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Amundsen PA, Underwood M, Burton K, Grotle M, Engedahl MS, Malmberg-Heimonen I, Irgens PMS, Højen M, Kisa A, Hagen M, Holmgard TE, Martinsen A, Lothe J, Monsen SS, Froud R. Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: an internal pilot study of a cohort randomised controlled approach. Pilot Feasibility Stud 2024; 10:110. [PMID: 39138502 PMCID: PMC11321075 DOI: 10.1186/s40814-024-01538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Persistent pain is a frequent cause of sick leave and work disability in Norway. A return-to-work intervention featuring supported work placements, developed in the UK, demonstrated feasibility, and a return-to-work rate of 20% within 6 months was observed in the sample. We sought to adapt the intervention for delivery in Norway and to confirm feasibility prior to a full-scale trial. METHODS In this internal pilot, we used a pragmatic cohort randomised controlled approach with national recruitment in Norway. We recruited people who were unemployed (for at least 1 month), having persistent pain (for at least 3 months), aged between 18 and 64, and wanting to return to work. We initially recruited people to an observational cohort study of the impact of being unemployed with persistent pain. After baseline measurement, we randomly sub-sampled participants to whom we offered the intervention, which featured individual case management and support, work-familiarisation sessions, and the offer of a 6-week part-time unpaid work placement. We assessed recruitment rates (aiming to recruit 66, and sub-sample 17 within 6 months); optimal recruitment pathways; intervention acceptance rates; the feasibility of data collection; using video links for work-familiarisation sessions and remote case manager support. RESULTS The pilot ran from June to November 2022. Of 168 people expressing interest, 94 consented. Recruitment posts on Facebook yielded the most 'expressions of interest' (66%, n = 111). After screening for eligibility, we included 55 participants. Of these, 19 were randomised to be offered the intervention. Of these, less than half (n = 8) consented to intervention participation. Remote case manager and work-familiarisation sessions appeared feasible. Following a delay in identifying placements, three participants received offers of work placements, with one starting and completing during the pilot period. Data collection methods were feasible, and no adverse events were reported. CONCLUSIONS Recruitment and logistical processes, such as remote management by video link, are feasible. However, delivery of the intervention is challenging. In particular, sourcing placements and the time required for identifying appropriate placements was more challenging than anticipated. A full-scale trial is feasible but will require improvements to the placement identification processes. TRIAL REGISTRATION ISRCTN85437524 (Referring to the ReISE trial, of which this internal pilot was a part), Registered 31 of May 2022 https://doi.org/10.1186/ISRCTN85437524 TRIAL FUNDING: Norwegian Research Council.
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Affiliation(s)
- Pål André Amundsen
- School of Health Sciences, Kristiana University College, PB 1190, 0107, Sentrum, Oslo, Norway.
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Kim Burton
- University of Huddersfield, Queensgate Huddersfield, Huddersfield, HD1 3DH, UK
- University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK
| | - Margreth Grotle
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Building 37BNydalen, P.O. Box 4956, 0424, Ullevål Oslo, Norway
| | - Martin Stav Engedahl
- School of Health Sciences, Kristiana University College, PB 1190, 0107, Sentrum, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | | | - Magnus Højen
- School of Health Sciences, Kristiana University College, PB 1190, 0107, Sentrum, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiana University College, PB 1190, 0107, Sentrum, Oslo, Norway
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
| | - Milada Hagen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Thor Einar Holmgard
- Norwegian Back Pain Association, Fjellhagen, P.O.Box 9612, 3065, Drammen, Norway
| | - Amy Martinsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Building 37BNydalen, P.O. Box 4956, 0424, Ullevål Oslo, Norway
- Co/FORMI, The Norwegian Council for Musculoskeletal Health, Oslo Universitetssykehus, 4956 Nydalen, P.O. Box , 0424, Oslo, Norway
| | - Jakob Lothe
- Co/FORMI, The Norwegian Council for Musculoskeletal Health, Oslo Universitetssykehus, 4956 Nydalen, P.O. Box , 0424, Oslo, Norway
| | | | - Robert Froud
- School of Health Sciences, Kristiana University College, PB 1190, 0107, Sentrum, Oslo, Norway
