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Troeung L, Sarunga Raja TL, Mann G, Wagland J, MacLeod C, Martini A. IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study. BMJ Open 2024; 14:e080030. [PMID: 38508623 PMCID: PMC10953309 DOI: 10.1136/bmjopen-2023-080030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility. METHODS AND ANALYSIS A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility. ETHICS AND DISSEMINATION Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey. TRIAL REGISTRATION NUMBER ACTRN12623000990628.
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Affiliation(s)
- Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Thilaga L Sarunga Raja
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- Oats Street Rehabilitation Centre, Brightwater Care Group, East Victoria Park, Western Australia, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Janet Wagland
- Disability Services, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Colin MacLeod
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- The University of Western Australia, Crawley, Western Australia, Australia
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Kreienbrinck A, Hanft-Robert S, Mösko M. Usability of technological tools to overcome language barriers in health care: a scoping review protocol. BMJ Open 2024; 14:e079814. [PMID: 38458787 DOI: 10.1136/bmjopen-2023-079814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION In many healthcare contexts globally, where the languages of care providers and patients do not match, miscommunication or non-communication can lead to inaccurate diagnoses and subpar treatment outcomes. In order to bridge these language barriers, a range of informal practices are used, such as family members or staff acting as interpreters, 'receptive multilingualism' or machine translation. The development and use of technological tools are increasing, but factors such as translation quality for complex health-related texts vary widely between languages. The objective of this scoping review is to (1) identify and describe the technological tools used in direct patient-provider communication to overcome a language barrier in a healthcare setting, (2) identify how the usability of these tools was evaluated and (3) assess the usability of the technological tools. METHODS AND ANALYSIS The scoping review will follow the Joanna Briggs Institute methodology. A search strategy using variations of the keywords 'technological tools', 'language barrier' and 'healthcare' will be applied in the following databases and research platforms: PubMed, PsycArticle, Scopus, EBSCOhost, ProQuest and Web of Science. All literature where individuals use a technological tool to overcome a language barrier in a healthcare context will be included and exported into the screening assistant software Rayyan. The search will be limited to articles written in German or English. Two independent reviewers will screen the articles, and all relevant extracted data will be presented in a descriptive summary. ETHICS AND DISSEMINATION This scoping review does not require ethical approval, as the study's methodology consists of collecting data from publicly available sources. The findings will be disseminated through publication in an open-access, peer-reviewed journal and presentations at scientific conferences. The scoping review results will also guide future research in a multinational project investigating multilingualism in providing (mental) healthcare to migrants.
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Affiliation(s)
- Annika Kreienbrinck
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Saskia Hanft-Robert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
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Hutchings HA, Cochrane M, Battle C. Study to evaluate the readability and visual appearance of online resources for blunt chest trauma: an evaluation of online resources using mixed methods. BMJ Open 2024; 14:e078552. [PMID: 38320839 PMCID: PMC10860042 DOI: 10.1136/bmjopen-2023-078552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Blunt chest trauma (BCT) is characterised by forceful and non-penetrative impact to the chest region. Increased access to the internet has led to online healthcare resources becoming used by the public to educate themselves about medical conditions. This study aimed to determine whether online resources for BCT are at an appropriate readability level and visual appearance for the public. DESIGN We undertook a (1) a narrative overview assessment of the website; (2) a visual assessment of the identified website material content using an adapted framework of predetermined key criteria based on the Centers for Medicare and Medicaid Services toolkit and (3) a readability assessment using five readability scores and the Flesch reading ease score using Readable software. DATA SOURCES Using a range of key search terms, we searched Google, Bing and Yahoo websites on 9 October 2023 for online resources about BCT. RESULTS We identified and assessed 85 websites. The median visual assessment score for the identified websites was 22, with a range of -14 to 37. The median readability score generated was 9 (14-15 years), with a range of 4.9-15.8. There was a significant association between the visual assessment and readability scores with a tendency for websites with lower readability scores having higher scores for the visual assessment (Spearman's r=-0.485; p<0.01). The median score for Flesch reading ease was 63.9 (plain English) with a range of 21.1-85.3. CONCLUSIONS Although the readability levels and visual appearance were acceptable for the public for many websites, many of the resources had much higher readability scores than the recommended level (8-10) and visually were poor.Better use of images would improve the appearance of websites further. Less medical terminology and shorter word and sentence length would also allow the public to comprehend the contained information more easily.
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Affiliation(s)
| | - Max Cochrane
- School of Medicine, Swansea University, Swansea, UK
| | - Ceri Battle
- School of Medicine, Swansea University, Swansea, UK
- Physiotherapy Department, Swansea Bay University Health Board, Swansea, UK
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Yew SQ, Trivedi D, Adanan NIH, Chew BH. Facilitators and barriers of digital health technologies implementation in hospital settings in lower-income and middle-income countries since the COVID-19 pandemic: a scoping review protocol. BMJ Open 2024; 14:e078508. [PMID: 38296272 PMCID: PMC10831434 DOI: 10.1136/bmjopen-2023-078508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION The implementation of digital health technologies (DHTs) in hospitals worldwide has been uneven since the COVID-19 pandemic. Ambiguity in defining the landscape of DHTs adds to the complexity of this process. To address these challenges, this scoping review aims to identify the facilitators and barriers of implementing DHTs in hospitals in lower-income and middle-income countries (LMIC) since COVID-19, describe the DHTs that have been adopted in hospital settings in LMIC during this period, and develop a comprehensive classification framework to define the landscape of DHTs implemented in LMIC. METHODS AND ANALYSIS We will conduct a systematic search in PubMed, Scopus, Web of Science and grey literature. Descriptive statistics will be used to report the characteristics of included studies. The facilitators and barriers to DHTs implementation, gathered from both quantitative and qualitative data, will be synthesised using a parallel-results convergent synthesis design. A thematic analysis, employing an inductive approach, will be conducted to categorise these facilitators and barriers into coherent themes. Additionally, we will identify and categorise all available DHTs based on their equipment types and methods of operation to develop an innovative classification framework. ETHICS AND DISSEMINATION Formal ethical approval is not required, as primary data collection is not involved in this study. The findings will be disseminated through peer-reviewed publications, conference presentations and meetings with key stakeholders and partners in the field of digital health.
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Affiliation(s)
- Sheng Qian Yew
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia Fakulti Perubatan, Cheras, Federal Territory of Kual, Malaysia
| | - Daksha Trivedi
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hertfordshire, UK
| | | | - Boon How Chew
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Harper A, Monks T, Wilson R, Redaniel MT, Eyles E, Jones T, Penfold C, Elliott A, Keen T, Pitt M, Blom A, Whitehouse MR, Judge A. Development and application of simulation modelling for orthopaedic elective resource planning in England. BMJ Open 2023; 13:e076221. [PMID: 38135323 DOI: 10.1136/bmjopen-2023-076221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVES This study aimed to develop a simulation model to support orthopaedic elective capacity planning. METHODS An open-source, generalisable discrete-event simulation was developed, including a web-based application. The model used anonymised patient records between 2016 and 2019 of elective orthopaedic procedures from a National Health Service (NHS) Trust in England. In this paper, it is used to investigate scenarios including resourcing (beds and theatres) and productivity (lengths of stay, delayed discharges and theatre activity) to support planning for meeting new NHS targets aimed at reducing elective orthopaedic surgical backlogs in a proposed ring-fenced orthopaedic surgical facility. The simulation is interactive and intended for use by health service planners and clinicians. RESULTS A higher number of beds (65-70) than the proposed number (40 beds) will be required if lengths of stay and delayed discharge rates remain unchanged. Reducing lengths of stay in line with national benchmarks reduces bed utilisation to an estimated 60%, allowing for additional theatre activity such as weekend working. Further, reducing the proportion of patients with a delayed discharge by 75% reduces bed utilisation to below 40%, even with weekend working. A range of other scenarios can also be investigated directly by NHS planners using the interactive web app. CONCLUSIONS The simulation model is intended to support capacity planning of orthopaedic elective services by identifying a balance of capacity across theatres and beds and predicting the impact of productivity measures on capacity requirements. It is applicable beyond the study site and can be adapted for other specialties.
