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Nedergård H, Sandlund M, Häger CK, Palmcrantz S. Users' experiences of intensive robotic-assisted gait training post-stroke - "a push forward or feeling pushed around?". Disabil Rehabil 2023; 45:3861-3868. [PMID: 36342771 DOI: 10.1080/09638288.2022.2140848] [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] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Robotic-assisted gait training (RAGT) is suggested to improve walking ability after stroke. The purpose of this study was to describe experiences of robotic-assisted gait training as part of a gait training intervention among persons in the chronic phase after stroke. MATERIALS AND METHODS Semi-structured interviews were performed with 13 participants after a 6-week intervention including treadmill gait training with the Hybrid Assistive Limb® (HAL) exoskeleton. Data were analysed using qualitative content analysis. RESULTS Four categories emerged: (1) A rare opportunity for potential improvements describes the mindset before the start of the intervention; (2) Being pushed to the limit represents the experience of engaging in intensive gait training; (3) Walking with both resistance and constraints reveals barriers and facilitators during HAL training; (4) Reaching the end and taking the next step alone illustrates feelings of confidence or concern as the intervention ended. CONCLUSIONS The gait training intervention including RAGT was considered demanding but appreciated. Support and concrete, individual feedback was crucial for motivation, whilst the lack of variation was a barrier. Results encourage further development of exoskeletons that are comfortable to wear and stimulate active participation by enabling smoothly synchronised movements performed during task-specific activities in different environments. IMPLICATIONS FOR REHABILITATIONWhen provided in a suitable context, the mental and physical challenges of intensive robotic-assisted gait training can be both inspiring and motivating.Support and engagement along with informative feedback from therapists are suggested crucial for motivation.Intensive task-specific gait training may preferably be performed in an enriched environment and combined with other physiotherapy treatments to stimulate engagement.
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Affiliation(s)
- Heidi Nedergård
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Susanne Palmcrantz
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Ownsworth T, Mitchell J, Griffin J, Bell R, Gibson E, Shirota C. Electronic Assistive Technology to Support Memory Function After Traumatic Brain Injury: A Systematic Review of Efficacy and User Perspectives. J Neurotrauma 2023; 40:1533-1556. [PMID: 36792919 DOI: 10.1089/neu.2022.0434] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Abstract Rapid technology advances have led to diverse assistive technology (AT) options for use in memory rehabilitation after traumatic brain injury (TBI). This systematic review aimed to evaluate the efficacy of electronic AT for supporting phases of memory in daily life after TBI. A secondary aim was to examine user perspectives on the utility of AT and factors influencing uptake or use. A systematic search of PsycINFO, MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica database (Embase), Scopus, and Cochrane Library was conducted from database inception to June 13, 2022, to identify eligible studies. Methodological quality was assessed by two independent reviewers. Nineteen eligible articles involving a total of 311 participants included four randomized controlled trials (RCTs; Class I), five single-case experimental designs (Class II), and 10 pre-post group (n > 10) or single-case studies without experimental control (Class III). Three Class I studies, two Class II studies and eight Class III studies supported the efficacy of AT for supporting memory functioning. Treatment fidelity was not examined in any study. There was the most empirical support for the efficacy of AT for facilitating retrieval and execution phases of memory (i.e., supported by 6/9 studies) with external support to encode memory intentions or pre-programmed reminders. Further controlled studies are needed to determine whether outcomes vary according to individuals' level of independence with use (e.g., self-initiated vs. pre-programmed reminders) and to examine user characteristics and design features influencing uptake and effectiveness. Greater involvement of end-users with brain injury in the design and evaluation of AT features is also recommended to enhance usability and uptake in daily life.
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Affiliation(s)
- Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Janelle Griffin
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ryan Bell
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Emily Gibson
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
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Joseph L, Greenfield S, Manaseki‐Holland S, T. R. L, S. S, Panniyammakal J, Lavis A. Patients', carers' and healthcare providers' views of patient-held health records in Kerala, India: A qualitative exploratory study. Health Expect 2023; 26:1081-1095. [PMID: 36782391 PMCID: PMC10154823 DOI: 10.1111/hex.13721] [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: 02/10/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Poor medical information transfer across healthcare visits and providers poses a potential threat to patient safety. Patient-held health records (PHRs) may be used to facilitate informational continuity, handover communication and patient self-management. However, there are conflicting opinions on the effectiveness of PHRs, other than in maternal and child care. Moreover, the experiences of users of PHRs in low- and middle-income countries are critical in policy decisions but have rarely been researched. AIM This study aimed to explore similarities and differences in the perspectives of patients, carers and healthcare providers (HCPs) on the current PHRs for diabetes and hypertension in Kerala. METHODS A qualitative design was used comprising semistructured interviews with patients with diabetes/hypertension (n = 20), carers (n = 15) and HCPs (n = 17) in Kerala, India. Data were analysed using thematic analysis. RESULTS Themes generated regarding the experiences with PHRs from each user group were compared and contrasted. The themes that arose were organized under three headings: use of PHRs in everyday practice; the perceived value of PHR and where practice and value conflict. We found that in the use of PHRs in everyday practice, multiple PHRs posed challenges for patients carrying records and for HCPs locating relevant information. Most carers carried all patients' past PHRs, while patients made decisions on which PHR to take along based on the purpose of the healthcare visit. HCPs appreciated having PHRs but documented limited details in them. The perceived value of PHRs by each group for themselves was different. While HCPs placed value on PHRs for enabling better clinical decision-making, preventing errors and patient safety, patients perceived them as transactional tools for diabetes and hypertension medications; carers highlighted their value during emergencies. CONCLUSION Our findings suggest that users find a variety of values for PHRs. However, these perceived values are different for each user group, suggesting minimal functioning of PHRs for informational continuity, handover communication and self-management. PATIENT AND PUBLIC INVOLVEMENT Patients and carers were involved during the pilot testing of topic guides, consent and study information sheets. Patients and carers gave their feedback on the materials to ensure clarity and appropriateness within the context.
