Telephone Communication Research Articles

Assessing the Feasibility and Acceptability of Virtual Reality for Remote Group-Mediated Physical Activity in Older Adults: Pilot Randomized Controlled Trial.

Physical inactivity represents a major health concern for older adults. Most social, at-home physical activity (PA) interventions use videoconference, email, or telephone communication for program delivery. However, evidence suggests that these platforms may hinder the social connection experienced by users. Recent advancements in virtual reality (VR) suggest that it may be a rich platform for social, at-home interventions because it offers legitimate options for intervention delivery and PA. This pilot study aims to determine the feasibility and acceptability of VR compared to videoconference as a medium for remote group-mediated behavioral intervention for older adults. The information generated from this investigation will inform the use of VR as a medium for intervention delivery. Nine low-active older adults (mean age 66.8, SD 4.8 y) were randomized to a 4-week home-based, group-mediated PA intervention delivered via VR or videoconference. Feasibility (ie, the total number of sessions attended and the number of VR accesses outside of scheduled meetings) and acceptability (ie, the number of participants reporting high levels of nausea, program evaluations using Likert-style prompts with responses ranging from -5=very difficult or disconnected to 5=very easy or connected, and participant feedback on immersion and social connection) are illustrated via descriptive statistics and quotes from open-ended responses. None of the participants experienced severe VR-related sickness before randomization, with a low average sickness rating of 1.6 (SD 1.6) out of 27 points. Attendance rates for group meetings were 98% (59/60) and 96% (46/48) for the VR and videoconference groups, respectively. Outside of scheduled meeting times, participants reported a median of 5.5 (IQR 5.3-5.8, range 0-27) VR accesses throughout the entire intervention. Program evaluations suggested that participants felt personally connected to their peers (VR group: median 3.0, IQR 2.5-3.5; videoconference group: median 3.0, IQR 2.7-3.3), found that goals were easy to accomplish (VR group: median 3.0, IQR 2.8-3.3; videoconference group: median 3.0, IQR 2.6-3.4), and had ease in finding PA options (VR group: median 4.0, IQR 3.5-4.3; videoconference group: median 2.0, IQR 1.6-2.4) and engaging in meaningful dialogue with peers (VR group: median 4.0, IQR 4.0-4.0; videoconference group: median 3.5, IQR 3.3-3.8). Open-ended responses regarding VR use indicated increased immersion experiences and intrinsic motivation for PA. These findings suggest that VR may be a useful medium for social PA programming in older adults, given it was found to be feasible and acceptable in this sample. Importantly, all participants indicated low levels of VR-related sickness before randomization, and both groups demonstrated very high attendance at meetings with their groups and behavioral coaches, which is promising for using VR and videoconference in future interventions. Modifications for future iterations of similar interventions are provided. Further work using larger samples and longer follow-up durations is needed. ClinicalTrials.gov NCT04756245; https://www.clinicaltrials.gov/study/NCT04756245.

Long-term effects of non-pharmacological interventions in adolescents and young adults with type 1 diabetes: A systematic review and meta-analysis.

Consistent diabetes control is crucial for patients with type 1 diabetes (T1D) to prevent diabetic complications. Analyzing the long-term effects of non-pharmacological interventions can improve diabetes management. To examine the long-term effects of non-pharmacological interventions in adolescents and young adults with T1D through a systematic review and meta-analysis of randomized controlled trials (RCTs). The searches, without any year limitations, were conducted in seven databases. Two reviewers independently performed data extraction and risk of bias assessments. The meta-analysis was conducted using the RevMan 5.4 program and R Studio. The study was registered with PROSPERO (CRD42024503185). A total of 40 studies were included in the systematic review, of which 28 were included in the meta-analysis. Notably, non-pharmacological interventions were effective in improving glycated hemoglobin (HbA1c) at 6 months and self-care at >12 months of follow-up. Subgroup analyses revealed that combined interventions encompassing self-care behavior management, education, and psychological interventions could enhance self-care. Additionally, a combination of face-to-face and telephonic communication was effective in improving HbA1c. Non-pharmacological interventions are effective in improving HbA1c levels and self-care in adolescents and young adults undergoing long-term treatment. However, few studies have analyzed their effects on cardiovascular disease risk factors. Future studies should investigate the long-term effects of non-pharmacological interventions.

