Supervision Of Health Professionals Research Articles

The Attitudes of Patients with Cardiovascular Diseases towards Online Exercise with the Mobile Monitoring of Their Health-Related Vital Signs.

The health care cost of cardiovascular diseases (CVD) in the EU is estimated to be today over 282 billion euros. It is well documented today that exercise training is one of the main strategies for secondary disease prevention and the follow-up integration of these patients. This study aimed to examine patients' attitudes towards online exercise with mobile monitoring of their vital signs. More specifically, the research objectives were as follows: (a) to examine patients' attitudes and expectations of online exercise, (b) cluster patients in high- and low-attitude groups and examine their intention to participate in online exercise, and (c) to examine age and gender differences in terms of their intention to exercise online. The final goal of this project was to develop a real application that could be of use to patients and professionals. Data were collected from fifty patients in the city of Thessaloniki, Greece. The results revealed that most patients were positive about exercising online if the programs were perceived as fun and, especially, safe. The use of an online monitoring application with the distant supervision of health professionals could both motivate them and strengthen their feeling of safety.

The impact of ketogenic diet on some metabolic and non-metabolic diseases: Evidence from human and animal model experiments.

The ketogenic diet (KD) is recognized as minimum carbohydrate and maximum fat intakes, which leads to ketosis stimulation, a state that is thought to metabolize fat more than carbohydrates for energy supply. KD has gained more interest in recent years and is for many purposes, including weight loss and managing serious diseases like type 2 diabetes. On the other hand, many believe that KD has safety issues and are uncertain about the health drawbacks. Thus, the outcomes of the effect of KD on metabolic and non-metabolic disease remain disputable. The current narrative review aims to evaluate the effect of KD on several diseases concerning the human health. To our best knowledge, the first report aims to investigate the efficacy of KD on multiple human health issues including type 2 diabetes and weight loss, cardiovascular disease, kidney failure and hypertension, non-alcoholic fatty liver, mental problem, oral health, libido, and osteoporosis. The literature searches were performed in Databases, PubMed, Scopus, and web of Science looking for both animal and human model designs. The results heterogeneity seems to be explained by differences in diet composition and duration. Also, the available findings may show that proper control of carbohydrates, a significant reduction in glycemic control and glycated hemoglobin, and weight loss by KD can be an approach to improve diabetes and obesity, hypertension, non-alcoholic fatty liver, PCOS, libido, oral health, and mental problem if isocaloric is considered. However, for some other diseases like cardiovascular disease and osteoporosis, more robust data are needed. Therefore, there is robust data to support the notion that KD can be effective for some metabolic and non-metabolic diseases but not for all of them. So they have to be followed cautiously and under the supervision of health professionals.

Individual satisfaction with HIV/AIDS care in Belo Horizonte, Brazil

ABSTRACT Individual satisfaction is associated with increased retention in HIV/AIDS care services and adherence to treatment. This study assessed factors associated with individual satisfaction at the initiation of antiretroviral therapy and compared the proportions of satisfaction at the initiation of antiretroviral therapy and after three months of follow-up. Face-to-face interviews were carried out among 398 individuals of three HIV/ AIDS healthcare services in Belo Horizonte, Brazil. Variables included sociodemographic and clinical characteristics, perception about healthcare services, and domains of quality of life. Individuals that rated the quality of healthcare services as good or very good were classified as satisfied. A logistic regression analysis of the association between independent variables and individual satisfaction was performed. The proportion of individual satisfaction with healthcare services was 95.5% at the initiation of antiretroviral therapy and 96.7% after three months and these changes were not statistically significant (p = 0.472). The physical domain of quality of life was found to be associated with satisfaction at the initiation of antiretroviral therapy (OR = 1.38; CI = 1.11–1.71; p = 0.003). Training and supervision of health professionals for addressing the needs of individuals with lower levels of physical domain of quality of life may improve satisfaction with HIV/ AIDS care.