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Affiliation(s)
- Linju Joseph
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of Birmingham EdgbastonBirminghamUK
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of Birmingham EdgbastonBirminghamUK
| | - Semira Manaseki‐Holland
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of Birmingham EdgbastonBirminghamUK
| | - Lekha T. R.
- Achutha Menon Centre for Health Science StudiesSree Chitra Tirunal Institute for Medical Sciences and TechnologyTrivandrumKeralaIndia
| | - Sujakumari S.
- Achutha Menon Centre for Health Science StudiesSree Chitra Tirunal Institute for Medical Sciences and TechnologyTrivandrumKeralaIndia
| | - Jeemon Panniyammakal
- Achutha Menon Centre for Health Science StudiesSree Chitra Tirunal Institute for Medical Sciences and TechnologyTrivandrumKeralaIndia
| | - Anna Lavis
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of Birmingham EdgbastonBirminghamUK
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Mooney J, Dominic A, Lewis A, Chafe R. Young adults with eating disorders perspectives on educational resources to support the transition into adult medicine: a thematic analysis. J Eat Disord 2023; 11:46. [PMID: 36959660 PMCID: PMC10034871 DOI: 10.1186/s40337-023-00771-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
Background Eating disorders (EDs) commonly develop in adolescence and can be a chronic condition. Once patients reach the age when it is no longer permitted or appropriate for them to be seen in a children’s healthcare setting, they will need to transition into adult-focused care. This transition period can be challenging, with increased risks of negative health outcomes and disruptions in care. Appropriate educational resources could be an effective support for patients during this transition. Our objectives were to engage patients about the value of developing educational supports and determine how these supports should be structured to be most useful to young adults with EDs. Methods Patients who had transitioned out of a hospital-based ED program between 2017 and 2020 were invited to participate in a semi-structured interview. Data were analyzed using thematic analysis and qualitative description. Results Six young adults (5 females and 1 male) with EDs were interviewed. All participants thought it would be helpful to have an educational resource. Three main themes and seven subthemes were identified. Themes identified related to the unique challenges of transition for ED patients given the age of onset and cycle of symptoms; issues in adult care related to comorbidities and new level of autonomy; and the value of educational resources as both a connection tool and a benchmark. Participants also thought it would be useful to include in any educational resource a summary of their previous treatments, information regarding the transition process, a list of main healthcare providers they saw for their ED, a description of the differences and expectations of the adult system, a list of their follow up appointments, and a list of community and emergency mental health resources. Conclusions Participants said that educational supports can play a useful role for young adults with EDs during their transition into adult care. They also provided valuable insights into the desired contents of such supports and expanded on the roles that educational resources could serve for ED patients. Most adolescents who have an eating disorder will reach an age when it is no longer appropriate for them to receive care in a children’s health program. They will then need to transition to an adult-focused program. This transition period can be challenging, with increased risks of negative health outcomes and disruptions in care. One approach for better supporting patients during transition is through the development of appropriate educational resources. Before developing these resources, it is important to hear from patients about how they should be structured to be as useful as possible. We interviewed six patients who had recently transitioned out of a pediatric eating disorder program about the value of an educational transition resource and what should be included in it. Patients identified several unique transition issues for young adults with eating disorders. We identified valuable insights and seven key themes from these interviews. While all patients recognized the value of educational resources, rather than being just a static source of information, they envisioned a resource that could also be a dynamic record of their previous care and a tool for engaging with their new adult-focused health care providers.
