Kyphosis-Related Information On The Internet Is the Quality, Content and Readability Sufficient for the Patients?

STUDY DESIGN

A quality-control Internet-based study using recognized quality scoring systems.

OBJECTIVE

The aim of the study is to evaluate the quality, content and readability of online information on kyphosis.

METHODS

The 3 most frequently used search engines were identified and a search for "Kyphosis" was made in each. The 2 reviewers categorized their Web-sites by type, and the quality of each was assessed using well-known scoring systems, including the DISCERN score, JAMA benchmark, GQS, and the kyphosis specific content score. The Flesch-Kincaid grade level (FKGL) was used to assess the readability. The quality of the information was also evaluated according to the presence and absence of the HONcode.

RESULTS

Sixty unique Web sites were identified and analyzed. The distribution of the categories was 33 (55%) medical, 22 (36.7%) academic, 2 (3.3%) non-physician, 2 (3.3%) commercial and 1 (1.7%) physician. There wasn't statistically significant difference between the sources in terms of DISCERN, JAMA, GQS and KSC scores (P > 0.05). However, a review of the FKGL scores revealed that the academic-based websites' FKGL score was significantly higher than the medical-based websites (P: 0.007). Also there wasn't statistically significant difference among the DISCERN, JAMA, GQS, KSC, FKRS and FKGL scores of the web-sites according to the HON code's presence (P > 0.05).

CONCLUSION

Information about kyphosis on the Internet is of limited quality and low information value. The readability of the online information in our results showed a significantly higher reading level than the sixth grade level recommended by the AMA and NIH.

A Qualitative Study Exploring the Lives and Caring Practices of Young Carers of Stroke Survivors

This study investigated the life transformation of children when a parent returned home from hospital after a stroke. The study explored children’s experiences of taking on caring roles in partnership with their well parent and stroke survivors’ perceptions of the young carer roles. The study aimed to identify unmet support needs in order to inform future service provision. Semi-structured interviews were conducted separately with stroke survivors (n = 7) (age range 41–60 years, mean 50.6) and their young carers (n = 11) (age range 11–20 years, mean 16). Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Three overarching themes were identified: the lives of young carers, impact of stroke, and insulating the family. All the children were providing some level of care. None were in receipt of any formal support. Children moved in and out of the caring role in the absence of an adult, to act as primary carer. Young carers valued the life skills they were gaining but reported gaps in their knowledge and understanding of stroke. The well parent and young carers worked together in a bi-directional partnership to ameliorate the impact of stroke on the family. The study concluded that age appropriate and stroke specific information for children of stroke survivors could enhance agency and optimise positive outcomes of caring.

Assessment of the Quality, Understandability, and Reliability of YouTube Videos as a Source of Information on Basal Cell Carcinoma: Web-Based Analysis

Background

Patients with skin cancer increasingly watch online videos to acquire disease-related information. Until now, no scientific evaluation of the quality of videos available for German-speaking patients with basal cell carcinoma (BCC) has been performed.

Objective

In this study, we aimed to identify and evaluate videos about BCC provided on YouTube.

Methods

A video search on YouTube was conducted in July 2020, using German BCC-related keywords (eg, “Basalzellkarzinom,” “Basaliom,” “weißer hautkrebs,” and “heller hautkrebs”). The first three pages (ie, 60 videos) were searched by two independent researchers for each keyword. Two authors evaluated videos that met the predefined eligibility criteria. The quality of the information of the videos was evaluated using the DISCERN tool and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The reliability was assessed with the JAMA (Journal of the American Medical Association) criteria score. Subgroup differences were identified using the Kruskal-Wallis test.

Results

A total of 41 videos were included in the evaluation. The mean assessment scores were as follows: DISCERN, 3.3 (SD 0.80); GQS, 3.8 (SD 1.1); JAMA, 27.74% (SD 22.1%); understandability, 70.8% (SD 13.3%); and actionability, 45.9% (SD 43.7%). These values indicated that the videos were of medium to good quality and had good understandability, low actionability, and poor reliability. The quality of videos provided by health professionals was significantly higher than that of videos provided by laypersons.

Conclusions

Optimization of health-related videos about BCC is desirable. In particular, adaptation to reliability criteria is necessary to support patient education and increase transparency.

Patient-reported participation in hepatopancreatobiliary surgery cancer care: A pilot intervention study with patient-owned fast-track protocols

Objective

Fast‐track concepts have been implemented in hepatopancreatobiliary surgery cancer care to improve postoperative recovery. For optimal postoperative care, patient participation is also required. The aim was to investigate and analyse whether an intervention with patient‐owned fast‐track protocols (PFTPs) may lead to increased patient participation and improve information for patients who underwent surgery for hepatopancreatobiliary cancer.

Methods

A quantitative comparative design with a control and intervention group was used. The participants in the intervention group followed a PFTP during their admission. After discharge, the patients answered a questionnaire regarding patient participation. Data analyses were performed with descriptive statistics and ANCOVA.

Results

The results are based on a total of 222 completed questionnaires: 116 in the control group and 106 in the intervention group. It is uncertain whether the PFTP increased patient participation and information, but its use may indicate an improvement for the patient group.

Conclusion

A successful implementation strategy for the use of PFTP, with daily reconciliations, could be part of the work required to improve overall satisfaction with patient participation.

ClinicalTrials.gov ID: NCT04061902

The Relationship between Religious Beliefs and Attitudes towards Public Health Infection Prevention Measures among an Ultra-Orthodox Jewish Population during the COVID-19 Pandemic

The ultra-Orthodox population in Israel was heavily impacted by COVID-19; it is important to understand the factors that contributed to this. There may be a friction between religious versus governmental guidelines that may reduce adherence to COVID mitigation guidelines, such as social distancing and masking. The purpose of this study is to explore this tension and the extent to which it existed in the surveyed sample. The study identified attitudes of ultra-Orthodox individuals concerning religious and public health measures to mitigate COVID-19 infection. A closed-ended questionnaire was completed by 405 ultra-Orthodox Jews. Most respondents believe that religious learning protects from harm (91%); 74% believe that periodically there are inconsistencies between religious guidelines and medical guidelines; 59% believe that preventive medicine may clash with “Divine protection”. Some public health measures applied to contain the pandemic threaten religious lifestyle; this is a source of dissonance among ultra-religious populations, which may substantially decrease willingness to comply with public health measures.

Psychometric Evaluation of a Fear of COVID-19 Scale in China: Cross-sectional Study

BACKGROUND

At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic.

OBJECTIVE

This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong.

METHODS

A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale ("Fear Scale") and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants' fear levels.

RESULTS

A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed.

CONCLUSIONS

The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Human psychology in the cities

This article considers the concept of a city as an organized and complex system, the main inhabitant/consumer of which is a human being. The human being, in its turn, is also a complex organized system. Separately, the functioning of both these systems is well enough studied, however to date in science little attention has been paid to the interaction of these systems with each other. The main object of study in the article is the psychological state of a person in an urban environment. The concepts of interest, excitement, boredom, stress, and so forth are investigated and their impact on physical health. Moreover, the problem of interaction of the real world with virtual technologies-their confrontation and mutual help in an urban context is also considered. At the end, there are several assumptions about the return of full-bloodedness to the streets of modern cities. It was concluded that the cities can help stimulate the brain cells of citizens and maintain their brain activity at a certain level of productivity.

The prevalence of self-medication in breastfeeding mothers during the COVID-19 pandemic

BACKGROUND

Self-medication is an important health and social issue, especially for women due to critical periods such as pregnancy and lactation. Accordingly, this study aimed to investigate the use of nonprescribed medications by lactating mothers visiting health centers affiliated to Kerman University of Medical Sciences during the COVID-19 pandemic.

