Contact Restrictions Research Articles

Move, connect and go outside! A randomized controlled trial of two online interventions and analysis of helpful coping strategies in COVID-19 "homestayers".

The COVID-19 pandemic has led to a global health crisis and a significant increase in psychological distress and psychopathological symptoms. We conducted a randomized controlled trial with two online interventions derived from positive psychology (PP) and acceptance and commitment therapy (ACT) in N = 138 "homestayers" during the first lock-down period in Germany. PP exercises had a positive impact on anxiety scores, which decreased significantly during the intervention, particularly in participants without access to a garden. Direct or indirect social contact, movement/exercise, and exposure to nature were the most frequently reported helpful coping strategies. We conclude that low-threshold online interventions with a focus on positive aspects of people's lives may be helpful to support mental health during pandemic crises. From a mental health perspective, the results also reinforce the approach of countries that allow their citizens to, for example, still go for walks during periods of contact restrictions, compared to full lock-down conditions.

РЫНОК КЕЙТЕРИНГОВЫХ УСЛУГ И ОСОБЕННОСТИ ЕГО УЧЕТА

This article explores the organization of accounting for catering services, which includes both catering and comprehensive service offerings for company employees at locations specified by clients. The demand for catering services is on the rise, fueled by heightened competition and significant socio-economic impacts stemming from the Covid-19 pandemic. In Kazakhstan, corporate clients represent the primary consumer group for catering services, making up 70% of all orders. The article examines the current landscape and future potential of the catering sector in Kazakhstan, identifying key segments such as catering services, corporate offerings, and in-flight catering. It also addresses the legal regulations as well as the documentation, synthetic, and analytical accounting methods relevant to transactions in this field. The findings of this study are practically beneficial for catering businesses, particularly concerning specific documents and accounting entries. With the expansion of catering services in local enterprises and ongoing social contact restrictions due to the Covid-19 pandemic, there is a pressing need to enhance methods and types of catering service delivery, along with the accounting for related expenses.

Telemedicine technologies in allergology: implementation experience in clinical practice, problems and perspectives

In 2020, the need for widespread restriction of social contacts around the world has raised the issue of alternative types of medical care and, in particular, the development of online consultations with physicians of subspecialties. However, even before the Covid-19 pandemic, telemedicine technologies were demonstrating their ability to save financial and time resources, increase access to health services and improve adherence to treatment for patients with allergic diseases. Despite some technical and legal difficulties associated with the organization of remote appointments, the clinic of the National Research Center – Institute of Immunology Federal Medical-Biological Agency managed to successfully implement a platform for telemedicine consultations. During the period from 1.09.2020 to 19.04.2024, 4675 patients were consulted, 945 of whom filled out a questionnaire on the quality of medical care provided. According to the results of analyzing the obtained data, we observed high patient satisfaction with the new medical service as well as economic profitability of the project. The purpose of this article is to provide a visual overview of the world and domestic experience of telemedicine implementation in the clinical practice of an allergist, to tell about the way of organization and operation of the platform for telemedicine consultations in the National Research Center – Institute of Immunology Federal Medical-Biological Agency, and to highlight the current state of the problem.

Anxiety and depression in cancer patients and survivors in the context of restrictions in contact and oncological care during the COVID-19 pandemic.

