Ocular radiation protection efficiency and ergonomic performance of a novel Shoulder-Mounted radiation shield for interventional procedures.

Episodic virtual care (EVC) offers patients rapid access to virtual primary care services but lacks relational continuity with a primary care clinician or team. We investigated patients' experiences with EVC and examined differences based on access to a regular primary care clinician and self-reported complexity of medical needs. In this convergent parallel mixed methods study, we conducted a descriptive and exploratory survey of EVC users' health service access, self-reported medical needs, EVC use, and demographics. Participants included adults (aged ≥ 18) living in Nova Scotia or New Brunswick who self-reported using EVC in the past year. We used descriptive statistics to summarize numeric and ordinal data of patient experience and stratified findings by having a regular primary care clinician and medical complexity. We conducted inductive content analysis of free-text survey responses. We integrated quantitative and qualitative data at the interpretation phase. We identified mixed experiences among EVC users, with quantitative data portraying virtual care experiences more favourably than free-text responses. Most users felt EVC met their health needs, although those without a regular primary care clinician and with greater medical complexity tended to rate experiences less favourably. In free-text responses, some participants expressed concerns with the technological aspects of virtual visits and voiced preferences for in-person care. Patients with a regular primary care clinician tended to access EVC for short-term health concerns, whereas those without a regular primary care clinician sought care for ongoing/chronic problems and prescription renewals. EVC is helping to address some gaps in access, particularly for patients without a regular primary care clinician, by providing care where there might otherwise be none. However, EVC often falls short of meeting ongoing and more comprehensive care needs, underscoring the importance of improving access to longitudinal primary care.

To provide a worked example of the process used in developing data collection tools to measure the profile and practice of Australian general practice nurses (GPNs). Methodological discussion. An iterative design process encompassing the steps of sandpit development, alpha, beta and pilot (field) testing, alongside stakeholder consultations, was used to develop the Occasions of Care Explained and Analysed (OCEAN)-GPN tools. At each stage, the 'think-aloud' method was used to collect qualitative data and a user survey measured satisfaction with tool development. The application of user-centred design principles shows how the data collection tools were developed for this major national study. Examples of iterative testing strategies illustrate how participants' experiences can inform data-collection processes. The OCEAN-GPN tools have been rigorously developed to capture Australian GPNs' profile and clinical activity. The iterative processes and extensive consultation ensured that the tools were fit for purpose and met user needs. Collection of study data using these tools will enable evaluation to inform policy, research, education and clinical practice.

To test whether mobile phone surveys conducted remotely might generate data on deaths that are not covered by mortality surveillance systems established in laboratories and health facilities, or in institutions involved in the post-mortem management of corpses (e.g., morgues, cemeteries). We conducted a national survey of mobile phone users in Bangladesh during the COVID-19 pandemic. Respondents were asked to list the deaths that had occurred in their household in recent years. For each death, they were also asked to indicate whether the deceased had been diagnosed with COVID-19 prior to death, whether the death occurred at home or at a health facility, and where the burial took place. Using these data, we represented the overlap between data generated by the mobile phone survey and several potential mortality surveillance systems, which focus on counting deaths in health facilities or communal cemeteries. We described the socio-demographic characteristics of the deaths that were uniquely recorded by the mobile phone survey. From December 2021 to July 2022, 506,659 calls were placed, resulting in 22,731 interviews completed by mobile phone. Respondents reported 1527 deaths that had occurred in their household since 2020. Among those deaths, 99 (6.5%) had received a pre-mortem diagnosis of COVID-19. The proportion of reported deaths that were not covered by other potential mortality surveillance systems, was 32.4% in the large city corporations of Dhaka and Chittagong, 36.3% in other urban areas and 49.6% in rural areas. In urban areas, deaths among men, as well as among youth and the elderly, were more likely to be covered solely by the mobile phone survey. Mobile phone surveys can potentially remedy gaps in the data generated by other recommended mortality surveillance methods.

Feasibility of implementation, diagnostic accuracy, and end-user impact of an electronic health record (EHR)-based ureteral stent tracking tool in a pediatric population.