MATERIAL AND METHODS

This descriptive-analytical cross-sectional study was conducted in Kerman from October to December 2020. The research population included all lactating women who visited health centers affiliated to Kerman University of Medical Sciences to receive health services. The data in this study were collected using a checklist.

RESULTS

A total of 228 mothers who met the inclusion criteria participated in the study. A total of 221 mothers (97.0%) received nonprescribed medications (377 drugs in total). Among 377 nonprescribed medications, 279 drugs (74.0%) could be used while breastfeeding. The three most commonly used nonprescribed medications were acetaminophen tablets (84 [22.3%]), gelofen compound (51 [13.5%]), and adult cold medications. The majority of the mothers, 153 (40.6%), chose nonprescribed medications based on pharmacy staff recommendations. The COVID-19 outbreak was the most common reason for using 246 (65.3%) nonprescribed drugs. There was a statistically significant relationship between the mothers' education and the accuracy of their information about the side effects of nonprescribed medications use.

CONCLUSION

The prevalence of self-medication by lactating women during the COVID-19 pandemic was very high. A significant percentage of the mothers did not have correct information about the adverse effect of arbitrary use of nonprescribed drugs on their babies.

Health literacy in communication, decision-making and outcomes among cancer patients, their families and clinicians in India: A multicentre cross-sectional qualitative study

OBJECTIVE

Cancer patients in India prefer full information regarding diagnosis and prognosis, but evidence suggests poor insight. This study aimed to identify the role of health literacy among adult patients living with cancer, their families and health professionals in decision-making and treatment outcomes in India.

METHODS

This cross-sectional in-depth study recruited patients, families and clinicians from three centers. Inductive thematic analysis informed a novel conceptual model.

RESULTS

We recruited n = 34 cancer patients, n = 33 family members, n = 11 doctors and n = 14 nurses (N = 92). Principle emergent themes were the following: (1) Preferences and dynamics of diagnosis and prognosis disclosure, for example, the dominant preference was for families who held hope for cure to discourage disclosure; clinicians sometimes disclosed in line with perceived ability to pay for treatment. (2) Understanding of disease and its treatment options (etiology, potential trajectory, treatment options), for example, lay understandings of cancer etiology as contamination from outside the home, and reluctance of patients to ask questions of clinicians. (3) Priorities in decision-making, for example, not engaging patients due to fear of patient distress, patients initiated on anticancer treatments without knowledge or consent, pursuing futile treatments. (4) Anxieties over finances and outcomes (disclosure, decision-making, care pathways), for example, clinicians attempting to reduce families pursuing expensive and inappropriate treatment options with patients who have poor insight, catastrophic spending based on poor decisions.

CONCLUSION

The novel evidence-based health literacy model offers potential for feasible and acceptable intervention to support families in communication, disclosure and decision-making. This may improve patients' access to informed, appropriate care pathways.

Depressed mood, associated factors, and understanding of delirium among caregivers of patients with delirium

OBJECTIVE

Delirium is stressful for both the patient and caregiver. However, caregivers have attracted minimal attention. We here identify depressed moods and associated factors among caregivers and caregiver knowledge of the delirium and non-pharmacological management.

METHODS

This was a cross-sectional study. Caregiver and patient demographic characteristics, and patient clinical data, were collected. Caregiver depressed mood was analysed using the Hospital Anxiety and Depression Scale-depression subscale (HADS-D). We explored caregiver understanding of delirium and knowledge of non-pharmacological management. We used a multivariate linear regression model to identify factors associated with caregiver depressed mood.

RESULTS

For 224 caregivers, the median (interquartile range) HADS-D score was 8.0 (4.0-11.8). More than half (54.9%) had scores ≥8. Answers to multiple choice questions revealed that delirium was frequently misinterpreted as "anxiety" (25.9%) or "dementia" (25.4%). Of all caregivers, 74% had received no information on non-pharmacological delirium management. Younger age of patient, a longer time from delirium detection to consultation, a patient past history of depression, a spousal relation with the patient, and misinterpretation of delirium as dementia were associated with the depressed mood of caregivers.

CONCLUSIONS

The mental health of caregivers of patients with delirium requires more attention; they should be recommended to be informed and educated about delirium. Also, the clinicians need to find an easier term for the delirium to help caregivers understand.

The Mental Maxwell Relations: A Thermodynamic Allegory for Higher Brain Functions

The theoretical framework of classical thermodynamics unifies vastly diverse natural phenomena and captures once-elusive effects in concrete terms. Neuroscience confronts equally varied, equally ineffable phenomena in the mental realm, but has yet to unite or to apprehend them rigorously, perhaps due to an insufficient theoretical framework. The terms for mental phenomena, the mental variables, typically used in neuroscience are overly numerous and imprecise. Unlike in thermodynamics or other branches of physics, in neuroscience, there are no core mental variables from which all others formally derive and it is unclear which variables are distinct and which overlap. This may be due to the nature of mental variables themselves. Unlike the variables of physics, perhaps they cannot be interpreted as composites of a small number of axioms. However, it is well worth exploring if they can, as that would allow more parsimonious theories of higher brain function. Here we offer a theoretical exercise in the spirit of the National Institutes of Health Research Domain Criteria (NIH RDoC) Initiative and the Cognitive Atlas Project, which aim to remedy this state of affairs. Imitating classical thermodynamics, we construct a formal framework for mental variables, an extended analogy - an allegory - between mental and thermodynamic quantities. Starting with mental correlates of the physical indefinables length, time, mass or force, and charge, we pursue the allegory up to mental versions of the thermodynamic Maxwell Relations. The Maxwell Relations interrelate the thermodynamic quantities volume, pressure, temperature, and entropy and were chosen since they are easy to derive, yet capable of generating nontrivial, nonobvious predictions. Our "Mental Maxwell Relations" interlink the mental variables consciousness, salience, arousal, and distraction and make nontrivial, nonobvious statements about mental phenomena. The mental system thus constructed is internally consistent, in harmony with introspection, and respects the RDoC criteria of employing only psychologically valid constructs with some evidence of a brain basis. We briefly apply these concepts to the problem of decision-making and sketch how some of them might be tested empirically.

What Neuroscientists Think, and Don't Think, About Consciousness

The approach the majority of neuroscientists take to the question of how consciousness is generated, it is probably fair to say, is to ignore it. Although there are active research programs looking at correlates of consciousness, and explorations of informational properties of what might be relevant neural ensembles, the tacitly implied mechanism of consciousness in these approaches is that it somehow just happens. This reliance on a "magical emergence" of consciousness does not address the "objectively unreasonable" proposition that elements that have no attributes or properties that can be said to relate to consciousness somehow aggregate to produce it. Neuroscience has furnished evidence that neurons are fundamental to consciousness; at the fine and gross scale, aspects of our conscious experience depend on specific patterns of neural activity - in some way, the connectivity of neurons computes the features of our experience. So how do we get from knowing that some specific configurations of cells produce consciousness to understanding why this would be the case? Behind the voltages and currents electrophysiologists measure is a staggeringly complex system of electromagnetic fields - these are the fundamental physics of neurons and glia in the brain. The brain is entirely made of electromagnetism (EM) phenomena from the level of the atoms up. The EM field literally manifests the computations, or signaling, or information processing/activities performed by connected cellular ensembles that generate a 1st-person perspective. An investigation into the EM field at the cellular scale provides the possibility of identifying the outward signs of a mechanism in fundamental terms (physics), as opposed to merely describing the correlates of our mental abstractions of it.

The 'digital transnational solidarity' and protection of the health: Commentary to Principle no. 7 of the Rome Declaration

BACKGROUND

Point 7 of the Rome Declaration is aimed at improving data sharing and technological and knowledge transfer as instruments to implement health policies.