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Affiliation(s)
- Jennifer Mooney
- grid.17091.3e0000 0001 2288 9830Division of Adolescent Health and Medicine, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Anna Dominic
- grid.25055.370000 0000 9130 6822Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, Room 409, Janeway Hostel, 300 Prince Phillip Drive, St. John’s, NL A1B 3V6 Canada
| | - Alyona Lewis
- grid.25055.370000 0000 9130 6822Canadian Longitudinal Study On Aging (CLSA), Memorial University of Newfoundland, St. John’s, Canada
| | - Roger Chafe
- grid.25055.370000 0000 9130 6822Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, Room 409, Janeway Hostel, 300 Prince Phillip Drive, St. John’s, NL A1B 3V6 Canada
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Holm S, Petersen MA, Enghoff O, Hesse M. Psychedelic discourses: A qualitative study of discussions in a Danish online forum. Int J Drug Policy 2023; 112:103945. [PMID: 36669238 DOI: 10.1016/j.drugpo.2022.103945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND This study focuses on user-perspectives related to norms, beliefs and practices concerning psychedelic substances as they are articulated in a Danish online forum. The study combines an interest in online drug research with a focus on discourse analysis to account for the dialectical relationship between individual and shared knowledge regarding the use and meaning of psychedelics. METHODS A total of 1,865 posts from 154 threads of online discussion were coded and analyzed thematically, inspired by a socio-cognitive approach to the study of discourse. All topics were arranged into 54 categories which were further analyzed to map recurring patterns in the construction of meaning resulting in a limited number of dominant discourses. RESULTS Five dominant discourses were identified: the recreational, the therapeutic, the spiritual, the scientific and the performance discourse. We suggest that these discourses can be seen as the available frameworks which forum users draw upon and reproduce when they describe, discuss, and negotiate their understandings and uses of psychedelics. CONCLUSION This study demonstrates the importance of having a nuanced approach to user perceptions. Future drug policy and practice development should take these nuances into account and expect significant variation in the motives and modalities of the use of psychedelics.
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Cerdan de las Heras J, Andersen SL, Matthies S, Sandreva TV, Johannesen CK, Nielsen TL, Fuglebjerg N, Catalan-Matamoros D, Hansen DG, Fischer TK. Hospitalisation at Home of Patients with COVID-19: A Qualitative Study of User Experiences. Int J Environ Res Public Health 2023; 20:1287. [PMID: 36674043 PMCID: PMC9858642 DOI: 10.3390/ijerph20021287] [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] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection and clinicians engage with and experience communication and self-monitoring activities following the HaH model. A qualitative study based on semi-structured interviews of patients and clinicians participating in the early development phase of HaH were conducted. We interviewed eight clinicians and six patients. Five themes emerged from clinicians: (1) staff fear and concerns, (2) workflow, (3) virtual closeness, (4) patient relatives, and (5) future HaH models; four themes emerged from patients: (1) transition to home, (2) joint responsibility, (3) acceptability of technologies, and (4) relatives. Despite technical problems, both patients and clinicians were enthusiastic about the conceptual HaH idea. If appropriately introduced, treatment based on self-monitoring and remote communication was perceived acceptable for the patients; however, obtaining vitals at night was an overwhelming challenge. HaH is generally acceptable, perceived patient-centred, influencing routine clinical workflow, role and job satisfaction. Therefore, it calls for educational programs including more perspective than issues related to technical devices.
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Affiliation(s)
- Jose Cerdan de las Heras
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Signe Lindgård Andersen
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Sophie Matthies
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | | | - Caroline Klint Johannesen
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Virology and Microbiological Special Diagnostics, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Thyge Lynghøj Nielsen
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Natascha Fuglebjerg
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | | | - Dorte Gilså Hansen
- Institute of Public Health, Research Unit of General Practice, University of Southern Denmark, 5230 Odense, Denmark
| | - Thea K. Fischer
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
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Atik E, Schückes M, Apolinário-Hagen J. Patient and Therapist Expectations for a Blended Cognitive Behavioral Therapy Program for Depression: Qualitative Exploratory Study. JMIR Ment Health 2022; 9:e36806. [PMID: 36583934 PMCID: PMC9840101 DOI: 10.2196/36806] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/24/2022] [Accepted: 11/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Blended cognitive behavioral therapy (bCBT)-the combination of digital elements and face-to-face psychotherapy-has been proposed to alleviate challenges that patients and therapists face in conventional cognitive behavioral therapy. There is growing evidence that adding digital elements to face-to-face psychotherapy can contribute to better treatment outcomes. However, bCBT programs still show considerable shortcomings, and knowledge on how to improve digital apps using a bCBT protocol is limited. OBJECTIVE This study aimed to inductively identify functions and qualities that are expected from a bCBT treatment for depression in the eyes of patients and psychotherapists who were not currently receiving or practicing bCBT treatment. METHODS We used a qualitative exploratory study design and conducted 3 focus group interviews (n=6 in each) and 5 semistructured in-depth interviews with therapists as well as 11 individual interviews with patients with a primary diagnosis of depression and currently undergoing cognitive behavioral therapy treatment in Germany. Themes and categories were established inductively from transcribed interview records based on a rigorous coding method. RESULTS Both therapists and patients expected a digital app to provide patients with the opportunity to track their mood, work on therapeutic homework activities, easily access an intervention set for harder moments, and efficiently facilitate administrative tasks. The desire to be able to customize bCBT protocols to individual patient circumstances was evident in both patient and therapist interviews. Patients differed with respect to what content and the amount of material the app should focus on as well as the method of recording experiences. Therapists viewed digital apps as potentially aiding in their documentation work outside of sessions. Different attitudes surfaced on the topic of data security, with patients not as concerned as therapists. CONCLUSIONS Both patients and therapists had substantially positive attitudes toward the option of an integrated bCBT treatment. Our study presents novel findings on the expectations and attitudes of patients and therapists.