This study examines the phenomenon of pseudoconfident knowledge in the context of the everyday use of generative artificial intelligence. By pseudoconfident knowledge, we mean a response that is substantively plausible, rhetorically coherent, and outwardly persuasive but is treated and understood as knowledge before its actual reliability has been established. Of course, we do not use the term “pseudoconfident knowledge” to denote knowledge in the strict epistemological sense. Rather, it denotes a special form of AI-generated content that acquires the status of knowledge in the user’s perception before its reliability, source-based justification, or factual correctness have been established. The problem here is not that such an answer is already knowledge but that it is prematurely accepted as knowledge because of its coherence, completeness, and rhetorical confidence. The aim of the study is to identify the epistemic gap between the everyday operational integration of artificial intelligence and the user’s critical ability to distinguish between persuasiveness and justification. The theoretical framework combines approaches to AI literacy, epistemic vigilance, and contemporary forms of digital mediation in the circulation of knowledge. The empirical basis of the study is an online survey of AI users. The analysis was conducted using descriptive statistics, contingency tables, and methods for testing associations between categorical variables. The results show that the key differentiating factor is not the frequency of AI use, but the strategy used in handling its responses. More epistemically robust positions are associated with practices of comparison, editing, and verification, whereas uncritical acceptance of the answer is associated with greater vulnerability to pseudoconfident knowledge. We conclude that the spread of generative artificial intelligence is producing a new socioepistemic problem that calls for a shift in emphasis from simple instrumental literacy toward a culture of verification, doubt, and epistemic responsibility.

BackgroundBy 2015, the emergence and dissemination of multidrug-resistant Plasmodium falciparum in the Greater Mekong Subregion threatened regional and global malaria control efforts. In response, Greater Mekong Subregion countries committed to malaria elimination by 2030, with strengthened surveillance as a strategic pillar. In 2017, Cambodia introduced an elimination-oriented digital Malaria Information System (MIS). Its health center app enables real-time, geo-located, case-based malaria reporting across primary health centers, and is fully integrated with the MIS.ObjectiveThis study aimed to evaluate the real-world national implementation of Cambodia’s Android-based health center app, considering coverage, fidelity, timeliness, and data use, and their effects on malaria surveillance performance, case management, programmatic response, and public health outcomes.MethodsSystem performance and public health use were assessed using system-generated metadata, national surveillance data, and user surveys. Operational indicators included technical performance, data completeness, and reporting timeliness, alongside surveillance outcomes such as case notification, classification, reactive case detection, and foci investigation. Nationwide user experience was measured via a survey of 761 health centers across 21 provinces, with in-depth structured surveys at 9 health centers in 3 provinces. Descriptive analyses evaluated system functionality, contribution to malaria surveillance and response, and usability among frontline health workers.ResultsThe health center app demonstrated strong technical performance, with rapid loading and resilient data transmission under low-bandwidth conditions, supporting reliable reporting in resource-constrained settings. Integrated real-time dashboards provided analytics for case management, surveillance monitoring, risk stratification, and targeted public health interventions. Data completeness remained high (99%, 89/90 fields in 2024), demonstrating consistent routine use even as case incidence declined. Between January 1, 2025, and July 31, 2025, 69 malaria cases were reported nationally (23 locally acquired, 7 domestically imported, and 39 internationally imported). Of these, 95.7% (66/69) were notified and classified within 1 day. Reactive case detection was completed within 3 days for all 21 eligible cases, and 16 of 19 eligible foci received a response within 7 days, indicating strong operational responsiveness. User surveys showed 96.3% (733/761) of health centers were satisfied or very satisfied, 90.1% (686/761) reported rare or no technical issues, and 91.7% (698/761) found the app easy to navigate. Operational challenges included limited internet connectivity, transport to remote areas, and electricity interruptions. In-depth surveys confirmed high uptake, confidence in reporting, and routine use of surveillance data, although gaps in local analytical capacity were identified.ConclusionsDeveloped and managed locally to enhance sustainability, the MIS drove significant reductions in malaria case incidence, with the health center app contributing timely, complete, structured reporting at the point of care. Public health responses were facilitated by real-time analysis, targeted interventions, and decentralized decision-making. User engagement was sustained as malaria cases declined, and further enhancements are planned to ensure seamless transition to postelimination surveillance, reducing the risk of malaria reestablishment in Cambodia.