The Effect of Hospital-to-Home Discharge Interventions on Reducing Unplanned Hospital Readmissions: A Systematic Review and Meta-analysis.

Unplanned hospital readmissions (UHRs) constitute a persistent health concern worldwide. A high level of UHRs imposes a burden on individuals, their families, and health care system budgets. This systematic review and meta-analysis aimed to evaluate the effectiveness of discharge interventions in the transition from hospital to home in the context of reducing UHRs. The study design was a meta-analysis of randomized and nonrandomized controlled trials. Eight databases were searched. The effect on UHR rates (odds ratio [OR]) of discharge interventions in the transition from hospital to home was calculated at a 95% confidence interval (95% CI) based on meta-regression and meta-analysis of random-effects models. Results showed that discharge interventions were effective in reducing rehospitalizations (effectiveness/OR =1.39; 95% CI, 1.24-1.55). It was furthermore determined that the studies showed heterogeneous characteristics (P ≤ .001, Q = 50.083, I2 = 44.093; df = 28). According to Duval and Tweedie's trim and fill results, there was no publication bias. Interventions in which telephone communications and hospital visits (OR = 1.64; 95% CI, 1.25-2.16; P < .001) were applied together were effective among patients with cardiovascular diseases (OR = 1.54; 95% CI, 1.28-2.09; P < .001), and it was found that UHRs were reduced within a period of 90 days (OR = 1.68; 95% CI, 1.16-2.42; P < .001). It was also found that discharge interventions applied to transitions from hospital to home had a diminishing effect on UHRs as the publication dates of the reviewed studies advanced from the past to the present (OR = 0.015; 95% CI, 0.002-0.003; P < .001). Supporting and facilitating cooperation between health care professionals and families should be a key focus of discharge interventions.

In-depth mixed-method case study to assess how to support and communicate with the families of hospitalised patients during COVID-19: a social innovation embedded in clinical teams

ObjectivesThe purpose of this study is to describe and evaluate, in a real-life context, the support and communicate with families (SCF) team’s contribution to maintaining communication and supporting relatives when...

Challenges with communication of critical laboratory results in a resource-limited setting in South Africa.

Critical laboratory results are test results suggesting a patient is in immediate danger unless treatment is administered promptly. There is a paucity of studies in sub-Saharan Africa on clinicians' utility of these results and affected patients' outcomes. In our resource-limited setting in South Africa, we rely on telephonic communication to convey critical results. The aim of this study was to determine the average time for clinicians to acknowledge these results on the laboratory information system and to determine the outcome of affected patients. A retrospective descriptive audit at Tygerberg Academic Hospital was conducted between 01 October 2021 and 31 March 2022. Critical results and the time of acknowledgement by clinicians on the laboratory information system were obtained from inpatients and outpatients. One hundred and twenty inpatient critical results were randomly selected for a folder review to determine patient outcome. Overall, 2514 critical results were reported, and 63 results were excluded. The remaining 2451 results were obtained from 1346 patients. The majority (94.5%) of results were obtained from inpatients, where 1681 (68.6%) were acknowledged within 24 h. The folder audit of 120 patients determined that 40 (33.3%) patients demised. In 82 (68.3%) patients, communication of a critical result did not alter clinical management. Critical laboratory results are crucial to patient care. This study found that approximately one-third of critical laboratory results were not used within 24 h. Engaging clinicians in current practice and implementing a means of improved communication of critical results is required. The study adds to the evidence of challenges experienced with communicating critical results to clinicians which could impact patient care. This is especially true in resource-limited settings; clinicians need to be made aware of the importance of these results, and communication modes need to be improved.