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Affiliation(s)
- Alison Harper
- University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | - Thomas Monks
- University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | - Rebecca Wilson
- NIHR Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Maria Theresa Redaniel
- NIHR Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Emily Eyles
- NIHR Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Tim Jones
- NIHR Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Chris Penfold
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- University of Bristol, Bristol, UK
| | | | - Tim Keen
- North Bristol NHS Trust Southmead Hospital, Bristol, UK
| | - Martin Pitt
- University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | | | | | - Andrew Judge
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- University of Bristol, Bristol, UK
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Buckley A, Tai N. The DMS must rapidly reshape its systems to cultivate and sustain innovation and the implementation of new digital technologies. BMJ Mil Health 2023; 169:385-387. [PMID: 34551986 DOI: 10.1136/bmjmilitary-2021-001924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Andrew Buckley
- UK STRATCOM, jHubMed, London, UK
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - N Tai
- UK STRATCOM, jHubMed, London, UK
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
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Bernardes ML, Rosendo-Silva B, Rosendo I, Monteiro-Soares M. Web-based interventions to improve blood pressure control in patients with hypertension: a protocol for a systematic review. BMJ Open 2023; 13:e067610. [PMID: 37558452 PMCID: PMC10414092 DOI: 10.1136/bmjopen-2022-067610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 06/22/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Hypertension is the major cause of cardiovascular disease and mortality in the world. Blood pressure control (BPC) is recognised as a key measure in the management of hypertension. Several studies have been conducted assessing the impact of specific web-based interventions in improving BPC. Our systematic review intends to identify all the available web-based interventions and determine if and which are more effective than usual care in improving BPC. METHODS AND ANALYSIS We will include randomised control trials completed until April 2023 including patients diagnosed with hypertension comparing the effect of receiving usual care versus web-based interventions in BPC. No language restriction will be applied. We will start with an extensive electronic database search, in the Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, EU Clinical Trials Register, Pan-African Clinical Trials Registry and ClinicalTrials.gov. Eligibility criteria will be applied blindly and independently by two researchers to the title and abstract of the references, in the first stage, and to the full version of the ones selected. All divergences will be solved by a third researcher. We will conduct a narrative description and meta-analysis (if adequate) of the results of the included studies, structured according to the type of intervention, characteristics of the population and outcome measurement. We will extract features of the web-based interventions, selecting the ones with the best outcomes regarding BPC, to later propose an ideal web-based intervention to improve BPC in hypertensive patients and/or guide future research on this topic. The risk of bias will be assessed using Cochrane's RoB2 Tool. ETHICS AND DISSEMINATION Ethical approval is not required since this is a protocol for a systematic review. The findings of this study will be disseminated through peer-reviewed publications and national or international conference presentations. Updates of the review will be conducted, as necessary. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020184166.
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Affiliation(s)
- Maria Leonor Bernardes
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Unidade de Saúde Familiar do Arco, Lisboa, Portugal
| | - Beatriz Rosendo-Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês Rosendo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
- Unidade de Saúde Familiar Coimbra Centro, Center Regional Health Administration, Coimbra, Portugal
| | - Matilde Monteiro-Soares
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
- MEDCIDS - Departamento de Ciências da Informação e da Decisão em Saúde, Faculty of Medicine, University of Porto, Porto, Portugal
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Sirkis T, Maitland S. Monitoring real-time junior doctor sentiment from comments on a public social media platform: a retrospective observational study. Postgrad Med J 2023; 99:423-427. [PMID: 37294728 DOI: 10.1136/pmj-2022-142080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate whether sentiment analysis and topic modelling can be used to monitor the sentiment and opinions of junior doctors. DESIGN Retrospective observational study based on comments on a social media website. SETTING Every publicly available comment in r/JuniorDoctorsUK on Reddit from 1 January 2018 to 31 December 2021. PARTICIPANTS 7707 Reddit users who commented in the r/JuniorDoctorsUK subreddit. MAIN OUTCOME MEASURE Sentiment (scored -1 to +1) of comments compared with results of surveys conducted by the General Medical Council. RESULTS Average comment sentiment was positive but varied significantly during the study period. Fourteen topics of discussion were identified, each associated with a different pattern of sentiment. The topic with the highest proportion of negative comments was the role of a doctor (38%), and the topic with the most positive sentiment was hospital reviews (72%). CONCLUSION Some topics discussed in social media are comparable to those queried in traditional questionnaires, whereas other topics are distinctive and offer insight into what themes junior doctors care about. Events during the coronavirus pandemic may explain the sentiment trends in the junior doctor community. Natural language processing shows significant potential in generating insights into junior doctors' opinions and sentiment.
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Affiliation(s)
- Tamir Sirkis
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Stuart Maitland
- Translational Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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Aulbach MB, van Alebeek H, Kahveci S, Blechert J. Testing the effectiveness of a mobile approach avoidance intervention and measuring approach biases in an ecological momentary assessment context: study protocol for a randomised-controlled trial. BMJ Open 2023; 13:e070443. [PMID: 37185192 PMCID: PMC10151942 DOI: 10.1136/bmjopen-2022-070443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Unhealthy eating behaviour is a major contributor to obesity and related diseases and is associated with a behavioural bias to approach rather than avoid desired foods, as measured with reaction time tasks. Approach-avoidance interventions (AAIs) have been proposed as a way to modify food evaluations and help people to eat in accordance with their dietary goals. Mobile implementations of AAI might be easily accessible, low threshold interventions, but their effectiveness has not been established yet. METHODS AND ANALYSIS Participants who aim to change their eating behaviour are randomised to intervention or control groups. They complete six sessions of a smartphone-based AAI, in which they push (ie, avoid) or pull (ie, approach) personalised food images. Intervention group participants always avoid foods that they personally want to eat less often and approach foods that they personally want to eat more often. In the control group, images are paired equally often with both response directions. To evaluate contextual and dynamic intervention effects, ecological momentary assessment (EMA) is measured throughout, with questions about food intake, hunger, stress, emotions, eating intentions, food craving and impulsivity twice a day. Additional EMA preintervention and postintervention measures are administered before and after the intervention phase (4 days each) with a 1-day follow-up EMA 4 weeks after the intervention. Multilevel models will examine the temporal covariance between approach bias and self-reported variables as well as short-term and long-term intervention effects on approach bias, food intake and craving. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the University of Salzburg. Results will be published in peer-reviewed scientific journals and presented at scientific conferences. TRIAL REGISTRATION NUMBER German Clinical Trials Register DRKS, registration number DRKS00030780.