OBJECTIVE

The objective of the current paper is to understand if the legal framework (especially at a transnational level) may actually help to achieve the objectives laid down by Principle 7 or if some interpretative or legislative actions will be necessary.

METHODS

The paper analyses the legal sources at international and EU levels.

RESULTS

The applicable rules are based on the idea that the information and material are forms of 'property' of the individuals or of the states (i.e., the sovereign). According to the traditional idea of property, the owner has a sort of absolute power over the res and is entitled to exclude others from any rights over the thing. The 'property paradigm' may be useful to protect some relevant interests, but it can also affect collective interests, such as those concerning health during the COVID-19 pandemic.

CONCLUSIONS

In order to build a global system for the exchange of data and materials as provided for by Principle 7 of the Rome Declaration, a new legal approach should be elaborated which takes into consideration the international corpus of fundamental rights, including research freedom, the right to health and the principle of transnational 'digital' solidarity.

COVID-19 information received by the Peruvian population, during the first phase of the pandemic, and its association with developing psychological distress: Information about COVID-19 and distress in Peru

It is suspected that the information the population has about coronavirus disease 2019 (COVID-19) determines both its preventive measures and its effects on mental health. The internet and social media are the sources that have largely replaced the official and traditional channels of information. The objective of this study is to analyse the influence of the sources used by the population in Peru to obtain information on COVID-19 and its association with developing psychological distress (PD) and preventive measures against contagion.1699 questionnaires were analysed. A previously validated instrument adapted to Peru was used. Participants were questioned about the information received regarding COVID-19, its sources, time of exposition, assessment, or beliefs about it. Mental health was measured with the Goldberg General Health Questionnaire. Descriptive and bivariate analysis were performed, developing a classification and regression tree for PD based on beliefs and information about the pandemic.The most used source of information on COVID-19 in Peru was social media and this is associated with developing PD, both in the general population and among health professionals. The quality of the information about treatments for COVID-19 is associated with PD in the general population, whereas prognosis generates more distress among healthcare professionals. The biggest concern is transmitting the virus to family members, close persons, or patients, with more confidence in health professionals than in the health system.The health authorities should use the social media to transmit quality information about COVID-19 and, at the same time, to gather in real time the opinions on the implemented preventive measures. For all, this it is necessary to have higher credibility in the population to increase the confidence in the health system, looking at basic aspects for compliance with prevention measures and improvement of mental health.

Intensive care-treated COVID-19 patients' perception of their illness and remaining symptoms

Background

The remaining symptoms in patients with coronavirus disease 2019 (COVID‐19) treated in intensive care unit are limited described. Therefore, we assessed patient's perception of their COVID‐19 disease, stay in intensive care, and remaining symptoms three to six months after intensive care.

Methods

Prospective cohort study was performed in one intensive care unit of a university hospital in Sweden during the first wave. A questionnaire with open‐ended questions and closed‐ended questions was used. Data were analyzed using qualitative and quantitative content analysis and descriptive statistics.

Results

Out of 123 patients treated for COVID‐19, 64 answered the questionnaire 3–6 months after discharge from intensive care. Memories from illness and hospital stay revealed in three categories; awareness of the illness, losing anchor to reality and being cared for in a dynamic environment. Information was perceived as spare by 48% and they wanted the information to be more personal. The diary was perceived as personal and was received by 33% patients. The relationship with family was affected among 39% and 13% of the patients indicated that they had not resumed their daily life. A large amount, 84%, indicated that they had remaining symptoms from COVID‐19. The dominated symptoms were impaired strength and energy both physically and mentally.

Conclusion

Patients reported a variety of physical and mental symptoms, and revealed memories from the ICU, and specific awareness of other patients’ health. It illustrates the need for screening patients for remaining symptoms after COVID‐19 disease and ICU care and may affect resuming patients’ daily life.

How children in Sweden accessed and perceived information during the first phase of the Covid-19 pandemic

AIM

To describe how children in Sweden accessed and perceived information about SARS-CoV2 and Covid-19 during the first phase of the outbreak.

METHODS

This study is a substudy of an international cross-sectional online mixed methods survey examining elements of children's health literacy in relation to Covid-19. The survey included multiple-choice questions, open-ended questions and drawings and collected information from 50 Swedish children (7-12 years). Data were analysed concurrently on a descriptive level using statistics and content analysis. Quantitative and qualitative data, including the drawings, were considered equally important and resulted in six categories, illuminating how children accessed and perceived information about the pandemic.

RESULTS

The survey showed that children accessed information mainly from school but also from TV. They preferred information from reliable sources. Children reported the information they accessed as easy to understand and it prompted them to ask new questions. They reported they knew a lot about the pandemic, for example, the potential danger to themselves and others and how to act to protect themselves and others. They perceived the pandemic as an intrusion on their lives.

CONCLUSIONS

This study indicates that Swedish children between 7 and 12 years old were well informed about SARS-CoV2 and Covid-19 during the first phase of the pandemic. School was shown to be an important source of information. The children could explain how to act to protect themselves and others from becoming infected by the virus.

Information on migraine drugs in commonly available Indian drug information sources - Whether we satisfied the community needs?

Drug information can be obtained from various drug information sources that were available as government (National Formulary of India [NFI]; Central Drugs Standard Control Organization [CDSCO]), as well as commercial documents (Current Index of Medical Specialties [CIMS] and Monthly Index of Medical Specialties [MIMS]). Irrational drug usage may happen due to wide variation in the information available in these sources. In this study, we tried to assess these variations in a sample of drugs for the acute-specific management of migraine with ergot and Triptans antimigraine drugs in drug information sources such as NFI, CIMS, MIMS, and CDSCO. Scoring was done for various drug information based on the completeness of information about drugs used in acute-specific management of migraine. The scores for the completeness of drug information about the selected antimigraine drugs are 18.37% for CIMS (Ergotamine, Sumatriptan, Rizatriptan, and Zolmitriptan), 21.1% for NFI (Dihydroergotamine, Sumatriptan), 72.79% for MIMS (Ergotamine tartrate, Sumatriptan, Rizatriptan, Naratriptan, zolmitriptan, Almotriptan) and 21.77% for CDSCO (Ergotamine tartrate, Sumatriptan, Rizatriptan, Naratriptan, Zolmitriptan, eletriptan and almotriptan). The information for the antimigraine drugs available from various sources found to so much deficient. Necessary steps need to be taken in case of government public or hard documents to streamline drug information available with them as well the commercial documents as to provide reliable drug information uniformly for promoting rational use of the drug.

Antimicrobial Consumption in Latin American Countries: First Steps of a Long Road Ahead

Background:

Irrational antimicrobial consumption (AMC) became one of the main global health problems in recent decades.

Objective:

In order to understand AMC in Latin-American Region, we performed the present research in 6 countries.

Methods:

Antimicrobial consumption (J01, A07A, P01AB groups) was registered in Argentina, Chile, Colombia, Costa Rica, Paraguay, and Peru. Source of information, AMC type, DDD (Defined Daily Doses), DID (DDD/1000 inhabitants/day), population were variables explored. Data was analyzed using the Global Antimicrobial Resistance and Use Surveillance System (GLASS) tool.

Results:

Source of information included data from global, public, and private sectors. Total AMC was highly variable (range 1.91-36.26 DID). Penicillin was the most consumed group in all countries except in Paraguay, while macrolides and lincosamides were ranked second. In terms of type of AMC according to the WHO-AWaRe classification, it was found that for certain groups like “Reserve,” there are similarities among all countries.

Conclusion and Relevance:

This paper shows the progress that 6 Latin-American countries made toward AMC surveillance. The study provides a standardized approach for building a national surveillance system for AMC data analysis. These steps will contribute to the inclusion of Latin-America among the regions of the world that have periodic, regular, and quality data of AMC.

