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Hoesterey S, Onnasch L. A New Experimental Paradigm to Manipulate Risk in Human-Automation Research. HUMAN FACTORS 2024; 66:1170-1185. [PMID: 36257770 PMCID: PMC10903125 DOI: 10.1177/00187208221133878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Two studies serve as a manipulation check of a new experimental multi-task paradigm that can be applied to human-automation research (Virtual Reality Testbed for Risk and Automation Studies; ViRTRAS), in which a subjectively experienceable risk can be manipulated as part of a virtual reality environment. BACKGROUND Risk has been postulated as an important contextual factor affecting human-automation interaction. However, experimental evidence is scarce due to the difficulty operationalizing risk in an ethical way. In the new paradigm, risk is varied by the altitude at which participants carry out the task, including the possibility of virtually falling in case of a mistake. METHOD Key components of the paradigm were used to investigate participants' risk perception in a low (0.5 m) and high altitude (70 m) using subjective self-reports and objective behavioral measures. RESULTS In the high-altitude condition risk perception was significantly higher with medium to large effect sizes. In addition, results of the behavioral measures reveal that participants habituated with length of exposure. However, this habituation seems to occur similarly in both altitude conditions. CONCLUSION The manipulation checks were successful. The new paradigm is a promising tool for automation research. It incorporates the contextual factor of risk and creates a situation which is more comparable to what real-life operators experience. Additionally, it meets the same requirements of other multi-task environments in human-automation research. APPLICATION The new paradigm provides the basis to vary the contextual factor of risk in human-automation research, which has previously been either neglected or operationalized in an arguably inferior way.
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Winslow B, Mills E. Future of service member monitoring: the intersection of biology, wearables and artificial intelligence. BMJ Mil Health 2023:e002306. [PMID: 36702525 DOI: 10.1136/military-2022-002306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/15/2023] [Indexed: 01/28/2023]
Abstract
While substantial investment has been made in the early identification of mental and behavioural health disorders in service members, rates of depression, substance abuse and suicidality continue to climb. Objective and persistent measures are needed for early identification and treatment of these rising health issues. Considerable potential lies at the intersection of biology, wearables and artificial intelligence to provide high accuracy, objective monitoring of mental and behavioural health in training, operations and healthcare settings. While the current generation of wearable devices has predominantly targeted non-military use cases, military agencies have demonstrated successes in monitoring and diagnosis via off-label uses. Combined with context-aware and individualised algorithms, the integration of wearable data with artificial intelligence allows for a deeper understanding of individual-level and group-level mental and behavioural health at scale. Emerging digital phenotyping approaches which leverage ubiquitous sensing technology can provide monitoring at a greater scale, lower price point and lower individual burden by removing the need for additional body-worn technology. The intersection of this technology will enable individualised strategies to promote service member mental and physical health, reduce injury, and improve long-term well-being and deployability.
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Affiliation(s)
| | - E Mills
- Design Interactive Inc, Orlando, Florida, USA
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Duque A, Cano-López I, Puig-Pérez S. Effects of psychological stress and cortisol on decision making and modulating factors: a systematic review. Eur J Neurosci 2022; 56:3889-3920. [PMID: 35589606 DOI: 10.1111/ejn.15721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/09/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
Evidence suggests that psychological stress has effects on decision making, but the results are inconsistent, and the influence of cortisol and other modulating factors remains unclear. Based on the PRISMA criteria, 18 studies carried out between 2015 and 2020 that examined the effects of psychological stress on decision making and measured cortisol levels were selected. Eight studies employed uncertainty-based economic tasks, five studies used decision-making tasks in hypothetical situations that can be encountered in real life or in a specific setting, and five studies employed prosocial decision tasks. Seventeen studies assessed acute stress, and two assessed chronic stress; eight evaluated the influence of sex. Most of the studies that explored the association between stress and decision making using uncertainty-based economic tasks found statistically significant differences as a function of stress exposure and the cortisol response to stress, whereas most of the studies that employed non-economic decision-making tasks in hypothetical situations did not find statistically significant differences. When prosocial decision making was evaluated, more altruistic decisions were found after acute stress, and these decisions were positively associated with cortisol. Half of the studies that assessed the role of sex observed a greater impact on decision making after stress in women. Results suggest that it is important to consider modulating factors - the type of decision-making task, the cortisol response to stress, the characteristics of the psychological stressor, or the subject's sex - when trying to understand psychosocial stress phenomena.