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Affiliation(s)
- Matthias Burkard Aulbach
- Department of Psychology, Paris Lodron Universitat Salzburg, Salzburg, Austria
- Department of Psychology, Centre for Cognitive Neuroscience, Salzburg, Austria
| | - Hannah van Alebeek
- Department of Psychology, Paris Lodron Universitat Salzburg, Salzburg, Austria
- Department of Psychology, Centre for Cognitive Neuroscience, Salzburg, Austria
| | - Sercan Kahveci
- Department of Psychology, Paris Lodron Universitat Salzburg, Salzburg, Austria
- Department of Psychology, Centre for Cognitive Neuroscience, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Paris Lodron Universitat Salzburg, Salzburg, Austria
- Department of Psychology, Centre for Cognitive Neuroscience, Salzburg, Austria
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Abstract
OBJECTIVES The current study measures the differences in humble leadership and team performance in nursing based on the sample's characteristics. DESIGN A cross-sectional study. SETTING In 2022, the current study sample was recruited from governmental and private universities and hospitals using an online survey. PARTICIPANTS A convenience snowball sample of 251 nursing educators, nurses and students was recruited. RESULTS A leader's humble leadership, a team's humble leadership and overall humble leadership were at moderate levels. The overall mean team performance was 'working well'. The single male humble leaders, aged more than 35 years and working full-time in an organisation with quality initiatives, have a higher leader's humble leadership. Members of the team aged more than 35 years working full-time in organisations with quality initiatives have a higher team's humble leadership. Team performance in organisations with quality initiatives was higher in resolving many conflicts by compromising between team members, with each one giving in a little. There was a moderate correlation (r=0.644) between the total scores of the overall humble leadership and team performance. Humble leadership correlated significantly but negatively and weakly with quality initiatives (r=-0.169) and the participant's role (r=-0.163). There was no significant correlation between team performance and the sample's characteristics. CONCLUSIONS Humble leadership has positive outcomes, such as team performance. The shared sample characteristic that sets the differences between a leader's and a team's humble leadership and team performance was the presence of quality initiatives in the organisation. The shared sample characteristics that set the differences in a leader's and a team's humble leadership were working full-time and the presence of quality initiatives in the organisation. Humble leaders are contagious; they will produce creative team members by 'social contagion', 'behavioural similarity', 'team potency' and 'collective focus'. Thus, leadership protocols and interventions are mandated to fuel humble leadership and team performance.
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Affiliation(s)
- Majd T Mrayyan
- Faculty of Nursing, Department of Community and Mental Health Nursing, PO Box 330127, The Hashemite University, 13133 Zarqa, Jordan
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Tsang KCH, Pinnock H, Wilson AM, Salvi D, Shah SA. Predicting asthma attacks using connected mobile devices and machine learning: the AAMOS-00 observational study protocol. BMJ Open 2022; 12:e064166. [PMID: 36192103 PMCID: PMC9535155 DOI: 10.1136/bmjopen-2022-064166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Supported self-management empowering people with asthma to detect early deterioration and take timely action reduces the risk of asthma attacks. Smartphones and smart monitoring devices coupled with machine learning could enhance self-management by predicting asthma attacks and providing tailored feedback.We aim to develop and assess the feasibility of an asthma attack predictor system based on data collected from a range of smart devices. METHODS AND ANALYSIS A two-phase, 7-month observational study to collect data about asthma status using three smart monitoring devices, and daily symptom questionnaires. We will recruit up to 100 people via social media and from a severe asthma clinic, who are at risk of attacks and who use a pressurised metered dose relief inhaler (that fits the smart inhaler device).Following a preliminary month of daily symptom questionnaires, 30 participants able to comply with regular monitoring will complete 6 months of using smart devices (smart peak flow meter, smart inhaler and smartwatch) and daily questionnaires to monitor asthma status. The feasibility of this monitoring will be measured by the percentage of task completion. The occurrence of asthma attacks (definition: American Thoracic Society/European Respiratory Society Task Force 2009) will be detected by self-reported use (or increased use) of oral corticosteroids. Monitoring data will be analysed to identify predictors of asthma attacks. At the end of the monitoring, we will assess users' perspectives on acceptability and utility of the system with an exit questionnaire. ETHICS AND DISSEMINATION Ethics approval was provided by the East of England - Cambridge Central Research Ethics Committee. IRAS project ID: 285 505 with governance approval from ACCORD (Academic and Clinical Central Office for Research and Development), project number: AC20145. The study sponsor is ACCORD, the University of Edinburgh.Results will be reported through peer-reviewed publications, abstracts and conference posters. Public dissemination will be centred around blogs and social media from the Asthma UK network and shared with study participants.
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Affiliation(s)
- Kevin Cheuk Him Tsang
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Andrew M Wilson
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norwich University Hospital Foundation Trust, Colney Lane, Norwich, UK
| | - Dario Salvi
- Internet of Things and People Research Centre, Malmo University, Malmo, Sweden
| | - Syed Ahmar Shah
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
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Jones CW, Adams A, Misemer BS, Weaver MA, Schroter S, Khan H, Margolis B, Schriger DL, Platts-Mills TF. Peer Reviewed Evaluation of Registered End-Points of Randomised Trials (the PRE-REPORT study): a stepped wedge, cluster-randomised trial. BMJ Open 2022; 12:e066624. [PMID: 36171034 PMCID: PMC9528603 DOI: 10.1136/bmjopen-2022-066624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To test whether providing relevant clinical trial registry information to peer reviewers evaluating trial manuscripts decreases discrepancies between registered and published trial outcomes. DESIGN Stepped wedge, cluster-randomised trial, with clusters comprised of eligible manuscripts submitted to each participating journal between 1 November 2018 and 31 October 2019. SETTING Thirteen medical journals. PARTICIPANTS Manuscripts were eligible for inclusion if they were submitted to a participating journal during the study period, presented results from the primary analysis of a clinical trial, and were peer reviewed. INTERVENTIONS During the control phase, there were no changes to pre-existing peer review practices. After journals crossed over into the intervention phase, peer reviewers received a data sheet describing whether trials were registered, the initial registration and enrolment dates, and the registered primary outcome(s) when enrolment began. MAIN OUTCOME MEASURE The presence of a clearly defined, prospectively registered primary outcome consistent with the primary outcome in the published trial manuscript, as determined by two independent outcome assessors. RESULTS We included 419 manuscripts (243 control and 176 intervention). Participating journals published 43% of control-phase manuscripts and 39% of intervention-phase manuscripts (model-estimated percentage difference between intervention and control trials = -10%, 95% CI -25% to 4%). Among the 173 accepted trials, published primary outcomes were consistent with clearly defined, prospectively registered primary outcomes in 40 of 105 (38%) control-phase trials and 27 of 68 (40%) intervention-phase trials. A linear mixed model did not show evidence of a statistically significant primary outcome effect from the intervention (estimated difference between intervention and control=-6% (90% CI -27% to 15%); one-sided p value=0.68). CONCLUSIONS These results do not support use of the tested intervention as implemented here to increase agreement between prospectively registered and published trial outcomes. Other approaches are needed to improve the quality of outcome reporting of clinical trials. TRIAL REGISTRATION NUMBER ISRCTN41225307.
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Affiliation(s)
- Christopher W Jones
- Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Amanda Adams
- Medical Library, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | | | - Mark A Weaver
- Mathematics and Statistics, Elon University, Elon, North Carolina, USA
| | | | - Hayat Khan
- Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Benyamin Margolis
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Sirkis T, Maitland S. Monitoring real-time junior doctor sentiment from comments on a public social media platform: a retrospective observational study. Postgrad Med J 2022:7127884. [PMID: 37073549 DOI: 10.1136/postmj/pmj-2022-142080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/06/2022] [Indexed: 04/20/2023]
Abstract
OBJECTIVES To investigate whether sentiment analysis and topic modelling can be used to monitor the sentiment and opinions of junior doctors. DESIGN Retrospective observational study based on comments on a social media website. SETTING Every publicly available comment in r/JuniorDoctorsUK on Reddit from 1 January 2018 to 31 December 2021. PARTICIPANTS 7707 Reddit users who commented in the r/JuniorDoctorsUK subreddit. MAIN OUTCOME MEASURE Sentiment (scored -1 to +1) of comments compared with results of surveys conducted by the General Medical Council. RESULTS Average comment sentiment was positive but varied significantly during the study period. Fourteen topics of discussion were identified, each associated with a different pattern of sentiment. The topic with the highest proportion of negative comments was the role of a doctor (38%), and the topic with the most positive sentiment was hospital reviews (72%). CONCLUSION Some topics discussed in social media are comparable to those queried in traditional questionnaires, whereas other topics are distinctive and offer insight into what themes junior doctors care about. Events during the coronavirus pandemic may explain the sentiment trends in the junior doctor community. Natural language processing shows significant potential in generating insights into junior doctors' opinions and sentiment.
