Videoconferencing Technology Research Articles

NAMAH—An Innovative Tele-ECHO Mentoring Program to Foster Well-being Among Physicians

Background: The current study aimed to develop and implement the National Assistance in Mental Health for Health Care Providers (NAMAH) module, which focused on wellness and building resilience for a cohort of physicians. Methods: The NAMAH module is a 12-week tele-mentoring program leveraging videoconference technology that uses the ECHO (Extension of Community Healthcare Outcome) HUB and SPOKE and consists of real-life case discussions and a brief didactic. The module’s content was developed after iterative feedback from experts and incorporated suggestions from healthcare providers (HCPs) following a needs assessment. A pre and post-design was used to assess the impact of the module on psychological distress using the self-reported Kessler Psychological Distress Scale (K10) and burnout using the Maslach Burnout—Inventory-Human Services Survey (MBI-HSS) among the 32 physicians who participated. Results: There was a significant decrease in the mean scores before (19.5 ± 6.27) and after (17.38 ± 6.23) the NAMAH module ( p < .05) in the psychological distress as measured by K 10 with a Cohen’s d of 0.41 (95% CI: 0.05–0.77). There was also a significant decrease in the mean scores after the intervention in the emotional exhaustion and depersonalization domain of the MBI-HSS with a medium effect size (Cohen’s d of 0.65) and large effect size (Cohen’s d of 0.94), respectively. Conclusion: The findings from this pilot study lay a foundational framework, encouraging further exploration, research, and scaling-up of such interventions to enhance mental health among physicians and HCPs.

Examining use of telehealth in jails: linking women to community OUD services

BackgroundOpioid use disorder (OUD) remains a significant health care need for women, particularly those involved in the criminal legal system (CLS). There are no studies to date that focus on the utilization of telehealth as a platform for assessment and linkage to medications to treat opioid use disorder (MOUD) at community re-entry for women, despite the fact that women have unique risk factors that may contribute to opioid relapse in the community. The purpose of this mixed-methods study is to provide an overview of the innovative use of telehealth for linking incarcerated women to community MOUD treatment in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN).MethodsThis study incorporates qualitative and quantitative data collection with MOUD providers, recovery staff involved in peer navigation services, and women who are incarcerated to understand perceptions of the use of telehealth prior to jail release as a linkage to community services.ResultsFindings from this study suggest overall support for the use of telehealth between community MOUD treatment providers and women who are incarcerated using videoconferencing technology. On average, there was very little variation in provider favorable feedback related to clinical engagement or in face-to-face comparability, as well as how telehealth allowed the participant to discuss personal and sensitive issues during the clinical assessment.ConclusionsStudy findings suggest benefits associated with the use of telehealth in increasing access to treatment for women with OUD. Jails are critical venues for telehealth interventions because they provide the opportunity to reach women who have been actively using illicit substances, often have advanced-stage substance use disorders which have compromised their health and mental health, and often have not been previously identified as needing treatment.Trial registration: This study was originally registered on 8/23/19, ClinicalTrials.gov, #NCT04069624.

Testing home-based exercise strategies in underserved minority cancer patients undergoing chemotherapy (THRIVE) trial: a study protocol.