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Affiliation(s)
- Aránzazu Duque
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Irene Cano-López
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Sara Puig-Pérez
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
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A Narrative Review of the Current State of Extended Reality Technology and How it can be Utilised in Sport. Sports Med 2022; 52:1473-1489. [PMID: 35286617 PMCID: PMC9213326 DOI: 10.1007/s40279-022-01669-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 12/04/2022]
Abstract
Extended reality is an umbrella term used to describe three computer-generated technologies including virtual reality, augmented reality and mixed reality. Extended reality is an emerging technology that has been utilised in many high-performance domains including psychology, medicine and the military, with the aim of enhancing perceptual-cognitive skills and motor skills. However, the use of extended reality in sport, particularly at the elite level, has only recently started to receive attention. While the growth of extended reality technology continues to accelerate at a rapid rate, empirical evidence aimed at understanding how these devices can best be applied in high-performance sport has not followed suit. Therefore, the purpose of this review is to provide clarity for high-performance sport organisations, researchers, sport scientists, coaches and athletes about the current state of extended reality technology and how it has been utilised in sport. In doing so, we first define and give examples of the types of extended reality technology including virtual reality, augmented reality and mixed reality that are available at the present time. Second, we detail how skill acquisition principles underpinned by the theoretical framework of ecological dynamics can be used to help inform the design and assessment of extended reality training tools. Third, we describe how extended reality has been utilised in sport, including how extended reality tools have been assessed for their level of representativeness, and the effectiveness of extended reality training interventions for improving perceptual-cognitive skills and motor skills. Finally, we discuss the future utilisation of extended reality in sport, including the key learnings that can be drawn from other domains, future research directions, practical applications and areas for consideration related to the use of extended reality for training skills in sport.
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Kleitman S, Jackson SA, Zhang LM, Blanchard MD, Rizvandi NB, Aidman E. Applying Evidence-Centered Design to Measure Psychological Resilience: The Development and Preliminary Validation of a Novel Simulation-Based Assessment Methodology. Front Psychol 2022; 12:717568. [PMID: 35082711 PMCID: PMC8786081 DOI: 10.3389/fpsyg.2021.717568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Modern technologies have enabled the development of dynamic game- and simulation-based assessments to measure psychological constructs. This has highlighted their potential for supplementing other assessment modalities, such as self-report. This study describes the development, design, and preliminary validation of a simulation-based assessment methodology to measure psychological resilience-an important construct for multiple life domains. The design was guided by theories of resilience, and principles of evidence-centered design and stealth assessment. The system analyzed log files from a simulated task to derive individual trajectories in response to stressors. Using slope analyses, these trajectories were indicative of four types of responses to stressors: thriving, recovery, surviving, and succumbing. Using Machine Learning, the trajectories were predictive of self-reported resilience (Connor-Davidson Resilience Scale) with high accuracy, supporting construct validity of the simulation-based assessment. These findings add to the growing evidence supporting the utility of gamified assessment of psychological constructs. Importantly, these findings address theoretical debates about the construct of resilience, adding to its theory, supporting the combination of the "trait" and "process" approaches to its operationalization.
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Affiliation(s)
- Sabina Kleitman
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Simon A. Jackson
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Lisa M. Zhang
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Nikzad B. Rizvandi
- Centre for Translational Data Science, The University of Sydney, Sydney, NSW, Australia
| | - Eugene Aidman
- Land Division, Defence Science and Technology Group, Edinburgh, SA, Australia
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Corrigan SL, Roberts S, Warmington S, Drain J, Main LC. Monitoring stress and allostatic load in first responders and tactical operators using heart rate variability: a systematic review. BMC Public Health 2021; 21:1701. [PMID: 34537038 PMCID: PMC8449887 DOI: 10.1186/s12889-021-11595-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Awareness of the cumulative stress placed on first responders and tactical operators is required to manage acute fatigue, which can impair occupational performance, and may precipitate negative chronic health outcomes. The aim of this review was to investigate the utility of heart rate variability (HRV) to monitor stress and allostatic load among these populations. METHODS A systematic search of Academic Search Complete, MEDLINE complete, PsycINFO, SPORTDiscus and Scopus databases was conducted. Eligibility criteria: original peer reviewed research articles, written in English, published between 1985 and 2020, using human participants employed as a first responder or tactical operator, free from any psychological disorder. RESULTS Of the 360 articles screened, 60 met the inclusion criteria and were included for full text assessment. Articles were classified based on single or repeated stressor exposure and the time of HRV assessment (baseline, during stressor, post stressor). Singular stressful events elicited a reduction in HRV from baseline to during the event. Stressors of greater magnitude reduced HRV for extended durations post stressor. Lower resting HRV was associated with lower situational awareness and impaired decision-making performance in marksmanship and navigation tasks. There were insufficient studies to evaluate the utility of HRV to assess allostatic load in repeated stressor contexts. CONCLUSION A reduction in HRV occurred in response to acute physical and cognitive occupational stressors. A slower rate of recovery of HRV after the completion of acute occupational stressors appears to occur in response to stressors of greater magnitude. The association between lower HRV and lower decision-making performance poses as a useful tool but further investigations on within subject changes between these factors and their relationship is required. More research is required to investigate the suitability of HRV as a measure of allostatic load in repeated stress exposures for fatigue management in first responder and tactical operators.