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Affiliation(s)
- Tamir Sirkis
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Stuart Maitland
- Translational Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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14
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Shilton S, Stvilia K, Japaridze M, Tsereteli N, Usharidze D, Phevadze S, Jghenti M, Mozalevskis A, Markby J, Luhmann N, Johnson C, Nabeta P, Ongarello S, Reipold EI, Gamkrelidze A. Home-based hepatitis C self-testing in people who inject drugs and men who have sex with men in Georgia: a protocol for a randomised controlled trial. BMJ Open 2022; 12:e056243. [PMID: 36691209 PMCID: PMC9462102 DOI: 10.1136/bmjopen-2021-056243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/11/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Globally, it is estimated that more than three-quarters of people with chronic hepatitis C virus (HCV) are unaware of their HCV status. HCV self-testing (HCVST) may improve access and uptake of HCV testing particularly among key populations such as people who inject drugs (PWID) and men who have sex with men (MSM) where HCV prevalence and incidence are high and barriers to accessing health services due to stigma and discrimination are common. METHODS AND ANALYSIS This randomised controlled trial compares an online programme offering oral fluid-based HCVST delivered to the home with referral to standard-of-care HCV testing at HCV testing sites. Eligible participants are adults self-identifying as either MSM or PWID who live in Tbilisi or Batumi, Georgia, and whose current HCV status is unknown. Participants will be recruited through an online platform and randomised to one of three arms for MSM (courier delivery, peer delivery and standard-of-care HCV testing (control)) and two for PWID (peer delivery and standard-of-care HCV testing (control)). Participants in the postal delivery group will receive an HCVST kit delivered by an anonymised courier. Participants in the peer delivery groups will schedule delivery of the HCVST by a peer. Control groups will receive information on how to access standard-of-care testing at a testing site. The primary outcome is the number and proportion of participants who report completion of testing. Secondary outcomes include the number and proportion of participants who (a) receive a positive result and are made aware of their status, (b) are referred to and complete HCV RNA confirmatory testing, and (c) start treatment. Acceptability, feasibility, and attitudes around HCV testing and cost will also be evaluated. The target sample size is 1250 participants (250 per arm). ETHICS AND DISSEMINATION Ethical approval has been obtained from the National Centers for Disease Control and Public Health Georgia Institutional Review Board (IRB) (IRB# 2021-049). Study results will be disseminated by presentations at conferences and via peer-reviewed journals. Protocol version 1.1; 14 July 2021. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04961723).
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Affiliation(s)
| | - Ketevan Stvilia
- National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Nino Tsereteli
- Center for Information and Counselling on Reproductive Health-Tanadgoma, Tbilisi, Georgia
| | | | | | | | | | | | - Niklas Luhmann
- Global HIV, Hepatitis and STI Programmes, WHO Headquarters, Geneva, Switzerland
| | - Cheryl Johnson
- Global HIV, Hepatitis and STI Programmes, WHO Headquarters, Geneva, Switzerland
| | | | | | | | - Amiran Gamkrelidze
- National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia
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Ezeaka C, Fajolu I, Ezenwa B, Chukwu E, Patel S, Umoren R. Perspectives of medical students on simulation-based training: the Nigerian experience. Pan Afr Med J 2022; 43:16. [PMID: 36451726 PMCID: PMC9674531 DOI: 10.11604/pamj.2022.43.16.25542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/01/2022] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION simulation-based education (SBE) is becoming more prevalent in higher education. However, little is known of the perceptions of medical students towards this training approach. The objective of this study was to explore the perceptions of Nigerian medical students on manikin-based and virtual simulation training. METHODS in January 2019, a paper-based 25-item survey on simulation-based training was administered to a convenience sample of 120 medical students in the 4th year (400 level) and final year (600 level). Data were analysed using descriptive statistics, Pearson´s chi square, and the Fisher´s Exact test. RESULTS a total of 95 surveys were completed (RR 79%). Respondents were mostly 21-30 years 95 (81%) and about half were female 60 (51%). Under half of 600 level students 22 (38%) reported receiving simulation-based training in Basic Life Support. A lack of curriculum 27 (28%), instructors trained in simulation education 31 (33%) and funding 52 (55%) were perceived as challenges to manikin-based simulation. Lack of awareness was the greatest single challenge to online simulation 50 (53%). A majority of medical students 181 (96%) owned smartphones, but only 3% (n=3) of respondents had experienced a virtual reality (VR) simulation. If facilities were available, 99% of respondents would recommend the use of online simulation. CONCLUSION there is an opportunity for increased exposure to simulation-based training during undergraduate medical education in Nigeria. Instruction in simulation methods for clinical lecturers in medical schools would increase awareness of the potential advantages of simulation-based training and access for medical students to simulation education.
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Affiliation(s)
| | | | | | - Emeka Chukwu
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Shruti Patel
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Rachel Umoren
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
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16
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Peiris RG, Ross H, Chan CT, Poon S, Auguste BL, Rac VE, Farkouh M, McDonald M, Kaczorowski J, Code J, Duero Posada J, Ong S, Kobulnik J, Tomlinson G, Huszti E, Arcand J, Thomas SG, Akbari A, Maunder R, Grover S, Seto E, Simard A, Pope B, Bains M, McIntyre C, Torbay C, Syed F, Nolan RP. Automated digital counselling with social network support as a novel intervention for patients with heart failure: protocol for randomised controlled trial. BMJ Open 2022; 12:e059635. [PMID: 36691152 PMCID: PMC9445232 DOI: 10.1136/bmjopen-2021-059635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Heart failure (HF) symptoms improve through self-care, for which adherence remains low among patients despite the provision of education for these behaviours by clinical teams. Open Access Digital Community Promoting Self-Care, Peer Support and Health Literacy (ODYSSEE-vCHAT) combines automated digital counselling with social network support to improve mortality and morbidity, engagement with self-care materials, and health-related quality of life. METHODS AND ANALYSIS Use of ODYSSEE-vCHAT via Internet-connected personal computer by 162 HF patients will be compared with a control condition over 22 months. The primary outcome is a composite index score of all-cause mortality, all-cause emergency department visits, and HF-related hospitalisation at trial completion. Secondary outcomes include individual components of the composite index, engagement with self-care materials, and patient-reported measures of physical and psychosocial well-being, disease management, health literacy, and substance use. Patients are recruited from tertiary care hospitals in Toronto, Canada and randomised on a 1:1 ratio to both arms of the trial. Online assessments occur at baseline (t=0), months 4, 8 and 12, and trial completion. Ordinal logistic regression analyses and generalised linear models will evaluate primary and secondary outcomes. ETHICS AND DISSEMINATION The trial has been approved by the research ethics boards at the University Health Network (20-5960), Sunnybrook Hospital (5117), and Mount Sinai Hospital (21-022-E). Informed consent of eligible patients occurs in person or online. Findings will be shared with key stakeholders and the public. Results will allow for the preparation of a Canada-wide phase III trial to evaluate the efficacy of ODYSSEE-vCHAT in improving clinical outcomes and raising the standard of outpatient care. TRIAL REGISTRATION NUMBER NCT04966104.