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Affiliation(s)
- Ece Atik
- Ruhr University Bochum, Bochum, Germany
| | - Magnus Schückes
- Institute for SME Research and Entrepreneurship, University of Mannheim, Mannheim, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Faculty of Medicine, Centre for Health and Society, Heinrich Heine University Dusseldorf, Dusseldorf, Germany
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Ekendahl M, Karlsson P, Månsson J, Heimdahl Vepsä K. Self-interpellation in narratives about craving: Multiple and unitary selves. Sociol Health Illn 2022; 44:1391-1407. [PMID: 36031748 PMCID: PMC9804802 DOI: 10.1111/1467-9566.13534] [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] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
The concept of addiction seeks to explain why people act contrary to their own best interest. At the centre stage of addiction discourse is craving, conceptualised as a strong urge to use substances. This article analyses how talk therapies such as relapse prevention and self-help groups shape identity constructions and understandings of craving among clients. Drawing upon interviews with individuals who have engaged in talk therapies in Sweden, we analyse how craving is made up through 'self-interpellation', that is, personal narratives about past, present or future thoughts, feelings and actions. The main 'self-interpellation' included multiple selves, where craving was elided by the true self and only felt by the inauthentic self. Less dominant were narratives which drew on a unitary self that remained stable over time and had to fight craving. The notion of multiple selves appeared as a master narrative that the participants were positioned by in their identity constructions. We conclude that this multiplicity seems ontologically demanding for people who try to recover from substance use problems. A demystification of craving, in which neither substance effects nor malfunctioning brains are blamed for seemingly irrational thoughts and actions, may reduce the stigmatisation of those who have developed habitual substance use.
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Affiliation(s)
- Mats Ekendahl
- Department of Social WorkStockholm UniversityStockholmSweden
| | - Patrik Karlsson
- Department of Social WorkStockholm UniversityStockholmSweden
| | - Josefin Månsson
- Department of Social WorkStockholm UniversityStockholmSweden
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van der Hout-van der Jagt MB, Verweij EJT, Andriessen P, de Boode WP, Bos AF, Delbressine FLM, Eggink AJ, Erwich JJHM, Feijs LMG, Groenendaal F, Kramer BWW, Lely AT, Loop RFAM, Neukamp F, Onland W, Oudijk MA, te Pas AB, Reiss IKM, Schoberer M, Scholten RR, Spaanderman MEA, van der Ven M, Vermeulen MJ, van de Vosse FN, Oei SG. Interprofessional Consensus Regarding Design Requirements for Liquid-Based Perinatal Life Support (PLS) Technology. Front Pediatr 2022; 9:793531. [PMID: 35127593 PMCID: PMC8809135 DOI: 10.3389/fped.2021.793531] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 12/23/2022] Open
Abstract
Liquid-based perinatal life support (PLS) technology will probably be applied in a first-in-human study within the next decade. Research and development of PLS technology should not only address technical issues, but also consider socio-ethical and legal aspects, its application area, and the corresponding design implications. This paper represents the consensus opinion of a group of healthcare professionals, designers, ethicists, researchers and patient representatives, who have expertise in tertiary obstetric and neonatal care, bio-ethics, experimental perinatal animal models for physiologic research, biomedical modeling, monitoring, and design. The aim of this paper is to provide a framework for research and development of PLS technology. These requirements are considering the possible respective user perspectives, with the aim to co-create a PLS system that facilitates physiological growth and development for extremely preterm born infants.
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Affiliation(s)
- M. Beatrijs van der Hout-van der Jagt
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - E. J. T. Verweij
- Department of Obstetrics and Gynecology, Division of Fetal Therapy, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Peter Andriessen
- Department of Neonatology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Applied Physics, School of Medical Physics and Engineering Eindhoven, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Willem P. de Boode
- Division of Neonatology, Department of Perinatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, Netherlands
| | - Arend F. Bos
- Department of Neonatology, University Medical Center Groningen, University of Groningen, Beatrix Children's Hospital, Groningen, Netherlands
| | - Frank L. M. Delbressine
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Alex J. Eggink
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Jan Jaap H. M. Erwich
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Loe M. G. Feijs
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Floris Groenendaal
- Department of Neonatology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Boris W. W. Kramer
- Department of Neonatology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands
| | - A. Titia Lely
- Department of Obstetrics and Gynecology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Rachel F. A. M. Loop
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Franziska Neukamp
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Wes Onland
- Department of Neonatology, Amsterdam UMC, Amsterdam, Netherlands
| | - Martijn A. Oudijk
- Amsterdam Reproduction and Development Research Institute, Department of Obstetrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Arjan B. te Pas
- Department of Neonatology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Irwin K. M. Reiss
- Department of Neonatology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Mark Schoberer
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Ralph R. Scholten
- Department of Obstetrics and Gynecology, Radboud Medical Centre, Nijmegen, Netherlands
| | - Marc E. A. Spaanderman
- Department of Obstetrics and Gynecology, Radboud Medical Centre, Nijmegen, Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands
| | - Myrthe van der Ven
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marijn J. Vermeulen
- Department of Neonatology, Erasmus Medical Centre, Rotterdam, Netherlands
- Care4Neo Foundation, Rotterdam, Netherlands
| | - Frans N. van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - S. Guid Oei
