Preferred Mode Of Delivery Research Articles

Obstetric anesthesia management of dilated cardiomyopathies and heart failure: a narrative review

Pregnancy in patients with dilated cardiomyopathy carries a significantly increased risk of maternal mortality or severe morbidity, and pregnancy is typically considered contraindicated for patients with severely reduced ventricular function. Nonetheless, anesthesiologists will still encounter patients with cardiomyopathy requiring delivery or termination care. This review describes how NT-ProBNP testing and echocardiography can help with early recognition of heart failure in pregnancy, and describes a suggested approach to anesthetic management of patients with cardiomyopathies or acute heart failure, including hemodynamic goals, use of vasoactive medications and mechanical support. Vaginal delivery, with effective neuraxial anesthesia is the preferred mode of delivery in most patients with cardiomyopathy, with cesarean delivery reserved for maternal or fetal indications. The Pregnancy Heart Team is vital in coordinating the multidisciplinary care necessary to safely support these patients through pregnancy.

Client perspectives: Telehealth for mental health services.

The COVID-19 pandemic required mental health clinicians globally to transition to the delivery of care via telehealth. This study aimed to gain an understanding of clients' satisfaction with and attitudes towards telehealth mental health services. Seventy adults who had attended a clinic for mood and anxiety disorders, and participated in at least one telehealth consultation with a psychologist or psychiatrist, completed an anonymous online survey. The majority of participants (81.5%) reported satisfaction with telehealth mental health care provided during the COVID-19 pandemic. However, satisfaction overall was significantly higher amongst participants who had received both telehealth and face-to-face mental health care, compared to participants who received care via telehealth only. Advantages of telehealth care reported included convenience and increased access to mental health clinicians. However, disadvantages of telehealth care included greater difficulty developing a rapport with a clinician and expressing oneself via telehealth. Whilst client satisfaction with telehealth mental health care for mood and anxiety disorders is generally high, clinicians should consider the limitations of telehealth from clients' perspectives. In particular, strategies to enhance therapeutic connection during telehealth sessions may be needed, and client preferences for mode of delivery should be taken into consideration when possible.

INVESTIGATING UNIVERSITY LEVEL STUDENTS’ PREFERENCES BETWEEN TRADITIONAL AND BLENDED LEARNING APPROACHES

This research assessed the students’ attitudes toward blended learning at universities, specifically accenting delivery mode preferences, exam format preferences, and trust in the digital instructional resources. The study used a quantitative research method with descriptive survey design. A purposive sample of 450 students from public and private universities was used. The study utilized the validated instruments. It was also notable that students had highly positive inclination toward face-to-face interaction, and hands-on practice, which suggested a hybrid approach of face-to-face teaching and online instruction was preferred over the fully online style of teaching. The analysis revealed that university type and academic year influence attitudes. Concerning the exam types, students were more comfortable with traditional paper and pencil tests; but male students were more accepting of technology-based tests. The level of trust in digital instructional materials was high, although it varied by year of study. Thus, teachers should adopt a gradual approach in integration of blended learning into their classroom. There is need to support learning from diverse backgrounds. The study can help inform educational policy, course development & faculty professional growth in institutions.

OCCUPATIONAL THERAPIST PRACTITIONERS’ PERCEPTIONS OF CONTINUING EDUCATION FOR NEUROREHABILITATION: A QUALITATIVE STUDY

Occupational therapists are required to obtain CE units to ensure professional competency. This study examined occupational therapy practitioners to understand: What are OTPs’ perceived challenges and CE needs when working with populations with neurological impairments? And how can CE courses be tailored towards addressing these challenges and gaps in knowledge effectively? There were 14 responses and 6 themes identified. Participants indicated if they had access to supportive resources as well as their preferred mode of delivery for CE. The findings of this study can be used to identify the preferences, specific clinical skillsets currently used, and gaps in supportive resources. Keywords: continuing education, occupational therapy, perceptions, neurorehabilitation