Getting rapid diagnostic test data into the appropriate hands by leveraging pharmacy staff and a clinical surveillance platform: a case study from a US community hospital

Abstract Objectives To outline the procedural implementation and optimization of rapid diagnostic test (RDT) results for bloodstream infections (BSIs) and to evaluate the combination of RDTs with real-time antimicrobial stewardship team (AST) support plus clinical surveillance platform (CSP) software on time to appropriate therapy in BSIs at a single health system. Methods Blood culture reporting and communication were reported for four time periods: (i) a pre-BCID [BioFire® FilmArray® Blood Culture Identification (BCID) Panel] implementation period that consisted of literature review and blood culture notification procedure revision; (ii) a BCID implementation period that consisted of BCID implementation, real-time results notification via CSP, and creation of a treatment algorithm; (iii) a post-BCID implementation period; and (iv) a BCID2 implementation period. Time to appropriate therapy metrics was reported for the BCID2 time period. Results The mean time from BCID2 result to administration of effective antibiotics was 1.2 h (range 0–7.9 h) and time to optimal therapy was 7.6 h (range 0–113.8 h) during the BCID2 Panel implementation period. When comparing time to optimal antibiotic administration among patients growing ceftriaxone-resistant Enterobacterales, the BCID2 Panel group (mean 2.8 h) was significantly faster than the post-BCID Panel group (17.7 h; P = 0.0041). Conclusions Challenges exist in communicating results to the appropriate personnel on the healthcare team who have the knowledge to act on these data and prescribe targeted therapy against the pathogen(s) identified. In this report, we outline the procedures for telephonic communication and CSP support that were implemented at our health system to distribute RDT data to individuals capable of assessing results, enabling timely optimization of antimicrobial therapy.

Effectiveness of a Systems-Wide Initiative to Address Motivation and Expectations for Treatment on Initial Session Attendance to Outpatient Gambling Treatment.

This brief report expands the results of a prior efficacy study that examined the effect of a letter addressing prospective clients' motivation and expectations for outpatient gambling disorder treatment on initial session attendance. The results of that efficacy study indicated more clients attended the initial session when receiving the letter (77%) compared to receiving a reminder telephone call (51%). The present study examines the effectiveness of messages addressing prospective clients' motivation and expectations for outpatient gambling treatment across an entire treatment system. Messages were sent via letters, telephone, and in-person communication with all clinic staff. Participants were 54 clients with gambling disorder who were seeking outpatient psychological treatment. Results indicated that the percentage of clients attending the initial session was 85%, and no differences in attendance were found between in-person and telehealth sessions. These findings suggest that messages that address motivation and expectations persist under real-world conditions, and treatment systems can make meaningful changes that increase attendance to initial treatment sessions.

Advancing ocular oncology care through teleophthalmology: a patient-centric perspective

ObjectiveAssessing patient satisfaction is an important component of understanding a program's efficacy and quality. The purpose of this study is to evaluate patient satisfaction with a teleophthalmology program tailored for ocular oncology that provides screening, remote assessment, care planning, and follow-up. Study designRetrospective survey. MethodsAn adapted version of the Telehealth Satisfaction Scale, consisting of the 8 questions plus 5 additional questions specific to the teleophthalmology program, was used to survey patients. The teleophthalmology program involves diagnostic imaging, remote physician assessments, and follow-up phone calls from health care team members to deliver results to patients. For reporting, the Consensus-Based Checklist for Reporting of Survey Studies was used. T-tests explored satisfaction differences across demographics and teleophthalmology visits. ResultsAmong the 95 patients contacted, 91 agreed to participate in the survey (96% response rate). Participants exhibited high overall satisfaction with the teleophthalmology program, reflected in a mean Telehealth Satisfaction Scale score of 28.88 (SD = 3.35 of 32). The median number of teleophthalmology visits completed was 4.0 (range of 1–8 appointments). No significant differences in satisfaction were found on the basis of age (P = 0.56), urban or rural residence (P = 0.17), or the number of telemedicine appointments (P = 0.51). ConclusionsThis analysis displays high satisfaction levels among patients within an ocular oncology clinic participating in the current telemedicine program, irrespective of age, geography, or number of teleophthalmology visits. Participants reported having their health care needs met with minimal clinical encounters due to remote consultations and telephone communications.