Quality and Reliability Analysis of Essential Tremor Disease Information on Social Media: The Study of YouTube

Background

YouTube has evolved into an important educational tool and information source for patients and their families. YouTube videos have the potential to influence the patients' health-related diagnosis and treatment decision-making. We aimed to evaluate the quality and usefulness of videos on essential tremor available on YouTube using quantitative instruments.

Methods

Video searches were performed by typing the keywords 'essential tremor', 'postural tremor', 'action tremor', 'essential tremor hand', and 'essential tremor head' into the YouTube search bar. The top 30 videos were reviewed for each search term. The videos were analyzed by two independent raters using the DISCERN and Global Quality Scale (GQS) scoring systems. Qualitative and quantitative data were recorded for each video.

Results

A total of 83 videos were analyzed. The mean DISCERN score was 41.96 out of 75 possible points, and the mean GQS score was 2.97 out of 5 possible points. Twelve percent of the videos were categorized as very poor, 38.6% as poor, 20.5% as fair, 19.3% as good, and 9.6% as excellent. The videos containing qualitative content features, such as clear information, symptoms, etiology, diagnosis, treatment, treatment response, epidemiology, diagrams, and radiological images had significantly higher DISCERN and GQS scores.

Discussion

We consider that reliable and useful content is not provided on YouTube for individuals searching for information on essential tremor. We listed the best-quality videos on this topic as a reference for healthcare practitioners and patients. Patients should always verify information provided in such videos through more reliable sources.

[Associations, key players in the sickle cell patient's journey]

The associations fighting against sickle cell disease contribute to the well-being of patients and their families by providing them moral, practical, financial, social and legal support. They provide information on the disease to patients and the public, notably through digital communication.

Disabled people in Britain and the impact of the COVID-19 pandemic

This paper reports on in-depth qualitative interviews conducted with 69 disabled people in England and Scotland, and with 28 key informants from infrastructure organisations in the voluntary and statutory sectors, about the impact of COVID-19, and measures taken to control it. Participants were recruited through voluntary organisations. As with everyone, the Pandemic has had a huge impact: we discuss the dislocations it has caused in everyday life; the failures of social care; the use of new technologies; and participants' view on leadership and communication. We conclude with suggestions for urgent short term and medium term responses, so that the United Kingdom and other countries can respond better to this and other pandemics, and build a more inclusive world.

Analysis of local qualitative cancer patient experience alongside the 2019 results of the UK National Cancer Patient Experience Survey

OBJECTIVES

This study analyses data from local qualitative interviewing about what matters most to patients with information from the National Cancer Patient Experience Survey (NCPES) to formulate an accurate improvement plan. This study seeks to provide a deeper analysis of the results of the 2019 NCPES.

METHODS

Qualitative data were collected through a focus group, telephone and virtual interviews from patients in North East London. Ten questions from the NCPES were asked. Interviews were recorded, transcribed verbatim and analysed using an NVivo framework matrix. The results were analysed considering the 2019 National Cancer Patient Experience report.

KEY FINDINGS

In total, 17 patients and 4 carers participated. The interview answers provided a more in-depth response when compared with the NCPES results, allowing for a deeper understanding of patient experience. This provided an insightful understanding of what matters most to our patients.

CONCLUSIONS

The NCPES results are not always reflective of the patient population. Limitations of the survey make it hard for healthcare providers to develop accurate improvement plans. It is important to use other data sources such as qualitative interviewing alongside the NCPES. The data collated during this study have been used to identify themes and deliverables for achievable and sustainable improvements to be made.

Rate of Entropy Production in Stochastic Mechanical Systems

Entropy production in stochastic mechanical systems is examined here with strict bounds on its rate. Stochastic mechanical systems include pure diffusions in Euclidean space or on Lie groups, as well as systems evolving on phase space for which the fluctuation-dissipation theorem applies, i.e., return-to-equilibrium processes. Two separate ways for ensembles of such mechanical systems forced by noise to reach equilibrium are examined here. First, a restorative potential and damping can be applied, leading to a classical return-to-equilibrium process wherein energy taken out by damping can balance the energy going in from the noise. Second, the process evolves on a compact configuration space (such as random walks on spheres, torsion angles in chain molecules, and rotational Brownian motion) lead to long-time solutions that are constant over the configuration space, regardless of whether or not damping and random forcing balance. This is a kind of potential-free equilibrium distribution resulting from topological constraints. Inertial and noninertial (kinematic) systems are considered. These systems can consist of unconstrained particles or more complex systems with constraints, such as rigid-bodies or linkages. These more complicated systems evolve on Lie groups and model phenomena such as rotational Brownian motion and nonholonomic robotic systems. In all cases, it is shown that the rate of entropy production is closely related to the appropriate concept of Fisher information matrix of the probability density defined by the Fokker-Planck equation. Classical results from information theory are then repurposed to provide computable bounds on the rate of entropy production in stochastic mechanical systems.

The Spread of COVID-19 Crisis Communication by German Public Authorities and Experts on Twitter: Quantitative Content Analysis

BACKGROUND

The COVID-19 pandemic led to the necessity of immediate crisis communication by public health authorities. In Germany, as in many other countries, people choose social media, including Twitter, to obtain real-time information and understanding of the pandemic and its consequences. Next to authorities, experts such as virologists and science communicators were very prominent at the beginning of German Twitter COVID-19 crisis communication.

OBJECTIVE

The aim of this study was to detect similarities and differences between public authorities and individual experts in COVID-19 crisis communication on Twitter during the first year of the pandemic.

METHODS

Descriptive analysis and quantitative content analysis were carried out on 8251 original tweets posted from January 1, 2020, to January 15, 2021. COVID-19-related tweets of 21 authorities and 18 experts were categorized into structural, content, and style components. Negative binomial regressions were performed to evaluate tweet spread measured by the retweet and like counts of COVID-19-related tweets.

RESULTS

Descriptive statistics revealed that authorities and experts increasingly tweeted about COVID-19 over the period under study. Two experts and one authority were responsible for 70.26% (544,418/774,865) of all retweets, thus representing COVID-19 influencers. Altogether, COVID-19 tweets by experts reached a 7-fold higher rate of retweeting (t8,249=26.94, P<.001) and 13.9 times the like rate (t8,249=31.27, P<.001) compared with those of authorities. Tweets by authorities were much more designed than those by experts, with more structural and content components; for example, 91.99% (4997/5432) of tweets by authorities used hashtags in contrast to only 19.01% (536/2819) of experts' COVID-19 tweets. Multivariate analysis revealed that such structural elements reduce the spread of the tweets, and the incidence rate of retweets for authorities' tweets using hashtags was approximately 0.64 that of tweets without hashtags (Z=-6.92, P<.001). For experts, the effect of hashtags on retweets was insignificant (Z=1.56, P=.12).

CONCLUSIONS

Twitter data are a powerful information source and suitable for crisis communication in Germany. COVID-19 tweet activity mirrors the development of COVID-19 cases in Germany. Twitter users retweet and like communications regarding COVID-19 by experts more than those delivered by authorities. Tweets have higher coverage for both authorities and experts when they are plain and for authorities when they directly address people. For authorities, it appears that it was difficult to win recognition during COVID-19. For all stakeholders studied, the association between number of followers and number of retweets was highly significantly positive (authorities Z=28.74, P<.001; experts Z=25.99, P<.001). Updated standards might be required for successful crisis communication by authorities.

An Evaluation of the Source and Content of Dupuytren's Disease Information Available on the Internet

Introduction

The internet continues to expand in both size and number of users, and patients are using the internet with increasing frequency to research orthopedic conditions and treatment options. Despite the prevalence of patients searching for medical information, the quality of the available information varies substantially. The purpose of this study was to investigate the reliability and accuracy of the information available on the internet for Dupuytren’s disease. We hypothesized that the informational content found on the internet regarding this condition would be of acceptable quality.