Bibliometric Analysis of MSC-based Therapies for Non-COVID-19 ARDS

Background: Acute respiratory distress syndrome (ARDS) poses a significant challenge as it lacks specific treatments and can occur due to various etiologies. Mesenchymal stem cells (MSCs) have emerged as a promising cell-based therapy for ARDS due to their immunomodulatory, anti-inflammatory, and anti-fibrotic properties. Despite encouraging findings from preclinical studies, clinical evidence supporting the efficacy of MSCs in non-COVID-19 ARDS remains insufficient. Methods: We conducted a systematic search of three major databases (Web of Science Core Collection, Scopus, and PubMed) to identify original articles focusing on MSCs in non-COVID-19 ARDS. Subsequently, we employed the bibliometric package in R Studio to analyze and visualize bibliometric indicators derived from the retrieved articles. Results: Our analysis of 244 original studies revealed a notable trend in research on MSCs and non-COVID-19 ARDS. While the number of publications in this area saw an increase beginning in 2007, it exhibited a decline after 2019, with only 20 articles published in 2022. Notably, a significant proportion (131/244) of these studies originated from Chinese scholars. MSC derivatives emerged as a recent research focus due to their unique advantages as an alternative to MSCs. Specifically, umbilical cord/placental-derived MSCs have gained traction, surpassing the use of bone marrow-derived MSCs by 2022. The route of delivery is still mainly intravenous. Despite the potential advantages of the intratracheal route for lung-related diseases, the intravenous route remains the preferred mode of drug delivery. Conclusion: Research on non-COVID-19 ARDS deserves further attention and investments. Existing studies have primarily focused on MSC derivatives that have shown clinical efficacy. Furthermore, umbilical cord/placental-derived MSCs are expected to replace traditional bone marrow- derived MSCs in research. Intratracheal delivery, which offers advantages for treating pulmonary diseases, still requires extensive experiments to validate.

Preferences and factors determining preferences for mode of delivery among primigravida mothers.

Childbirth is a beautiful life event, a unique personal experience for each woman. The study aimed to assess the preferences and factors determining preference for mode of delivery among primigravida mothers. A descriptive exploratory design was applied to explore the factors for preferring the mode of delivery among 250 antenatal mothers, selected by convenient sampling technique. A self-structured dichotomous questionnaire on preference and factors influencing preference for mode of delivery was used. Descriptive and inferential statistical analysis was done using SPSS 20 software. The majority of participants (98.4%) preferred vaginal delivery over elective cesarean section as a mode of delivery. The significant factor influencing preferences was speedy recovery after delivery (89.8%). However, significant factors for preferring the cesarean mode of delivery were the obstetrician's advice and the baby's safety (100%). The majority of women preferred a vaginal mode of delivery; they still undergo cesarean mode of delivery. Considering factors, there is a need to develop a positive attitude toward NVD and actions to create awareness toward a safe mode of delivery by building a mutual trust environment and increasing effective dissemination of correct and neutral delivery option advice.

Student experience using synchronous and asynchronous instruction in mathematics classes

This paper aims to study the effects that asynchronous and synchronous instructional methods have on student perceptions and attitudes towards online education. We analyze both qualitative and quantitative survey responses from 496 students in three large (greater than 200 enrolled students) first-year calculus classes at the University of Guelph. The survey results show significant differences among the three online instructional formats in students’ attitudes toward asking questions, the similarity of each instructional modality to face-to-face delivery, technology issues encountered, students’ perceived ability to keep up with course content, how collaborative the course felt, and student preferences for mode of delivery. There were no significant differences reported in relation to time-management skills or communication with instructors. Qualitative analysis of student comments also revealed perceived strengths and weaknesses of each mode of instruction. The results are used to make suggestions for improving student experience in online, post-secondary mathematical teaching.

Fast-Track Training in Emergency Department During the COVID-19 Pandemic: Evaluation of a Hybrid Education Model.

