Telephone Communication Research Articles

Clinical Characteristics Analysis of Gastrointestinal Peripheral T-Cell Lymphoma:Impact of Non-Emergency Surgery on Overall Survival

Introduction The gastrointestinal tract is the most common extranodal site involved in non-Hodgkin lymphoma (NHL) and most NHL cases are of B-cell origin. Peripheral T-cell lymphoma (PTCLs) involving the gastrointestinal is less commont, comprising only about 4-6% of gastrointestinal lymphomas. This study retrospectively analyzed the clinical characteristics and potential clinical factors influencing survival outcomes in patients diagnosed with PTCLs through gastrointestinal tissue biopsy at our center. Methods Based on the clinical data, patients were reevaluated for clinical staging and risk stratification, including Ann Arbor staging, IPI scoring, and gastrointestinal lymphoma Lugano staging. Patient's follow-up was conducted through outpatient medical records and telephone communication. For the analysis of categorical data, the chi-square test or Fisher's exact test was used. Survival time was estimated using the Kaplan-Meier method. The Cox proportional hazards model was employed to calculate hazard ratios (HR) and their 95% confidence intervals (CI) to analyze prognostic factors. Data analysis was performed using SPSS 23 for Windows software. Results A total of 622 gastrointestinal tissue biopsy samples from October 2014 to September 2022 were retrieved from the medical records system. Among them, 67 cases (10.8%) were diagnosed as PTCLs. Among them, 5 cases had no available clinical data and were excluded. Detailed information regarding patient clinical characteristics can be found in the table. Treatment and Efficacy: Among the 62 patients with available clinical data, 43 received gastrointestinal surgical resection treatment, including 21 cases (33.9%) of elective non-emergency surgery and 22 cases (35.5%) of emergency surgery due to acute abdomen. The median courses of chemotheray was 5 (1~8). 15 patients (31.3%) achieved complete response (CR)/CRu; 10 patients (20.8%) achieved partial response (PR). Among the 59 patients who received chemotherapy and/or surgical treatment, progression-free survival (PFS) was evaluated with a median follow-up time of 48.4 months, and the median PFS was 4.4 months (95% CI: 2.5-6.3) (Figure). Multivariate analysis identified advanced Ann Arbor stage (stage 3/4) (HR=3.53, 95% CI: 1.53-8.17, P=0.003) as independent adverse prognostic factors for PFS. Receiving chemotherapy (HR=0.24, 95% CI: 0.09-0.66, P=0.005) and elective surgery (HR=0.45, 95% CI: 0.22-0.92, P=0.029) were identified as independent favorable prognostic factors for PFS. As of the last follow-up, a total of 49 patients (79.0%) had died and the median overall survival (OS) was 6.4 months (95% CI: 3.8-8.9) (Figure). Multivariate analysis identified Ann Arbor stages 3-4 (HR=3.01, 95% CI: 1.34-6.74, P=0.007) as an independent adverse prognostic factor for OS, and receiving chemotherapy (HR=0.13, 95% CI: 0.05-0.31, P<0.001), elective surgery (HR=0.36, 95% CI: 0.16-0.74, P=0.006) were identified as independent favorable prognostic factors for OS. Conclusion Data from four hematological disease treatment centers located in Zhejiang Province, southeastern China, showed that PTCLs involving the gastrointestinal tract accounted for approximately 10.8% (67/622) of all gastrointestinal lymphoma patients. These patients had a relatively high incidence of gastrointestinal perforation (35.5%). The overall treatment efficacy for patients was poor, with a majority of them succumbing to disease progression. The median PFS and OS were approximately six months. Elective surgery and chemotherapy appeared to improve the patients' outcomes.