Higher rates of physical inactivity and comorbid conditions are reported in Hispanic/Latinx and Black cancer patients receiving chemotherapy compared to their White counterparts. Despite the beneficial effect of exercise training for cancer patients, rates of participation in exercise oncology clinical trials are low among disadvantaged and racial and ethnic minority groups. Here, we will examine the effect of an exercise intervention using a novel, accessible, and cost-effective home-based exercise approach among Hispanic/Latinx and Black cancer patients receiving chemotherapy on exercise participation and cardiovascular disease risk. The THRIVE trial is an 8-month prospective, three-arm study of 45 patients who are randomized in a 1:1:1 fashion to a supervised exercise intervention (SUP), unsupervised exercise (UNSUP), or an attention control (AC) group. Eligible patients include those with breast, colorectal, or prostate cancer, who are sedentary, overweight or obese, self-identify as Hispanic/Latinx or Black, and plan to receive chemotherapy. Patients randomized to the SUP group participate in a home-based 16-week periodized aerobic and resistance exercise program performed three days per week, supervised through video conference technology. Patients randomized to the UNSUP group participate in an unsupervised 16-week, telehealth-based, periodized aerobic and resistance exercise program performed three days per week using the same exercise prescription parameters as the SUP group. Patients randomized to the AC group receive a 16-week home-based stretching program. The primary outcome is changes in minutes of physical activity assessed by 7-day accelerometry at post-intervention. Secondary outcomes include cardiovascular risk factors, patient-reported outcomes, and physical function. Outcome measures are tested at baseline, post-intervention at month 4, and after a non-intervention follow-up period at month 8. The THRIVE trial is the first study to employ a novel and potentially achievable exercise intervention for a minority population receiving chemotherapy. In addition, this study utilizes an intervention approach to investigate the biological and behavioral mechanisms underlying exercise participation in these cancer patients. Results will guide and inform large randomized controlled trials to test the effect of home-based exercise on treatment outcomes and comorbid disease risk in minority patients with cancer undergoing chemotherapy. https://classic.clinicaltrials.gov/ct2/show/NCT05327452, identifier (NCT#05327452).

"It gave me a sense of achievement and a sense of purpose"-a qualitative study of patient experiences of a virtually supervised exercise program for adults with advanced cancer and cachexia.

To explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer. Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis. Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included the following: (1) Deciding to exercise involves balancing concerns and expectations, (2) the exercise program is a positive experience, and (3) moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased convenience. Participants emphasized the need to recommend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits. Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.

PATIENT EXPERIENCES OF A VIRTUALLY SUPERVISED EXERCISE PROGRAM FOR ADULTS WITH ADVANCED CANCER AND CACHEXIA – A QUALITATIVE STUDY

INTRODUCTION & AIMS People with advanced cancer and cachexia experience significant body weight loss, impairing physical function and lowering quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients’ experiences of exercise, including their ability to cope with structured exercise, is limited. The aim of this qualitative study was to explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer. METHODS Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis. RESULTS Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included: 1) Deciding to exercise involves balancing concerns and expectations, 2) The exercise program is a positive experience, and 3) Moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased exercise convenience. Participants emphasized the need to extend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits. CONCLUSION Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.

AO Spine/Praxis Clinical Practice Guidelines for the Management of Acute Spinal Cord Injury: An Introduction to a Focus Issue.

Narrative overview and summary. The objective of this introductory manuscript is to provide an overview of the effort that was undertaken to establish clinical practice guidelines for a number of important topics in spinal cord injury (SCI). These topics included: 1. The role and timing of surgical decompression after acute traumatic SCI; 2. The hemodynamic management of acute traumatic SCI; and 3. The definition, diagnosis, and management of intra-operative SCI. Here, we introduce the rationale for the guidelines, the methodology utilized, and summarize how the topics are addressed within various manuscripts of this Focus Issue. The key clinical questions were defined using the PICO format for treatment reviews (patient; intervention; comparison; outcomes) or PPO format (patient, prognostic factor, outcomes) for risk factor review. Multi-disciplinary, international guideline development groups (GDGs) were established to evaluate and collate the available evidence in a rigorous, systematic manner, followed by a review of systematically obtained evidence within the framework of the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria and application of the Evidence to Decision process. Consensus meetings, using a modified Delphi approach, were held with the multidisciplinary, international GDGs using online video-conferencing technology and anonymous voting to develop the final recommendations for each of the topics addressed. All systematic review protocols followed PRISMA standards and were registered on PROSPERO; all potential conflicts were vetted in an open and transparent manner. The funders (AO Spine and Praxis Spinal Cord Institute) had no influence over editorial content or the guidelines process). Updated guidelines were established for the timing of surgical decompression after acute SCI, with surgical decompression within 24hours of injury now "recommended" as a treatment option. Updated guidelines were also established for hemodynamic management, with an expanded target range for mean arterial pressure (MAP) of 75-80 to 90-95mmHg for between 3 to 7days post-injury now "suggested" as a treatment option. The available literature mandated scoping and systematic reviews on the topic of intra-operative SCI, and this resulted in manuscripts to address the definition, frequency, and risk factors, to define the role of intra-operative neuromonitoring, and to suggest an evidence-based care pathway for management. A rigorous process following GRADE standards was undertaken to review the available evidence and establish guideline recommendations around the role and timing of surgery in acute SCI, optimal hemodynamic management of acute SCI and the prevention, diagnosis and management of intraoperative SCI. This effort also identified key knowledge gaps and future directions for study, which will serve to refine these recommendations in the future.