Emergency department (ED) fast track (FT) for the ambulatory, minor injury patient cohort requires rapid patient assessment, treatment, and turnover, yet specific nursing education is limited. The study aimed to test the feasibility and staff satisfaction of an education program to expand nursing skills and knowledge of managing FT patients during the COVID-19 pandemic. This quasi-experimental study, including self-rating surveys and interviews, assessed the pre- and postimplementation of an education program for nurses working in FT in a metropolitan hospital ED in Australia. Hybrid (face-to-face and Teams) education sessions on 10 topics of staff-perceived limited knowledge were delivered over 8 months. Participants demonstrated higher knowledge scores after the implementation of short online education sessions to cover the core facets of minor injury management. Overall staff satisfaction with the program was high. Interview discussions involved three key themes, including "benefits to staff learning," "positive impact on patient care and flow," and "preferred mode of delivery." Recorded education sessions on minor injury topics for nurses working in FT have proved effective, and this program has now become a core facet of ED education in our hospital.

Type 1 Narcolepsy in Pregnancy: A Case Report and Review of Literature

Abstract: Background: Type 1 Narcolepsy (with cataplexy) is a rare disorder affecting the central nervous system, and is characterized by the inability to control sleep-wake cycles. There is a paucity of data regarding management during pregnancy. Case: This is a 23-year-old with narcolepsy and cataplexy, treated with methylphenidate in the third trimester, resulting in an improvement of episodes of cataplexy. A review of the literature reveals information regarding options for medical management and the mode of delivery for these women. Conclusion: Type 1 Narcolepsy can be treated with medications after consideration of risks and benefits. For patients who are symptomatic at the time of birth, cesarean section may be the preferred mode of delivery in women with type 1 narcolepsy.

Pulmonary Hypertension in Women.

Pulmonary arterial hypertension (PAH) is a rare devastating disease characterized by elevated pulmonary artery pressure and increased pulmonary vascular resistance. Females have a higher incidence of PAH, which is reflected globally across registries in the United States, Europe, and Asia. However, despite female predominance, women had better outcomes compared with male patients, a finding that has been labeled the "estrogen paradox." Special considerations should be given to women with PAH regarding sexual health, contraception, family planning, and treatment before, during, and after pregnancy. Pregnant women with PAH should be referred to a pulmonary hypertension care center; a multidisciplinary team approach is recommended, and Cesarean section is the preferred mode of delivery. While pregnancy outcomes have improved over the years with PAH-specific therapy, pregnancy portends a high-risk for those with PAH. Continued research is needed to tailor PAH treatment for women.

Potholes and Patches: Lessons Learned From The Transition of Two Professional Programs to Online Learning

This paper reports on students’ perceptions of two different modes of delivery: synchronous online learning and face-to-face learning. The study examines the perspectives of both medical and law students and the factors influencing their preferred mode of delivery. Data were obtained from 11 focus group interviews conducted between 2020 and 2021 with 29 students from the Schools of Law and Medicine. Two themes were generated from the analysis and indicate that both groups of students preferred the flexible blended learning mode of delivery, appreciating the advantages of face-to-face and online learning. Although learning experiences between the empirical discipline of medicine and the more rationalist study of law showed contrasts, to some degree, both groups of students endorsed changes to programs that afforded greater flexibility in learning opportunities. Various factors, including the nature of the discipline, required skills sets, and individual preferences, were found to influence the students’ preferred mode of delivery. This study contributes to the understanding of students’ perceptions and preferences, providing insights for educational institutions in designing effective instructional strategies in a rapidly evolving educational landscape.

Medical Nutrition Therapy, In-Person, or Telephone Group Lifestyle Intervention for Type 2 Diabetes? A Qualitative Study of Patient Perceptions and Treatment Preferences.