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Affiliation(s)
- Sean L Corrigan
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
| | - Spencer Roberts
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Stuart Warmington
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Jace Drain
- Defence Science and Technology Group, Fishermans Bend, Australia
| | - Luana C Main
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
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Sarlija M, Popovic S, Jagodic M, Jovanovic T, Ivkovic V, Zhang Q, Strangman G, Cosic K. Prediction of Task Performance From Physiological Features of Stress Resilience. IEEE J Biomed Health Inform 2021; 25:2150-2161. [PMID: 33253118 DOI: 10.1109/jbhi.2020.3041315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this paper, we investigate the potential of generic physiological features of stress resilience in predicting air traffic control (ATC) candidates' performance in a highly-stressful low-fidelity ATC simulator scenario. Stress resilience is highlighted as an important occupational factor that influences the performance and well-being of air traffic control officers (ATCO). Poor stress management, besides the lack of skills, can be a direct cause of poor performance under stress, both in the selection process of ATCOs and later in the workplace. 40 ATC candidates, within the final stages of their selection process, underwent a stimulation paradigm for elicitation and assessment of various generic task-unrelated physiological features, related to resting heart rate variability (HRV) and respiratory sinus arrhythmia (RSA), acoustic startle response (ASR) and the physiological allostatic response, which are all recognized as relevant psychophysiological markers of stress resilience. The multimodal approach included analysis of electrocardiography, electromyography, electrodermal activity and respiration. We make advances in computational methodology for assessment of physiological features of stress resilience, and investigate the predictive power of the obtained feature space in a binary classification problem: prediction of high- vs. low-performance on the developed ATC simulator. Our novel approach yields a relatively high 78.16% classification accuracy. These results are discussed in the context of prior work, while considering study limitations and proposing directions for future work.
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Jung SJ, Jeon YJ, Choi KW, Yang JS, Chae J, Koenen KC, Kim HC. Correlates of psychological resilience and risk: Prospective associations of self-reported and relative resilience with Connor-Davidson resilience scale, heart rate variability, and mental health indices. Brain Behav 2021; 11:e02091. [PMID: 33638932 PMCID: PMC8119814 DOI: 10.1002/brb3.2091] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There are several ways to determine psychological resilience. However, the correlation between each measurement is not clear. We explored associations of baseline relative "resilience" and risk with later self-reported trait resilience and other biological/mental health indices. METHODS We utilized baseline and follow-up survey data from 500 participants aged 30-64 in the community cohort. Baseline "relative" resilience was defined by: (a) negative life events (NLEs) in the six months before baseline and (b) depressive symptoms at baseline, yielding four groups of individuals: i) "Unexposed and well," "Vulnerable (depression)," "Reactive (depression)," and "Resilient." "Trait" resilience at follow-up was self-reported using the Connor-Davidson Resilience Scale (CD-RISC). Associations between relative resilience at baseline, CD-RISC, and heart rate variability (HRV) indices at follow-up were assessed with generalized linear regression models after adjustments. Associations between baseline resilience and subsequent loneliness/depression indices were also evaluated. RESULTS Overall trait resilience and its subfactors at follow-up showed strong negative associations with "Reactive" at baseline (adj-β for total CD-RISC score: -11.204 (men), -9.472 (women)). However, resilience at baseline was not associated with later HRV, which was compared with the significant positive association observed between CD-RISC and HRV at the same follow-up time point. The "Reactive" exhibited significantly increased depressive symptoms at follow-up. The overall distribution pattern of CD-RISC subfactors differed by baseline resilience status by sex. CONCLUSIONS The "relative" resilience based on the absence of depression despite prior adversity seems to be highly related with trait resilience at follow-up but not with HRV. The sub-factor pattern of CD-RISC was different by sex.