The black box of the relationship between breast cancer patients and accompanying patients: the accompanied patients’ point of view

BackgroundThe PAROLE-Onco program was introduced in the province of Quebec, Canada in 2019. It integrates accompanying patients (APs), i.e., people who have been affected by cancer, into the clinical team as full members. These APs use their experiential knowledge with people undergoing treatment and with clinical teams. The aim of this paper is to evaluate, within the framework of two university medical centers, the perceptions of breast cancer patients who receive support from APs, particularly in terms of their active involvement in their care trajectory.MethodsA qualitative study based on semi-structured interviews with accompanied patients was performed. Fourteen individual interviews were conducted between July and September 2021 with women presenting different profiles in terms of age, education, professional status, type of treatment, family situation, and clinical background. The data were analyzed using thematic analysis, focusing on patients’ perceptions of APs’ contributions and suggested improvements for accessing AP support.ResultsThree themes emerged from the semi-structured interviews: communication modalities used to connect patients with their APs, the characteristics of the support provided by APs, and the perceived effects of this support on the patients. Patients expressed a preference for telephone communication, highlighting its convenience and accessibility. The support provided by APs included emotional and informational support, neutrality, and adaptability. This relationship improved patient communication, reduced anxiety, helped regain control, and enhanced overall quality of life. The results emphasized the added value of APs in complementing the support offered by healthcare professionals. Patients noted the critical role of APs in helping them navigate the healthcare system, better understand their treatment processes, and manage their emotions. The ability of APs to provide practical advice and emotional reassurance was particularly valued. Overall, the findings underscored the significant impact of AP support on patients’ experiences and highlighted areas for enhancing this service.ConclusionThis study highlights, during the care trajectory of people affected by breast cancer, APs’ contribution to patients’ emotional well-being because they improve, in particular, the management of emotions and communication with health professionals.

A Novel Radiology Communication Tool to Reduce Workflow Interruptions: Clinical Evaluation of RadConnect.

Despite the importance of communication, radiology departments often depend on communication tools that were not created for the unique needs of imaging workflows, leading to frequent radiologist interruptions. The objective of this study was test the hypothesis that a novel asynchronous communication tool for the imaging workflow (RadConnect) reduces the daily average number of synchronous (in-person, telephone) communication requests for radiologists. We conducted a before-after study. Before adoption of RadConnect, technologists used three conventional communication methods to consult radiologists (in-person, telephone, general-purpose enterprise chat (GPEC)). After adoption, participants used RadConnect as a fourth method. Technologists manually recorded every radiologist consult request related to neuro and thorax CT scans in the 40 days before and 40 days after RadConnect adoption. Telephone traffic volume to section beepers was obtained from the hospital telephone system for the same period. The value and usability experiences were collected through an electronic survey and structured interviews. RadConnect adoption resulted in 53% reduction of synchronous (in-person, telephone) consult requests: from 6.1 ± 4.2 per day to 2.9 ± 2.9 (P < 0.001). There was 77% decrease (P < 0.001) in telephone volume to the neuro and thorax beepers, while no significant volume change was noted to the abdomen beeper (control group). Survey responses (46% response rate) and interviews confirmed the positive impact of RadConnect on interruptions. RadConnect significantly reduced radiologists' telephone interruptions. Study participants valued the role-based interaction and prioritized worklist overview in the survey and interviews. Findings from this study will contribute to a more focused work environment.

Older parents’ perceptions of children's filial piety in rural China: The roles of coresidence, geographic proximity, and intergenerational support

Filial piety—the belief that children should provide care, support, respect, and obedience to their older parents—is a fundamental normative expectation in East Asian societies. This study investigates the relationship between the geographic proximity of children and the support received from them, and their parents’ perceptions of filial piety in rural China. We used the 2021 wave of the Longitudinal Study of Older Adults in Anhui Province to predict parental assessments of filial piety for each of their children. Random-effects linear probability models using an internal moderator approach were employed to compare coresident children with non-coresident children based on their proximity and support provided. Findings indicate that parents tend to perceive their coresident children as being more filial compared to non-coresident children, particularly when parents are in worse functional health. However, non-coresident children can compensate for their deficiency in being perceived as filial by providing more financial support and maintaining frequent telephone communication with their parents. The study's results suggest that filial piety norms in rural China have adapted to the diminished emphasis on intergenerational coresidence resulting from the trends of urbanization and significant rural–urban migration in modern China, requiring that children find alternative ways to fulfill their filial obligations.