The purpose of the study was to explore the thoughts, feelings, motivations, and assignment preferences of community health center patients with type 2 diabetes considering participation in a 2-year lifestyle intervention trial aimed at weight loss and increased physical activity. The reasons for patients' delivery mode preferences were also explored to aid in the design of future interventions for controlled trials. Using structured telephone interview guides, 57 patients with type 2 diabetes receiving primary care at 3 community health centers affiliated with an academic medical center were interviewed regarding the perceived pros and cons of each of the 3 possible treatment assignments: telephone conference group, in-person group, or individual medical nutrition therapy. The interview data were organized using NVIVO and analyzed using content analysis. Findings on whether preferences varied by age, gender, or diabetes duration were also examined. Six categories related to patient treatment preferences were identified: (1) perception of time, (2) learning style, (3) comfort, (4) prior experience with weight loss programs and conference calls, (5) desire for support/idea exchange, and (6) accountability. Preferences did not seem to vary by age, gender, or diabetes duration. Key factors influencing preference of treatment assignment included schedule demands, belief about learning style, and past experiences. These findings demonstrate the importance of having a variety of nutrition and lifestyle treatment options available to meet the needs of people with type 2 diabetes.

Consumer's preferences and willingness to pay for immune enhanced dairy products in Canada

This study examined consumer preferences for, willingness to pay for, and the most preferred mode of delivery for immune enhanced dairy products across Canada. Two sets of choice experiments were designed to evaluate preferences for functional foods and nutraceuticals as the modes of delivery for immune enhanced dairy products. Data (N = 1001) was collected through an online stated preference survey and analyzed using conditional logit model. Results revealed that there is a general consumer interest in immune enhanced dairy products, and consumers place a premium on them. Also, the presence of children below the age of fifteen in a household was a major factor that increased consumer receptivity towards the products. Further results revealed that individuals who usually consume functional foods are less likely to be interested in nutraceuticals, and vice versa, implying that the preferred mode of delivery depended on consumer preferences for either functional foods or nutraceuticals.

Ageing in the right place—usability of a web-based housing counselling service

Introduction Residential reasoning is a complex process that includes decisions on whether to age in place or to relocate. Ageing in the Right Place (ARP), a web-based housing counselling service was created to support older adults in this process. The study’s aim was to evaluate the usability of the ARP as regards content, design, specific functions, and self-administration as a mode of delivery and to lay the ground for further optimisation. Material and method Nine women and five men (aged 66–82) completed a series of tasks using the ARP. Qualitative and quantitative usability data were collected through online interviews. Data were analysed using qualitative content analysis and descriptive statistics. Results Experiences of the specific functions, content, and design of the ARP were described as mainly positive. Additions to the content and optimisation to assist in the general navigation of the website were suggested. The participants disagreed regarding the preferred mode of delivery, which indicates a need for selectable options. A system usability scale median score of 84 indicated acceptable usability. Conclusion The ARP seems to have acceptable usability, which paves the way for further evaluation. Significance By enabling residential reasoning, older adults are supported to make proactive choices based on informed decisions.

Mode of delivery preferences: the role of childbirth fear among nulliparous women.

The increasing Cesarean Section (CS) rates may be attributed to women's increasing requests for elective CS. High Fear of Childbirth (FOC), especially among nulliparous women, may be significantly associated with CS preference without medical indications. The current study aims to investigate the impact of childbirth fear on the mode of delivery preference among nulliparous women. A cross-sectional correlational study was performed in the Maternal and Children Hospital (MCH) from the beginning of October 2022 to the end of February 2023 and incorporated a convenience sample of 342 nulliparous women. The data was collected using a self-reported questionnaire comprising participants' demographic and obstetrics characteristics and the FOC questionnaire. A logistic regression model examined the relationship between CS preference and the other independent variables. The results indicated that 74.3% of the nulliparous women preferred vaginal delivery, while 25.7% preferred Cesarean Section. Concerning childbirth-related fear, the highest mean scores were related to fear of clinical procedures, fear of harming or distressing the infant, and fear of pain 5.19 ± 1.13, 5.12 ± 1.27, and 5.09 ± 1.22, respectively. High FOC was present among 74.6%, moderate in 17.3%, and severe in 6.7% of the participants. Logistic regression analysis showed maternal age and monthly income were the significant sociodemographic determinants of choosing CS as the preferred delivery mode (p < 0.05). Moreover, the participants who had increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, fear from not being involved in decision-making, and overall FOC had a higher probability of choosing CS as the preferred delivery mode compared to the participants who had lower fear (p < 0.05). Having high FOC increases the CS preference among nulliparous women. Increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, and fear from not being involved in decision- making seem to be significant dimensions of childbirth fear associated with CS preference among nulliparous women.