What is my value? Visually impaired student reflections about feeling valued in PE

This study explored visually impaired youths’ perspectives toward feeling valued in integrated physical education. Situated in an experiential qualitative approach, this study utilized inclusion understood as an intersubjective experience broadly, and feeling valued specifically, as a conceptual lens to guide and inform methodological and data interpretation decisions. Eighteen visually impaired youth completed two interviews each using video conference technology or phone call, and audio recorded, transcribed, and subjected to reflexive thematic analysis. Three interrelated themes were constructed, depicting the participants experiences and perspectives of what it means to be valued, and if they felt valued, within integrated physical education: (a) feeling valued is contingent on others, (b) value is unavailable without accessibility, and (c) being valued for possessing (non-athletic) characteristics. Participants described feeling valued or unvalued based on accommodative (e.g. peers acknowledging their impairment) or un-accommodative (e.g. teachers forgetting their impairment and needs) experiences with others within the PE context.

A feasibility randomised waitlist-controlled trial of a personalised multi-level language treatment for people with aphasia: The remote LUNA study.

Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment and treatments. LUNA is a multi-level treatment targeting words, sentences and discourse macrostructure in personal stories that addresses this clinical need. This study aimed to assess the feasibility and acceptability of LUNA trial procedures in a randomised waitlist-controlled trial; and to evaluate preliminary efficacy. This paper reports a phase II, waitlist-controlled, proof-of-concept feasibility trial. Participants with chronic aphasia (n = 28) were recruited from the community and randomised to an Immediate (n = 14) or Delayed (n = 14) group. LUNA treatment was delivered twice weekly for 10 weeks via the videoconferencing technology, Zoom. Feasibility was assessed in terms of participant recruitment and retention, adherence, missing data, and treatment fidelity. Preliminary treatment efficacy was assessed in terms of between group differences in outcome measures relating to discourse, language, and psychosocial state. The remote LUNA trial was feasible: 85% of those eligible consented to the trial; trial retention was 86%; 87% of treatment sessions were delivered as scheduled, and 79% of participants completed 80%+ of the treatment programme; data was missing only for participants who withdrew; treatment fidelity was high at 92% adherence; and only one clinical outcome measure demonstrated ceiling effects. ANCOVA analysis of the clinical outcome measures revealed group differences with medium and large effect sizes, indicating, improvements in the production of words, sentences, discourse macrostructure, overall language functioning (WAB-R), and psychosocial state (VAMS) following LUNA treatment. For most outcomes measured, similar treatment benefits were suggested in a secondary, non-parametric analysis. Large-scale evaluation of the clinical efficacy and cost-effectiveness of LUNA is warranted and supported by these findings. Clinical trials registration: NCT05847023 (clinical trials.gov).

Obstacles and Opportunities for Labour Dispute Resolution Using Videoconferencing Technology

Obstacles and Opportunities for Labour Dispute Resolution Using Videoconferencing Technology

A Videoconference Physical Activity Intervention for Colorectal Cancer Survivors: A Pilot Randomized Controlled Trial