Exploring Prisoners’ Communication Strategies with their Supervisors when Studying in E-Learning Mode: A Case of Namibia

This study delves into the communication strategies used by inmates when engaging in e-learning within the confines of a Namibian prison. Despite the challenging living conditions inherent in such environments, the research posits that inmates exhibit a strong motivation to pursue further education. The rise of e-learning has opened educational opportunities for diverse populations, including those incarcerated. In Namibia, prisoners have access to education through e-learning platforms, allowing them to pursue studies and gain qualifications. However, this mode of learning presents unique challenges, particularly in communication with supervisors. The objective was to understand the challenges faced by prisoners following higher education programs in communicating with their supervisors. Method: Data was collected through interviews, situated within an interpretive paradigm. The study focused on a sample of prisoners enrolled in e-learning programs in a Namibian correctional facility. Analysis: Verbatim transcripts of audio-recorded interviews were meticulously prepared by a skilled transcriber, offering the author a comprehensive material for interpretation. Thematic analysis was used to interpret the data. Results: It was found that prisoners’ communication strategies with their supervisors, amongst others, included communication via-email; telephonic communication; communication via the internet and online studies, as well as through in-person appointments. Furthermore, the study contextualized its findings within the evolution of Namibia's legal system, highlighting a significant shift from punitive measures towards a rehabilitative focus on corrections and community reintegration. Namibia's legal system is rehabilitative instead of being punitive. This transformation underscores the broader societal changes in attitudes towards incarceration and highlights the importance of educational initiatives within correctional facilities.

Technical and Vocational Education and Training (Tvet) Program Experiences for Persons with Traumatic Spinal Cord Injury in Nepal: A Narrative Inquiry

This study explores the experiences of TVET programs for persons with traumatic SCI in Nepal. Recently, the National Planning Commission published the 15th plan that aims to encourage the country as a prosperous, independent, and socialist-oriented national economy through healthy, educated, decent citizens who enjoy equal opportunity (National Planning Commission, 2019). In terms of economic growth, it ensures inclusive and equitable access to quality technical education and vocational skill development. Persons with traumatic spinal cord injury are eligible for ensuring the aforementioned equitable access and high living standards. TVET emphasizes linking persons with traumatic spinal cord injury and the labor market to achieve economic success. The deepening stories by the research question that how do persons with traumatic spinal cord injury narrate their experience of TVET programs are included in the study. Through are view of disability and TVET related literature, I learned that the TVET program acted as a bridge between employment and disability. Besides, employment made affirmative impacts on economic independence for persons with traumatic spinal cord injury. Several types of research justified showing a significance of the program in diverse Asian countries such as Taiwan, Bangladesh. I could not find the study associated with TVET and spinal cord injury patients in Nepal. Many researchers investigated the effects of TVET on persons with physical disabilities, but the cases were blended with different types of disabilities. Thus, comprehensive findings could be partially applicable for persons with the injury. In this study, I used a narrative inquiry within the interpretative framework. Also, I conducted an in-depth interview to pay attention to the voice of persons with traumatic spinal cord injury. The interview helped me to understand the stories. Especially five participants who were experienced in TVET programs were purposefully selected for the study. I considered that my participants are the range of twenty-one to forty years of ii age. The participants were six months post-injured. A total of five participants were interviewed physically and through telephone communication. The stories and information were analyzed and interpreted based on the theory of the social model. The social model concentrated on social oppression to make unjust circumstances rather than physical impairment. The stories of the study show that persons with traumatic spinal cord injury are excluded from the main stream in TVET program. They have frequently been deprived of the opportunity of participating in the program due to physical limitations. To be specific, their stories interpreted some similarities that motivation: encourage to be independent, low accessibility: information, disability-friendly educational environment, lack of awareness of disability in society, limited training curricula, devasting economic consequences. Reintegration signifies not economic empowerment but emotional independence. As firstly said, despite persons with traumatic spinal cord injury has faced uncountable barriers in training, it is sure that supported them to reintegrate into the community. On the other hand, TVET provides an essential opportunity to back to the community, but circumstantial constraints restrict the chance. Most private TVET institutes are not prepared for disability-friendly education environments. For instance, the institution is located on the 2nd floor without a lift. People with wheelchairs have no access to the program. Like this, disability is not considered training conditions, insufficient space to move a wheelchair, steps have prevailed. Financial hardship was a critical problem for my participants. Moreover, they appealed to the attitude of TVET educators. When TVET stakeholders whom my participants met, they showed disrespectful attitudes about disability. Although participants were in difficulties, they succeeded in completing the vocational training. The training led them to innovate life through generating income. Now they could maintain livelihood, looking after children. By discovering participants' stories, I came to know the importance of hearing their experiences in the TVET program. Otherwise, fundamental interests and needs overlooked TVET programs are likely to be planned. It may decline the effectiveness iii of the program. My participants’ experiences refer that ensuring education rights in TVET programs is the first step to improve the quality of life of persons with traumatic spinal cord injury.