Methods

The search phrasing “‘Dupuytren’ OR ‘Dupuytren’s’” was used to mimic how patients would likely search for information on the disease. These terms were entered into the five English-language search engines with the most frequent use on the internet. On each search engine, the first 50 URLs were recorded, including sponsored sites. The 250 total sites were filtered to remove duplicate sites and URLs linking to other search engines, resulting in a final list of 84 websites for informational scoring. A previously published information evaluation protocol was used to grade each website. Each site was graded according to these guidelines by two authors and scored based on authorship, content, disease summary, treatment options, pathogenesis, complications, and results. A third author resolved any conflict on authorship or content before analysis. The resultant “informational value” is the sum of the disease summary, treatment options, pathogenesis, complications, and results and can range from 0-100. 

Results

The mean total information score for all sites was 47.5 out of 100 points. Forty-three (51.2%) of the websites evaluated were authored by a physician or academic institution, and thirty-four (40.5%) of the sites were commercial in nature. The final seven websites (8.3%) had nonphysician, unidentified, or lay authorship. Physician and academic institution authored websites had an average informational score of 55.5 out of 100 points, compared to 39.7 out of 100 for all other websites. This difference was statistically significant (p <0.01). The mean informational score for the 10 sponsored websites was 16.4 out of 100.

Conclusion

We concluded that internet information on Dupuytren’s disease is of poor quality and incomplete. Academic and physician authored sites have higher quality than commercial sites, but significant room for improvement still exists. Patients should be advised to identify the authorship of the websites they obtain information from and avoid advertisements and commercial sites.

Using Real-Time Data to Develop and Improve Teaching of Clinical Skills in Virtual Nursing Simulation Laboratories During COVID-19 Pandemic

During COVID-19 pandemic public health measures, face-to-face simulation laboratories were cancelled. A rapid transition to online teaching environments required staff and students to rapid upskilling in digital literacy. The purpose of this article is to describe a model of virtual nursing simulation laboratory implemented in graduate entry to practice Master's nursing program to teach clinical skills. The model used cloud-based communication app Zoom and real time feedback data to improve content delivery, student engagement and confidence in skill development. This model was co-designed with the student cohort to ensure students, as stakeholders, had a voice in having their education needs met during these challenging times.

Disconnection in Information Exchange During Pediatric Trauma Transfers: A Qualitative Study

Pediatric patients experiencing an emergency department (ED) visit for a traumatic injury often transfer from the referring ED to a pediatric trauma center. This qualitative study sought to evaluate the experience of information exchange during pediatric trauma visits to referring EDs from the perspectives of parents and referring and accepting clinicians through semi-structured interviews. Twenty-five interviews were conducted (10 parents and 15 clinicians) and analyzed through qualitative thematic analysis. A 4-person team collaboratively identified codes, wrote memos, developed major themes, and discussed theoretical concepts. Three interdependent themes emerged: (1) Parents’ and clinicians’ distinct experiences result in a disconnect of information exchange needs; (2) systems factors inhibit effective information exchange and amplify the disconnect; and (3) situational context disrupts the flow of information contributing to the disconnect. Individual-, situational-, and systems-level factors contribute to disconnects in the information exchanged between parents and clinicians. Understanding how these factors’ influence information disconnect may offer avenues for improving patient–clinician communication in trauma transfers.

Information-theoretic approach in allometric scaling relations of DNA and proteins

Allometric scaling relations can be observed in between molecular parameters. Hence, we looked for presence of such relation among sizes (i.e., lengths) of proteins and genes. Protein lengths exist in the literature as the number of amino acids. They can also be derived from the mRNA lengths. Here, we looked for allometric scaling relation by using such data and simultaneously, the data was compared with the sizes of genes and proteins that were obtained from our modified information-theoretic approach. Results implied presence of scaling relation in the calculated results. This was expected due to the implemented modification in the information-theoretic calculation. Relation in the literature-based data was lacking high goodness of fit value. It could be due to physical factors and selective pressures, which ended up in deviations of the literature-sourced values from those in the model. Genome size is correlated with cell size. Intracellular volume, which is related to the DNA size, would require certain number of proteins, the sizes of which can therefore be correlated with the protein sizes. Cell sizes, genome sizes, and average protein and gene sizes, along with the number of proteins, namely the expression levels of the genes, are the physical factors, and the molecular factors influence those physical factors. The selective pressures on those can act through the connection between those physical factors and limit the dynamic ranges. Biological measures could be prone to such forces and are likely to deviate from expected models, regardless of the validity of assumptions, unless those are also implemented in the models. Yet, present discrepancies could be pointing at the need for model improvement, data imperfection, invalid assumptions, etc. Still, current work highlights possible use of information-theoretic approach in allometric scaling relations' studies.

Men's perception of information and descriptions of emotional strain in the diagnostic phase of prostate cancer-a qualitative individual interview study

OBJECTIVE

To explore men`s perception of information and their possible emotional strain in the diagnostic phase of prostate cancer.

DESIGN, SETTING, PATIENTS

A qualitative explorative research design was employed. Data were collected from June to November 2017. The study was set at a urological outpatient clinic at a university hospital in Norway. Semi-structured interviews were conducted with ten men who had been examined for prostate cancer. Interviews were analyzed using Systematic Text Condensation (STC).

RESULTS

The analysis revealed three themes. The theme 'Different needs and perceptions of information' illustrated that information should be personalized. Despite different information needs, insufficient information about prostate cancer may prevent some men from being involved in decisions. The theme, 'A discovery of not being alone', indicated that a sense of affinity occurs when men realize the commonality of prostate cancer. Some men benefited from other men's experiences and knowledge about prostate cancer. The last theme 'Worries about cancer and mortality' showed that the emotional strain was affected by men's knowledge of cancer and the received information. Men expressed conflicting feelings toward prostate cancer that could be difficult to express.

CONCLUSIONS

The findings indicate that men in the diagnostic phase of prostate cancer are not a homogeneous group, but need personalized information. Some men may benefit from other men's experiences and support. Men's emotional strain can affect their communication about prostate cancer, which should be acknowledged. Procedures that identify patients' information needs early on should be an integrated part of the diagnostic phase of prostate cancer.KEY POINTSKnowledge about men's information needs and possible emotional strain in the diagnostic phase of prostate cancer are limited.Men with suspected prostate cancer have different preferences and information needs; however, insufficient information prevents men from participating in decisions.Men experience a sense of affinity with other men affected by prostate cancer, and some men benefit from exchanging experiences.Men consider prostate cancer as a less aggressive type of cancer but may experience emotional strain.

Accounting conservatism and firm performance during the COVID‐19 pandemic

We explore whether firms with more conditionally conservative accounting practices have higher stock returns than other firms during the Covid‐19 outbreak. We find evidence that Chinese firms listed on the Shanghai and Shenzhen Stock Exchanges applying more conditionally conservative reporting have lower declines in stock return performance during the Covid‐19 outbreak relative to other firms. We also find that the beneficial role of conditional conservatism is higher when firms have greater information asymmetry following the Covid‐19 pandemic. Our results are robust to various model specifications with four different measures of conservatism and an alternative return window.

Oncology Nurses: Influencers on Social Media

As oncology nurses, we know that we can provide our patients and caregivers with fact-based information to help them manage symptoms, support their coping, and provide clarity for their decision-making (Gaguski et al., 2017). The credibility of nurses has been confirmed by multiyear surveys, placing nurses at the top of trusted professions in the United States (Saad, 2020). Our ability as nurses to provide accurate information is one of our nursing superpowers-a way to counteract the slurry of misinformation that unfortunately permeates societal discourse of late.

The meaning of being a visiting child of a seriously ill parent receiving care at the ICU

PURPOSE

Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU.