Physical activity (PA) after a colorectal cancer (CRC) diagnosis can improve physical function and quality of life and is associated with decreased mortality rates and longer disease-free survival. The accelerated use of videoconference technology during and following the COVID-19 pandemic offers an opportunity to explore the potential of a virtually supervised intervention to help survivors of CRC increase PA. A two-arm single blind pilot randomized controlled trial of individuals who had completed treatment for CRC within the previous five-years (NCT03781154, 12/19/2018). The 12-week intervention consisted of circuit-based, combined aerobic and resistance exercise, twice per week for approximately one-hour per session, and five social cognitive theory-based PA behavior change discussion sessions. All intervention components were delivered in real-time via Zoom. Feasibility and acceptability were assessed, and the effects of the intervention were explored for the outcomes of PA (activPAL™ accelerometers and self-report), social cognitive theory constructs (barriers self-efficacy and outcome expectations), and physical fitness (submaximal aerobic capacity, upper and lower body muscular strength and endurance). Twenty-nine eligible individuals (55.2% women, <em>Mean</em> = 61 ± 11 years old, <em>Mean</em> = 22.0 ± 15.1 months since diagnosis) were randomized to the videoconference PA intervention (<em>n</em> = 15) or a PA education control (<em>n</em> = 14). A total of <em>N</em> = 25 completed the study for a retention rate of 86.7% in the intervention arm and 85.7% in the control. Adherence to intervention components was >86%. The intervention was highly acceptable with ≥90% responding “yes” or “definitely yes” that they enjoyed participating. Trends suggested that intervention participants had greater improvements in accelerometer measured steps per day, daily minutes of light PA, sedentary time, and aerobic fitness. There was no change in social cognitive theory constructs, and muscular strength and endurance improved in both the intervention and control. A 12-week videoconference PA intervention was feasible and acceptable among survivors of CRC, and the greatest magnitude of difference for intervention effects was observed for light PA and sedentary time. A fully powered trial is needed to determine efficacy of the intervention for increasing PA and physical functioning.

Investigating the Telerehabilitation With Aims to Improve Lower Extremity Recovery Poststroke Program: A Feasibility Study.

The purpose of this study was to examine the feasibility of a progressive virtual exercise and self-management intervention, the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke program (TRAIL), in individuals with stroke. A single group pre-post study design was used. Thirty-two participants were recruited who were aged 19years or older, had a stroke within 18months of the beginning of the study, had hemiparesis of the lower extremity, and were able to tolerate 50minutes of activity. Participants completed TRAIL, a synchronous exercise and self-management program delivered via videoconferencing. Participants received 8 telerehabilitation sessions over 4weeks that were 60 to 90minutes, with a trained physical therapist in a ≤2 to 1 participant-to-therapist ratio. Feasibility indicators in the areas of process (recruitment and retention rates, perceived satisfaction), resources (treatment fidelity and adherence, participant and assessor burden, therapist burden), management (equipment, processing time), and scientific indicators (safety, treatment response, treatment effect) were collected throughout the study using a priori criteria for success. The treatment effect was examined on the Timed "Up & Go" test, the virtual Fugl-Meyer Lower Extremity Assessment, the 30-Second Sit-to-Stand Test, the Functional Reach, the Tandem Stand, the Activities-Specific Balance Confidence Scale, the Stroke Impact Scale, and the Goal Attainment Scale. Forty-seven individuals were screened, of which 32 (78% male; median age of 64.5years) were included for the study from 5 sites across Canada. Nine feasibility indicators met our study-specific threshold criteria for success: retention rate (0 dropouts), perceived satisfaction, treatment fidelity, adherence, therapist burden, equipment, and safety. In terms of treatment response and effect, improvements were observed in Timed "Up & Go" test (Cohen d= 0.57); Fugl-Meyer Lower Extremity Assessment (d= 0.76); 30-Second Sit-to-Stand Test (d= 0.89); and Goal Attainment Scale (d= 0.95). The delivery of TRAIL, a lower extremity stroke rehabilitation program using videoconferencing technology, is feasible and appears to have positive influences on mobility, lower extremity impairment, strength, and goal attainment. Community-based telerehabilitation programs, such as TRAIL, could extend the continuum of care during the transition back to community postdischarge or during global disruptions, such as Coronavirus Disease 2019 (COVID-19). Delivery of synchronous lower extremity rehabilitation via videoconferencing to community-dwelling stroke survivors is feasible.