Treatment modifications and contact restrictions were common during the COVID-19 pandemic and can be stressors for mental health. There is a lack of studies assessing pandemic-related risk factors for anxiety and depression of cancer patients and survivors systematically in multifactorial models. A total of 2391 participants, mean age 65.5 years, ≤5 years post-diagnosis of either lung, prostate, breast, colorectal cancer, or leukemia/lymphoma, were recruited in 2021 via the Baden-Württemberg Cancer Registry, Germany. Sociodemographic information, pandemic-related treatment modifications, contact restrictions, and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed via self-administered questionnaire. Clinical information (diagnosis, stage, and treatment information) was obtained from the cancer registry. Overall, 22% of participants reported oncological care modifications due to COVID-19, mostly in follow-up care and rehabilitation. Modifications of active cancer treatment were reported by 5.8%. Among those, 50.5% had subclinical anxiety and 55.4% subclinical depression (vs. 37.4% and 45.4%, respectively, for unchanged active treatment). Age <60 years, female sex, lung cancer, low income, and contact restrictions to peer support groups or physicians were identified as independent risk factors for anxiety. Risk factors for depression were lung cancer (both sexes), leukemia/lymphoma (females), recurrence or palliative treatment, living alone, low income, and contact restrictions to relatives, physicians, or caregivers. The study demonstrates that changes in active cancer treatment and contact restrictions are associated with impaired mental well-being. The psychological consequences of treatment changes and the importance for cancer patients to maintain regular contact with their physicians should be considered in future responses to threats to public health.

Getting breastfeeding started under pandemic visiting restrictions: lessons learned in Germany

BackgroundThe COVID-19 pandemic contact restrictions considerably changed maternal visiting contacts during the time in which breastfeeding is initiated. We wanted to know how maternity ward staff and mothers rated the conditions of starting breastfeeding under contact restrictions.MethodsIn the Breastfeeding in North Rhine-Westphalia (SINA) study, Germany, 2021/22, chief physicians as well as ward staff from 41 (out of 131) maternity hospitals (82 members of the healthcare sector in total) were surveyed by telephone concerning structural and practical conditions for breastfeeding support before and during the pandemic; 192 (out of 426 eligible) mothers answered an online-questionnaire about their breastfeeding experiences at 2 weeks and 2 months after birth.ResultsIn almost all of the hospitals, visits were restricted due to the pandemic, with the exception of the primary support person. After more than one year of pandemic experience, the ward staff were convinced that the restrictions were mostly positive for the mothers (97.6%) and for the ward staff themselves (78.0%). A total of 80.5% of the ward staff would maintain the restrictions beyond the pandemic. The mothers themselves mostly rated the restrictions in the hospital as being just right; moreover, many mothers voluntarily maintained the restrictions at home, at least in part.ConclusionsThe unprecedented visiting restrictions in hospitals during the pandemic were like an “experiment” born out of necessity. Restricting visiting arrangements may be an underestimated beneficial component for the development of the mother-infant dyad in perinatal breastfeeding care, particularly in healthcare systems where almost all births occur in the maternity hospital.Trial registrationGerman Clinical Trials Register (DRKS) (DRKS00027975).

Development Of Long-Term Care Dependency And Utilisation Of Long-Term Care Services From 2017 To 2022 In Germany, Saxony-Anhalt: Analysis Of Health Insurance Data

Saxony-Anhalt has the highest old-age dependency ratio among the German federal states. The proportion of long-term care-dependent people can be expected to increase in the future, given the aging of the population. The SARS-CoV-2 pandemic has influenced nursing care, reduced the utilisation of services and led to changes in care arrangements. The aim of this study was to analyse the development of long-term care-dependency in Saxony-Anhalt, Germany, taking into account the legal changes, the pandemic and the development after the lifting of the contact ban. The analysis uses aggregated and anonymised health claims data from people insured with AOK Saxony-Anhalt from 2017 to 2022 in need of long-term care. Changes over time in the use of various care services were analysed. In 2017, 64,591 people insured in the statutory health insurance AOK Saxony-Anhalt (AOK ST) were in need of long-term care. The prevalence increased continuously throughout the observation years. For the lowest level of care (minor impairment of independence), the most significant and strongest increase was recorded in the first years after its introduction from 2017-2019. The majority of people in need of long-term care (41-44%) were in the category of care level 2 (considerable impairment of independence). Overall, the proportion of cash benefits has risen steadily since 2017, from 40.5% to 50.3% in 2022. At the same time, the proportion of long-term care in nursing homes decreased at all care levels. The trend toward less nursing home care has become stronger since 2017 and particularly since the onset of the SARS-CoV-2 pandemic in 2020. Since the introduction of the new definition of the need for long-term care in Germany, the analysis shows an increase in the number of people in need of long-term care, with those with considerable impairment of independence making up the largest proportion. There has been a significant increase in the number of people receiving cash benefits and a decline in nursing home care. Compared to the nationwide data of health claims, data show a greater use of nursing services in home-based arrangements. The analysis during the COVID-19 pandemic shows a trend towards home care, but no fundamental change. Special situations such as contact restrictions may have influenced the use of care services. Future research should examine the design of home care arrangements and the needs of those affected in greater detail.