A5Sustainable healthcare placement preparation: enhancing AHP student preparation through immersive simulation and online learning

In 2021, a diverse international and inter-professional team designed and implemented an intensive in-person simulation week and an interactive online learning programme to enhance student preparation for clinical placement (the Clinical Placement Enhancement Project) supported with funding from Health Education England. The simulation programme aimed for students to develop their patient-centred communication skills, assessment and therapeutic management by attending three simulation scenarios and inter-professional understanding through participation in a multi-disciplinary team (MDT) meeting. The bespoke online programme was designed with similar learning outcomes and utilized various learning materials, including 360° images of clinical environments linked to case studies. The study design was an integrative mixed-methods feasibility study, with 29 AHP students participating in the simulation and 24 students taking part in the online arm of the study. Students from physiotherapy, occupational therapy and podiatry self-selected their preferred delivery mode for placement preparation. The evaluation explored the experiences of both domestic and international students attending the simulation and using the online learning. In addition, perspectives of the clinical educators and actor role players were explored. Data were inductively analysed using a reflexive thematic approach and integrated with the quantitative data. The key findings from the pilot study showed the value of the simulation programme in allowing students to apply their learning, particularly helping them to develop their confidence in communication, rapport building and interventions. By contrast, the online learning programme was most effective at developing students’ clinical reasoning and proficiency with documentation [1]. We have built on these findings this year, to upscale the simulation programme to include all first-year AHP students ( By combining the immersive simulation with the online learning, we have created a sustainable and achievable approach to better prepare AHP students for clinical placement, and this combined approach may help to reduce the burden for our clinical educators. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Preferred type, timing and format of dementia information: A cross-sectional survey of carers of people living with dementia.

To clarify the unmet information needs of carers of people living with dementia, including the stage of their care journey at which topics become relevant, and the preferred format and mode of delivery of information. A cross-sectional survey of carers of people living with dementia was conducted between April 2022 and October 2022. Carers were recruited through public and private geriatric hospital and community clinics, aged care providers, an online research register and community dementia services. Consenting carers completed a survey assessing sociodemographic characteristics, preferred type and timing of information about dementia, accessing services, changes in behaviour/personality, changes in physical/emotional health, managing own health/well-being and preferred information format and mode of delivery. A total of 163 carers returned a survey (20% response rate). Most carers (75-98%) reported wanting information across a range of topics. Carers preferred general dementia information at diagnosis, information about accessing services at or within the first year of diagnosis, and information on managing symptoms as they emerged. Carers were most interested in receiving information in-person face-to-face (60% very interested), written information (51% very interested) or via face-to-face group information sessions (42% very interested). Carers of people living with dementia expressed a desire for information on a wide range of topics, which changed as the dementia of the person they cared for progressed. Information needs to be made available in a variety of formats to cater for differing ways in which it is consumed.

Consulting patients and providers of assisted reproductive technologies to inform the development of a group psychological intervention for women with infertility

ObjectiveTo consult providers and women patients of Assisted Reproductive Technologies regarding their preferences for the format, duration and content in the development of a group psychological intervention. MethodsProviders and current and past women patients of Assisted Reproductive Technologies completed an online cross-sectional survey comprising items about session content, number, frequency, timing, format, delivery mode and inclusion of experiential practice of psychological strategies to promote well-being. ResultsEight providers, 51 current women patients and 51 women who previously underwent Assisted Reproductive Technologies participated. Sixty-two percent of participants indicated a group psychological program would be helpful; and 34% thought it may be helpful. Face-to-face was the preferred delivery mode (42%). Seventy-one percent preferred 60-min sessions held fortnightly (64%), with six sessions most acceptable (24%). Most respondents (74%) felt group participants would likely complete at-home practice. Detailed thematic content from participants highlighted a complex range of consumer challenges. Relevant behaviour change techniques were verified, with those to be included identified as: feedback and monitoring, regulation, self belief, reward and threat, natural consequences, identity, support, shaping knowledge, and comparison of outcomes. ConclusionProviders and patients were supportive of the development of a group psychological intervention to provide support for women undergoing Assisted Reproductive Technologies. InnovationThe results of this study provide insight informing the co-design of a group psychological program for women with infertility.