Development of Serious Games for the Rehabilitation of the Human Vertebral Spine for Home Care

With the occurrence of pandemics, such as COVID-19, which lead to social isolation, there is a need for home rehabilitation procedures without the direct supervision of health professionals. The great difficulty of treatment at home is the cost of the conventional equipment and the need for specialized labor to operate it. Thus, this paper aimed to develop serious games to assist health professionals in the physiotherapy of patients with spinal pain for clinical and home applications. Serious games integrate serious aspects such as teaching, rehabilitation, and information with the playful and interactive elements of video games. Despite the positive indication and benefits of physiotherapy for cases of chronic spinal pain, the long treatment time, social isolation due to pandemics, and lack of motivation to use traditional methods are some of the main causes of therapeutic failure. Using Unity 3D (version 2019.4.24f1) software and a personal computer with a webcam, we developed aesthetically pleasing, smooth, and attractive games, while maintaining the essence of seriousness that is required for rehabilitation. The serious games, controlled using OpenPose (version v1.0.0alpha-1.5.0) software, were tested with a healthy volunteer. The findings demonstrated that the proposed games can be used as a playful tool to motivate patients during physiotherapy and to reduce cases of treatment abandonment, including at home.

Exploring the Role of Wearable Electronic Medical Devices in Improving Cardiovascular Risk Factors and Outcomes Among Adults: A Systematic Review.

There is a developing trend of using wearable electronic devices as health aides, spurred on by telecommunication companies as fitness devices and marketed as such. They have been shown to count steps, pulse, and record arrhythmias, doubling as communication devices and prompting healthcare providers in some instances. We sought to determine if there was a direct correlation between device use and increased physical activity as recommended by the World Health Organization, or if this physical activity increase was only marginal at best. In addition, we sought to investigate if there were additional benefits to using these devices besides increased self-awareness of health. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Keywords for searching articles centered around cardiovascular disease, wearable electronic devices, and their synonyms. Most of the data were obtained from PubMed, although other contributing databases were used, including ResearchGate, Science.gov, ScienceDirect, and PubMed Medical Subject Headings database. Only full-text articles were used. We identified 62 articles that met our search criteria but narrowed them down to 19 following qualitative assessment. Increased physical activity was found to be the one parameter that stood out by way of benefit from the device. Other findings, such as reduced waist circumference, obesity, glycated hemoglobin, and lipid levels, shared mixed results. At this time, we do not have a definition of what duration of device use is deemed standard for health. We have no consensus on which devices are superior health-wise. Our study, however, indicates that these devices, used with adequate health professional supervision, have a role to play in motivation and increased physical activity, enough to cause impactful gains in cardiovascular health.

A Questionnaire-Based Study on Medicinal Plant Use in Patients with a Chronic Disease Diagnosis

Chronic diseases are the most common non-communicable diseases worldwide. Today, with the increase in the elderly population, the burden of the disease is gradually increasing, and alternative treatment methods for these diseases are gaining importance. Potential adverse reactions, contraindications, and interactions with prescription drugs and herbals are important to evaluate. Therefore, the use of plants by chronic patients should be under supervision of health professionals. In this study, we aimed to obtain comprehensive data by questioning the plants used by patients using drugs for chronic disease, their usage patterns, and changes seen as a result of plant use. For this purpose, 60 people over the age of 18 (47% female, 53% male) participated in the survey study, and 53.3% of the patients stated that they used plants in the treatment. Twenty-one plants have been identified. Linden and mint-lemon mixture are the most commonly used plants, accounting for 62% and 15% of the total, respectively. The most commonly used preparation method is decoction (60%). 62.5% of the users obtain the plants from herbalists' stores; 59.37% of the patients learned the use of plants through advice (friend, neighbor, relative); 96.87% of the patients stated that they benefited from the use of plants. According to these results, the patients need to be informed about the use of plants as a complementary treatment. Thus, further efforts should be made to raise awareness of the use of herbal medicine and possibility of herb-drug interactions among physicians and other health professionals.

Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews.

Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews.

Motivators for physical activity in patients with minor stroke: a qualitative study