Implementation and Evaluation of a Gait Training Assistant for the Use of Crutches: Usability Study.

Surgical procedures on the lower extremities often require weight-bearing on crutches as part of the rehabilitation process. Orthopedic elective procedures enable patients to learn the correct use of crutches in a controlled preoperative setting. Digital assistance systems can safely circumvent a shortage of skilled staff and any contact restrictions that may be necessary. The usability of a newly developed gait training assistant (GTA) for the use of crutches will be evaluated. An intervention group trained to use crutches by the digital trainer will be compared with a control group trained to use crutches conventionally by a physiotherapist. As part of the development and implementation of a novel GTA, 14 patients learned to walk with crutches by completing specific exercises while receiving live feedback. Their movements were detected by a depth sensor and evaluated in real time. Specific parameters (step length, synchronous movement, crutch angle, and crutch distance to the feet) were compared with a control group (n=14) trained to use crutches by physiotherapists. The intervention group was also assessed by a physiotherapist. At the end of the study, the patients completed questionnaires to evaluate the usability of the system (Brooke's System Usability Scale score) and patient satisfaction. All patients trained by the novel GTA were able to use crutches correctly. The intervention group showed significantly better values for crutch angle (mean -6.3°, SD 3.5° vs mean -12.4°, SD 4.5°; P<.001) and crutch position (mean 3.3, SD 5.1 cm vs mean -8.5, SD 4.9 cm; P=.02). Both groups reported that they felt confident in the use of crutches, were able to follow the instructions, and enjoyed the training. Even though the majority (12/14, 86%) preferred physical therapy over a purely digital approach, most participants enjoyed using the system (13/14, 93%) and were interested in trying out other digital assistants (11/14, 79%). The usability of the GTA was rated above average by the majority (9/14, 64%) of the patients. The newly designed GTA is a safe method of teaching the use of crutches and is statistically superior to training by a physiotherapist. Even if patients prefer interaction with a physiotherapist over a purely digital approach, digital devices provide a safe and motivating opportunity to learn the essential locomotor skills for rehabilitation.

Inferring enterovirus D68 transmission dynamics from the genomic data of two 2022 North American outbreaks

Enterovirus D68 (EV-D68) has emerged as a significant cause of acute respiratory illness in children globally, notably following its extensive outbreak in North America in 2014. A recent outbreak of EV-D68 was observed in Ontario, Canada, from August to October 2022. Our phylogenetic analysis revealed a notable genetic similarity between the Ontario outbreak and a concurrent outbreak in Maryland, USA. Utilizing Bayesian phylodynamic modeling on whole genome sequences (WGS) from both outbreaks, we determined the median peak time-varying reproduction number (Rt) to be 2.70, 95% HPD (1.76, 4.08) in Ontario and 2.10, 95% HPD (1.41, 3.17) in Maryland. The Rt trends in Ontario closely matched those derived via EpiEstim using reported case numbers. Our study also provides new insights into the median infection duration of EV-D68, estimated at 7.94 days, 95% HPD (4.55, 12.8) in Ontario and 10.8 days, 95% HPD (5.85, 18.6) in Maryland, addressing the gap in the existing literature surrounding EV-D68’s infection period. We observed that the estimated Time since the Most Recent Common Ancestor (TMRCA) and the epidemic’s origin coincided with the easing of COVID-19 related social contact restrictions in both areas. This suggests that the relaxation of non-pharmaceutical interventions, initially implemented to control COVID-19, may have inadvertently facilitated the spread of EV-D68. These findings underscore the effectiveness of phylodynamic methods in public health, demonstrating their broad application from local to global scales and underscoring the critical role of pathogen genomic data in enhancing public health surveillance and outbreak characterization.