“I am the only one I know of who participates in research”: Promoting Equitable Research Methods for Underserved Communities in Dementia Risk Reduction Research

AbstractBackgroundIt is widely understood that dementia researchers need to do more to foster diversity and equitable access to research participation for underserved groups (e.g. members of racialised communities, those living in low socioeconomic status, and members of the LGBTQIA+ community). Currently, the vast majority of large‐scale dementia risk reduction research participants represent white, upper middle‐class individuals from urban areas. This project identifies the motives, facilitators, and barriers to participation in dementia risk‐reduction research in healthy middle‐aged adults who are traditionally under‐represented in research.MethodsThis is a qualitative study which worked in conjunction with the PREVENT Programme, a large‐scale, multi‐centre programme which aims to establish early biomarkers of Alzheimer’s disease. Participants for this study were healthy middle‐aged adults currently participating in the PREVENT Programme, who also identified as belonging to an underserved population. The method for data collection was semi‐structured interviews using video conference technology (N = 19). Thematic analyses was used by the research team.ResultsFindings from this study highlight motivators for participating falling in three camps: altruistic, individual health curiosity and interest in research. Facilitators to inclusion in research include strong rapport with the research team, clear understanding of the study protocol, flexible scheduling of participation (e.g., evening and weekends), monetary support to facilitate on site attendance and to support time away from paid employment, and innovative use of remote digital methods of data collection. Barriers to participation encompass a lack of awareness of opportunities to participate, and research illiteracy and stigma associated with both dementia and research participation.ConclusionFindings highlight individuals from under‐served communities are less likely to take part in research for a variety of reasons. The onus is on the research community to ensure equitable access to research participation amongst diverse populations. The outcome of this study is the development of guidelines for large‐scale epidemiological studies to encourage diverse, equitable, inclusive and supportive recruitment and engagement of participants from underserved from populations. This will further support the inclusion and diversity of both our research ventures and the solutions developed from them.

“Growing up we’re taught about physical activity, but very little mention of brain health, but it’s all brain health”: Exploring the Conceptualisation of Brain Health in 18–39‐year‐olds in Europe and North America

AbstractBackgroundIt is widely theorised that the accumulation of risk factors for neurodegenerative diseases like Alzheimer’s and other dementias likely begins during young adulthood, yet there is limited understanding about how young adults conceptualise their own brain health. The NextGen research programs aims to explore brain health and exposure to risk factors in adults before mid‐life. In this study, we explored young adults’ (18‐39 years) understanding and attitudes towards their brain health.MethodsThis qualitative study recruited community‐based adults aged 18‐39 years from the NextGen Programme of research, a large‐scale, international, multi‐centre research programme. Participants (N = 39; 18 female) had a mean age of 26 years (SD = 3.68) and were equally represented from North America (n = 20) and Europe (n = 19). Most participants identified as Black (76%), followed by White (15%), Asian (6%) and mixed race (3%). Data collection took place over focus groups using video conference technology and a semi‐structured discussion guide. A live Illustrator was present for each focus group to provide an immediate visual output of the group discussion. Data were analysed using thematic analyses by the research team.ResultsPreliminary themes highlight discrepancies between individuals’ awareness and understanding of their brain health, in relation to their general health, family history of dementia and personal experience of brain health issues (e.g., traumatic brain injury). Regarding factors that can positively affect brain health, participants highlighted the importance of rest, good nutrition and physical exercise. Regarding factors that can negatively affect brain health, participants highlighted exposure to racism and discrimination, poor quality sleep, stress, and excessive alcohol consumption. Participants also reported being unsure about many factors, such as screen‐time, cannabis use, engagement with social media and video games.ConclusionFindings from this study are among the first to explore young adults’ perceptions around brain health. We found that young adults had a moderate level of awareness of brain health risk factors, but they often did not connect these factors to risk of Alzheimer’s disease or other dementias. Outputs from this study will be used to inform a large‐scale, international survey to explore brain health awareness, understanding and exposure to risk factors among 18‐39‐year‐olds.

Veterinarians are reluctant to recommend virtual consultations to a fellow veterinarian.