The AlzMatch Pilot Study - Feasibility of Remote Blood Collection of Plasma Biomarkers for Preclinical Alzheimer’s Disease Trials

BackgroundAdvances in plasma biomarkers to detect Alzheimer’s disease (AD) biology allows researchers to improve the efficiency of participant recruitment into preclinical trials. Recently, protein levels of plasma amyloid-beta and tau proteins have been shown to be predictive of elevated amyloid in brain. Online registries, such as the Alzheimer’s Prevention Trials (APT) Webstudy, include and follow participants using remote assessments to facilitate efficient screening and enrollment of large numbers of individuals who may be at higher risk for AD.ObjectivesThe AlzMatch Pilot Study investigated the feasibility of recruiting individuals from an online registry for blood sample collection at community-based phlebotomy centers and plasma biomarker quantification to assess an individual’s eligibility for AD preclinical trials.DesignPilot feasibility study with co-primary outcomes.SettingThis pilot feasibility study included participants from the APT Webstudy, the remote assessment arm of the Trial-ready cohort for Preclinical and Prodromal AD (TRC-PAD) Platform. Novel design included collection of electronic consent, use of community laboratories for plasma collection, mass spectrometry-based biomarker assay, and telephone communication of plasma biomarker screening eligibility.ParticipantsParticipants invited to the AlzMatch pilot feasibility study were active in the APT Webstudy, 50 years of age or older, resided within 50 miles of both a Quest Diagnostics Patient Services Center (a national diagnostic laboratory with convenient locations for sample collection and processing) and one of six TRC-PAD vanguard clinical trial sites, had no self-reported dementia diagnosis, were able to communicate in English and engaged with the APT Webstudy within the prior 6 months.MeasurementsPrimary feasibility outcomes were completion of electronic consent (e-consent) for invited participants and collection of usable blood samples. Additional feasibility outcomes included invitation response rate, plasma biomarker eligibility status (based on amyloid beta-42/40 [Aβ42/40] concentration ratio), ApoE proteotype, and trial inclusion criterion), and completion of telephone contact to learn eligibility to screen for a study.Results300 APT Webstudy participants were invited to consent to the AlzMatch study. The AlzMatch e-consent rate was 39% (n=117) (95% CI of 33.5%–44.5%) overall, which was higher than the expected rate of 25%. Similar consent rates were observed across participants based on self-defined sex (41% Female (n=75), 37% Male (n=42)) and race and ethnicity (37% from underrepresented groups (URG) (n=36), 40% not from URG (n=79)). Among those that consented (n=117), plasma was successfully collected from 74% (n=87) (95% CI of 66%–82%), with similar rates across sex (76% Female (n=57), 71% Male (n=30)) and race and ethnicity (75% URG (n=27) and 75% not from URG (n=59)). 60% (n=51) of participants with plasma biomarker results were eligible to screen for future preclinical AD trials.ConclusionElectronic consent of participants through an online registry, blood sample collection at community-based centers, plasma biomarker quantification and reporting, and biomarker assessments for study eligibility were all feasible with similar engagement rates across demographic groups. Although this pilot was a small and selective sample, participants engaged and consented at higher than expected rates. We conclude that collecting blood at community laboratories for biomarker analyses may improve accessibility beyond research, and may facilitate broader access for clinical use of AD plasma biomarkers. Based on our results, an expanded version of the AlzMatch study is underway, which involves expanding invitations to additional APT Webstudy participants and clinical trial sites.