Sociodemographic influences on private and professional contact behaviour during the COVID-19 pandemic in Germany: cross-sectional analysis based on a Regional Blood Donor Cohort

ObjectiveThe COVID-19 pandemic has had significant health and socioeconomic impacts worldwide. Extensive measures, including contact restrictions, were implemented to control the spread of the virus. This study aims to examine the factors that influenced private and professional contact behaviour during the COVID-19 pandemic.ResultsWe used baseline data (January–April 2021) from the SeMaCo study (Serologische Untersuchungen bei Blutspendern des Großraums Magdeburg auf Antikörper gegen SARS-CoV-2), a longitudinal, regional cohort study assessing COVID-19 seroprevalence in blood donors from Magdeburg and surrounding areas in Germany. In the blood donor cohort (n = 2,195), there was a general reduction in private contacts (by 78.9%) and professional contacts (by 54.4%) after March 18, 2020. Individuals with higher education reduced both private (by 84.1%) and professional (by 70.1%) contacts more than those with lower education levels (private contacts 59.5%; professional contacts 37%). Younger age groups (18–30 years) reduced private contacts more frequently (by 85.4%) than older individuals (61–83 years, by 68.6%) and demonstrated a higher likelihood of private contact reduction compared to older age groups (51–60 years: odds ratio (OR) 0.45 [95% [CI] 0.32–0.65]; 61–83 years: OR 0.33 [95% [CI] 0.22–0.48]).

Social contacts in Switzerland during the COVID-19 pandemic: Insights from the CoMix study

To mitigate the spread of SARS-CoV-2, the Swiss government enacted restrictions on social contacts from 2020 to 2022. In addition, individuals changed their social contact behavior to limit the risk of COVID-19. In this study, we aimed to investigate the changes in social contact patterns of the Swiss population. As part of the CoMix study, we conducted a survey consisting of 24 survey waves from January 2021 to May 2022. We collected data on social contacts and constructed contact matrices for the age groups 0–4, 5–14, 15–29, 30–64, and 65 years and older. We estimated the change in contact numbers during the COVID-19 pandemic to a synthetic pre-pandemic contact matrix. We also investigated the association of the largest eigenvalue of the social contact and transmission matrices with the stringency of pandemic measures, the effective reproduction number (Re), and vaccination uptake. During the pandemic period, 7084 responders reported an average number of 4.5 contacts (95% confidence interval, CI: 4.5–4.6) per day overall, which varied by age and survey wave. Children aged 5–14 years had the highest number of contacts with 8.5 (95% CI: 8.1–8.9) contacts on average per day and participants that were 65 years and older reported the fewest (3.4, 95% CI: 3.2–3.5) per day. Compared with the pre-pandemic baseline, we found that the 15–29 and 30–64 year olds had the largest reduction in contacts. We did not find statistically significant associations between the largest eigenvalue of the social contact and transmission matrices and the stringency of measures, Re, or vaccination uptake. The number of social contacts in Switzerland fell during the COVID-19 pandemic and remained below pre-pandemic levels after contact restrictions were lifted. The collected social contact data will be critical in informing modeling studies on the transmission of respiratory infections in Switzerland and to guide pandemic preparedness efforts.

Rise of remote work across borders: opportunities and implications for migrant-sending countries.