The Use of Telemedicine in Outpatient Pain Management: A Scoping Review

BACKGROUND: Telemedicine is an increasingly important tool in outpatient pain management. Telemedicine can be implemented through various strategies and a multitude of approaches have been described in existing literature. OBJECTIVES: This scoping review aims to survey how telemedicine has been approached in published literature, providing insight for continued implementation. STUDY DESIGN: Scoping review. SETTING: Outpatient pain management. METHODS: Ovid MEDLINE and Embase databases were queried. Two board-certified pain management physicians screened search results for relevant publications based on predetermined criteria. Included publications focused on outpatient pain management via live video or telephone and reported empirical outcomes. Publications were excluded that focused on acute pain, progressive muscle relaxation, physical therapy, or psychiatry, including cognitive behavioral therapy, or that primarily described educational modules, apps, mobile tracking, or automated calls. Nonfull publications (abstracts) and articles not available in English were also excluded. A third reviewer performed full-text screening, extracting variables of interest. Systematic reviews and meta-analyses were excluded from final selection. RESULTS: Text and abstract screening of 3,302 results yielded 88 publications. Upon full-text screening, 64 additional publications were excluded, yielding 24 publications. High-quality randomized controlled trials (RCTs) were described in 5 (21%) publications, pilot RCTs in 4 (17%), prospective studies in 1 (4%), retrospective studies in 5 (21%), survey-based studies in 7 (29%), and other types of studies in 2 (8%). Cancer pain was the focus of 3 (13%) studies, headache/facial pain the focus of 4 (17%), musculoskeletal the focus of 3 (13%), and unspecified chronic pain the focus of 14 (58%). Patient experiences were the focus of 18 (75%) publications, provider experiences the focus of 2 (8%), and both patient and provider experiences the focus of 4 (17%). Outcome improvement measures were studied in 17 (71%) publications, process improvement measures in 5 (21%), and both types of measures in 2 (8%). Standard visits without on-site support were described in 4 (17%) publications, while standard visits with on-site support were described in 9 (38%). The remaining 11 (46%) described structured/integrated pain management programs. Positive pain-related outcomes were reported in 9 (38%) studies. Increased access or decreased barriers to care were reported in 9 (38%). Patient satisfaction was reported in 12 (50%) publications, with 10 (42%) describing positive results. LIMITATIONS: This scoping review focused on telemedicine delivered via telephone or live video communication, excluding a substantial body of literature focused on virtual courses, modules, and other telehealth programs not involving live communication. CONCLUSIONS: Current literature describes telemedicine implementation with various levels of technological and logistical support. Models of telemedicine represented in current literature include: standard visits with on-site support, standard visits without on-site support, and structured/integrated pain management programs. Presently, no literature has directly compared outcomes from these different approaches. Choice of model will depend on the specific goals and available resources. Patient satisfaction was studied most frequently and generally demonstrated positive results. Though current literature is heterogeneous and lacks RCTs, it consistently demonstrates benefits of telemedicine to patient satisfaction, pain, and access to care. KEY WORDS: Chronic pain, telemedicine, telehealth, pandemic, health care equity, disability, health care resources

Prognosis of Zero Coronary Artery Calcium Score in Symptomatic Patients of South Asian Descent – An Experience From a Tertiary Care Center in Pakistan

Objectives: To estimate the prevalence of non-calcified coronary artery disease in patients with chest pain and a zero coronary artery calcium score, and to assess the prognostic significance of a zero coronary artery calcium score in these symptomatic patients.
 Methodology: All consecutive patients who underwent a CT coronary angiogram (CTCA) for evaluation of angina or angina-equivalent symptoms from 2009 to December 2020 were enrolled retrospectively. Patients with prior myocardial infarction, history of revascularization, and congenital heart disease were excluded. Follow-up data was collected by using the hospital's electronic patient record system and telephone communication. The endpoint, major-adverse cardiovascular events (MACE) was defined as the total of cardiac death, non-fatal myocardial infarction, and/or non-elective revascularization.
 Results: A total of 534 patients were enrolled after final exclusion. The mean age was 53 years ± 11. Males constituted 68.4% of the study population. Dyslipidemia was the most common co-morbid condition identified (50%), followed by diabetes (18.4%) and hypertension (3.6%). Chest pain was the most common presenting complaint (97.4%) followed by dyspnea. At least 28.8% of patients with zero CAC scores had the presence of coronary artery disease (soft plaque) of any degree. Obstructive CAD (>50%) was present in 5.8% of patients. Follow-up was available for 61.4% of patients. The mean follow-up duration was 96.6 months ± 49.8 (range 21 – 194 months). All-cause Major Adverse Cardiovascular Event (MACE) was observed in 8.8% of patients. The most common MACE outcome was angina (3.96%) and all-cause mortality (3%). Only 2.7% required revascularization on follow-up with 1.2% having myocardial infarction and non-urgent revascularization. The baseline characteristics, all-cause MACE (p = 0.79), mortality (0.82), angina (p = 0.765), revascularization (p = 0.45), non-fatal MI, and non-elective revascularization (p = 0.6) did not differ significantly in patients with and without obstructive CAD. The baseline characteristics did not differ significantly between patients with and without MACE.
 Conclusion: The incidence of soft plaque in this South Asian cohort is higher than that reported in international studies. However, in symptomatic South Asians, a CAC score of zero carries a good long-term prognosis, irrespective of the degree of CAD.