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Affiliation(s)
- Sun Jae Jung
- Department of Preventive MedicineYonsei University College of MedicineSeoulSouth Korea
- Department of Public HealthYonsei University Graduate SchoolSeoulSouth Korea
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Ye Jin Jeon
- Department of Public HealthYonsei University Graduate SchoolSeoulSouth Korea
| | - Karmel W. Choi
- Department of PsychiatryMassachusetts General HospitalBostonMAUSA
| | - Ji Su Yang
- Department of Public HealthYonsei University Graduate SchoolSeoulSouth Korea
| | - Jeong‐Ho Chae
- Department of PsychiatrySt. Mary’s HospitalSeoulSouth Korea
| | - Karestan C. Koenen
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Hyeon Chang Kim
- Department of Preventive MedicineYonsei University College of MedicineSeoulSouth Korea
- Department of Public HealthYonsei University Graduate SchoolSeoulSouth Korea
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Atalağ O, Gotshalk LA, Queen L, Wottlin S. More stress for the eastward travelling student athlete: A preliminary analysis. ISOKINET EXERC SCI 2019. [DOI: 10.3233/ies-192170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bensouda B, Mandel R, Mejri A, Lachapelle J, St-Hilaire M, Ali N. Effect of an audience on trainee stress and performance during simulated neonatal intubation: a randomized crossover trial. BMC MEDICAL EDUCATION 2018; 18:230. [PMID: 30285715 PMCID: PMC6171149 DOI: 10.1186/s12909-018-1338-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Neonatal intubation is a stressful procedure taught to trainees. This procedure can attract additional observers. The impact of observers on neonatal intubation performance by trainees has not been studied. Our objective was to evaluate if additional observers present during neonatal mannequin endotracheal intubation (NMEI) by junior trainees, affects their performance and their stress levels. METHODS A randomized cross over trial was conducted. First year residents with no experience in neonatal intubation were assigned to NMEI condition A or B randomly on day 1. Subjects were crossed over to the other condition on day 2. Condition A: Only one audience member was present Condition B: Presence of an audience of 5 health care providers. Differences in the time to successful NMEI was recorded and compared between conditions. A portable heart rate monitor was used to measure peak heart rate above baseline during NMEI under both conditions. RESULTS Forty nine residents were recruited. 72% were female with a median age of 25 years (IQR: 24-27). Time to successful intubation was comparable under both conditions with a mean difference of - 3.94 s (95% CI: -8.2,0.4). Peak heart rate was significantly lower under condition A (mean difference - 11.9 beats/min, 95% CI -15.98 to - 7.78). CONCLUSION Although the time required to NMEI did not increase, our results suggest that presence of observers significantly increases trainee stress. The addition of extraneous observers during simulation training may better equip residents to deal with such stressors. TRIAL REGISTRATION Date of registration: March 2016, NCT 02726724 .
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Affiliation(s)
- Brahim Bensouda
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
| | - Romain Mandel
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
| | - Abdelwaheb Mejri
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
| | - Jean Lachapelle
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
| | - Marie St-Hilaire
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
| | - Nabeel Ali
- Maisonneuve Rosemont Hospital, Pediatric Department, University of Montreal, 5415 Boulevard de l’Assomption, Montréal, QC H1T2M4 Canada
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Winslow BD, Chadderdon GL, Dechmerowski SJ, Jones DL, Kalkstein S, Greene JL, Gehrman P. Development and Clinical Evaluation of an mHealth Application for Stress Management. Front Psychiatry 2016; 7:130. [PMID: 27507949 PMCID: PMC4960497 DOI: 10.3389/fpsyt.2016.00130] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/12/2016] [Indexed: 11/29/2022] Open
Abstract
A large number of individuals experience mental health disorders, with cognitive behavioral therapy (CBT) emerging as a standard practice for reduction in psychiatric symptoms, including stress, anger, anxiety, and depression. However, CBT is associated with significant patient dropout and lacks the means to provide objective data regarding a patient's experience and symptoms between sessions. Emerging wearables and mobile health (mHealth) applications represent an approach that may provide objective data to the patient and provider between CBT sessions. Here, we describe the development of a classifier of real-time physiological stress in a healthy population (n = 35) and apply it in a controlled clinical evaluation for armed forces veterans undergoing CBT for stress and anger management (n = 16). Using cardiovascular and electrodermal inputs from a wearable device, the classifier was able to detect physiological stress in a non-clinical sample with accuracy greater than 90%. In a small clinical sample, patients who used the classifier and an associated mHealth application were less likely to discontinue therapy (p = 0.016, d = 1.34) and significantly improved on measures of stress (p = 0.032, d = 1.61), anxiety (p = 0.050, d = 1.26), and anger (p = 0.046, d = 1.41) compared to controls undergoing CBT alone. Given the large number of individuals that experience mental health disorders and the unmet need for treatment, especially in developing nations, such mHealth approaches have the potential to provide or augment treatment at low cost in the absence of in-person care.
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Affiliation(s)
| | | | | | | | - Solomon Kalkstein
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Jennifer L Greene
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Philip Gehrman
- Philadelphia VA Medical Center, University of Pennsylvania , Philadelphia, PA , USA
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