Contact restrictions imposed during the COVID-19 pandemic have contributed to the rapid expansion of remote work. With this expansion, new opportunities arise for the typical migrant-sending countries in Central and Eastern Europe to remotely involve their diaspora in their labor market. The aim of this paper is, by using the case study of Latvia, to show the potential of cross-border remote work for alleviating human capital losses caused by emigration. We assess the main obstacles and necessary adjustments in taxes, social benefits, labor market regulation and other areas to facilitate the labor market transition and show what incentives the country can use to become a place of choice for performing remote work for the diaspora. Combining the perspectives of employers, employees and the government, this study sheds new light on the challenges and opportunities related to the rise of remote work for countries suffering from emigration. The comprehensive analysis builds on triangulating secondary data, analysis of policy documents, a survey of employers, as well as a survey and in-depth interviews with cross-border remote workers.

Individual differences in short-term social dynamics: Theoretical perspective and empirical development of the social dynamics scale

People have a need to form and maintain fulfilling social contact, yet they differ with respect to with whom they satisfy the need and how quickly this need is deprived or overly satiated. These social dynamics across relationships and across time are theoretically delineated in the current article. Furthermore, we developed a questionnaire to measure individual differences in three aspects of such social dynamics: (a) Family-friends interdependence, (b) Social deprivation, and (c) Social oversatiation. In a longitudinal study spanning 9 weeks in spring 2020, in total 471 participants (18–75 years, 47% women) answered the newly developed items on social dynamics, questionnaires on social dispositions (e.g., affiliation motive, need to be alone, social anxiety), and questions on personal and indirect contact with family and friends during nationwide contact restrictions related to COVID-19. The results showed that individual differences in Family-friends interdependence, Social deprivation, and Social oversatiation can be measured reliably, validly, and with predictive value for changes in daily contact as contact restrictions were loosened. We discuss potential applications of the Social Dynamics Scale (SDS) for studying social relationships in healthy and clinical populations, and conclude that the brief self-report questionnaire of social dynamics can be useful for situations and samples where direct behavioral observations are not feasible.

Development of Respiratory Infection Prevention and Control Self-Efficacy Scale for Adults.

This study aimed to develop a scale for respiratory infection prevention and control self-efficacy (R-PACS) to measure self-efficacy in the prevention and control of the spread of respiratory infections among adults and to confirm the applicability of the developed scale by testing its validity and reliability. This methodological study was conducted in two phases. During the first phase, the R-PACS scale was developed after conducting a thorough literature review, content validity, and a pilot test. In the second phase, its validity and reliability were verified against 210 university students in Korea. The criterion validity of the developed R-PACS scale was tested using the correlation with resilience scale. Item analysis, explanatory factor analysis, and convergent and discriminant validity analyses were conducted in order to verify construct validity. Furthermore, Cronbach's α was used to verify internal consistency reliability. The final version of the R-PACS scale comprises 4 factors and 16 items rated on a 5-point Likert scale. Higher scores are interpreted as higher levels of self-efficacy in the prevention and control of respiratory infection. The R-PACS scale exhibited good content validity, construct validity, criterion validity, and reliability. The correlation coefficient of the four factors was ≥.4, confirming the validity of item convergence; meanwhile, the Cronbach's α coefficient for the final 16 items of the developed scale was 0.923, verifying reliability. This scale consists of four factors: "environmental management", "contact restrictions", "general infection prevention and control", and "early detection". The applicability of the R-PACS scale exhibited acceptable validity and reliability. This scale can be utilized to assess and evaluate the degree of self-efficacy in the prevention and control of respiratory infections among adults. Data obtained using this scale can be utilized for preparing health behavior change and health promotion programs, and practical policies for preventing respiratory infections.

Comparing multiple infection control measures in a nursing home setting: a simulation study.