METHOD

A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach.

FINDINGS

Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding.

CONCLUSIONS

The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way.

Human Synchronization Maps-The Hybrid Consciousness of the Embodied Mind

We examine the theoretical implications of empirical studies developed over recent years. These experiments have explored the biosemiotic nature of communication streams from emotional neuroscience and embodied mind perspectives. Information combinatorics analysis enabled a deeper understanding of the coupling and decoupling dynamics of biosemiotics streams. We investigated intraindividual and interpersonal relations as coevolution dynamics of hybrid couplings, synchronizations, and desynchronizations. Cluster analysis and Markov chains produced evidence of chimaera states and phase transitions. A probabilistic and nondeterministic approach clarified the properties of these hybrid dynamics. Thus, multidimensional theoretical models can represent the hybrid nature of human interactions.

Patient-Reported Outcomes in a Nationally Representative Sample of Older Internet Users: Cross-sectional Survey

BACKGROUND

The rapid diffusion of the internet has decreased consumer reliance on health care providers for health information and facilitated the patients' ability to be an agent in control of their own health. However, empirical evidence is limited regarding the effects of health-related internet use among older adults, which is complicated by the proliferation of online health and medical sources of questionable scientific accuracy.

OBJECTIVE

We explore the effects of health-related internet use, education, and eHealth literacy on medical encounters and patient-reported outcomes. Patient-reported outcomes are categorized into two dimensions: (1) self-reported health problem and (2) affective distress (feeling worried and anxious) due to information obtained. We were particularly interested in whether education and eHealth literacy moderate the association between perceived strain in medical encounters and patient-reported outcomes.

METHODS

Our study sample consisted of online panel members who have used the internet as a resource for health information, randomly drawn from one of the largest probability-based online research panels. This paper specifically reports results obtained from older panel members (age≥60 years: n=194). First, we examined descriptive statistics and bivariate associations (Pearson correlations and independent samples t tests). We used hierarchical ordinary least squares regression analyses by running separate regressions for each patient-reported outcome. In model 1, we entered the main effects. In model 2, technology and medical encounter variables were included. Model 3 added the statistical interaction terms.

RESULTS

Age (β=-.17; P=.02), gender (β=-.22; P=.01), and medical satisfaction (β=-.28; P=.01) were significant predictors of self-reported health problems. Affective distress was positively predicted by gender (β=.13; P=.05) and satisfaction with medical encounters (β=.34; P<.001) but negatively predicted by education (β=-.18; P=.03) and eHealth literacy (β=-.32; P=.01). The association between experiencing a health problem in relation to health-related internet use and perception of strained medical encounters was greater among respondents with lower levels of education (β=-.55; P=.04). There was also a significant interaction between education and eHealth literacy in predicting the level of affective distress (β=-.60; P=.05), which indicated that higher levels of education predicted lower averages of feeling anxiety and worry despite lower eHealth literacy. Older women reported higher averages of affective distress (β=.13; P=.05), while older men reported higher averages of experiencing a self-reported health problem (β=-.22; P=.01).

CONCLUSIONS

This study provides evidence for the effect of health-related internet use on patient-reported outcomes with implications for medical encounters. The results could be used to guide educational and eHealth literacy interventions for older individuals.

Non-pharmacological interventions using information and communication technology for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis protocol

AIM

To review and examine the effectiveness of non-pharmacological interventions on behavioural and psychological symptoms of dementia using information and communication technology.

DESIGN

This is a systematic review and meta-analysis.

METHODS

The databases including PubMed, CINAHL with Full Text (EBSCOhost), PsycINFO, Embase, and the Cochrane Library will be searched for all published studies. Studies will be screened and selected with criteria described in PICOS format. Risk of bias will be assessed by the National Institute for Health and Clinical Excellence checklist. Data will be extracted from eligible studies and used to perform a meta-analysis examining the overall effects and effects on individual outcomes. Additionally, we will conduct meta-regression to examine the association between explanatory variables and behavioural and psychological symptoms. This study has been funded since June 2020.

DISCUSSION

This study will be the first to reveal the effects of non-pharmacological interventions using information and communication technology on behavioural and psychological symptoms of dementia. Furthermore, this study will provide updated and valid evidence of interventions using this for managing behavioural and psychological symptoms of dementia.

IMPACT

Although non-pharmacological interventions using information and communication technology for older adults living with dementia are continuously developing, their direct effect remains unclear. This study will evaluate the effectiveness of these interventions on behavioural and psychological symptoms of dementia and provide the evidence to implement these interventions among older adults living with dementia. Thus, caregivers and nursing staff can manage behavioural and psychological symptoms of dementia more effectively by incorporating information and communication technology.

Decoding of the coupling between the brain and facial muscle reactions in auditory stimulation

BACKGROUND

Analysis of the reactions of different organs to external stimuli is an important area of research in physiological science.

OBJECTIVE

In this paper, we investigated the correlation between the brain and facial muscle activities by information-based analysis of electroencephalogram (EEG) signals and electromyogram (EMG) signals using Shannon entropy.

METHOD

The EEG and EMG signals of thirteen subjects were recorded during rest and auditory stimulations using relaxing, pop, and rock music. Accordingly, we calculated the Shannon entropy of these signals.

RESULTS

The results showed that rock music has a greater effect on the information of EEG and EMG signals than pop music, which itself has a greater effect than relaxing music. Furthermore, a strong correlation (r= 0.9980) was found between the variations of the information of EEG and EMG signals.

CONCLUSION

The activities of the facial muscle and brain are correlated in different conditions. This technique can be utilized to investigate the correlation between the activities of different organs versus brain activity in different situations.

Variations in utilization of health facilities for information and services on sexual and reproductive health among adolescents in South-East, Nigeria

Background

Adolescents' sexual and reproductive health has an important influence on a country's long-term national growth. There is a high level of burden due to poor adolescent sexual and reproductive health (ASRH) in Nigeria, especially the Ebonyi State. Evidence shows that in the Sub-Saharan African region, most adolescents experience poor access to information and other services relating to their sexual and reproductive health. Many cultures in Africa see matters around sex and sexuality as social taboos.

Aims

This study aimed to access variations in the utilization of health facilities for sexual and reproductive health information and services among adolescents in the Ebonyi State, Nigeria. This will inform the design of interventions to improve ASRH.

Patients and Methods

A total of 1,057 in-school and out-of-school adolescents aged 13-18 years were selected using cluster sampling of households from the six selected local government areas (LGAs) in this cross-sectional survey. Structured questionnaires were used to collect data. Descriptive statistics were performed alongside stratification analysis. Tabulation, bivariate and multivariate logistic regression analyses were undertaken. A household wealth index was calculated using the total household consumption calculated divided by the number of people in the household (per capita household consumption). The per capita household consumption was used to categorize the households into socioeconomic quintiles. The variable was used to differentiate key variables into socioeconomic quintile equity analysis.

Results

A majority of the respondents had never visited any type of health facility to receive either sexual and reproductive health (SRH) information (90.2%) or services (97.1%). The utilization rate of health facilities for SRH information was 9.8% while for other SRH services was 2.8%. The patent medicine vendor (PMV) was the most visited type of facility for SRH information and other services. Schooling was a strong predictor of health facilities' utilization for SRH information (P < 0.01) and other services (P < 0.01).

Conclusion

Utilization of health facilities for information and services among adolescents in the Ebonyi State is very low and favorable toward informal service providers such as PMVs. The establishment and strengthening of the existing youth-friendly centers, school clinics, and occasional outreach programs designed specifically to target adolescents would perhaps improve adolescents' access to adequate information and health facility utilization for sexual, reproductive, and health services.