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Berg H, Prasolova-Førland E, Steinsbekk A. Developing a virtual reality (VR) application for practicing the ABCDE approach for systematic clinical observation. BMC MEDICAL EDUCATION 2023; 23:639. [PMID: 37670300 PMCID: PMC10478466 DOI: 10.1186/s12909-023-04625-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The Airways, Breathing, Circulation, Disability, Exposure (ABCDE) approach is an international approach for systematic clinical observation. It is an essential clinical skill for medical and healthcare professionals and should be practiced repeatedly. One way to do so is by using virtual reality (VR). The aim was therefore to develop a VR application to be used by inexperienced health students and professionals for self-instructed practice of systematic clinical observation using the ABCDE approach. METHODS An iterative human-centred approach done in three overlapping phases; deciding on the ABCDE approach, specifying the requirements, and developing the application. RESULTS A total of 138 persons were involved. Eight clinical observations were included in the ABCDE approach. The requirements included making it possible for inexperienced users to do self-instructed practice, a high level of immersion, and a sense of presence including mirroring the physical activities needed to do the ABCDE approach, allowing for both single and multiplayer, and automatic feedback with encouragement to repeat the training. In addition to many refinements, the testing led to the development of some new solutions. Prominent among them was to get players to understand how to use the VR hand controllers and start to interact with the VR environment and more instructions like showing videos on how to do observations. The solutions in the developed version were categorised into 15 core features like onboarding, instructions, quiz, and feedback. CONCLUSION A virtual reality application for self-instructed practice of systematic clinical observation using the ABCDE approach can be developed with sufficient testing by inexperienced health students and professionals.
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Affiliation(s)
- Helen Berg
- Department of Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.
| | - Ekaterina Prasolova-Førland
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Personalized Medicine for the Critically Ill Patient: A Narrative Review. Processes (Basel) 2022. [DOI: 10.3390/pr10061200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Personalized Medicine (PM) is rapidly advancing in everyday medical practice. Technological advances allow researchers to reach patients more than ever with their discoveries. The critically ill patient is probably the most complex of all, and personalized medicine must make serious efforts to fulfill the desire to “treat the individual, not the disease”. The complexity of critically ill pathologies arises from the severe state these patients and from the deranged pathways of their diseases. PM constitutes the integration of basic research into clinical practice; however, to make this possible complex and voluminous data require processing through even more complex mathematical models. The result of processing biodata is a digitized individual, from which fragments of information can be extracted for specific purposes. With this review, we aim to describe the current state of PM technologies and methods and explore its application in critically ill patients, as well as some of the challenges associated with PM in intensive care from the perspective of economic, approval, and ethical issues. This review can help in understanding the complexity of, P.M.; the complex processes needed for its application in critically ill patients, the benefits that make the effort of implementation worthwhile, and the current challenges of PM.
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Souza-Junior EVD, Rosa RS, Guedes TP, Silva CDS, Ribeiro DB, Balbinote FS, de Souza DF, Teixeira RB, Silva Filho BFD, Sawada NO. Ética e bioética no mundo científico: uma revisão integrativa. PERSONA Y BIOÉTICA 2020. [DOI: 10.5294/pebi.2020.24.2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivou-se analisar, por meio da literatura, a realidade das questões éticas e bioéticas no mundo científico. Trata-se de uma revisão integrativa, realizada com artigos contidos em três bases de dados. Foram utilizados sete Descritores em Ciências da Saúde, a partir dos quais foram elaboradas três combinações utilizadas em todas as bases. Após aplicar os critérios de inclusão, foram selecionados 18 artigos. As más condutas, especialmente o plágio, a falsificação e fabricação de dados vêm apresentando comportamento crescente e requerem medidas mais severas para seu controle, a fim de manter a credibilidade científica perante a sociedade e os órgãos superiores.
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