Purpose Physical inactivity is a major risk factor for stroke. However, to encourage physical activity after stroke, it is important to know what motivates the patients. We aimed to explore possible motivators and barriers for physical activity in patients discharged after minor stroke or transient ischemic attack (TIA). Methods A qualitative study including 35 patients (21 men) with minor stroke or TIA (median age; 69 years, range 47–90) in semi-structured focus group interviews. Audio recordings were transcribed to text verbatim and analyzed with qualitative content analysis. Results Six interviews of 60 min. revealed five categories; the patients had a positive attitude towards physical activity, and they preferred to exercise locally under supervision of health professionals. Physical activity with others was motivating and obligating, and if possible as a weekly habit. Some experienced physical- and mental sequelae, which kept them from exercising. Conclusion This study provides valuable knowledge of what motivates and prevents patients with minor stroke or TIA to be physically active after hospital discharge, and what to consider when designing future exercise studies. Consequently, it is recommended that patients with minor stroke or TIA are offered supervised physical activity to prevent worsening of cardiovascular disease and recurrent cardiovascular event. Implications for rehabilitation Participants were positive towards physical activity after minor stroke or transient ischemic attack (TIA). Physical activity with others was perceived as both motivating and obligating. Post-stroke fatigue, lack of energy, and overview should be considered when designing secondary prevention programs. Participants call for exercise opportunities arranged locally and as group exercise supervised by health professionals with knowledge of stroke.

Chronic Disease in the Community (CDCom) Program: Hypertension and non-communicable disease care by village health workers in rural Uganda.

BackgroundAlthough hypertension, the largest modifiable risk factor in the global burden of disease, is prevalent in sub-Saharan Africa, rates of awareness and control are low. Since 2011 village health workers (VHWs) in Kisoro district, Uganda have been providing non-communicable disease (NCD) care as part of the Chronic Disease in the Community (CDCom) Program. The VHWs screen for hypertension and other NCDs as part of a door-to-door biannual health census, and, under the supervision of health professionals from the local district hospital, also serve as the primary providers at monthly village-based NCD clinics.Objective/MethodsWe describe the operation of CDCom, a 10-year comprehensive program employing VHWs to screen and manage hypertension and other NCDs at a community level. Using program records we also report hypertension prevalence in the community, program costs, and results of a cost-saving strategy to address frequent medication stockouts.Results/ConclusionsOf 4283 people ages 30–69 screened for hypertension, 22% had a blood pressure (BP) ≥140/90 and 5% had a BP ≥ 160/100. All 163 people with SBP ≥170 during door-to-door screening were referred for evaluation in CDCom, of which 91 (59%) had repeated BP ≥170 and were enrolled in treatment. Of 761 patients enrolled in CDCom, 413 patients are being treated for hypertension and 68% of these had their most recent blood pressure below the treatment target. We find: 1) The difference in hypertension prevalence between this rural, agricultural population and national rates mirrors a rural-urban divide in many countries in sub-Saharan Africa. 2) VHWs are able to not only screen patients for hypertension, but also to manage their disease in monthly village-based clinics. 3) Mid-level providers at a local district hospital NCD clinic and faculty from an academic center provide institutional support to VHWs, stream-line referrals for complicated patients and facilitate provider education at all levels of care. 4) Selective stepdown of medication doses for patients with controlled hypertension is a safe, cost-saving strategy that partially addresses frequent stockouts of government-supplied medications and patient inability to pay. 5) CDCom, free for village members, operates at a modest cost of 0.20 USD per villager per year. We expect that our data-informed analysis of the program will benefit other groups attempting to decentralize chronic disease care in rural communities of low-income regions worldwide.

<p>Self-Medication and Associated Factors Among Pregnant Women Attending Antenatal Care at Kemisie General Hospital, North East Ethiopia</p>

IntroductionSelf-medication is an important part of daily self-care, without the supervision of health professionals. It is commonly practiced by pregnant women all over the world and may result in maternal and fetal risks. Hence, this study assessed self-medication practices and associated factors among pregnant women attending Kemisie General Hospital.MethodsA facility-based cross-sectional study was conducted using a structured questionnaire on pregnant women who were attending antenatal care at Kemisie General Hospital. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences version 20.ResultsAmong 223 pregnant women, 60 (26.9%; 95% CI: 20.9%, 32.9%) and 111 (48.9%; 95% CI: 43%, 58%) practiced self-medication on conventional and herbal medicine, respectively. The predictors of self-medication of conventional medicine among pregnant women were prior experience to the drug (P-value: 0.00, AOR=126.04, 95% CI: 32.55–488.04) and no pervious history of abortion (P-value: 0.00, AOR=0.01,95% CI:0.002–0.04), while college educational level (P-value: 0.00, AOR=13.45,95%, CI: 3.58–50.5), history prior herbal medicine use (P-value: 0.00, AOR=9, 95% CI: 3.32–24.39), Ruta chalepensis (P-value:0.001,AOR=193.7,95% CI:8.64–4342.1) and Ocimum lamiifolium type of herb use (P-value: 0.004, AOR=12.72, 95% CI: 2.27–71.38), and 5–10km health facility distance (P-value:0.022, AOR=0.1, 95% CI: 0.01–0.73) were predictors for self-medication practice of herbal medicines among pregnant women.ConclusionNearly one-third and two-third of pregnant women practiced self-medication on conventional and herbal medicine, respectively. Prior experience to the drug and no previous history of abortion associated with self-medication of conventional medicine, while college educational level, history prior herbal medicine use, Ruta chalepensis and, Ocimum lamiifolium type of herb use, and 5–10km distance were predictors for self-medication practice of herbal medicines. Improving health service coverage and awareness creation on rational medication use is recommended to prevent fetal and maternal risks.