IntroductionPatient-accessible electronic health records (PAEHRs) offer benefits, such as supporting self-management and care engagement. However, some patients, particularly those with mental health conditions, might experience negative emotions such as worry when reading unexpected or sensitive information in their PAEHRs.MethodsA web-based survey of 4459 respondents distributed via the Finnish national patient portal included multiple-choice and open-ended questions. Respondents consisted of two patient groups who had received care either for 1) mental health or 2) other conditions. Inductive content analysis was performed to explore the kind of information that was perceived as sensitive in the PAEHR. Associations between sociodemographic factors including the type of care and reporting health information as sensitive were calculated via the multivariable binary logistic regression analysis.ResultsMental health (61.3%), and intimate health (8.3%) were the most frequently mentioned as especially sensitive types of information among respondents, who also stressed that the sensitive nature of the health information depended on the context. Within the mental health information type, therapy or treatment was most often mentioned (3.5%) as sensitive. Respondents who had received mental health care were significantly more likely to perceive certain information as sensitive (53.2%) than other patients (28.8%; Adjusted OR=2.783, 95% CI=[2.333, 3.319], p<0.001).ConclusionsThis study delves into the sensitive character of mental health information within PAEHR. The sensitivity of information also depends on the consequences for the patients when data will be used in another context. Documenting sensitive information carefully and safeguarding it is recommended to maintain trust in electronic health records and healthcare.

The standard of the learning environment has direct and indirect effects on the cognitive performance of the learners and is one of the major elements in the visual identity provided by learning institutions. This study focuses on the development of new designs related to the acoustic, visual, environmental, or infrastructural characteristics of learning spaces that stimulate a positive learning atmosphere among learners, hence contribute towards improved performance. In accordance with the sustainability objectives imposed by the local and international communities, the concept of recycling and or the reuse of waste is incorporated in the learning environment. The proposed solution was applied in the Faculty of Technology and Education by Beni Suef University, through providing an overall intervention based on four principles, including (1) classroom rehabilitation, (2) lobby and administrative rehabilitation, (3) back facade rehabilitation, and (4) front facade rehabilitation. The intervention project was conducted through collaboration between researchers from the fields of architecture, electrical engineering, and art education. Based on the findings, a substantial portion of the recycled materials consisted of solid waste such as cork panels, paper, metals, plastic, and wood. Recycling these materials contributed to reducing environmental impact by avoiding additional carbon dioxide emissions. In addition, user survey feedback reflected positive perceptions, with participants reporting noticeable improvements in the quality of the learning space, a stronger sense of professionalism, and increased awareness of sustainability. Future work will examine scalability across campuses. Universities are encouraged to adopt continuous upcycling programs, standardized waste-management guidelines, and replicable design frameworks that combine aesthetic, environmental, and educational benefits.