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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Kinshella MLW, Naanyu V, Chomba D, Waiyego M, Rigg J, Coleman J, Hwang B, Ansermino JM, Macharia WM, Ginsburg AS. Qualitative study exploring the feasibility, usability and acceptability of neonatal continuous monitoring technologies at a public tertiary hospital in Nairobi, Kenya. BMJ Open 2022; 12:e053486. [PMID: 35017248 PMCID: PMC8753390 DOI: 10.1136/bmjopen-2021-053486] [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] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To assess the feasibility, usability and acceptability of two non-invasive, multiparameter, continuous physiological monitoring (MCPM) technologies for use in neonates within a resource-constrained healthcare setting in sub-Saharan Africa. DESIGN A qualitative study using in-depth interviews and direct observations to describe healthcare professional and caregiver perspectives and experiences with investigational MCPM technologies from EarlySense and Sibel compared with selected reference technologies. SETTING Pumwani Maternity Hospital is a public, high-volume, tertiary hospital in Nairobi, Kenya. PARTICIPANTS In-depth interviews were conducted with five healthcare administrators, 12 healthcare providers and 10 caregivers. Direct observations were made of healthcare providers using the technologies on 12 neonates overall. RESULTS Design factors like non-invasiveness, portability, ease-of-use and ability to measure multiple vital signs concurrently emerged as key themes supporting the usability and acceptability of the investigational technologies. However, respondents also reported feasibility challenges to implementation, including overcrowding in the neonatal unit, lack of reliable access to electricity and computers, and concerns about cost and maintenance needs. To improve acceptability, respondents highlighted the need for adequate staffing to appropriately engage caregivers and dispel misconceptions about the technologies. CONCLUSION Study participants were positive about the usefulness of the investigational technologies to strengthen clinical care quality and identification of at-risk neonates for better access to timely interventions. These technologies have the potential to improve equity of access to appropriate healthcare services and neonatal outcomes in sub-Saharan African healthcare facilities. However, health system strengthening is also critical to support sustainable uptake of technologies into routine care. TRIAL REGISTRATION NUMBER NCT03920761.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynecology, British Columbia Children's and Women's Hospital and The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for International Child Health, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Violet Naanyu
- School of Arts and Sciences, Moi University, Eldoret, Uasin Gishu County, Kenya
| | - Dorothy Chomba
- Department of Pediatrics, The Aga Khan University - Kenya, Nairobi, Kenya
| | - Mary Waiyego
- Department of Pediatrics, Pumwani Maternity Hospital, Nairobi, Kenya
| | - Jessica Rigg
- Centre for International Child Health, BC Children's Hospital, Vancouver, British Columbia, Canada
- Department of Anesthesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jesse Coleman
- Evaluation of Technologies for Neonates in Africa, Seattle, Washington, USA
| | - Bella Hwang
- Centre for International Child Health, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - J Mark Ansermino
- Centre for International Child Health, BC Children's Hospital, Vancouver, British Columbia, Canada
- Department of Anesthesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - William M Macharia
- Department of Pediatrics, The Aga Khan University - Kenya, Nairobi, Kenya
| | - Amy Sarah Ginsburg
- Clinical Trial Center, University of Washington, Seattle, Washington, USA
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Ginsburg AS, Kinshella MLW, Naanyu V, Rigg J, Chomba D, Coleman J, Hwang B, Ochieng R, Ansermino JM, Macharia WM. Multiparameter Continuous Physiological Monitoring Technologies in Neonates Among Health Care Providers and Caregivers at a Private Tertiary Hospital in Nairobi, Kenya: Feasibility, Usability, and Acceptability Study. J Med Internet Res 2021; 23:e29755. [PMID: 34709194 PMCID: PMC8587184 DOI: 10.2196/29755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/01/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization. Objective This study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting. Methods We assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software. Results Between July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies. Conclusions Overall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-035184
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Affiliation(s)
- Amy Sarah Ginsburg
- UW Clinical Trial Center, University of Washington, Seattle, WA, United States
| | - Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynecology, British Columbia Children's and Women's Hospital and The University of British Columbia, Vancouver, BC, Canada.,Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada
| | - Violet Naanyu
- School of Arts and Sciences, Moi University, Eldoret, Kenya
| | - Jessica Rigg
- Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Dorothy Chomba
- Department of Pediatrics, Aga Khan University, Nairobi, Kenya
| | - Jesse Coleman
- Evaluation of Technologies for Neonates in Africa, Nairobi, Kenya
| | - Bella Hwang
- Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada
| | | | - J Mark Ansermino
- Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, The University of British Columbia, Vancouver, BC, Canada
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O’Brien J, Mason A, Cassarino M, Chan J, Setti A. Older Women's Experiences of a Community-Led Walking Programme Using Activity Trackers. Int J Environ Res Public Health 2021; 18:ijerph18189818. [PMID: 34574741 PMCID: PMC8468609 DOI: 10.3390/ijerph18189818] [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] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Promoting physical activity amongst older adults represents a major public health goal and community-led exercise programmes present benefits in promoting active lifestyles. Commercial activity trackers potentially encourage positive behaviour change with respect to physical exercise. This qualitative study investigated the experiences and attitudes of older adults following a 6-week community-led walking programme utilising activity trackers. Eleven community-dwelling older women aged 60+ completed individual phone interviews following their involvement in the programme. The programme, codesigned with a group of senior citizens, equipped participants with wrist-worn activity trackers and included biweekly check-in sessions with a researcher to monitor progress and support motivation. Interviews explored participants’ experiences of the programme and of using activity trackers for the purpose of becoming more active. A thematic analysis produced three main themes: ‘programme as a source of motivation’, ‘user experiences with the technology’ and ‘views on social dimension of the programme’. Overall, participants highlighted the self-monitoring function of activity trackers as most beneficial for their exercise levels. This study provides insights into the personal and social factors perceived by older adults in relation to being part of a community-led programme using activity trackers. It highlights the role of the programme and trackers in maintaining motivation to stay active.