Impact of clinical supervision of health professionals on organizational outcomes: a mixed methods systematic review protocol.

The objective of this review is to develop an aggregated synthesis of qualitative and quantitative reviews to derive recommendations for policy and practice relevant to clinical supervision (CS). Clinical supervision is a process where supervisors and supervisees engage in guided evaluation and reflection on current practice to enhance future practice. Recent studies have demonstrated the positive impact of CS on patient outcomes; however, the impact of CS on organizational outcomes is less clear. Therefore, this review will investigate organization outcomes and how health practitioners experience and view CS. This review will consider quantitative and qualitative studies on health professional supervisees in nutrition and dietetics, occupational therapy, physiotherapy, psychology, podiatry, social work, speech pathology and exercise physiology in hospitals and community settings. The quantitative component will include studies on the effects of CS based on staff retention and recruitment, intent to stay, intent to leave, job satisfaction and quality of work life, burnout and absenteeism. The qualitative component will consider studies that explore health professional supervisees' experiences on CS related to organizational outcomes. CINAHL, Embase, PubMed, PsycINFO, PEDro and Scopus will be searched for studies published in English, without a date limit. Both quantitative and qualitative studies will be screened for inclusion and critically appraised for methodological quality, and both types of data extracted using JBI tools for mixed methods systematic reviews. A convergent segregated approach to synthesis and integration will be used. The findings of each single method synthesis will be configured according to JBI methodology.

Dirençli Epilepsi Tedavisinde Modifiye Atkins Diyeti Uygulaması: Olgu Sunumu

Ketojenik diyet; yüksek miktarda yağ, düşük miktarda karbonhidrat ve orta derecede protein içeren ve enerji kaynağı olarak karbonhidratlar yerine yağların kullanılmasını sağlayan bir diyettir. Yağların yıkılması sonucu ortaya çıkan ketonların beyne yaptığı bir etki mekanizması sayesinde epilepsi nöbetlerin azaldığı düşünülmektedir. Dirençli epilepside modifiye Atkins diyeti (MAD) ilk olarak 2003 yılında John Hopkins Hastanesi’nde geliştirilmiştir. MAD’de karbonhidrat alımı 10-20 g/gün iken enerji, protein, yağ (enerjinin yaklaşık %75’i) kısıtlaması yoktur ve hastalarda nöbet kontrolünü sağladığını gösteren çalışmalar mevcuttur. MAD, klasik ketojenik diyete göre daha az kısıtlayıcı ve uygulaması daha kolay olduğundan büyük çocuklar ve yetişkinlerde sıklıkla kullanılmaktadır. Bu olgu sunumunda, dirençli epilepsisi olan hastaya uygulanan MAD’nin nöbetler üzerindeki etkinliği incelenmiştir. Diyet tedavisine başladıktan 2 ay sonra nöbetler kesilmiştir ve ciddi bir yan etki görülmemiştir. İlaca yanıt vermeyen dirençli epilepsi hastalarında MAD sağlık profesyonellerinin gözetimi altında uygulanarak etkin bir tedavi seçeneği olarak görülebilir.

PROS AND CONS OF TECHNOLOGY FOR PATIENTS

Introduction: Technology developed specifically for patients progresses quickly and helps patients in hospital as well as at home. It helps the healthy population to stay healthy. Technology can broadly be divided into hardware and software. Main Text: When used under the supervision of health professionals, technology is mostly beneficial - when harm, or no benefit is detected, the technology is withdrawn or corrected. Uncontrolled use of technology without verification and without monitoring of outcomes often leads to negative effects. Without regulation, technology continues to be used even when proven to be useless or even harmful.