BackgroundNursing records are essential for maintaining patient care quality but impose a substantial workload on nurses, thus contributing to burnout and diverting attention from direct care. Voice input technology enables hands-free and eyes-free documentation, allowing simultaneous patient care and record entry. Despite its potential, its adoption in clinical nursing practice remains limited owing to concerns about patient privacy, technical instability, and the complexity of entering structured data into electronic medical record interfaces. Furthermore, most previous studies have been conducted in simulation settings or have focused on post hoc dictation. Thus, the feasibility of true simultaneous documentation in real-world clinical environments remains largely unexplored.ObjectiveThis pilot study was designed to explore the feasibility of using hands-free and eyes-free voice input for concurrent nursing documentation in the highly structured clinical environment of a catheterization laboratory.MethodsThis study was conducted at Kyoto University Hospital using a mixed methods exploratory design. Eight cases of percutaneous transhepatic cholangiodrainage and transcatheter arterial chemoembolization were observed between December 2022 and January 2023. Five nurses participated in this study and documented intraoperative events using both traditional handwritten records and a prototype voice dialogue system comprising a smartphone (Google Pixel 6a) and wireless earphones (Pixel Buds Pro). Researchers observed the nurses’ behavior in adjacent control rooms to minimize interference. Log data from voice input and the corresponding handwritten notes were compared to determine the proportion of events successfully captured. In addition, semistructured interviews and usability surveys were conducted to obtain qualitative feedback on usability, practicality, and perceived barriers.ResultsVoice input successfully recorded 40% to 100% of events during the preoperative and intraoperative phases, but only 0% to 12% during postoperative documentation. Observations and interviews revealed that the postoperative phase involved higher cognitive and communication demands, thereby making simultaneous voice documentation difficult. A significant barrier identified was the “social awkwardness” of interacting with the system; nurses reported feeling embarrassed when speaking loudly to activate the device and often stepped away from patients to record data, negating the benefit of concurrent entry. Concerns about disturbing patients or interrupting medical communication have also hindered use.ConclusionsThis pilot study identified two major barriers in applying concurrent voice input in clinical settings: (1) the instability and unreliability of using voice input as the sole recording method and (2) the conflict between voice interaction and the social dynamics of care. To overcome these, future implementations should consider visible devices to signal recording status, support for whisper recognition, and protocols for code words to handle sensitive information. Gradual implementation may reduce nurses’ cognitive and psychological burdens. Further large-scale longitudinal studies are warranted to validate these strategies in routine nursing documentation.

Drawing "digital nutrients": A study on the impact mechanism of users' digital hoarding on information utilization.

Scientific research, especially in experimental disciplines, depends on laboratories (labs), which are among the most energy- and resource-intensive facilities within universities. Despite their significant environmental footprint, labs are often overlooked in sustainability strategies, even though their contribution is crucial to achieving institutional and global climate goals. This Utrecht university case study presents the development of Green Labs initiatives and the use of the Laboratory Efficiency Assessment Framework (LEAF) as a scalable approach towards structured sustainability practices. We conducted a partial assessment of the university-wide lab-related environmental impact and a detailed evaluation of environmental and social outcomes from LEAF-bronze (entry-level) implementation in the Department of Pharmaceutical Sciences. Results show that LEAF low-cost measures produced measurable environmental benefits while enhancing user motivation and satisfaction. Post-implementation monitoring of a 910 m2 lab-facility showed a 5% reduction in total electricity use and a 38% decrease in targeted equipment electricity use, saving 15 MWh, 2.9 t CO2e, and 1500 EUR annually. Waste segregation improved substantially, particularly in plastic and paper recycling, while hazardous waste volumes remained stable. Surveys of lab users (n = 99) and LEAF-team members (n = 18) indicated high satisfaction, increased motivation for sustainable practices, and perceived -benefits for lab organization, safety, and team cohesion. Beyond technical interventions, the findings underscore the importance of grassroots initiatives, community engagement, and institutional support in driving systemic, long-lasting change. This case study offers a replicable model for embedding sustainability in academic labs and advancing the transition toward climate-neutral, resource-efficient, and socially responsible research environments.

Introduction Coercive measures (CM) are commonly used in mental health care. From a mental health service user perspective, CM are often associated with physical and psychological harm and a serious infringement on personal autonomy. Danish health legislation, therefore, adheres to principles requiring the use of the least intrusive CM. However, limited knowledge exists about service users’ perceptions of what constitutes the least intrusive CM. Purpose To survey mental health service users’ perceptions of intrusiveness related to various CM and to identify which interventions they consider the least intrusive. Methods A cross-sectional survey was conducted, which was developed in consultation with mental health service users, inspired by previous international research. Perceived intrusiveness was rated on a 0–10 visual analogue scale (VAS). Data were analysed descriptively and statistically using non-parametric tests. Results Of 8,250 eligible participants, 1,367 (16.6%) completed the survey. Ratings revealed two clusters: constant observation, time-out, and chemical restraint were perceived as less intrusive, while seclusion and mechanical restraint (belt alone or with straps) were rated as more intrusive. Female participants, younger participants, and those who have prior CM experience consistently rated all interventions as more intrusive. Conclusion Rather than identifying a single most or least intrusive measure, the findings suggest a broader distinction between types of CM. Two clusters emerged—those generally perceived as more intrusive and those perceived as less so. This pattern may inform future clinical decision-making and policy development, highlighting the need for further research into subjective, modifiable factors that shape service users lived experiences.