The experience and attitudes of long-term care workers with teaching and learning modalities for the delivery of continuing professional development activities: a mixed-methods study

Aimto develop a better understanding of the attitudes and experiences of healthcare workers and managers with face-to-face, online asynchronous (pre-recorded), and online synchronous (live) modalities for Continuing Professional Development (CPD) working in the Long-Term Care (LTC) sector. BackgroundThe recent global pandemic significantly interrupted the delivery and organisation of education and training for healthcare professionals internationally. As a result of the restrictions, healthcare professionals’ access to CPD was limited, consequentially education and training activities were mostly delivered online. Research into the experiences of healthcare workers with the various teaching and learning modalities in the LTC setting is limited. DesignAn explanatory mixed methods study using an exploratory sequential design. MethodsA two-phase study conducted from January 2022 to September 2022, in the Republic of Ireland. In phase one, researchers conducted four focus groups and in phase two 168 participants completed a survey to explore the results of phase one. ResultsFrom the focus groups interviews five themes emerged regarding participants’ experiences, attitudes and preferences with the three modalities of CPD education and training in the field of LTC: 1) Flexibility, 2) Networking, 3) Resources and Support, 4) Engaging and meaningful learning, and 5) Balancing online and face-to-face learning through Blended Learning. Results from the survey found the preferred modality was face to face (n = 54, 32.1%), followed very closely by blended learning (n = 51, 30.4%). Most of the respondents reported that synchronous online CPD education was convenient, flexible, offers the opportunity to interact with peers, and that its quality depends on educators’ skills. The majority of respondents (n = 155, 92.3%) declared that they would require support in the workplace to implement their new knowledge and skills. ConclusionsThis study revealed the significance participants place on ‘engagement’ when taking part in education and training. Engagement was described as a key factor to improve the delivery of CPD in the LTC setting. In addition, regardless of the mode of delivery, participants reported that they need to be supported in the workplace to implement their new knowledge and skills. This requires the support and endorsement of employers and managers, who could ensure more protected time for learning, technical support and championing facilitators and mentors in the workplace to enhance the translation of new knowledge into clinical practice. Tweetable abstractIn LTC settings, face-to-face CPD is the preferred mode of delivery. Although synchronous online CPD is very convenient, educators must be able to engage learners. LTC workers need support by managers to implement their new knowledge and skills in their workplace.

Digital Redesign of Problem-Based Learning (PBL) from Face-to-Face to Synchronous Online in Biomedical Sciences MSc Courses and the Student Perspective

PBL is a widely used teaching approach that is increasingly incorporating digital components. Although, by its nature, a face-to-face approach is the preferred mode of delivery, its digital counterpart is gaining ground. The current paper discusses the digital redesign of PBL in an MSc in Biomedical Sciences. Face-to-face and online PBL followed the seven steps of the PBL process, and each case was completed in three sessions. For the delivery of online PBL, collaborative tools were utilized, including CiscoWebex, the online platform for synchronous meetings, and OneDrive, shareable PPT, and Moodle for synchronous and asynchronous self-directed learning. Three cohorts were followed, and students had both face-to-face and online PBL experiences. Student feedback was obtained using focus groups, and data analysis utilized a deductive and inductive approach. Our data indicate that CiscoWebex is a suitable and user-friendly platform for synchronous online PBL. The students enjoyed both formats and stated that online PBL is an effective teaching approach for promoting student learning. In regards to student interaction, the face-to-face mode was preferred, while online PBL was perceived as more organized. The redesign allowed for effective student learning and could pave the way forward for a fully online MSc program in Biomedical Sciences.