Compare the effectiveness of multiple mitigation measures designed to protect nursing home residents from infectious disease outbreaks. Agent-based simulation study. Simulation environment of a small nursing home. We collected temporally detailed and spatially fine-grained location information from nursing home healthcare workers (HCWs) using sensor motes. We used these data to power an agent-based simulation of a COVID-19 outbreak using realistic time-varying estimates of infectivity and diagnostic sensitivity. Under varying community prevalence and transmissibility, we compared the mitigating effects of (i) regular screening and isolation, (ii) inter-resident contact restrictions, (iii) reduced HCW presenteeism, and (iv) modified HCW scheduling. Across all configurations tested, screening every other day and isolating positive cases decreased the attack rate by an average of 27% to 0.501 on average, while contact restrictions decreased the attack rate by an average of 35%, resulting in an attack rate of only 0.240, approximately half that of screening/isolation. Combining both interventions impressively produced an attack rate of only 0.029. Halving the observed presenteeism rate led to an 18% decrease in the attack rate, but if combined with screening every 6 days, the effect of reducing presenteeism was negligible. Altering work schedules had negligible effects on the attack rate. Universal contact restrictions are highly effective for protecting vulnerable nursing home residents, yet adversely affect physical and mental health. In high transmission and/or high community prevalence situations, restricting inter-resident contact to groups of 4 was effective and made highly effective when paired with weekly testing.

Social Distance Behind Bars: Vergleich der Wahrnehmung des sozialen Klimas während der COVID-19-Pandemie zwischen Insassen und Vollzugsbediensteten in deutschen Gefängnissen

AbstractThe COVID-19 pandemic presented challenges to prison officers and inmates alike. Since it impacted all areas of the working and living environment, it was assumed that the social climate in prison changed as a result. As part of the Corona Behind Bars project, this study had two objectives: first, to compare how the social climate (Essen Climate Evaluation Schema) is perceived by inmates (N = 956) and prison officers (N = 502) as a result of the pandemic. Second, to analyze the impact of the burden of contact restrictions between inmates and prison officers on their respective perceptions of the social climate. In line with the differences between inmates and prison officers reported in the literature, inmates reported significantly higher values on the dimension experienced safety than did prison officers, while prison officers reported significantly higher values on the dimension therapeutic hold. No significant difference was found for the dimension inmate cohesion. Compared to norm values both the prison officers and the inmates rated the social climate as clearly below average. The moderation analysis revealed an interaction of status group × burden of contact restriction: The impact of the burden of contact restriction on social climate perception was more pronounced for inmates than for prison officers. Overall, the results suggest that the perception of the social climate was adversely affected by the pandemic for the prison officers and the inmates. However, the specific factors contributing to this deterioration appear to be group-specific.

Interactive electronic visualization formats in student teaching

In the context of contact restrictions, conventional teaching is currently in need of optimization and expansion. The range of digital teaching formats in student training is very heterogeneous and their effectiveness uncertain. This study aims to investigate the extent to which an electronic ward round can be used as an alternative to the conventional ENT attendance practical course, and whether the use of electronic teaching formats has an influence on the quality of teaching. Instead of regular attendance practicals, bedside teaching took place once aweek in real time as avideo stream via tablet. Atotal of 43students in the seventh semester (winter semester 2020/2021) were included in the prospective study. Evaluation forms were used to examine the subjective didactic value of different visualization formats for the students. Examination results from previous years were used for comparison. The majority of students reported knowledge gain from the electronic rounds (93.02%) and that they were agood alternative to the traditional attendance clerkship (69.77%). The quality of the video and audio transmission as well as the comprehensibility of the case studies presented were consistently rated as good to very good. The students' examination results tended to be slightly worse in the test group compared to the control students of previous years. Integration of innovative interactive visualization options into teaching shows promising prospects as asupplement to conventional face-to-face teaching. The results of this study can contribute to the further expansion of digital teaching. Scaling up this model could be considered especially in countries with limited availability of face-to-face teaching.