With the rapid aging of the global population, there is an increasing need for innovative solutions to mitigate the physical burden on caregivers and improve safety for older people in medical and nursing-care settings. Falls represent a major threat to older people, significantly impacting their mobility and functional independence. In the present study, we introduced and evaluated a suspension-type fall-impact-mitigation robot designed to reduce fall speed and injury risk in daily living environments. The robot, which operates without the need for an external power source, was tested in a living lab simulating indoor and outdoor home spaces. High-performance, markerless motion-capture technology was employed to measure the velocity of falls across five scenarios, including forward/backward falls, sliding from a chair, and tripping on slopes. The results showed that wearing the suspension-type fall-impact-mitigation robot substantially reduced the velocity of falls, with hip velocities upon contact with the ground remaining below the biomechanical reference threshold of 2.0 m/s in 98.9% of measurements across all scenarios. A usability survey conducted among healthcare professionals further indicated high scores for safety and ease of use in care settings. These findings suggest that the fall-impact-mitigation robot is a promising solution for reducing fall-related injuries among older adults.

Implementation and initial evaluation of needs-based remote consultation systems for musculoskeletal conditions in children.

Performance of the uCGM 100 continuous glucose monitoring (CGM) system, featuring a 15.5-day, real-time, and factory-calibrated glucose sensor, is evaluated against venous plasma reference for adult participants (≥18 years) in a multicenter, prospective clinical study. A total number of 60 participants were enrolled at three clinical sites in China, and each participant wore sensors on the back of each upper arm for 15.5 days. Three in-clinic visits, lasting eight hours during each visit, were conducted by each participant to perform multiple venous plasma glucose measurements using Biosen C-Line GP+ (EKF Diagnostics) Glucose/Lactate Measuring System. Venous plasma blood glucose sample tests covered the start, middle, and end wear of the sensor (day 1, days 3-5, days 7-9, days 11-13, or the last 24 hours). Analytic performance included accuracy such as ±20% or ±20 mg/dL (%20/20) agreement rate with reference values, and mean absolute relative difference (MARD) between CGM and reference values. A total of 11 576 matched data pairs (120 sensors) were analyzed. The overall MARD and %20/20 agreement rate for the CGM system was 7.6% and 95.5%, respectively, compared with venous blood reference. The %20/20 agreement remained consistently above 93% across wear days and glucose ranges. No serious adverse events were recorded. Usability survey showed 99.8% positive feedback, demonstrating good usability. The novel CGM system was proven to provide accurate and reliable glucose readings in adults with diabetes.

ABSTRACTBackground and AimsMany factors are affected after amputation and prosthetic use in patients with diabetes mellitus. Our study aimed to evaluate complications, satisfaction, and walking ability of patients with diabetes following 1 year of using trans‐tibial prostheses.MethodsThe participants were diabetic patients with a history of using PTB‐SC transtibial prostheses design. Demographic and residual limb characteristics were collected. Twenty‐seven participants were included. A modified Orthotics Prosthetics Users Survey (OPUS) questionnaire, 2‐min walk test, and Visual Analogue Scale were used to evaluate satisfaction and complications, walking ability, and pain at rest, respectively. Descriptive statistics were used for analysis. Normality of the data was assessed using the Shapiro–Wilk test. The types of complications were grouped. The effect of the type of complication on walking ability and satisfaction was evaluated using one‐way analysis of variance. All statistical tests and calculations were performed using SPSS software.ResultsThe most common complications are put in four groups (group 1: volume change (11.1%), group 2: pain (during activity) (59.2%), group 3: redness(14.8%), and group 4: non‐complication(14.8%)). The mean for walking ability was 94.0 ± 36.7 m, satisfaction was 66.8 ± 5.8, and pain (at rest) was 20 (0,70). Pain (during activity) was the most common complication. The effect of type of complication on the walking ability and satisfaction, revealed no significant differences (p = 0.12, p = 0.057), with partial ŋ2 = 0.21 and 0.27, indicating a large effect size, respectively. Post‐hoc comparisons using the Tukey HSD test indicated that the mean score for group 3 was significantly different from group 4 (MD: 11.1, SD: 3.9) in evaluating the effect of the type of complications on the satisfaction.ConclusionThis study provides valuable insights into the experiences of individuals with diabetic amputations. Addressing complications and optimizing prosthetic design, alignment, and fitting are essential for enhancing functional outcomes and improving the overall quality of life of this population.