Establishing Sexual Assault Care Centres in Belgium: health professionals\u2019 role in the patient-centred care for victims of sexual violence

BackgroundHaving ratified the Convention of Istanbul, the Belgian federal government commits itself to the foundation of Sexual Assault Care Centres (SACC). In the light of researching the feasibility of these centres, this study aimed to evaluate the care for victims of sexual violence (SV) in Belgian hospitals anno 2016 as well as to formulate recommendations for the intended model.MethodsBetween April and October 2016, a questionnaire was distributed to 159 key health professionals active in 17 different hospitals attached to an AIDS Referral Centre. The survey covered four parts, i.e. the health professionals’ profile, their knowledge, attitude and practices, an assessment of the hospital’s policy and the caregivers’ opinion on the care for victims of SV and on the intended SACCs. Subsequently, a descriptive analysis using ‘IBM SPSS Statistics 23’ was performed.ResultsA total of 60 key health professionals representing 15 different hospitals completed the questionnaire resulting in a response rate of 38%. The results showed a lack of knowledge and practical experience of caregivers’ regarding the care for SV victims. Approximately 30% of responders face personal or professional difficulties upon provision of care to victims of SV. Participants evaluate the current care as good, despite the limited psychosocial support, follow-up, insight for the needs of vulnerable groups and support for family, relatives and health professionals. Yet, the majority of health professionals appraise the SACCs as the best approach for both victims and caregivers.ConclusionsBy introducing a SACC, the Belgian federal government aims to provide holistic and patient-centred care for victims of SV. Essential in patient-centred health care is an extensive and continuous education, training and supervision of health professionals concerning the care for victims, support for family, relatives and caregivers.At the end and as a result of a participatory process with many professional experts as well as victims, a specific Belgian model, adjusted to the health care system anno 2016 was developed for piloting. The main challenges in establishing SACCs are situated at the institutional and policy level. Collaborating with other institutions and further research are herewith required.

Using Skype to support remote clinical supervision for health professionals delivering a sustained maternal early childhood programme: a phenomenographical study

Background: Skype technology was implemented by the Australian Maternal Early Childhood Sustained Home-visiting (MECSH) Support Service as a tool for the remote provision of clinical supervision for clinicians working in the MECSH program in Seoul, South Korea.Objectives: To gain a better understanding of the processes underpinning sustainable delivery of remote clinical supervision using digital technologies.Design: A phenomenographical study.Methods: Recorded notes and reflections on each supervision session, noting exemplars and characteristics of the experience were read and re-read to derive the characterizations of the experience.Results: The experience has provided learnings in three domains: (1) the processes in using Skype; (2) supervisory processes; and (3) language translation, including managing clarity of, and time for translation.Conclusion: Skype has potential for use in remote provision of clinical supervision, including where translation is required. Further research evaluating the benefit of telesupervision from supervisor and supervisee perspectives is necessary to determine if it is a sustainable process.

Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review

BackgroundTo ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience.MethodsDatabases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience.ResultsSeventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience.ConclusionsClinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health outcomes. While few studies found a direct effect on patient health outcomes, when provided to mental health professionals clinical supervision may be associated with a reduction in psychological symptoms of patients diagnosed with a mental illness. There was no association found between clinical supervision and the patient experience.Review RegistrationCRD42015029643.

A technology-enabled Counselling program versus a delayed treatment control to support physical activity participation in people with inflammatory arthritis: study protocol for the OPAM-IA randomized controlled trial