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Affiliation(s)
- Rachel Grace Peiris
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Heather Ross
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
- Division of Cardiology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Christopher T Chan
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
- Division of Nephrology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Stephanie Poon
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
- Division of Cardiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Bourne Lewis Auguste
- Division of Nephrology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
- Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Valeria E Rac
- Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada
| | - Michael Farkouh
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
- Peter Munk Centre of Excellence in Multinational Clinical Trials, University Health Network, Toronto, Ontario, Canada
| | - Michael McDonald
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, University of Montreal Faculty of Medicine, Montreal, Quebec, Canada
| | - Jillianne Code
- Department of Curriculum and Pedagogy, University of British Columbia, Vancouver, British Columbia, Canada
- HeartLife Foundation, Vancouver, British Columbia, Canada
| | - Juan Duero Posada
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Stephanie Ong
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy Kobulnik
- Division of Cardiology, University Health Network, Toronto, Ontario, Canada
- Division of Cardiology, Sinai Health System, Toronto, Ontario, Canada
| | - George Tomlinson
- Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada
- Division of Biostatistics, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Ella Huszti
- Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Ayub Akbari
- Division of Nephrology, Ottawa Hospital, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Robert Maunder
- Department of Psychiatry, Sinai Health System, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Steven Grover
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Emily Seto
- Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Global eHealth Innovation, University Health Network, Toronto, Ontario, Canada
| | - Anne Simard
- Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada
| | - Brad Pope
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Marc Bains
- HeartLife Foundation, Vancouver, British Columbia, Canada
| | - Carmen McIntyre
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Chris Torbay
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Fatima Syed
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Robert P Nolan
- Cardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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17
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Ondersma SJ, Todd L, Jablonski S, Ahuja C, Gilstad-Hayden K, Goyert G, Loree A, Heffner J, Yonkers KA. Online randomised factorial trial of electronic Screening and Brief Intervention for alcohol use in pregnancy: a study protocol. BMJ Open 2022; 12:e062735. [PMID: 35922101 PMCID: PMC9352990 DOI: 10.1136/bmjopen-2022-062735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Approximately 1 in 7 pregnant women in the USA report past-month alcohol use. Strong evidence connects prenatal alcohol exposure with a range of adverse perinatal outcomes, including the spectrum of conditions known as fetal alcohol spectrum disorders. Screening and Brief Intervention (SBI) has been recommended for pregnant women but has proven difficult to implement. This study will test the efficacy of single-session technology-delivered SBI (electronic SBI) for alcohol use in pregnancy, while simultaneously evaluating the possible additional benefit of tailored text messages and/or booster sessions in a 3×2 factorial trial. METHOD AND ANALYSIS This full factorial trial will use online advertising and clinic-based flyers to recruit pregnant women meeting criteria for unhealthy alcohol use, and randomly assign them to one of six conditions crossing three levels of brief intervention (none, single 120-minute session and single session plus two 5-minute boosters) with two levels of tailored text messaging (none vs twice weekly messages). The primary analysis will test for dose-response effects of the brief intervention on alcohol abstinence, defined as no self-report of alcohol use in the 90 days prior to 34 weeks' gestation, and negative results for ethyl glucuronide analysis of fingernail samples. Secondary analyses will examine main and interaction effects of tailored text messaging as well as intervention effects on birth outcomes. ETHICS AND DISSEMINATION Ethical approval was provided by the Michigan State University Biomedical and Health Institutional Review Board (STUDY00005298). Results will be presented at conferences and community forums, in addition to being published in a peer-reviewed journal. Intervention content demonstrating sufficient efficacy and safety will be made publicly available. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04332172).
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Affiliation(s)
- Steven J Ondersma
- Division of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Flint, Michigan, USA
| | - Lisa Todd
- Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Samantha Jablonski
- Health Care Value-Business Analytics Division, Blue Cross Blue Shield of Michigan, Detroit, Michigan, USA
| | - Chaarushi Ahuja
- Department of Obstetrics, Gynecology, and Reproductive Science, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | | | - Gregory Goyert
- Division of Maternal Fetal Medicine, Henry Ford Health, Detroit, Michigan, USA
| | - Amy Loree
- Center for Health Policy & Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Jaimee Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kimberly A Yonkers
- Departments of Psychiatry and Obstetrics & Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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O'Hagan E, Traeger AC, Schabrun SM, O'Neill S, Wand BM, Cashin A, Williams CM, Harris IA, McAuley JH. It's safe to move! A protocol for a randomised controlled trial investigating the effect of a video designed to increase people's confidence becoming more active despite back pain. BMJ Open 2022; 12:e063250. [PMID: 35840303 PMCID: PMC9295673 DOI: 10.1136/bmjopen-2022-063250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Social media provide promising contemporary platforms for sharing public health information with a broad audience. Before implementation, testing social media campaigns that are intended to engage audiences and initiate behaviour change is necessary. This trial aims to investigate the effectiveness of a public health campaign to increase people's confidence in becoming more active despite low back pain in comparison with no intervention. METHODS AND ANALYSIS This is an online randomised controlled trial with two intervention groups and one control group in a 1:1:1 allocation. People over 18 years of age and fluent in English will be recruited via social media advertising. We developed a social media-based public health campaign to support recommendations for managing low back pain. The interventions are two videos. Participants in the control group will be asked questions about low back pain but will not view either video intervention. The primary outcome will be item 10 of the Pain Self-Efficacy Questionnaire, which asks participants to rate how confident they would feel to gradually become more active despite pain ranging from 0 (not at all confident) to 6 (completely confident). This outcome will be measured immediately in all participant groups. We will compare group mean of the three arms of the trial using univariate analyses of variance. ETHICS AND DISSEMINATION This trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry. We obtained ethical approval from our institutions Human Research Ethics Committee before data collection. We will publish the results in a peer-reviewed medical journal and on institution websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12622000466741).
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Affiliation(s)
- Edel O'Hagan
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales, Australia
- Maridulu Budyari Gumal, Sydney, New South Wales, Australia
| | - Adrian C Traeger
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Siobhan M Schabrun
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- Maridulu Budyari Gumal, Sydney, New South Wales, Australia
| | - Sean O'Neill
- Maridulu Budyari Gumal, Sydney, New South Wales, Australia
- South Western Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Benedict Martin Wand
- Faculty of Medicine, Nursing & Midwifery and Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Aidan Cashin
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Michael Williams
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Ian A Harris
- Maridulu Budyari Gumal, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- South Western Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia
| | - James H McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
- Maridulu Budyari Gumal, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Rimmer M, Elfaki N, Dunlop C, Coleburt D, Cowan N, Raglan O, Teh JJ, Fisher M, Mcrobbie S, Murugesu N, Ramcharn M, Abdelrahman M, Jibrel Y, Wood M, Parry-Smith W, Al Wattar BH. Effectiveness of a web-based virtual journal club to promote medical education (Web-Ed): protocol of a multicentre pragmatic randomised trial. BMJ Open 2022; 12:e058610. [PMID: 35710241 PMCID: PMC9207906 DOI: 10.1136/bmjopen-2021-058610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION A journal club (JC) is a commonly used medical educational tool. Videoconferencing technology can facilitate the delivery of JCs, however, there remains no evidence on the role of web-based virtual JCs in promoting the acquisition and retention of medical knowledge. The Web-Ed trial aims to evaluate the educational benefits, feasibility and acceptability of web-based virtual JCs compared with traditional face-to-face ones. METHODS AND ANALYSIS Web-Ed is a multicentre pragmatic parallel-group randomised trial across teaching hospitals within the UK National Health Service (NHS). We will enrol qualified doctors or medical students who are >18 years old, proficient in English and able to use online videoconferencing software. Block randomisation will be used to allocate participants in 1:1 ratio to either intervention group. Both groups will be presented with the same educational material and follow a standardised JC structure hosted by nominated moderators and medical faculty members.The primary outcome is the difference in participants' knowledge acquisition and retention 7 days after the JCs evaluated using standardised multiple-choice questions. We will report secondarily on the feasibility and acceptability of the JCs using Likert scale questionnaires. Assuming a 30% drop-out rate, we aim to enrol 75 participants to detect a 20% improvement in knowledge acquisition at 80% power and 5% significance. We will report using mean difference or risk ratio with 95% CIs and assess significance using parametric/non-parametric testing. Where relevant, we will adjust for predetermined characteristics (age, grade of training and session duration) using multivariate regression analyses. ETHICS AND DISSEMINATION Web-Ed was designed by doctors in training to address their learning needs and evaluate the preferred mode of learning. The trial results will be published in peer-reviewed journals and presented at relevant scientific conferences. The trial has been approved by the NHS Health Regulation Authority (21/HRA/3361). TRIAL REGISTRATION NUMBER ISRCTN18036769.