Development of the national injury resource database (NIRD)

IntroductionLack of an accurate, publicly available database of burn/trauma resources creates challenges in providing burn care. In response to this gap, our group developed the National Injury Resource Database (NIRD), a comprehensive database of all US burn centers (BC) and trauma centers (TC) and their capabilities. MethodsLists of all national BC and TC were obtained from the American Burn Association (ABA), the American College of Surgeons, and every state department of health. Data was cross-checked and included BC/TC were linked with a 7-digit identification number using the American Hospital Association Quick Search guide. Each center’s resources and verification status were validated with electronic or telephonic communications. ResultsThe final database includes 135 BC and 617 TC, of which 18 are BC-only, 500 are TC-only, and 117 are combined BC/TC. ABA-verified BC (n = 76) are only found in Washington DC and 31 states, and 8 states have no BC. In the last 10 years, a net increase of 7 burn centers was found nationally. The ABA’s online BC directory is outdated. ConclusionsNIRD represents the only up-to-date, comprehensive listing of BC and TC in existence. It categorizes all currently operating BC and TC across myriad classifications of designation and capabilities.

Utilization of the medical oncology pager and call center: Characterizing forgotten pillars of telemedicine in the digital era.

518 Background: Oncology has entered the digital era, accompanied by changes in patient interactions and expectations involving telemedicine. While much emphasis is appropriately placed on digital interactions with patients, little is known about modern non-digital interactions with patients in oncology practices. Methods: We analyzed Medical Oncology Pager (MOP) data from 7/1/18 – 4/14/23, during which patients had access to the electronic health record and messaging capabilities. The MOP for Mayo Clinic (Rochester) is covered by the medical oncology fellows, including after hours (6PM – 7AM). It covers consults and direct patient calls after hours and during weekends, in addition to critical results back up and inpatient oncology matters at all times. We also analyzed Medical Oncology Call Center (MOCC) data since 6/1/22, which takes inbound patient calls during working hours (7AM – 6PM) and is staffed by appointment office employees. Results: The MOP received a total of 17,679 pages during the analyzed period for a mean of 10.1 pages per day. Of these, 6,319 pages occurred after hours. The most after-hours pages were received on Fridays (n=1,091) and the least on Sundays (n=701); of those years with fully available data, 2022 had the highest volume (n=1,405) (Table 1). When comparing the MOP activity pre-pandemic (7/1/18 – 3/10/20) and intra-pandemic (3/11/20 – 4/14/23), the mean number of after-hours pages per day was relatively stable with 3.47 pre-pandemic and 3.69 intra-pandemic. Since 6/1/22, the MOCC has averaged 6,464 inbound calls per month during working hours, each of which had an average talk time of approximately five minutes. The majority of inbound calls occur on Monday mornings between 9 – 11AM, with over 6,500 recorded throughout the previous year. Conclusions: Telemedicine is multi-faceted, comprised of both digital and non-digital patient interactions. We show that many oncology patients utilize telephone communication with the healthcare system despite increased availability of digital capabilities. These data have implications for addressing the digital divide for those with limited digital access, serving older patient populations unfamiliar with digital technologies, healthcare navigation, trainee responsibilities, and resource allocation. Further work and standardization in non-digital telemedicine is necessary as it remains a pillar of modern healthcare delivery and oncology practices.[Table: see text]

A Review on Use of Telecommunication Tower over Host Structure

Abstract: Effective communication depends on strong towers since it has been used worldwide. The telephonic communication depends on this since it is the only way to connect different networks. It can be installed above the structure and over the ground but the failure of such structures during hazardous conditions can result in critical communication breakdowns. In this study different reviews based on the telecommunication towers installed on tall buildings worldwide has given. Usually, four-legged towers used for good communication and to transfer the load. Different reviews based on only tower analysis and remaining on the response over the host structure over which the tower rests. This literature review provides valuable visions and conclusions to identify the problems related to the telecommunication tower which has to be provided over the building and the location over which it has to be placed. From this study it has to be noted that previous studies were based on the location that was optimum for the host structure but no one used the worst case of tower placing if it will be necessary to provide at that location. From this, we came to know the conclusive outcome that aim to provide technical insights and recommendations for future research in this area