BackgroundBeing physically active is an essential component of successful self-management for people with inflammatory arthritis; however, the vast majority of patients are inactive. This study aims to determine whether a technology-enabled counselling intervention can improve physical activity participation and patient outcomes.MethodsThe Effectiveness of Online Physical Activity Monitoring in Inflammatory Arthritis (OPAM-IA) project is a community-based randomized controlled trial with a delayed control design. We will recruit 130 people with rheumatoid arthritis or systemic lupus erythematosus, who can be physically active without health professional supervision. Randomization will be stratified by diagnosis. In Weeks 1–8, participants in the Immediate Group will: 1) receive education and counselling by a physical therapist (PT), 2) use a Fitbit and a new web-based application, FitViz, to track and obtain feedback about their physical activity, 3) receive 4 biweekly follow-up calls from the PT. Those in the Delayed Group will receive the same program in Week 10. We will interview a sample of participants about their experiences with the intervention. Participants will be assessed at baseline, and Weeks 9, 18 and 27. The primary outcome measure is time spent in moderate/vigorous physical activity in bouts of ≥ 10 min, measured with a portable multi-sensor device in the free-living environment. Secondary outcomes include step count, time in sedentary behaviour, pain, fatigue, mood, self-management capacity, and habitual behaviour.DiscussionA limitation of this study is that participants, who also administer the outcome measures, will not be blinded. Nonetheless, by customizing existing self-monitoring technologies in a patient-centred manner, individuals can be coached to engage in an active lifestyle and monitor their performance. The results will determine if this intervention improves physical activity participation. The qualitative interviews will also provide insight into a paradigm to integrate this program to support self-management.Trial registrationDate of last update in ClinicalTrials.gov: September 18, 2015. ClinicalTrials.gov Identifier: NCT02554474.

Post Rape Care Provision to Minors in Kenya: An Assessment of Health Providers' Knowledge, Attitudes, and Practices.

Child sexual abuse (CSA) is a major global health challenge. Extant literature in Kenya indicates an alarming rate of sexually abused minors presenting to poorly equipped health facilities with untrained health providers for post rape care. National guidelines on management of sexual violence have been in existence since 2004; however, little is known on the impact of these guidelines on post rape care provision to minors. Therefore, the study aims to assess the knowledge, attitudes, and practices of health providers with regard to post rape care provision in a Kenyan District health facility. The study used a triangulation of different qualitative methods: review of 42 health records of minors seeking post rape care, 15 in-depth interviews, and informal conversations with health providers. Findings indicate that the Kenyan national guidelines on management of sexual violence were nonexistent in the health facility. Consequently, health providers possessed limited knowledge on post rape care administration. The limited knowledge translated to poor collection and preservation of evidence, inadequate psychosocial support, and clinical care. In addition, rape myth attitudes and religious beliefs contributed to survivor blaming and provider hesitance in provision of legal abortion care, respectively. To facilitate provision of quality post rape care, policy makers and health institutions' managers need to avail protocols in line with evidence-based best practices to guide health providers in post rape care administration. In addition, there is need for rigorous training and supervision of health professionals to ensure better service provision.

Helping Hands: Using Augmented Reality to Provide Remote Guidance to Health Professionals.

Access to expert practitioners or geographic distance can compound the capacity for appropriate supervision of health professionals in the workplace. Guidance and support of clinicians and students to undertake new or infrequent procedures can be resource intensive. The Helping Hands remote augmented reality system is an innovation to support the development of, and oversee the acquisition of procedural skills through remote learning and teaching supervision while in clinical practice. Helping Hands is a wearable, portable, hands-free, low cost system comprised of two networked laptops, a head-mounted display worn by the recipient and a display screen used remotely by the instructor. Hand hygiene was used as the test procedure as it is a foundation skill learned by all health profession students. The technology supports unmediated remote gesture guidance by augmenting the object with the Helping Hands of a health professional. A laboratory-based study and field trial tested usability and feasibility of the remote guidance system. The study found the Helping Hands system did not compromise learning outcomes. This innovation has the potential to transform remote learning and teaching supervision by enabling health professionals and students opportunities to develop and improve their procedural performance at the workplace.

Mental health among clients of the Sydney Medically Supervised Injecting Centre (MSIC).

The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm. The current study is the first to investigate the mental health among clients of a SIF. Validated instruments to examine clients’ mental health, social networks and trauma histories were administered to 50 frequently attending clients by a mental health nurse. The majority of respondents were unemployed, homeless and had a history of incarceration, and 82 % report they had been diagnosed with a mental health problem, but only 24 % report they were receiving treatment. Respondents had poor social networks, had poorer mental health symptoms compared to US inpatients and had experienced multiple traumatic events, and a high number of respondents had scores indicative of PTSD. These results highlight the need for mental health clinicians to be employed in SIFs and other drug consumption rooms (DCRs) to assist clients to address their mental health and psychosocial needs, particularly in light of the fact that these services are often the only places these PWID engage with in an ongoing way.