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Affiliation(s)
- Michael Rimmer
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Nagla Elfaki
- Reproductive Medicine Unit, University College London, London, UK
| | - Cheryl Dunlop
- Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Damien Coleburt
- Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, UK
| | - Neil Cowan
- Wishaw University Hospital, NHS Lanarkshire, Bothwell, UK
| | | | - Jhia Jiat Teh
- Faculty of Medicine, Imperial College London, London, UK
| | - Maria Fisher
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | | | - Meera Ramcharn
- University Hospital of Wales Healthcare NHS Trust, Cardiff, UK
| | | | - Yazid Jibrel
- Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Matthew Wood
- Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - William Parry-Smith
- Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
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Lei XG, Huang Z, Rashi T, Yang X. Effectiveness of mHealth/eHealth interventions on obesity treatment: a protocol for umbrella review of meta-analyses. BMJ Open 2022; 12:e052443. [PMID: 35667735 PMCID: PMC9171196 DOI: 10.1136/bmjopen-2021-052443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Mobile health (mHealth)/electronic health (eHealth) have the effect of facilitating weight loss in overweight and obese populations. However, studies have shown varied results and relatively high heterogeneity in the efficacy of mHealth/eHealth interventions. The aim of the paper was to systematically summarise published studies about the weight loss efficacy of mHealth/eHealth. METHODS AND ANALYSIS A comprehensive review of PubMed, Embase and Cochrane Library databases published from inception to 21 March 2021 will be conducted. The selected articles are meta-analyses that integrated the studies, which evaluated efficacy of mHealth/eHealth. Two people will select eligible articles and extract data independently. Any disputes will be resolved by discussion or the arbitration of a third person. The methodological quality of the included meta-analyses will be assessed with AMSTAR V.2 and the quality of evidence will be obtained with Grade of Recommendations Assessment, Development and Evaluation (GRADE). The study selection process will be presented using a flowchart. We will reanalyse each outcome with random effect methods. If possible, we will use funnel plot and Egger's test to evaluate if publication bias existed. ETHICS AND DISSEMINATION Ethical approval is not required for the study, as we collected data only from available published materials. This umbrella review will also be submitted to a peer-reviewed journal for publication after completion. PROSPERO REGISTRATION NUMBER CRD42021247006.
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Affiliation(s)
- Xiang-Guo Lei
- Geriatrics Department of Endocrinology and Metabolism, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Zhongheng Huang
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China
| | - Tamrakar Rashi
- Geriatrics Department of Endocrinology and Metabolism, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Xi Yang
- Geriatrics Department of Endocrinology and Metabolism, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Cardiocerebrovascular Diseases, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
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21
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Groves-Williams D, McHugh GA, Bennell KL, Comer C, Hensor EMA, Conner M, Nelligan RK, Hinman RS, Kingsbury SR, Conaghan PG. Evaluation of two electronic-rehabilitation programmes for persistent knee pain: protocol for a randomised feasibility trial. BMJ Open 2022; 12:e063608. [PMID: 36194515 PMCID: PMC9171213 DOI: 10.1136/bmjopen-2022-063608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/20/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Persistent, knee pain is a common cause of disability. Education and exercise treatment are advocated in all clinical guidelines; however, the increasing prevalence of persistent knee pain presents challenges for health services regarding appropriate and scalable delivery of these treatments. Digital technologies may help address this, and this trial will evaluate the feasibility and acceptability of two electronic-rehabilitation interventions: 'My Knee UK' and 'Group E-Rehab'. METHODS AND ANALYSIS This protocol describes a non-blinded, randomised feasibility trial with three parallel groups. The trial aims to recruit 90 participants (45 years or older) with a history of persistent knee pain consistent with a clinical diagnosis of knee osteoarthritis. Participants will be randomly assigned in a 1:1:1 allocation ratio. The 'My Knee UK' intervention arm will receive a self-directed unsupervised internet-based home exercise programme plus short message service support (targeting exercise behaviour change) for 12 weeks; the 'Group E-Rehab' intervention arm will receive group-based physiotherapist-prescribed home exercises delivered via videoconferencing accompanied by internet-interactive educational sessions for 12 weeks; the control arm will receive usual physiotherapy care or continue with their usual self-management (depending on their recruitment path). Feasibility variables, patient-reported outcomes and clinical findings measured at baseline, 3 and 9 months will be assessed and integrated with qualitative interview data from a subset of Group E-Rehab and My Knee UK participants. If considered feasible and acceptable, a definitive randomised controlled trial can be conducted to investigate the clinical effectiveness and cost-effectiveness of one or both interventions with a view to implementation in routine care. ETHICS AND DISSEMINATION The trial was approved by the West of Scotland Research Ethics Committee 5 (Reference: 20/WS/0006). The results of the study will be disseminated to study participants, the study grant funder and will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN15564385.
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Affiliation(s)
- Dawn Groves-Williams
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
| | - Gretl A McHugh
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Kim L Bennell
- Department of Physiotherapy, The University of Melbourne Centre for Health Exercise and Sports Medicine, Melbourne, Victoria, Australia
| | - Christine Comer
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
- Musculoskeletal and Rehabilitation Service, Leeds Community Healthcare NHS Trust, Leeds, West Yorkshire, UK
| | - Elizabeth M A Hensor
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
- NIHR Leeds Biomedical Research Centre, Leeds, West Yorkshire, UK
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Rachel K Nelligan
- Department of Physiotherapy, The University of Melbourne Centre for Health Exercise and Sports Medicine, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Department of Physiotherapy, The University of Melbourne Centre for Health Exercise and Sports Medicine, Melbourne, Victoria, Australia
| | - Sarah R Kingsbury
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
- NIHR Leeds Biomedical Research Centre, Leeds, West Yorkshire, UK
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
- NIHR Leeds Biomedical Research Centre, Leeds, West Yorkshire, UK
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22
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Kothari A, Foisey L, Donelle L, Bauer M. How do Canadian public health agencies respond to the COVID-19 emergency using social media: a protocol for a case study using content and sentiment analysis. BMJ Open 2021; 11:e041818. [PMID: 33888527 PMCID: PMC8068947 DOI: 10.1136/bmjopen-2020-041818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Keeping Canadians safe requires a robust public health (PH) system. This is especially true when there is a PH emergency, like the COVID-19 pandemic. Social media, like Twitter and Facebook, is an important information channel because most people use the internet for their health information. The PH sector can use social media during emergency events for (1) PH messaging, (2) monitoring misinformation, and (3) responding to questions and concerns raised by the public. In this study, we ask: what is the Canadian PH risk communication response to the COVID-19 pandemic in the context of social media? METHODS AND ANALYSIS We will conduct a case study using content and sentiment analysis to examine how provinces and provincial PH leaders, and the Public Health Agency of Canada and national public heath leaders, engage with the public using social media during the first wave of the pandemic (1 January-3 September 2020). We will focus specifically on Twitter and Facebook. We will compare findings to a gold standard during the emergency with respect to message content. ETHICS AND DISSEMINATION Western University's research ethics boards confirmed that this study does not require research ethics board review as we are using social media data in the public domain. Using our study findings, we will work with PH stakeholders to collaboratively develop Canadian social media emergency response guideline recommendations for PH and other health system organisations. Findings will also be disseminated through peer-reviewed journal articles and conference presentations.