Digital technologies in training the accompanist: practical dimension

Statement of the problem. The modern distance learning changes pedagogical strategies, methods, approaches, and the educational process. Institutions of art education, where training involves personal communication between the teacher and the student in the process of individual practical classes, found themselves in the most difficult situation. Therefore, it is important to understand the practical achievements of art universities in the field of distance learning as proven ways to overcome the remote “gap” between a teacher and a student. Recent research and publications. The problems of distance learning, taking into account the creative specificity, are investigated in the articles of the following Ukrainian scientists: Hubarieva et al., 2021; Lytvyn et al., 2021; Ponomarova et al., 2021; Davydov et al., 2022; Dedusenko et al., 2022; Ohrimenko et al., 2022; Prudnikova & Prudnikova, 2022; Tkachenko et al., 2022; Fabian et al., 2022. The works devoted to the formation of a pianist-accompanist are Molchanova, 2019, 2021, 2022; Nikitska & Savchenko, 2022. Objectives, methods and novelty of the research. The purpose of the study is to consider the positive and negative effects of distance education on the performing formation of a pianist-accompanist using digital technologies. A comprehensive approach is applied, combining the methods of analysis and generalization, systematization and projection, comparative, empirical, and experimental methods in accordance with the performance ensemble specifics. The scientific novelty consists in the study of practical developments in the distance learning of pianists of the Piano Accompaniment Department of Kharkiv I. P. Kotlyarevsky National University of Arts (Ukraine). Research results. The distance education in Ukraine has been complicated by the state of war, the departure of specialists abroad, funding restrictions and changes in educational policy. The formation of the accompanist is carried out by two strategies: together with the vocalist / instrumentalist and in the absence of soloists. All study participants face certain problems. For a pianist-apprentice, these are: loss of time on technological tasks, lack of sound display, unbalanced load. For soloists, these are: impossibility of synchronous performance, lack of emotional communication, singing or playing to the recorded accompaniment. For teachers, these are: the lack of direct contact with the ensemble members, the difficulty of correcting the sound, the obligatory verbalization of all remarks. Digital technologies that provide remote training of accompanist are as follows: 1. Google Meet and Zoom video conferences (“the teacher’s presence” effect); 2.MOODLE and GoogleClassroom platforms (organization of independent work and creation of online classes); 3. YouTube and Google Disk resources (access to video files with performance of compositions); 4. Messengers Viber, Telegram, ChatOn, WhatsApp, etc. (communication); 5. Editing applications – Adobe Acrobat Reader, Foxit Reader, Paint, Scissors, etc. (visualization of comments); 6. Applications for working with video recordings (for example, YouCut); 7. Ordinary telephone communication. General technical problems: instability of the Internet connection and its speed; obsolescence of gadget models; digital ignorance of distance learning participants, lack of a “common denominator” for evaluating the results of ensemble performance. Conclusion. The perspective of art education can be seen in finding hybrid forms of learning, combining synchronous and asynchronous models, taking into account the achievements of distance and face-to-face education and finding algorithms for building a combinatorial strategy.

Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia.

The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP). A retrospective single-center review of patients who underwent ESP ablation between December 2014 and September 2022 was performed. Follow-up included telephone communication, letter questionnaire and outpatient presentation. Recurrence was based on typical symptoms. 115 patients aged 6-81 years (median age 36.3 years, 59.1% female; 26 pts < 18 years) were included. A typical history was present in all patients (100%), an ECG documentation of narrow complex tachycardia in 97 patients (84%). Patients were divided into three groups: Group 1 without DAVNP (n = 23), Group 2 with AH jump (n = 30) and Group 3 with AH jump and at least one AV nodal echo beat (n = 62). No permanent AV block was observed. During a median follow-up of 23.6 ± 22.7 months, symptom recurrence occurred in 7/115 patients (6.1%) with no significant difference between the groups (p = 0.73, log-rank test). Symptom recurrence occurred significantly more often in patients without (5/18 patients; 27%) as compared to patients with ECG documentation (2/97 patients; 2.1%; p = 0.025). No correlation between age and success rate was found (p > 0.1). ESP ablation is effective and safe in patients with non-inducible AVNRT. Overall, recurrence of symptoms during long-term follow-up is low, even if no DAVNP is present. Tachycardia documentation before the EP study leads to a significantly lower recurrence rate following ESP ablation.