Introduction: Pandemic and Post-Pandemic Publication Patterns in Political Science

The COVID-19 pandemic triggered rapid transformations across the globe. Probably no other event in the past 50 years has changed the working environment more comprehensively. When the pandemic started in February and March of 2020, university campuses all over the globe shut down in less than a week. Most remained closed or had heavily restricted access for almost two years, depending on the country and the city. Overnight online teaching replaced in-person instruction; all professional and student interactions moved to Zoom, Teams, or Skype; academic conferences either did not take place or moved to an online format; and field research became almost impossible. In addition, contact restrictions, lockdowns, curfews, and homeschooling were unprecedented challenges for many people, especially members of the academic community who had small children (Del Boca et al. 2020). It is important to note that even in normal times women bear the greatest burden of childcare, social care for older people, and general household tasks. The COVID-19 pandemic quickly amplified these disparities (Ohlbrecht and Jellen 2021; Yerkes et al. 2022). Discussions emerged in many sectors, including academia, about specific ways that the pandemic was impacting professional lives, especially those of women. Given the acute pressure to publish in most higher-education institutions, it is important to evaluate the effect that the pandemic had on this central aspect of scholarly careers.

Feasibility of clinical examination scenarios under pandemic conditions

Due to the COVID-19 pandemic, contact restrictions occurred worldwide, which affected medical schools as well. It was not possible to hold classroom lectures. Teaching contents had to be converted to adigital curriculum within avery short time. Conditions for assessments posed an even greater challenge. For example, solutions had to be found for objective structured clinical examinations (OSCE), which were explicitly forbidden in some German states. The aim of this study was to evaluate the feasibility of an OSCE under pandemic conditions. At the end of the 2020 summer semester, 170students completed acombined otolaryngology and ophthalmology OSCE. Examinations were held in small groups over the course of 5days and complied with strict hygiene regulations. The ophthalmology exam was conducted face to face, and the ENT OSCE virtually. Students were asked to rate the OSCE afterwards. Between 106 and 118 of the students answered the questions. Comparing the face-to-face OSCE with the virtual OSCE, about 49% preferred the face-to-face OSCE and 17% preferred the virtual OSCE; 34% found both variants equally good. Overall, the combination of an ENT and ophthalmology OSCE was rated as positive. It is possible to hold an OSCE even under pandemic conditions. For optimal preparation of the students, among other things, it is necessary to transform teaching contents to adigital curriculum. The combination of an ENT and ophthalmology OSCE was positively evaluated by the students, although the face-to-face OSCE was preferred. The overall high satisfaction of the students confirms the feasibility of avirtual examination with detailed and well-planned preparation.

Database Performance Optimization using Lazy Loading with Redis on Online Marketplace Website

With the pandemic lasting over 2 years, many businesses start to adapting a digital approach of their business to stay alive. While in the same time, a number of users of digital platform also skyrocketed due to physical contact restriction policy. This causes a performance hit toward several online services such as an online marketplace due to high network traffic from many users accessing it in the same time, including latency issues. In this research, the authors try to implement an application-level caching with an in-memory database, Redis, using Lazy Loading approach. Beside implementing caching, authors also compare the performance of using cache and not using cache by load testing both implementation using similarly built application. Based on the result, there is a performance gain of 38-65% based on the load and scenario by using application-level caching

Digitalization in orthopaedics: a narrative review.

Advances in technology and digital tools like the Internet of Things (IoT), artificial intelligence (AI), and sensors are shaping the field of orthopaedic surgery on all levels, from patient care to research and facilitation of logistic processes. Especially the COVID-19 pandemic, with the associated contact restrictions was an accelerator for the development and introduction of telemedical applications and digital alternatives to classical in-person patient care. Digital applications already used in orthopaedic surgery include telemedical support, online video consultations, monitoring of patients using wearables, smart devices, surgical navigation, robotic-assisted surgery, and applications of artificial intelligence in forms of medical image processing, three-dimensional (3D)-modelling, and simulations. In addition to that immersive technologies like virtual, augmented, and mixed reality are increasingly used in training but also rehabilitative and surgical settings. Digital advances can therefore increase the accessibility, efficiency and capabilities of orthopaedic services and facilitate more data-driven, personalized patient care, strengthening the self-responsibility of patients and supporting interdisciplinary healthcare providers to offer for the optimal care for their patients.