Caravan toilets and chemical choices: Exploring user perspectives and preferences to understand wastewater quality from dumpsites.

Purpose The study investigates the clinical impact of the Oxford Visual Perception Screen (OxVPS), a standardised assessment for post-stroke visual perception difficulties. Methods In this mixed-method study, OxVPS use, benefits, and changes to practice were explored through repeated cross-sectional user surveys 3 (n = 234), 6 (n = 136), 12 months (n = 70) post-registration and interviews with 33 health professionals. Results At 3–6 months, 85% of participants reported using OxVPS, compared to 94% at 12 months. Between 54% and 67% of participants said that OxVPS had influenced their clinical practice. The survey data revealed that OxVPS amplified awareness of visual perception difficulties in 89%-98% of participants, and interviews highlighted increased knowledge. For 48% of participants, OxVPS had become the standard screening tool. Both interviews and surveys showed ease of implementation: participants found OxVPS quicker (71%-76%), easier to use (72%-81%), more suitable for their patients (77%- 85%), and more user-friendly (74%-78%) than other screening tools. OxVPS allowed 93%-94% of participants to screen patients in a more standardised way and supported rehabilitation planning. Ninety-four percent would recommend OxVPS to a colleague. Conclusions Clinicians find OxVPS quicker and easier to use compared to other assessments, and supportive of rehabilitation planning. Consequently, more patients are assessed in a standardised way.

BackgroundTimely and appropriate diagnosis and treatment are key to ending tuberculosis (TB). Incorporating users’ preferences when implementing decentralised strategies for diagnosis may facilitate scale-up and impact. This qualitative study embedded within a cluster randomised controlled trial explored the values and preferences of multiple stakeholders regarding a TB diagnostic strategy using the Truenat platform, mycobacterium tuberculosis (MTB) Plus and rifampicin Dx Assays in Mozambique and Tanzania.MethodsWe conducted semi-structured interviews with people with presumptive TB (n=35), professional users (laboratory technicians, nurses, clinicians, n=19) and national decision-makers (n=5). Direct observations of testing procedures and usability surveys (n=12) were also conducted. Thematic analysis was performed, informed by the Consolidated Framework for Implementation Research.ResultsFacilities varied in testing capacity, number of cases and time-to-results (from same-day to >2 weeks). Availability and supply of reagents and cartridges were described as an issue by healthcare providers and a potential cause for delayed results. The Truenat platform for detection of TB was considered easy to use (median SUS score 90/100) as well as acceptable and fit to the context where the evaluation was conducted. Truenat’s advantage was appreciated in facilities with limited prior testing capacity (eg, shipping samples, using microscopy), including short time-to-results, reduced need to return to provide more samples and fewer infrastructure needs (compared with GeneXpert). People with presumptive TB preferred the same-day results and rapid initiation of treatment enabled by Truenat testing. Some viewed waiting longer time (>1 day) for the results acceptable if it were to result in increased accuracy. Regarding the diagnostic process, participants valued the support and counselling from the healthcare workers.ConclusionsThe Truenat platform and TB assays were perceived as easy to use by health providers, and as acceptable and feasible across stakeholder groups. Its implementation in decentralised settings was considered a preferred alternative to off-site Xpert testing for TB in Mozambique and Tanzania.Trial registration numberNCT04568954.