Enhancing Speech Signal Quality through Noise Reduction for Improved Communication

Abstract: Speech is a fundamental and reliable mode of human communication, conveying not only linguistic content but also essential cues about the speaker, including language, emotion, gender, and identity. However, in contemporary telephone and audio-based communication systems, speech signals are highly susceptible to the deleterious effects of ambient and Gaussian noise. To detach this noise from the signal, many Digital Audio Filters can be employed, including the Audio Weighting Filter, low-pass and High-pass filter, Band Pass Filter, and Band Stop Filter. This paper implements and compares various digital filters for audio signal enhancement using MATLAB Simulink and compares the outcome to identify the best filter for this specific purpose.

When the connectivity is lost: infrastructural uncertainty and reaction to it amongst the tundra nomads of the Yamalo-Nenets Autonomous Okrug

The present paper contributes to the study of ‘infrastructural failures’ as one of the rapidly developing in re-cent times areas of the anthropology of infrastructure. In the focus of the research is a ‘failure’ of the satellite tele-phone communications in Russian Arctic, which occurred as a result of the decision of one of the providers, Globalstar inc., to withdraw from the Russian market in March 2022. This provider was particularly popular amongst the groups of the native population of Russian Arctic due to low prices for the service and equipment. In the paper, the ethnographic data collected during a fieldwork amongst reindeer herding nomads of Nadym District of the Yamalo-Nenets Autonomous Okrug, Russia, are used, on the basis of which the study is carried out on how the tundra nomads were adapting to the failure and overcoming its consequences. The paper starts with a short historical review of the development of long-range communications in tundra and the social norms, strategies, and behavioural patterns formed at different times amongst the reindeer herders in respect to these communications. This review, the materials for which comprised published literature and fieldwork records of the author collected in the late 1990s — early 2000s, demonstrates that up until the arrival of mobile and satellite telephones in tundra during the second decade of the 21st century, radiocommunications of the reindeer herders were, firstly, public and, secondly, relied in messaging on the social networks and mutual obligations of the nomadic groups with regard to transferring information. The review is followed by the description and analysis of the field data collected by the author during the fieldwork in August 2022. It is shown that the loss of the satellite connectivity in the spring of that year disturbed the reindeer herders very much and even caused a change in the movement routes of some of their groups. However, the herders soon managed to adapt to the new conditions. For that, the mobile phones, which were working on a part of the migration territory of the herders, were employed, as well as, impor-tantly, there were restored the social networks and obligations with respect to the information transfer that allowed reliable and relatively fast communications with the locations where the mobile connectivity was lacking. As the result, the communications once again became public, but the serious problems, which might have been caused by the interruption of the satellite connectivity, were able to be avoided. Meanwhile, the acute feeling of uncer-tainty that the herders were experiencing after the failure of the satellite connectivity, shows that the role of the long-range radiocommunications in their lives has increased significantly over the last two decades. The results of the study are also discussed in the context of the recent hypothesis on the “societies of the failure normality”.

The Influence of Consumer Impulse Buying and Electronic Word of Mouth on Purchasing Decisions

This study aims to analyze or find out about conditions and how much influence Consumer Impulse Buying and Electronic Word Of Mouth have on purchasing decisions through surveys of consumers of Skincare Avoskin Yourbae Serum products on TikTok. Impulse buying is the tendency of consumers to make purchases spontaneously, unreflected, in a hurry driven by the psychological emotional aspects of a product and tempted by persuasion from marketers. Electronic Word Of Mouth is an informal, non- commercial online communication about opinions on a service or product, which occurs in person, by telephone, e-mail, or other communication method. Purchasing decisions are decisions where consumers actually decide to buy and enjoy goods or services among various alternative choices. Based on the results of this study, it shows that Consumer Impulse Buying is considered quite good by consumers and has a positive and significant effect on Purchase Decisions. Electronic Word of Mouth is considered good by consumers and has a positive and significant effect on Purchasing Decisions. Consumer Impulse Buying and Electronic Word of Mouth have a positive and significant effect on Consumer Purchase Decisions on Avoskin Yourbae Serum Skincare Products on TikTok and are considered to have a partial and simultaneous effect, because with the ability of companies to utilize and create Consumer Impulse Buying and Electronic Word of Mouth, it will have an impact consumer purchasing decisions for Avoskin products, especially Skincare Avoskin Yourbae Serum.