To explore veterinarians' use of virtual veterinarian-client-patient consultations before and during the coronavirus disease 2019 (COVID-19) pandemic and examine veterinarians' attitudes toward virtual consultations. 135 companion animal veterinarians in Canada, the US, and Europe. An anonymous online survey was distributed to gather participating veterinarians' use of information and communication technologies and their perception of virtual consultations' effect on patient care, client communication, and their own well-being. Willingness to recommend virtual consultations was evaluated using the Net Promoter Score. Multivariable logistic regression explored factors associated with willingness to recommend virtual consultations. Percentage of participating veterinarians using the telephone and videoconferencing increased significantly (P < .001) from before (83.6% and 3.0%, respectively) to during the COVID-19 pandemic (97.0% and 22.4%, respectively). Participants were significantly less confident (P < .001) about their ability to reach a diagnosis using a virtual consultation as compared to a hands-on patient examination. Participants perceived client communication to be more challenging during virtual as compared to face-to-face consultations, particularly for building rapport and expressing empathy. Participants were extremely unwilling to recommend virtual consultations (Net Promoter Score = -41.4) with 21.6% (24/111) promoters and 63.1% (70/111) detractors. Confidence doing a virtual patient examination and comfort using videoconferencing technology were both positively associated (P < .05) with willingness to recommend virtual consultations. Veterinary practices and organizations interested in encouraging virtual veterinarian-client-patient consultations likely need to prioritize veterinarians' acceptance as an initial focus. The veterinary profession would benefit from further research and education to inform virtual veterinary care.

Incorporation of social determinants of health: Refining Associate Degree Nursing Programs

BackgroundThere is a lack of evidence to support how social determinants of health (SDOH) are incorporated into associate degree nursing (ADN) programs. AimThe purpose of this study was to explore the integration of SDOH content into courses and the curricula of ADN programs, strategies for teaching SDOH, and factors that have influenced educators’ decisions about this education. MethodsAn interpretive description approach was employed to elicit an understanding of the influencing factors of ADN educators incorporating SDOH into their teaching-learning experiences and how this is being accomplished. Participant interviews were conducted through video-conferencing technology. ResultsThe analysis of the interviews revealed an overarching theme of Forging Ahead with Refining ADN education. Two sub-themes related to influences of SDOH incorporation: (1) living the experience of SDOH and (2) navigating the program's culture. Two sub-themes related to strategies used to incorporate SDOH: (1) creating awareness of SDOH (2) fusing SDOH with content. ConclusionThis study highlighted how ADN educators are intentionally incorporating SDOH through various strategies as experiences have emphasized the importance. There are obstacles within their program that are barriers to full program integration.

Scholar’s vocabulary-knowledge favored listening-reading tenets: Concurrences from Madura

The study objective was to seek the favored tenets betwixt mobile-assisted-language-learning (MALL) listening-reading appliances by video-conferencing-technology (VCT) and direct-listening-reading appliances to Madurese-scholar’s second-language (L2) vocabulary-knowledge (VK) listening-reading competencies. The analysis of variance (ANOVA), which produced concurrences, contained 41 scholars in two distinct emplacements amidst a Madurese-scholars preponderance and the different amounts in groups. Several significant conclusions emerged from the current ANOVA analysis. First, the comprehensive implication betwixt MALL listening-reading-appliance and direct-listening-reading-appliance to scholar’s L2-VK listening-reading competencies was not substantiated because it was more than level significant (0.440&amp;gt;0.05). Second, we convened cognizance by direct perception, inside and outside deliberation, and documented it. Third, the cross-examination eventualities of perception-documentation were coded, and research eventualities established the Madurese-scholar higher education framework to pervade case study evidence vacuity that aims to scrutinize: i) the Madurese-scholar teaching-learning peculiarities performance of MALL-VCT-Zoom and Smart-TV multimedia edification; ii) Madurese-scholar interminable concurrences in MALL-VCT-Zoom and Smart-TV; and iii) impediments obtain by MALL-VCT-Zoom and Smart-TV during participation in edification. Irrevocably, concurrence betwixt MALL-VCT-Zoom and smart-TV to scholars’ L2-VK listening-reading competencies were interrelated impacts as Madurese-scholars can learn conveniently with their necessity and concurrently utilize smart-TV or Zoom despite their impediments.