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Affiliation(s)
- Anita Kothari
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Lyndsay Foisey
- Health Information Science Graduate Program, Western University, London, Ontario, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michael Bauer
- Department of Computer Sciences, Faculty of Science, Western University, London, Ontario, Canada
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23
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Treadgold BM, Teasdale E, Muller I, Roberts A, Coulson N, Santer M. Parents and carers' experiences of seeking health information and support online for long-term physical childhood conditions: a systematic review and thematic synthesis of qualitative research. BMJ Open 2020; 10:e042139. [PMID: 33372077 PMCID: PMC7772330 DOI: 10.1136/bmjopen-2020-042139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To systematically review and synthesise qualitative research exploring parents/carers' experiences of seeking online information and support for long-term physical childhood conditions. DESIGN Systematic review and thematic synthesis of qualitative research. DATA SOURCES Medline, CINAHL, Embase, PsycINFO and the International Bibliography of the Social Sciences were searched from inception to September 2019. We used thematic synthesis to analyse findings. ELIGIBILITY CRITERIA Primary research papers presenting qualitative data collection and analysis, focusing on parents/carers' experiences of seeking health information and support from online resources for long-term physical childhood health conditions. No language restrictions were placed. RESULTS 23 studies from seven countries met inclusion criteria and were included in the synthesis. Included studies presented data collected through interviews/focus groups with 559 parents/carers; free-text surveys and essays with 26 parents/carers and 2407 messages from online support groups. Parents/carers developed a variety of strategies to obtain information and support online, based on personal preferences, appraisal of trustworthiness, perceived needs and previous experiences online. Many parents sought the benefits of online information and support, which included reassurance and validation from online communities, and feeling they had greater knowledge about their children's conditions. Some concerns and perceived risks were discussed, which often stemmed from prior unsatisfactory experiences of seeking information and support online, consultations with health professionals and seeing distressing stories online. CONCLUSION Most parents/carers were successful in obtaining information and support online. Many continued to share experiences with other parents/carers online. The need for information was particularly apparent early after diagnosis of the condition, whereas the need for peer support continued. The potential concerns and perceived risks with information and support online were especially apparent among parents/carers of children with life-limiting long-term conditions. Findings may be useful for health professionals to facilitate discussions regarding use of online resources, and researchers designing online health resources for parents/carers. PROSPERO REGISTRATION NUMBER CRD42018096009.
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Affiliation(s)
- Bethan Mair Treadgold
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Emma Teasdale
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ingrid Muller
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Amanda Roberts
- Centre of Evidence-Based Dermatology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Neil Coulson
- Division of Rehabilitation, Ageing and Wellbeing, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Miriam Santer
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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Deepika V, Soundariya K, Karthikeyan K, Kalaiselvan G. 'Learning from home': role of e-learning methodologies and tools during novel coronavirus pandemic outbreak. Postgrad Med J 2020; 97:590-597. [PMID: 33154099 DOI: 10.1136/postgradmedj-2020-137989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/20/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND During the crucial time of coronavirus pandemic, education is being remodelled: opening the doors of electronic learning (e-learning). The review emphasises on the various e-learning methods that can be used in the current scenario. METHODS The review was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines on databases, namely, PubMed, Google Scholar and Cochrane. Out of 1524 identified articles, after the process of screening and based on the eligibility criteria, 45 full-text articles were reviewed. RESULTS Though there are many caveats on the path of successful implementation this is the right time that we step towards e-learning. The article discusses the methods and tools in e-learning that can modify the traditional ways of content delivery, record maintenance, assessment and feedback. CONCLUSION During the period of 'planet arrest', when the whole world is locked down with the motive of social distancing, let us stay connected with e-learning.
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Affiliation(s)
- Velusami Deepika
- Department of Physiology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India .,Medical Education Unit, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Krishnamurthy Soundariya
- Department of Physiology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.,Medical Education Unit, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Kaliaperumal Karthikeyan
- Medical Education Unit, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.,Department of of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Ganapathy Kalaiselvan
- Medical Education Unit, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.,Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Ricci L, Epstein J, Buisson A, Devos C, Toussaint Y, Peyrin-Biroulet L, Guillemin F. Flare-IBD: development and validation of a questionnaire based on patients' messages on an internet forum for early detection of flare in inflammatory bowel disease: study protocol. BMJ Open 2020; 10:e037211. [PMID: 32611745 PMCID: PMC7332197 DOI: 10.1136/bmjopen-2020-037211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Crohn's disease and ulcerative colitis, the two major forms of inflammatory bowel disease (IBD), are chronic disabling conditions characterised by flares followed by periods of remission. However, patients with IBD are seen every 3-6 months in the outpatient clinic, and the occurrence of a flare between two outpatient visits is not captured. To our knowledge, there is no validated patient-reported outcome (PRO) tool to measure the phenomenon of flare in IBD. This study aimed to use an innovative methodology to collect messages posted by patients in an internet forum for developing and validating a PRO measuring flare in IBD. METHODS AND ANALYSIS The design involves (1) computer engineering sciences for scraping extraction of messages posted in an internet forum and for identification of messages related to flare; (2) qualitative methods for thematic content analyse of the messages posted, for candidate items generation, for items selection (Delphi process) and for items adjustment ('think-aloud' interviews) and (3) quantitative methods for psychometric validation of the PRO. ETHICS AND DISSEMINATION Ethical approval was obtained from the Comité de Protection des Personnes (CPP) CPP Nord-Ouest I (19.07.15.44139) in November 2019. The project aims to provide a tool to evaluate IBD flare in current medical practice that is constructed with patients' perspectives. Items generation from a source corresponding to exchanges in an internet forum is an innovative method in this field and provides a wider coverage of qualitative data. If such a forum can result in interesting material, then this could be a new methodological perspective for generating items for questionnaires. Findings will be reported and disseminated widely through international peer-reviewed journal publications, oral and poster presentations at scientific conferences. TRIAL REGISTRATION NUMBER NCT04180345.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France, Nancy, France
| | - Jonathan Epstein
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France, Nancy, France
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | | | | | - Yannick Toussaint
- Laboratoire lorrain de recherche en informatique et ses applications, Université de Lorraine, Nancy, France
| | - Laurent Peyrin-Biroulet
- INSERM, U1256 NGERE and gastroenterology Department, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France, Nancy, France
- Université de Lorraine, APEMAC, F-54000, Nancy, France
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Coumoundouros C, von Essen L, Sanderman R, Woodford J. Implementation of e-mental health interventions for informal caregivers of adults with chronic diseases: a protocol for a mixed-methods systematic review with a qualitative comparative analysis. BMJ Open 2020; 10:e035406. [PMID: 32565461 PMCID: PMC7307546 DOI: 10.1136/bmjopen-2019-035406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Informal caregivers provide the majority of care to individuals with chronic health conditions, benefiting the care recipient and reducing use of formal care services. However, providing informal care negatively impacts the mental health of many caregivers. E-mental health interventions have emerged as a way to provide accessible mental healthcare to caregivers. Much attention has been given to reviewing the effectiveness and efficacy of such interventions, however, factors related to implementation have received less consideration. Therefore, this mixed-methods systematic review will aim to examine factors associated with the effectiveness and implementation of e-mental health interventions for caregivers. METHODS AND ANALYSIS Eligible studies published since 1 January 2007 will be searched for in several electronic databases (CINAHL Plus with Full Text, the Cochrane Library, EMBASE, PsycINFO, PubMed and Web of Science), clinical trial registries and OpenGrey, with all screening steps conducted by two independent reviewers. Studies will be included if they focus on the implementation or effectiveness of e-mental health interventions designed for informal adult caregivers of adults with cancer, heart disease, stroke, diabetes, dementia or chronic obstructive pulmonary disease. Pragmatic randomised controlled trials quantitatively reporting on caregiver anxiety, depression, psychological distress or stress will be used for a qualitative comparative analysis to identify combinations of conditions that result in effective interventions. Qualitative and quantitative data on implementation of e-mental health interventions for caregivers will be integrated in a thematic synthesis to identify barriers and facilitators to implementation. These results will inform future development and implementation planning of e-mental health interventions for caregivers. ETHICS AND DISSEMINATION Ethical approval is not required for this study as no primary data will be collected. Results will be disseminated in the form of a scientific publication and presentations at academic conferences and plain language summaries for various stakeholders. PROSPERO REGISTRATION NUMBER CRD42020155727.