Comparison of incisional gastropexy with and without addition of two full-thickness stomach to body wall sutures.

To compare complications between a modified incisional gastropexy (MIG) technique and standard incisional gastropexy (SIG). 347 client-owned dogs. Dogs that had undergone SIG or MIG from March 2005 through April 2019 were identified through a medical record search of the University of Missouri Veterinary Health Center. The MIG technique is identical to SIG except 2 additional simple interrupted sutures are added, 1 cranial and 1 caudal to the continuous suture line, going full thickness into the stomach to ensure engagement of submucosa. Medical record information was used to identify intraoperative, postoperative, and short-term complications, and telephone or email communication to pet owners and/or referring veterinarians was used to identify complications (short-term and long-term) after discontinuance of care at the University of Missouri Veterinary Health Center. Intraoperative, postoperative, short-term, and long-term complications were analyzed in aggregate within 6 matched groupings: (1) gastropexy for gastric dilatation-volvulus, (2) prophylactic gastropexy without other procedures, (3) gastropexy with ovariohysterectomy, (4) gastropexy with castration, (5) gastropexy with splenectomy, and (6) gastropexy with celiotomy other than splenectomy. Overall rates of complications potentially attributed to gastropexy were compared between SIG and MIG using the Fisher exact test. Overall rates of complications not attributed to gastropexy were compared between SIG and MIG using the χ2 test. There were no significant differences in overall complication rates between SIG and MIG. Surgeons who feel that engagement of gastric submucosa is important for gastropexy success may use the MIG technique with minimal fear of complications. However, superiority of one technique over the other cannot be determined on the basis of this study.

Call the on-Call: Authentic Team Training on an Interprofessional Training Ward - A Case Study.

There is a disconnect between how healthcare teams commonly are trained and how they act in reality. The purpose with this paper was to present a learning activity that prepares healthcare students to authentic teamwork where team members are fluent and move between different localities, and to explore how this setting affects learning. A learning activity "Call the On-Call" consisting of two elements, workplace team training where team members are separated into different locations, and a telephone communication exercise, was created. A case study approach using mixed methods was adopted to explore medical-, nurse-, physiotherapy- and occupational therapy students and supervisor perspectives of the effects of the learning activity. Data collection involved surveys, notes from reflection sessions, a focus group interview, and field observations. Thematic analysis was applied for qualitative data and descriptive statistics for quantitative data. The sociocultural learning theory, social capital theory, was used to conceptualize and analyse the findings. The majority of the students (n=198) perceived that the learning activity developed their interprofessional and professional competence, but to a varying degree. Especially nursing students found value in the learning activity, above all due to increased confidence in calling a doctor. Physio- and occupational therapy students lacked the opportunity to be active during the telephone exercise, however, they described how it increased their interprofessional competence. Authenticity was highlighted as the key strength of the learning activity from all professions. Concerns that team building would suffer as a result of splitting the student team proved unfounded. The learning activity created new opportunities for students to reflect on interprofessional collaboration. Constant physical proximity during training is not essential for effective healthcare team building. Splitting the student team during training may in fact enhance interprofessional learning and lead to progression in interprofessional communication.

A Model of Proactive Tele-Oncology Nursing Triage Through Remote Monitoring of Patient-Generated Health Data.

Telehealth approaches to remotely triage and manage patient issues are commonly used in surgical oncology. To date, most models place the burden of communication with the cancer care delivery system on the patient at home and in the community. This project presents a model for proactive tele-oncology nursing triage that leverages remotely captured, patient-generated health data to guide assessment and management. The nursing triage model is presented through three case studies, which illustrate the trajectory of proactive triage encounters, communication with the surgical oncology team, and management recommendations before surgery to 90 days post-hospital discharge. Patients were able to share intermittent electronic symptom data before and after surgery and postoperatively wear sensor devices to support functional recovery. Oncology triage nurses leveraged the data to guide telephone communication to address patients' needs.