Collaboration from a Distance: Remote Simulation in Hybrid Healthcare Education

Introduction: Simulation is an established method to teach interprofessional collaborative practice, but little is known about best practices when using simulation for remote learning activities in allied healthcare education. This mixed-methods study seeks to provide hybrid healthcare program educators with evidence regarding the effect of a remote simulation to address the topic of interprofessional collaboration. Methods: Authors investigated student self-assessed competency, satisfaction, and self-confidence in response to a remote learning activity in which Doctor of Physical Therapy (DPT) students and licensed occupational therapists and speech language pathologists collaborated in a simulated pediatric case discussion via video-conferencing technology. The Interprofessional Collaborative Competency Attainment Survey-Revised and the Student Satisfaction and Self-Confidence in Learning scale were administered to 97 entry-level Doctor of Physical Therapy (DPT) students. One-on-one semi-structured interviews were completed to acquire student perception about the learning experience. Results: Results confirmed a significant increase in self-assessed collaborative competency attainment and students reported general levels of satisfaction and self-confidence in learning related to the interdisciplinary, remote simulated experience. Qualitative responses revealed three main themes: (1) unique interaction in a structured simulation experience, (2) ‘it was definitely a point of confirmation’, a learning experience, and (3) collaboration. Discussion: The use of remote healthcare simulation has the potential to improve interprofessional collaborative learning and practice among allied healthcare students. Faculty might consider the use of remote simulated experiences for the purpose of interprofessional learning in hybrid or online programs. Use of this teaching method within other groups of allied healthcare students should be examined. Implications for Practice Remote simulation can be an effective and satisfactory method of teaching interprofessional collaboration among allied healthcare students in hybrid programs. Quantitative and qualitative findings offer evidence that entry-level DPT students in hybrid programs value remote simulation as a learning opportunity and were engaged in the educational process. Faculty of hybrid allied health professional education programs may want to consider implementation of remote simulation for the purposes of interprofessional collaboration with the intent of readying students for practice.

A Qualitative Investigation on Chronic Disease Management and Prevention Among Older Adults During the COVID-19 Pandemic.

To qualitatively describe experiences of chronic disease management and prevention in older adults (age ≥65 years) during COVID-19. Qualitative descriptive approach. Data collected online via telephone and video-conferencing technologies to participants located in various cities in British Columbia, Canada. Data analyzed by researchers in the cities of Vancouver and Kelowna in British Columbia. Twenty-four community-living older adults (n = 24) age ≥65 years. Each participant was invited to complete a 30-to-45-minute virtual, semi-structured, one-on-one interview with a trained interviewer. Interview questions focused on experiences managing health prior to COVID-19 and transitioning experiences of practicing health management and prevention strategies during COVID-19. Audio recordings of interviews were transcribed verbatim and analyzed thematically. The sample's mean age was 73.4 years (58% female) with 75% reporting two or more chronic conditions (12.5% none, 12.5% one). Three themes described participants' strategies for chronic disease management and prevention: (1) having a purpose to optimize health (i.e., managing health challenges and maintaining independence); (2) internal self-control strategies (i.e., self-accountability and adaptability); and (3) external support strategies (i.e., informational support, motivational support, and emotional support). Helping older adults identify purposes for their own health management, developing internal control strategies, and optimizing social support opportunities may be important person-centred strategies for chronic disease management and prevention during unprecedented times like COVID-19.

Telerehabilitation use and experiences in occupational and physical therapy through the early stages of the COVID-19 pandemic.