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Affiliation(s)
- Chelsea Coumoundouros
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Robbert Sanderman
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Carrillo-Larco RM, Tudor Car L, Pearson-Stuttard J, Panch T, Miranda JJ, Atun R. Machine learning health-related applications in low-income and middle-income countries: a scoping review protocol. BMJ Open 2020; 10:e035983. [PMID: 32393612 PMCID: PMC7223147 DOI: 10.1136/bmjopen-2019-035983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Machine learning (ML) has been used in bio-medical research, and recently in clinical and public health research. However, much of the available evidence comes from high-income countries, where different health profiles challenge the application of this research to low/middle-income countries (LMICs). It is largely unknown what ML applications are available for LMICs that can support and advance clinical medicine and public health. We aim to address this gap by conducting a scoping review of health-related ML applications in LMICs. METHODS AND ANALYSIS This scoping review will follow the methodology proposed by Levac et al. The search strategy is informed by recent systematic reviews of ML health-related applications. We will search Embase, Medline and Global Health (through Ovid), Cochrane and Google Scholar; we will present the date of our searches in the final review. Titles and abstracts will be screened by two reviewers independently; selected reports will be studied by two reviewers independently. Reports will be included if they are primary research where data have been analysed, ML techniques have been used on data from LMICs and they aimed to improve health-related outcomes. We will synthesise the information following evidence mapping recommendations. ETHICS AND DISSEMINATION The review will provide a comprehensive list of health-related ML applications in LMICs. The results will be disseminated through scientific publications. We also plan to launch a website where ML models can be hosted so that researchers, policymakers and the general public can readily access them.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Jonathan Pearson-Stuttard
- Department of Epidemiology and Biostatistics and MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | | | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rifat Atun
- Harvard T.H Chan School of Public Health and Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA
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Armitage LC, Kassavou A, Sutton S. Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis. BMJ Open 2020; 10:e032045. [PMID: 32005778 PMCID: PMC7045248 DOI: 10.1136/bmjopen-2019-032045] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To estimate the efficacy of app-based interventions designed to support medication adherence and investigate which behaviour change techniques (BCTs) used by the apps are associated with efficacy. DESIGN Systematic review of randomised controlled trials (RCTs), with meta-analysis. SETTING Medline/PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Embase and Web of Science were searched from 1990 to November 2018 for RCTs conducted in any healthcare setting. PARTICIPANTS Studies of participants of any age taking prescribed medication for any health condition and for any duration. INTERVENTION An app-based intervention delivered through a smartphone, tablet computer or personal digital assistant to help, support or advise about medication adherence. COMPARATOR One of (1) usual care, (2) a control app which did not use any BCTs to improve medication adherence or (3) a non-app-based comparator. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the pooled effect size of changes in medication adherence. The secondary outcome was the association between BCTs used by the apps and the effect size. RESULTS The initial search identified 13 259 citations. After title and abstract screening, full-text articles of 83 studies were screened for eligibility. Nine RCTs with 1159 recruited participants were included. The mean age of participants was >50 years in all but one study. Health conditions of target populations included cardiovascular disease, depression, Parkinson's disease, psoriasis and multimorbidity. The meta-analysis indicated that patients who use mobile apps to support them in taking medications are more likely to self-report adherence to medications (OR 2.120, 95% CI 1.635 to 2.747, n=988) than those in the comparator groups. Meta-regression of the BCTs did not reveal any significant associations with effect size. CONCLUSIONS App-based medication adherence interventions may have a positive effect on patient adherence. Larger scale studies are required to further evaluate this effect, including long-term sustainability, and intervention and participant characteristics that are associated with efficacy and app usage. PROSPERO REGISTRATION NUMBER PROSPERO Protocol Registration Number: CRD42017080150.
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Affiliation(s)
- Laura Catherine Armitage
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Aikaterini Kassavou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Abstract
OBJECTIVES To review the nature and scope of apps targeting individuals living with and beyond cancer. DESIGN Scoping review, searching the two largest app stores, Google Play and Apple's App store. App descriptions were exported verbatim, and summarised descriptively, thematically and by content coding. RESULTS We included 151 apps targeting individuals living with and beyond cancer. Most targeted all cancer types (n=89, 58.9%) or breast cancer (n=22, 14.6%) and originated in the USA (n=68, 45.0%). The country of origin was unclear for 31 (20.5%) apps. Most apps were developed by commercial companies/private individuals (n=64, 43%) or non-profit organisations (n=30, 19.9%) and marketed apps in terms of fighting metaphors, navigating a journey and becoming empowered to take control.App content could be summarised under five main categories: (1) imparting information about cancer; (2) planning and organising cancer care; (3) interacting with others (including others affected by cancer and healthcare professionals); (4) enacting management strategies and adjusting to life with or beyond cancer and (5) getting feedback about cancer management, for example, by sharing self-monitoring reports with professionals. We found some apps describing 'cures' for cancer or selling products, such as alkaline waters to cancer survivors. CONCLUSIONS Apps are currently available via on-line stores that cover a large spectrum of cancer survivorship activities. The effects of such apps on clinical consultations, patient work/burden and clinical outcomes merit further attention. Most apps are developed by commercial organisations, and promises of empowerment in the 'fight' against cancer are tempered by the potential for exaggerated claims and exploitation.
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Affiliation(s)
- Rosalind Adam
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Drew McMichael
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Daniel Powell
- Aberdeen Health Psychology Group, Institue of Applied Health Sciences, Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Peter Murchie
- Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Abstract
OBJECTIVES To determine the accuracy of the recruitment status listed on ClinicalTrials.gov as compared with the actual trial status. DESIGN Cross-sectional analysis. SETTING Random sample of interventional phase 2-4 clinical trials registered between 2010 and 2012 on ClinicalTrials.gov. PRIMARY OUTCOME MEASURE For each trial which was listed within ClinicalTrials.gov as ongoing, two investigators performed a comprehensive literature search for evidence that the trial had actually been completed. For each trial listed as completed or terminated early by ClinicalTrials.gov, we compared the date that the trial was actually concluded with the date the registry was updated to reflect the study's conclusion status. RESULTS Among the 405 included trials, 92 had a registry status indicating that study activity was either ongoing or the recruitment status was unknown. Of these, published results were available for 34 (37%). Among the 313 concluded trials, the median delay between study completion and a registry update reflecting that the study had ended was 141 days (IQR 48-419), with delays of over 1 year present for 29%. In total, 125 trials (31%) either had a listed recruitment status which was incorrect or had a delay of more than 1 year between the time the study was concluded and the time the registry recruitment status was updated. CONCLUSIONS At present, registry recruitment status information in ClinicalTrials.gov is often outdated or wrong. This inaccuracy has implications for the ability of researchers to identify completed trials and accurately characterise all available medical knowledge on a given subject.
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Affiliation(s)
- Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Michelle R Safferman
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Amanda C Adams
- Medical Library, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Timothy F Platts-Mills
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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