Modern Approaches to Providing Telematics Oral Health Services in Pediatric Dentistry: A Narrative Review

A structural and organizational redesign of the dental care system is necessary today due to current trends in the demographic process and the accompanying changes in the population’s healthcare needs. The purpose of this article is to review the literature, analyzing those trends that today represent useful tools for the oral health of pediatric patients, with particular reference to teledentistry and all the supports it uses to reach remote territories or patients who, for various reasons, cannot have access to dental care. An independent literature search was conducted in three electronic databases: PubMed/MEDLINE, Google Scholar, and the COCHRANE library. Thirty-one articles were considered. Reported findings highlight that teledentistry has been used in pediatrics to educate and promote oral health and to provide remote diagnosis and monitoring through mobile health applications, smartphone cameras and apps, intraoral cameras, websites and search engines, and telephonic communications. Specifically, teledentistry has been beneficial in providing dental care in remote locations with difficult access to pediatric dentists, conducting remote diagnostic and screening programs, monitoring patients between appointments, promoting children’s oral health through dental education, and providing behavioral counseling prior to office visits. Future research should further investigate the long-term use, additional applications, and cost-effectiveness of teledentistry in children.

Sentiment analysis of epidemiological surveillance reports on COVID-19 in Greece using machine learning models.

The present research deals with sentiment analysis performed with Microsoft Azure Machine Learning Studio to classify Facebook posts on the Greek National Public Health Organization (EODY) from November 2021 to January 2022 during the pandemic. Positive, negative and neutral sentiments were included after processing 300 reviews. This approach involved analyzing the words appearing in the comments and exploring the sentiments related to daily surveillance reports of COVID-19 published on the EODY Facebook page. Moreover, machine learning algorithms were implemented to predict the classification of sentiments. This research assesses the efficiency of a few popular machine learning models, which is one of the initial efforts in Greece in this domain. People have negative sentiments toward COVID surveillance reports. Words with the highest frequency of occurrence include government, vaccinated people, unvaccinated, telephone communication, health measures, virus, COVID-19 rapid/molecular tests, and of course, COVID-19. The experimental results disclose additionally that two classifiers, namely two class Neural Network and two class Bayes Point Machine, achieved high sentiment analysis accuracy and F1 score, particularly 87% and over 35%. A significant limitation of this study may be the need for more comparison with other research attempts that identified the sentiments of the EODY surveillance reports of COVID in Greece. Machine learning models can provide critical information combating public health hazards and enrich communication strategies and proactive actions in public health issues and opinion management during the COVID-19 pandemic.

36-LB: Dulce Digital-Me—A Randomized Comparative Effectiveness Trial of Static vs. Adaptive Digital Interventions for Hispanic Adults with Diabetes

We compared the effectiveness of Dulce Digital (DD), a diabetes education text messaging program, versus Dulce Digital-Me (DD-Me), which included DD text messaging plus algorithm-driven, personalized goal-setting and feedback, in improving diabetes outcomes in Hispanic adults with type 2 diabetes (T2D). In this open-label comparative effectiveness trial, Hispanic adults with T2D were randomized (1:1:1) to receive DD, or the more personalized DD-Me approach delivered via automated, algorithm-driven text messaging (DD-Me_Auto) or telephonic communication from a health coach (DD-Me_Tel) across 6-months as part of existing primary care. Changes in clinical (HbA1c—primary) and patient reported outcomes were examined over 12 months. We enrolled N=310 Hispanic participants (69.7% female; M=52.1±10.2 years; 93.2% Spanish preferred; HbA1c M= 9.3±1.6 %) to receive DD (n=107), DD-Me_Auto (n=106) or DD-Me_Tel (n=97). Mixed models revealed no difference between DD and DD-Me (combined Auto+Tel) in rate of HbA1c change across 6- or 12-months, ps&amp;gt;0.05. All groups showed clinically and statistically significant improvements in HbA1c across 6-months [DD ∆ = -0.17% per month post baseline (95% CI -0.22,-0.10); DD-Me_Auto ∆= -0.20% (95% CI -0.26,-0.14); DD-Me_Tel ∆ = -0.15% (95% CI -0.20,-0.10), ps&amp;lt;.001]. Effect sizes were slightly attenuated, but remained statistically significant at 12-months (∆ HbA1c= -0.08% to -0.05% per month; ps &amp;lt; 0.001). Self-management behaviors and diabetes distress improved across 12-months in all groups. DD-Me (combined) showed greater improvement in medication adherence versus DD over time (Bint=-0.20, 95% CI -0.33,-0.01, p&amp;lt; 0.01). Two low-cost digital interventions for Hispanic adults with low income and T2D had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities. Disclosure A. Philis-tsimikas: Advisory Panel; Dexcom, Inc., Novo Nordisk A/S, Sanofi, Other Relationship; Medtronic, Research Support; Novo Nordisk A/S, Lilly, Viking Therapeutics, NIH - National Institutes of Health. K. L. Savin: None. J. A. Jones: None. M. Chichmarenko: None. H. Sandoval: None. L. Gallo: None. A. L. Fortmann: Employee; Dexcom, Inc. T. Clark: None. S. R. Spierling bagsic: None. E. Farcas: None. S. Roesch: None. J. H. Schultz: None. T. P. Gilmer: None. J. G. Godino: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK1123221UL1, TR002550)