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Affiliation(s)
- Jessica O’Brien
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
- Correspondence:
| | - Amy Mason
- Department of Physical Education and Sport Science, University of Limerick, V94 TPX Limerick, Ireland;
| | - Marica Cassarino
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
| | - Jason Chan
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
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Čuš A, Edbrooke-Childs J, Ohmann S, Plener PL, Akkaya-Kalayci T. "Smartphone Apps Are Cool, But Do They Help Me?": A Qualitative Interview Study of Adolescents' Perspectives on Using Smartphone Interventions to Manage Nonsuicidal Self-Injury. Int J Environ Res Public Health 2021; 18:3289. [PMID: 33810106 DOI: 10.3390/ijerph18063289] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 01/05/2023]
Abstract
Nonsuicidal self-injury (NSSI) is a major mental health problem associated with negative psychosocial outcomes and it most often starts in early adolescence. Despite this, adolescents are rarely involved in informing the development of interventions designed to address their mental health problems. This study aimed to (1) assess adolescents’ needs and preferences about future interventions that are delivered through smartphones and (2) develop a framework with implications for designing engaging digital mental health interventions. Fifteen adolescent girls, aged 12–18 years, who met diagnostic criteria for a current NSSI disorder and were in contact with mental health services, participated in semi-structured interviews. Following a reflexive thematic analysis approach, this study identified two main themes: (1) Experiences of NSSI (depicts the needs of young people related to their everyday experiences of managing NSSI) and (2) App in Context (portrays preferences of young people about smartphone interventions and reflects adolescents’ views on how technology itself can improve or hinder engaging with these interventions). Adolescent patients expressed interest in using smartphone mental health interventions if they recognize them as helpful, relevant for their life situation and easy to use. The developed framework suggests that digital mental health interventions are embedded in three contexts (i.e., person using the intervention, mental health condition, and technology-related factors) which together need to inform the development of engaging digital resources. To achieve this, the cooperation among people with lived experience, mental health experts, and human computer interaction professionals is vital.
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14
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Bradby H, Lindenmeyer A, Phillimore J, Padilla B, Brand T. 'If there were doctors who could understand our problems, I would already be better': dissatisfactory health care and marginalisation in superdiverse neighbourhoods. Sociol Health Illn 2020; 42:739-757. [PMID: 32020646 PMCID: PMC7318273 DOI: 10.1111/1467-9566.13061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
How people in community settings describe their experience of disappointing health care, and their responses to such dissatisfaction, sheds light on the role of marginalisation and underlines the need for radically responsive service provision. Making the case for studying unprompted accounts of dissatisfaction with healthcare provision, this is an original analysis of 71 semi-structured interviews with healthcare users in superdiverse neighbourhoods in four European cities. Healthcare users spontaneously express disappointment with services that dismiss their concerns and fail to attend to their priorities. Analysing characteristics of these healthcare users show that no single aspect of marginalisation shapes the expression of disappointment. In response to disappointing health care, users sought out alternative services and to persuade reluctant service providers, and they withdrew from services, in order to access more suitable health care and to achieve personal vindication. Promoting normative quality standards for diverse and diversifying populations that access care from a range of public and private service providers is in tension with prioritising services that are responsive to individual priorities. Without an effort towards radically responsive service provision, the ideal of universal access on the basis of need gives way to normative service provision.
