both parents and pediatricians consider certain telemedicine modalities (phone, email, video, and instant message) pertinent in only specific clinical situations.Advantages of telemedicine outweigh disadvantages with parents and pediatricians appreciating the increased access to care, time savings, and avoiding transport. However, the lack of a physical examination remains a significant disadvantage.Convenience, quality of care, trust, strong pediatrician–parent relationship, technical reliability, user-friendliness, and privacy considerations play significant roles in shaping attitudes towards telemedicine.