Loneliness Decreased for Older Adults Using Telephone and Video Communications

ABSTRACT Aims To study feasibility and impact of telephone and video communication on perceptions of loneliness and social isolation in community-dwelling older adults. Methods Purposive flyer distribution to communities, area agencies on aging, meals on wheels, and snowball sampling. Sixteen people met inclusion criteria. Pre- and post-intervention data were collected: UCLA-3, UCLA20, FRAIL Scale, and Social Frailty Scale. Participants were allocated to either telephone or video communication groups, completing 8 weeks of one time per week 45–60-minute conversations. Results UCLA-20 demonstrated statistical significance (p = .017) for the full cohort with large effect size (Hedges’ g = 1.273). UCLA-3, SFS-8, and FRAIL Scale did not demonstrate statistically significant pre-post differences. No statistically significant differences (p > .05) were identified between the telephone and video communication groups. Conclusion Remote communication may have a positive impact on perceptions of loneliness that appear to be independent of the communication modality utilized. Randomized controlled trials are required to determine if either modality is more effective.

Analysis of student and parent satisfaction with the class teacher

Introduction. In today’s reality characterised by the exacerbation of numerous social problems that are conditioned, among many factors, by the impact of negative experience of the child-parent relationship in the family, the teacher’s ability to diagnose the state of child-parent interaction is of particular importance, contributing to the harmonisation of child-parent relations. Purpose of the research: to identify the role and potential of the class teacher in the context of his/her pedagogical influence on the child-parent relationship. Materials and methods. To handle the set tasks, the authors undertook an analysis of a number of publications – those devoted to the problems of interaction between the school and the child-adult family community, along with the description of the most successful practices of combining the class teacher’s and parents’ efforts in creating a favourable educational environment. The following methods were also used: analysis of documents; questioning; observation; interviewing; processing of factual material by analysis of ideas, facts, mathematical calculation of percentage or graphic indicators; comparative analysis; generalisation, establishing certain regularities. The survey covered a total of 246 parents, 120 learners, 17 head executives of general education institutions. Of them: parents: 215 – from the Chechen Republic, 18 – from the Republic of Ingushetia, 13 – from other regions of Russia; learners: 102 – from the Chechen Republic, 14 – from the Republic of Ingushetia 4 – from other regions of Russia; head executives of educational institutions: from the Republic of Ingushetia – 14, from the Chechen Republic – 3. The survey was conducted using the authors’ methodology containing questions aimed at identifying the nature of the relationship between the class teacher and the parents. Results. The close contact between the class teacher and the family revealed during the questioning (to illustrate it, more than 90% of the parents recognised the class teacher’s involvement in solving the problems they had with their children) makes it possible to positively assess the class teacher’s role in harmonising the parent-child relationship. Modern communications allow parents and class teachers to interact more closely; for instance, almost 70% of the learners noted that telephone communication was a frequent method. Nearly 80% of the parents reported systematic communication support by the class teacher. At the same time, 40% of the head executives of general education institutions noted class teachers’ difficulties in building relationships with the learners’ parents. Conclusion. Professional assistance to the family by the class teacher is characterised by the integration of pedagogical, psychological and social tasks, which encourages the teacher to search for new forms and ways of psycho-pedagogical support of the family. The teaching community’s efforts should be aimed at the formation of “conscious parenthood” supposing self-development of a parent capable of solving problems independently through awareness of own attitudes and expectations, family values and character-building style. The most effective forms are psychological education and counselling aimed at the formation of a value-oriented attitude towards child’s upbringing by involving parents in educational, training, organisational and reflective activities. At the same time, the search for new forms of interaction with the family is of particular relevance; the efficient practices thereof should be duly interpreted with the view to generalise and disseminate successful experience.

Improving communications in PPE: a solution for ‘landline’ telephone communication

BackgroundEmergency care staff wearing elastomeric respiratory personal protective equipment (PPE) report difficulties in communicating by telephone. We developed and tested an affordable technological solution aimed at improving telephone call intelligibility...