An online survey on emotions, impact on everyday life, and educational needs of women with HPV positivity or abnormal Pap smear result

This study aimed to evaluate the emotional path, impact on everyday life, and adequacy of patient education throughout the diagnostic and therapeutic journey of women who received a positive human papillomavirus (HPV) test or Pap smear result.An online survey was designed to determine the demographic characteristics, dominant feelings throughout the diagnostic and therapeutic procedures, major lifestyle changes, impact on social life, and perceived adequacy of patient information in Italian women with a positive HPV test or abnormal cervical cytology result. In this study, the phases of the "patient's journey" included the initial test, waiting for colposcopy or biopsy, waiting for surgery, and follow-up.Anxiety, worry, and fear were the most frequently cited emotions during the initial tests and intervals between procedures. Anxiety and fear gradually decreased during the journey until surgery, and higher levels of optimism were observed postsurgery. The most frequently reported lifestyle changes were attempts to boost the immune system, increased precautions in sexual practices, and dietary changes. Social life is affected by changes in sexual and intimate relationships with partners. Women reported receiving insufficient patient education on the diagnosis and its implications, progression, management, personal care, and resolution.Significant attention should be given to the psychosocial aspects of the entire patient journey after receiving a positive HPV test or an abnormal Pap smear result. It is essential to establish a good rapport between patients and healthcare professionals, and to educate women regarding the condition by minimizing the gap between the perceived and desired adequacy of information.

["Refusal of interventional cardiology care : what to do ? "]

In emergency, physicians are confronted with obligations that may appear in opposition: assistance to a person in danger and consent to care. Knowing the seriousness of acute coronary syndromes, the cardiologist in front of an ignorant patient should not too quickly resolve himself to accept a refusal. In 2 clinical cases, the different means to obtaining consent are recalled: the evocation of the risks in the absence of care (death, physical incapacity, professional aptitude, heavy treatments) taking into account the psychology of the patient, without him make them lose face, by reassuring them about the steps of the procedure, while explaining the lower effectiveness of other therapies (loss of chance). The participation of all medical and paramedical actors makes it possible to match a psychology adapted to the patient's profile, to prevent an incompatibility of mood leading to death by refusal of care. More than ever, the cardiologist has an "obligation" to implement "all means". If the refusal persists, it will be necessary to find the most effective alternative and to get the patient to return to the optimal strategy by a rapid contact, by involving his family and his attending physicians, who will be informed without delay, with remission of prescriptions. To protect themselves from possible prosecution, the healthcare team will record in detail the course of the events, as well as a detailed document of the refusal of care, signed by the patient who acknowledges having been informed of the risks involved.

Patient, Caregiver, and Provider Perspectives on Improving Information Delivery in Hemodialysis: A Qualitative Study

Background

Patients with kidney failure are exposed to a surfeit of new information about their disease and treatment, often resulting in ineffective communication between patients and providers. Improving the amount, timing, and individualization of information received has been identified as a priority in in-center hemodialysis care.

Objective

To describe and explicate patient, caregiver, and health care provider perspectives regarding challenges and solutions to information transfer in clinical hemodialysis care.

Design

In this multicenter qualitative study, we gathered perspectives of patients, their caregivers, and health care providers conducted through focus groups and interviews.

Setting

Five Canadian hemodialysis centers: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax.

Participants

English-speaking adults receiving in-center hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers.

Methods

Between May 24, 2017, and August 16, 2018, data collected through focus groups and interviews with hemodialysis patients and their caregivers subsequently informed semi-structured interviews with health care providers. For this secondary analysis, data were analyzed through an inductive thematic analysis using grounded theory, to examine the data more deeply for overarching themes.

Results

Among 82 patients/caregivers and 31 healthcare providers, 6 main themes emerged. Themes identified from patients/caregivers were (1) overwhelmed at initiation of hemodialysis care, (2) need for peer support, and (3) improving comprehension of hemodialysis processes. Themes identified from providers were (1) time constraints with patients, (2) relevance of information provided, and (3) technological innovations to improve patient engagement.

Limitations

Findings were limited to Canadian context, English speakers, and individuals receiving hemodialysis in urban centers.

Conclusions

Participants identified challenges and potential solutions to improve the amount, timing, and individualization of information provided regarding in-center hemodialysis care, which included peer support, technological innovations, and improved knowledge translation activities. Findings may inform the development of interventions and strategies aimed at improving information delivery to facilitate patient-centered hemodialysis care.

Life Worth Mentioning: Complexity in Life-Like Cellular Automata

Cellular automata (CA) have been lauded for their ability to generate complex global patterns from simple local rules. The late English mathematician, John Horton Conway, developed his illustrious Game of Life (Life) CA in 1970, which has since remained one of the most quintessential CA constructions-capable of producing a myriad of complex dynamic patterns and computational universality. Life and several other Life-like rules have been classified in the same group of aesthetically and dynamically interesting CA rules characterized by their complex behaviors. However, a rigorous quantitative comparison among similarly classified Life-like rules has not yet been fully established. Here we show that Life is capable of maintaining as much complexity as similar rules while remaining the most parsimonious. In other words, Life contains a consistent amount of complexity throughout its evolution, with the least number of rule conditions compared to other Life-like rules. We also found that the complexity of higher density Life-like rules, which themselves contain the Life rule as a subset, form a distinct concave density-complexity relationship whereby an optimal complexity candidate is proposed. Our results also support the notion that Life functions as the basic ingredient for cultivating the balance between structure and randomness to maintain complexity in 2D CA for low- and high-density regimes, especially over many iterations. This work highlights the genius of John Horton Conway and serves as a testament to his timeless marvel, which is referred to simply as: Life.

A content analysis of social media on outbreak of infodemic amidst COVID-19 pandemic

BACKGROUND

With so much content on social media platforms about COVID-19, determining which information is reliable can be a daunting task. Hence, this study is aimed to analyze various posts with regard to COVID-19 on various social media platforms for their reliability and also examined various factors that influence information reliability.

MATERIALS AND METHODS

A cross-sectional study was conducted, with 934 samples related to coronavirus pandemic published on Twitter, Instagram, and Facebook using systematic random sampling. We adopted the criteria given by Paul Bradshaw and modified to assess the characteristics of the samples. Training and calibration of the investigators were carried out for 3 consecutive days before beginning the study. The data were analyzed using the Chi-square test and multinomial logistic regression to estimate the odds ratios.

RESULTS

Out of 934 samples studied, only 570 (61%) were found to be reliable of which 243 (42.6%) were from Twitter, 117 (20.6%) from Instagram, and 210 (36.8%) from Facebook. We found that the reliability of the information on social media platforms is significantly influenced by network (odds: 1.32; 95% confidence interval [CI]: 1.16-1.52; P = 0.036), content (odds: 1.83; 95% CI: 1.69-1.92; P = 0.009), contextual update (odds: 1.41; 95% CI: 1.24-1.53) and age of the account (odds: 1.92; 95% CI: 1.64-2.09; P = 0.002).

CONCLUSION

Our study shows that the reliability of the social media posts significantly depends on the network, contextual update, and age of the account. Hence, cross verifying the information from a reliable source is the need of the hour to prevent panic and mental distress.

Halo Effect and Source Credibility in the Evaluation of Food Products Identified by Third-Party Certified Eco-Labels: Can Information Prevent Biased Inferences?

Despite the growing awareness of the need to promote the consumption of organic food, consumers have difficulties in correctly identifying it in the market, making frequent cognitive mistakes in the evaluation of products identified by sustainability labels and claims. This work analyzes the halo effect and the source credibility bias in the interpretation of product attributes based on third-party certified labels. It is hypothesized that, regardless of their specific meaning, official labels lead consumers to infer higher environmental sustainability, quality and price of the product, due to the credibility attributed to the certifying entity. It also examines the extent to which providing the consumer with accurate labeling information helps prevent biased heuristic thinking. An experimental between-subject study was performed with a sample of 412 Spanish business students and data were analyzed using partial least squares. Findings revealed that consumers tend to infer environmental superiority and, consequently, higher quality in products identified by both organic and non-organic certified labels, due to their credibility. Label credibility was also associated with price inferences, to a greater extent than the meaning attributed to the label. Interestingly, providing accurate information did not avoid biased heuristic thinking in product evaluation.