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Affiliation(s)
| | | | - Jenny Phillimore
- Institute for Research into Superdiversity (IRiS)School of Social PolicyUniversity of BirminghamBirminghamUK
| | - Beatriz Padilla
- Department of SociologyUniversity of South FloridaTampaUSA
- Instituto Universitario de Lisboa (ISCTE‐IUL)LisbonPortugal
| | - Tilman Brand
- Department Prevention and EvaluationLeibniz Institute for Prevention Research and Epidemiology – BIPSBremenGermany
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15
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Davenport K, Hardy G, Tai S, Mansell W. Individual experiences of psychological-based interventions for bipolar disorder: A systematic review and thematic synthesis. Psychol Psychother 2019; 92:499-522. [PMID: 30175881 DOI: 10.1111/papt.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/03/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To conduct a thematic synthesis to evaluate qualitative studies exploring individuals' experiences of psychological-based interventions for bipolar disorder (BD). METHOD A systematic search of relevant databases (Web of Science, PsycINFO, MEDLINE, CINAHL) was conducted using predefined search terms related to 'Bipolar' 'Qualitative method', 'Psychological-based interventions' and 'Adults'. Studies meeting the inclusion criteria were selected and were then evaluated using established quality appraisal criteria. A thematic synthesis was used to synthesize the findings. RESULTS From the thematic synthesis, nine analytical themes were derived from the 10 identified research studies. These were helpful and unhelpful aspects of the intervention, increased knowledge of BD, mood recognition, control of moods, change of perspective, mood stability, empowerment, improved relationships and lifestyle changes. CONCLUSIONS Findings from the review suggest there were characteristics of psychological-based interventions that individuals with BD valued and which helped facilitate areas of positive change, such as feeling empowered and in control of their moods and other aspects of their lives. However, there were also elements that individuals did not find as helpful and therefore reflects the challenge of a one-size-fits-all model or plan of interventions, compared to a wider recognition of the individuals as being the agent of their recovery. Future qualitative research is needed to explore individual experiences across a range of psychological interventions, in order to further understand the therapeutic processes, which may facilitate recovery. PRACTITIONER POINTS Psychological-based interventions for BD need to consider facilitating and measuring empowerment in individuals, rather than focusing just on mood stability. Clinicians with expertise and knowledge in BD should provide timely information to individuals and their families to help increase their understanding of the diagnosis.
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16
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van Ommeren AL, Smulders LC, Prange-Lasonder GB, Buurke JH, Veltink PH, Rietman JS. Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users' Needs. JMIR Rehabil Assist Technol 2018; 5:e10510. [PMID: 30497993 PMCID: PMC6293243 DOI: 10.2196/10510] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/24/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Technical innovations have the potential to compensate for loss of upper-limb motor functions after stroke. However, majority of the designs do not completely meet the needs and preferences of the end users. User-centered design methods have shown that the attention to user perspectives during development of assistive technology leads to devices that better suit the needs of the users. OBJECTIVE To get more insight into the factors that can bring the design of assistive technology to higher levels of satisfaction and acceptance, studies about user perspectives on assistive technology for the upper limb after stroke are systematically reviewed. METHODS A database search was conducted in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus from inception to August 2017, supplemented with a search of reference lists. Methodological quality of the included studies was appraised. User perspectives of stroke survivors, carers, and health care professionals were extracted. A total of 35 descriptive themes were identified, from which 5 overarching themes were derived. RESULTS In total, 9 studies with information gathered from focus groups, questionnaires, and interviews were included. Barriers and enablers influencing the adoption of assistive technology for the upper limb after stroke emerged within 5 overarching but highly interdependent themes: (1) promoting hand and arm performance; (2) attitude toward technology; (3) decision process; (4) usability; and (5) practical applicability. CONCLUSIONS Expected use of an assistive technology is facilitated when it has a clear therapeutic base (expected benefit in enhancing function), its users (patients and health care professionals) have a positive attitude toward technology, sufficient information about the assistive technology is available, and usability and practical applicability have been addressed successfully in its design. The interdependency of the identified themes implies that all aspects influencing user perspectives of assistive technology need to be considered when developing assistive technology to enhance its chance of acceptance. The importance of each factor may vary depending on personal factors and the use context, either at home as an assistive aid or for rehabilitation at a clinic.
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Affiliation(s)
- Anne L van Ommeren
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | | | - Gerdienke B Prange-Lasonder
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | - Jaap H Buurke
- Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Johan S Rietman
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
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17
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Abstract
A great many people of all ages around the world cannot fully control their bladder or bowel, or both. Either in the short or long term, they rely upon products and devices to manage the emptying of their bladders and bowels and to collect, absorb and contain leaked urine or faeces. The incontinence product market is large and growing, and ongoing developments in materials and technologies should lead to improvements in these products and devices. Engineers and designers who work in this field - or who plan to do so - need to recognise the breadth of factors that affect the effectiveness and acceptability of products. The primary functions of products for managing bladder and bowel dysfunctions are the collection and containment of urine or faeces - and the associated engineering and design challenges may be considered in terms of flow rates and volumes and methods of acquisition and containment. But products will fail if they do not take into account other factors, some of which relate less directly to these primary functions and some not at all. This article aims to highlight the product characteristics that are most important to the people who use them, and areas where user-centred innovation and development may lead to improvements.