Is there communication? Access to information by persons with disabilities in Serbia

Persons with disabilities often face barriers that hinder their ability to access information effectively. This study presents results of a survey which was conducted in the second half of 2022, on the topic of the accessibility of information for persons with disabilities in Serbia, as well as their means of communication. A convenience sample of 111 individuals with physical and/or sensory disabilities, with basic digital literacy, aged 18 to 59, was surveyed through the mediation of associations of persons with disabilities. The findings reveal the usage patterns, preferences, and challenges faced by individuals with disabilities in accessing information. It has been found that the internet (99.10%), social networks (91.89%), and specialized platforms (79.28%) are prominent sources of information. Although specialized applications for communication and telephone communication are widely used, personal contact communication (96.40% very often or often) is still the prevalent method of communication. Public institutions and state authorities are perceived as inadequately adapted to the needs of individuals with disabilities. The findings underscore the need for continued efforts to improve accessibility infrastructure and implement inclusive design principles to bridge the information gap for individuals with disabilities in Serbia.

Clinical and Demographic Characteristics of Patient-Initiated Encounters Before the 6-Week Postpartum Visit.

To identify characteristics associated with a higher likelihood of patient-initiated encounters with a health care professional before the scheduled 6-week postpartum visit. We performed a retrospective cohort study of postpartum persons who received prenatal care and delivered at a single academic level IV maternity care center in 2019. We determined associations between maternal sociodemographic and obstetric characteristics and the likelihood of patient-initiated early postpartum encounters with χ2 tests for categorical variables and Wilcoxon rank sum tests for continuous and ordinal variables. A total of 796 patients were included in our analysis, and 324 (40.7%) initiated an early postpartum encounter. Significantly more postpartum persons who initiated early postpartum encounters were primiparous persons (54.3%) than multiparous (33.8%) persons (P < .001). Postpartum persons who desired breastfeeding or who had prolonged maternal hospitalization, episiotomy, or cesarean or operative vaginal delivery were also significantly more likely to initiate early postpartum encounters (all P≤.002). Of postpartum persons who initiated early encounters, 44 (13.6%) initiated in-person visits, 138 (42.6%) initiated telephone or patient portal communication, and 142 (43.8%) initiated encounters of both types. Specifically, 39.2% of postpartum persons initiated at least one early postpartum encounter for lactation support, and nearly half of early postpartum encounters occurred during the first week after hospital discharge. Early postpartum encounters were more common among primiparas and postpartum persons who were breastfeeding or had prolonged hospitalization, episiotomy, cesarean delivery, or operative vaginal delivery. Future studies should focus on the development of evidence-based guidelines for recommending early postpartum visits.

Can video streaming improve first aid for injured patients? A prospective observational study from Norway

BackgroundVideo streaming in emergency medical communication centers (EMCC) from caller to medical dispatcher has recently been introduced in some countries. Death by trauma is a leading cause of death and injuries are a frequent reason to contact EMCC. We aimed to investigate if video streaming is associated with recognition of a need for first aid during calls regarding injured patients and improve quality of bystander first aid.MethodsA prospective observational study including patients from three health regions in Norway, from November 2021 to February 2023 (registered in clinical trials 10/25/2021, NCT05121649). Cases where video streaming had been used as a supplement during the medical emergency call were compared to cases where video streaming was not used during the call. Patients were included by ambulance personnel on the scene of accident if they met the following criteria: 1. Ambulance personnel arrived at a patient who had an injury, 2. One or more bystanders had been present before their arrival, 3. One or more of the following first aid measures had been performed by bystander or should have been performed: airway management, control of external bleeding, recovery position, and hypothermia prevention. Ambulance personnel assessed quality of first aid performed by bystander, and information concerning use of video streaming and patient need for first aid measures recognized by dispatcher was collected through EMCC audio logs and patient charts. We present descriptive data and results from a logistic regression analysis.ResultsData was collected on 113 cases, and dispatchers used video streaming in addition to standard telephone communication in 12/113 (10%) of the cases. The odds for the dispatcher to recognize a need for first aid during a medical emergency call were more than five times higher when video streaming was used compared to no use of video streaming (OR 5.30, 95% CI 1.11-25.44). Overall quality of bystander first aid was rated as “high”. The odds ratio for the patient receiving first aid of higher quality were 1.82 (p-value 0.46) when video streaming was used by dispatcher during the call.ConclusionOur findings show that video streaming is not frequently used by dispatchers in calls regarding patients with injuries, but that video streaming is associated with improved recognition of patients’ first aid needs. We found no statistically significant difference in first aid quality comparing the calls where video streaming as a supplement were used with the calls with audio only.