Telehealth has helped to increase access to rehabilitative services such as occupational and physical therapy. The early COVID-19 pandemic amplified the need for remote access to care, and the rapid implementation of telehealth systems provided a unique opportunity to learn from clinicians' experiences adopting telehealth for telerehabilitation applications. To understand these experiences, a self-administered online survey was conducted to capture perspectives on ease of telerehabilitation use and adoption from occupational and physical therapists. The survey captured retrospective views on telerehabilitation use pre-pandemic as well as real-time perspectives on telerehabilitation during the early stages of the pandemic (July to August 2020). The survey gathered information on clinician demographics (N = 109), clinicians' experiences with adopting or utilizing telerehabilitation systems, and their perceptions on remotely performing cognitive, emotional, and physical assessments via video-conferencing (a common mode of telehealth). Responses demonstrated a modest increase in telerehabilitation as a care setting (rate increase from 3.4% to 19.3%), and telerehabilitation was more generally tried during the early stages of the pandemic (41 clinicians explicitly reported telerehabilitation use). However, technology access and acceptance remained low, with 38 clinicians (35%) expressing concerns that technology was ineffective or impractical, unavailable, not covered by insurance, or not desired by their patients. Video-conferencing technology was perceived as generally ill-equipped to support clinicians in performing remote assessment tasks. Physical assessment tasks were considered particularly difficult, with 55% of clinicians rating their ability to perform these tasks in the range of moderately difficult to unable to perform. To address these difficulties and better augment clinical care, clinicians require more robust assessment methods that may combine video, mobile, and wearable technologies that would be accessible to a patient at home. When designing future telerehabilitation tools, information captured through these modes must be task-relevant, standardized, and understandable to a remote clinician.

Video-Delivered Family Therapy for Perinatal Women With Depressive Symptoms and Family Conflict: Feasibility, Acceptability, Safety, and Tolerability Results From a Pilot Randomized Trial.

Although individual-level treatments exist for pregnant and postpartum women with depression, family conflict is a significant factor that can contribute to the development and severity of perinatal depressive symptoms. Yet, there is a lack of research on family therapy for perinatal women with moderate to severe depressive symptoms and family conflict. Further, research is needed on the feasibility, acceptability, safety, and tolerability of family therapies for perinatal depression that are delivered using Health Insurance Portability and Accountability Act-compliant videoconferencing technology (VCT). This paper describes the feasibility, acceptability, safety, and tolerability of a VCT-based family therapeutic intervention, Resilience Enhancement Skills Training (REST), for perinatal women with moderate to severe depressive symptoms and moderate to high conflict with their family members. This paper includes data from an ongoing randomized trial that compares an experimental family therapeutic intervention (REST) to standard of care (VCT-based problem-solving individual therapy) for the treatment of moderate to severe depressive symptoms in perinatal women with moderate to high family conflict. Both interventions were delivered by masters-level therapists using VCT. A total of 83 perinatal women and their adult family members (N=166 individuals) were recruited for participation in the study. Feasibility, defined as therapist adherence to ≥80% of REST session content, was assessed in audio-recorded sessions by 2 expert raters. Acceptability was defined as ≥80% of families completing REST, including completion of ≥80% homework assignments and family report of satisfaction with REST. Completion of REST was assessed by review of therapist session notes, and satisfaction was assessed by participant completion of a web-based questionnaire. The Beck Depression Inventory-Second Edition was administered to perinatal women by research assistants (blind to study group assignment) to assess safety, defined as a reduction in depressive symptoms during the treatment phase. The Family Environment Scale-Family Conflict subscale was administered by therapists to participants during the treatment phase to assess tolerability, defined as a reduction in family conflict during the treatment phase. On average, the therapists achieved 90% adherence to REST session content. Of the families who started REST, 84% (32/38) of them completed REST, and on average, they completed 89% (8/9) of the homework assignments. Families reported satisfaction with REST. The results showed that REST is safe for perinatal women with moderate to severe depressive symptoms, and none discontinued due to worsened depressive symptoms. The results showed that REST is well tolerated by families, and no families discontinued due to sustained family conflict. The results show that REST is feasible, acceptable, safe, and tolerable for families. These findings will guide our interpretation of REST's preliminary effectiveness upon completion of outcome data collection. ClinicalTrials.gov NCT04741776; https://clinicaltrials.gov/ct2/show/NCT04741776.