Levers and Barriers to Vaccinate against COVID-19 in the Multicultural Context of French Guiana: A Qualitative Cross-Sectional Survey among Health Care Workers

In French Guiana, a French overseas territory in South America facing a fourth wave of COVID-19, vaccination coverage is very low, both in the population and among health care workers (HCWs). Vaccine hesitancy concerned 35.7% of the latter in early 2021. The objective of this complementary study is to understand barriers and levers and to adapt messages to increase vaccination coverage among HCWs. We conducted a regional cross-sectional survey of HCWs with a questionnaire containing open-ended questions exploring factors associated with vaccine hesitancy and the needs to adapt the vaccination campaign in French Guiana. The discourses were analyzed using a qualitative approach based on grounded theory, with open coding of data by themes and construction of abstract categories. The analysis of the 357 responses collected from January to March 2021 reveals several trends. The ethical aspect of the HCWs' role emphasizes the importance of getting vaccinated themselves (to protect patients, to set an example...) and of vaccinating as many people as possible, including the most geographically or socially distant, such as undocumented migrants. However, some HCWs remain suspicious of the vaccine with concerns over the efficacy and side effects, of health institutions, and of the pharmaceutical industry. The role of fake news circulating on social networks has been widely discussed. Efforts to explain and convince HCWs must be continued in French Guiana using the identified levers to improve the acceptability of vaccination.

Electrical Signaling of Plants under Abiotic Stressors: Transmission of Stimulus-Specific Information

Plants have developed complex systems of perception and signaling to adapt to changing environmental conditions. Electrical signaling is one of the most promising candidates for the regulatory mechanisms of the systemic functional response under the local action of various stimuli. Long-distance electrical signals of plants, such as action potential (AP), variation potential (VP), and systemic potential (SP), show specificities to types of inducing stimuli. The systemic response induced by a long-distance electrical signal, representing a change in the activity of a complex of molecular-physiological processes, includes a nonspecific component and a stimulus-specific component. This review discusses possible mechanisms for transmitting information about the nature of the stimulus and the formation of a specific systemic response with the participation of electrical signals induced by various abiotic factors.

Knowledge sharing practices among African health sciences librarians

Objective

The objective of this study was to investigate knowledge sharing practices among health sciences librarians in African countries.

Methods

A cross-sectional survey design was employed. The study population consisted of African health sciences librarians that attended the 16^th Biennial Conference of the Association for Health Information and Libraries in Africa on October 14-18, 2019, at the University of Ibadan in Nigeria. Data were collected using a questionnaire and analyzed using descriptive statistics.

Results

The types of knowledge most commonly shared by respondents were information on conferences, workshops, and seminars as well as information on new trends and technologies in librarianship. The main avenue of knowledge sharing was face-to-face interaction. Unwillingness to share knowledge and a lack of awareness about current trends and issues were the top identified challenges to knowledge sharing.

Conclusion

These survey results establish the existence of a low level of knowledge sharing among health science librarians in Africa and suggest that concerted efforts should be made to overcome barriers to knowledge sharing within and across African countries.

The experience of provided information and care during pregnancy and postpartum when diagnosed with preeclampsia: A qualitative study

INTRODUCTION

Despite preeclampsia being one of the most severe obstetrical complications there is only scant research describing women's experiences of preeclampsia. The aim of this study was to explore women's experience during pregnancy and the postpartum period regarding the provided information and care concerning preeclampsia.

METHODS

A qualitative study was designed. Semi-structured face-to-face interviews were performed with fifteen women who were diagnosed with preeclampsia and included at two maternity units located in southern Sweden. The material was analyzed using content analysis.

RESULTS

Suffering from preeclampsia was understood as being stressful, illustrated in four themes: fragmented information, lack of care planning, separation postpartum, and overall stress and worry.

CONCLUSIONS

The women experienced fragmented obstetrical care and information deficits when diagnosed with preeclampsia. Our findings indicate a need for additional support and professional guidance due to increased stress, worry, and despair of being separated from the newborn. Future research investigating specific care-planning and postpartum follow-up are suggested as steps to improve care for women with a pregnancy complicated by preeclampsia.

Decoding the coupling between the brain and skin reactions in auditory stimulation by information-based analysis of EEG and GSR signals

BACKGROUND

The analysis of brain activity in different conditions is an important research area in neuroscience.

OBJECTIVE

This paper analyzed the correlation between the brain and skin activities in rest and stimulations by information-based analysis of electroencephalogram (EEG) and galvanic skin resistance (GSR) signals.

METHODS

We recorded EEG and GSR signals of eleven subjects during rest and auditory stimulations using three pieces of music that were differentiated based on their complexity. Then, we calculated the Shannon entropy of these signals to quantify their information contents.

RESULTS

The results showed that music with greater complexity has a more significant effect on altering the information contents of EEG and GSR signals. We also found a strong correlation (r= 0.9682) among the variations of the information contents of EEG and GSR signals. Therefore, the activities of the skin and brain are correlated in different conditions.

CONCLUSION

This analysis technique can be utilized to evaluate the correlation among the activities of various organs versus brain activity in different conditions.

The Information Conveyed in a SPAC's Offering

The popularity of SPACs (Special Purpose Acquisition Companies) has grown dramatically in recent years as a substitute for the traditional IPO (Initial Public Offer). We modeled the average annual return for SPAC investors and found that this financial tool produced an annual return of 17.3%. We then constructed an information model that examined a SPAC′s excess returns during the 60 days after a potential merger or acquisition had been announced. We found that the announcement had a major impact on the SPAC’s share price over the 60 days, delivering on average 0.69% daily excess returns over the IPO portfolio and 31.6% cumulative excess returns for the entire period. Relative to IPOs, the cumulative excess returns of SPACs rose dramatically in the next few days after the potential merger or acquisition announcement until the 26th day. They then declined but rose again until the 48th day after the announcement. Finally, the SPAC’s structure reduced the investors’ risk. Thus, if investors buy a SPAC stock immediately after a potential merger or acquisition has been announced and hold it for 48 days, they can reap substantial short-term returns.

Social Acceptance of Gas, Wind, and Solar Energies in the Canary Islands

BACKGROUND

This study tested a theoretical model including key psychosocial factors that could be involved in the acceptance of different energy sources (gas, wind, and solar); Methods: Participants were 550 adult residents of the Canary Islands. Variables assessed were information and utility (normative motives), perceived risk and perceived benefits (gain motives), and negative and positive emotions (hedonic motives), with acceptance of each of the three energy sources as outcome variables; Results: It was found that renewable energies (wind and solar) had a higher degree of acceptance than non-renewable energy (gas). The proposed model satisfactorily explained the social acceptance of the three energy sources, although the psychosocial factors involved differed by energy source. The gain motives, mainly perceived benefits, were associated to a greater extent with gas energy, whereas normative motives, such as utility, and hedonic motives, such as positive emotions, had greater weight for renewables. Gender differences in gas energy were found. Information about renewable energy increased positive emotions and acceptance, whereas information about fossil fuel-based energy generated more negative emotions and perceived risk, decreasing acceptance; Conclusions: Utility, perceived benefits and positive emotions were involved on the acceptance of both renewables and non-renewables. The theoretical model tested seems to be useful for understanding the psychosocial functioning of the acceptance of the various energy sources as an essential aspect for the transition of non-renewable to renewable energies.