SupporTive Care At Home Research (STAHR) for patients with advanced cancer: Protocol for a cluster non-randomized controlled trial.

Advancements in the treatment and management of patients with cancer have extended their survival period. To honor such patients' desire to live in their own homes, home-based supportive care programs have become an important medical practice. This study aims to investigate the effects of a multidimensional and integrated home-based supportive care program on patients with advanced cancer. SupporTive Care At Home Research is a cluster non-randomized controlled trial for patients with advanced cancer. This study tests the effects of the home-based supportive care program we developed versus standard oncology care. The home-based supportive care program is based on a specialized home-based medical team approach that includes (1) initial assessment and education for patients and their family caregivers, (2) home visits by nurses, (3) biweekly regular check-ups/evaluation and management, (4) telephone communication via a daytime access line, and (5) monthly multidisciplinary team meetings. The primary outcome measure is unplanned hospitalization within 6 months following enrollment. Healthcare service use; quality of life; pain and symptom control; emotional status; satisfaction with services; end-of-life care; advance planning; family caregivers' quality of life, care burden, and preparedness for caregiving; and medical expenses will be surveyed. We plan to recruit a total of 396 patients with advanced cancer from six institutions. Patients recruited from three institutions will constitute the intervention group, whereas those recruited from the other three institutions will comprise the control group.

PDenoiser: A Personalized Speech Enhancement Neural Network for Pre-hospital Emergency Medical Services.

Pre-hospital emergency medical service (EMS) tasks often come with complex and diverse noise interferences, posing challenges in implementing ASR-based medical technologies and hindering efficient and accurate telephonic communication. Among the different types of noise distortion, interfering speech is especially annoying. To address these issues, our aim is to develop a technology capable of extracting the intended speech content of the target physician from noisy and mixed audio during EMS tasks. In this work, we propose a monoaural personalized speech enhancement (PSE) method called pDenoiser, which is a real-time neural network that operates in the time domain. By leveraging the prior vocalization cues of emergency physicians, pDenoiser selectively enhances target speech components while suppressing noise and nontarget speech components, thereby improving speech quality and speech recognition accuracy under noisy conditions. We demonstrate the potential value of our approach through evaluations on both public general-domain test sets and our self-collected real-world EMS test sets. The experimental results are promising, as our model effectively promotes both speech quality and ASR performance under various conditions and outperforms related methods across multiple evaluation metrics. Our methodology will hopefully elevate EMS efficiency and fortify security against nontarget speech during EMS tasks.

The secret of speech: Executive extraversion and firm innovation performance based on telephone communication

Innovatively departing from conventional methodologies such as questionnaires, interviews, or text analysis, this study introduces a single-gender speech personality measurement approach to identify extraversion traits in executives from a speech perspective. Central to the research is how executive extraversion influences firm innovation performance. The research samples are derived from the audio recordings of performance conference communication calls held by Chinese listed companies on the Wind 3C conference platform. Through hierarchical regression analysis, empirical results demonstrate an inverted U-shaped relationship between executive extraversion and firm innovation performance (measured by R&D personnel input, R&D expenditure, and patent applications). The study also reveals that situational factors, including the proportion of shareholding by pressure-resistant institutional investors, incentive compensation, and equity concentration, significantly moderate the inverted U-shaped relationship. This research provides compelling evidence of the importance of executive extraversion in firm innovation performance and offers a new perspective on the mechanisms through which executive extraversion influences firm innovation performance. The single-gender speech personality recognition method allows researchers to effectively utilize executives’ speech information in the big data era. The research viewpoint and findings contribute beneficially to the Upper Echelons Theory and offer actionable insights for leveraging executive traits to bolster innovation.