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Affiliation(s)
- Brian S Buckley
- 1 Department of Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,2 Urology Department, Zhongnan Hospital of Wuhan University, Wuhan, China.,3 The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
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18
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Christensen HM, Titlestad IL, Huniche L. Development of non-invasive ventilation treatment practice for patients with chronic obstructive pulmonary disease:Results from a participatory research project. SAGE Open Med 2017; 5:2050312117739785. [PMID: 29163942 PMCID: PMC5682580 DOI: 10.1177/2050312117739785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 10/03/2017] [Indexed: 11/17/2022] Open
Abstract
Objectives Non-invasive ventilation treatment for patients with acute exacerbation of chronic obstructive pulmonary disease is well documented. Communication with patients during treatment is inhibited because of the mask, the noise from the machine and patient distress. Assessing life expectancy and identifying end-stage chronic obstructive pulmonary disease posed difficulties and caused doubts concerning initiation and continuation of non-invasive ventilation as life-sustaining treatment. Health professionals expressed a need for knowledge of patients' perspectives and attitude towards non-invasive ventilation. Methods The study adheres to principles of Critical psychological practice research. Data on patients' and health professionals' perspectives were obtained from observations from the ward and semi-structured interviews with 16 patients. A group of health professionals was set up to form a co-researcher group. The co-researcher group described and analysed treatment practice at the department, drawing on research literature, results from observations and patients' interviews. Results Interviews revealed that 15 patients evaluated treatment with non-invasive ventilation positively, although 13 had experienced fear and 14 discomfort during treatment. The co-researcher group described health professionals' perspectives and analysed treatment practice based on data from patients' perspectives developing new management strategies in clinical practice with non-invasive ventilation. Conclusion The participatory approach enabled continuous and complementary development of knowledge and treatment practice. The investigation of patient perspectives was particularly productive in qualifying cooperation among health professionals. The study resulted in preparing, and implementing, new clinical strategies.
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Affiliation(s)
- Helle M Christensen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Ingrid L Titlestad
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Lotte Huniche
- Institute of Public Health, The Research unit of User Perspectives, University of Southern Denmark, Odense, Denmark
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19
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Abstract
INTRODUCTION Alcohol use disorders has been known and recently highlighted by the World Health Organization as a major worldwide problem. Harmful usage of alcohol has been linked to increased morbidity and mortality arising from common alcohol related disorders, such as liver disease, hypertension and violent deaths. Looking at the current literature, there have been previous peer reviewed publications about how technology has helped alcohol users. Of significance, a previous content analysis showed that the vast majority of the applications catered for alcohol use disorder which are currently available on the stores are not only not supported by evidence-base, but some of them seemed to be promoting drinking instead. Zhang et al. have described how they have attempted to overcome the limitations of current alcohol applications in their video feature recently published. OBJECTIVE The objective of this article is to evaluate (a) the receptiveness of the general population toward an alcohol tracker application and to determine (b) user preferences with regards to the different features present in an alcohol tracker. METHODS Android Java Developmental kit (ADK) was utilized to program the core functions of the applications. The entire developmental process took approximately 6 weeks to complete and the android version of the application was launched and offered for free download on the android play store since the 4th of February 2015. The utilization of the application was then monitored and recorded using Google analytics. User perspectives with regards to the individual features of the application were collated via an application feedback survey embedded within the application. RESULTS Based on the analytics, a total of 339 users have had access to the application. A cumulative total of 2029 downloads of the application have been made to date. Most of the participants are male (66%) and are of the age group of 30-39 years old (34%). The vast majority of the participants (94%) do not have any prior treatment for alcohol. Interestingly, the vast majority of the users have indicated that they have a drink 4 or more times a week (61%) and tend to drink between 3 to 4 drinks on a typical day they are out drinking. the vast majority reported that they were slightly and moderately comfortable with managing their alcohol use problem (25%). After the usage of the application, 27% of the individuals were moderately comfortable with managing their alcohol use problems and 20% of individuals were extremely comfortable with managing their alcohol use problems. CONCLUSION In conclusion, this is perhaps one of the first few studies to demonstrate the receptiveness of an alcohol tracker that has included other behavioral change methods within as well as a variant of the conventional methodology of tracking alcohol consumption. The current study shows the receptiveness of global users as well as how such an intervention could help them gain more control about managing their underlying alcohol issue.
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Affiliation(s)
- Melvyn W B Zhang
- National Addiction Management Service, Institute of Mental Health, Singapore
| | - Pan Fang
- Shandong University, Shandong, Jinan, China
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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20
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Scope A, Uttley L, Sutton A. A qualitative systematic review of service user and service provider perspectives on the acceptability, relative benefits, and potential harms of art therapy for people with non-psychotic mental health disorders. Psychol Psychother 2017; 90:25-43. [PMID: 27257043 DOI: 10.1111/papt.12093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 10/26/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE This systematic review aimed to synthesize qualitative evidence relating to user and service provider perspective on the acceptability and relative benefits and potential harms of art therapy for people with non-psychotic mental disorders. METHODS A comprehensive literature search was conducted in 13 major bibliographic databases from May to July 2013. A qualitative evidence synthesis was conducted using thematic framework synthesis. RESULTS The searches identified 10,270 citations from which 12 studies were included. Ten studies included data from 183 service users, and two studies included data from 16 service providers. The evidence demonstrated that art therapy was an acceptable treatment. The benefits associated with art therapy included the following: the development of relationships with the therapist and other group members; understanding the self/own illness/the future; gaining perspective; distraction; personal achievement; expression; relaxation; and empowerment. Small numbers of patients reported varying reasons for not wanting to take part, and some highlighted potentially negative effects of art therapy which included the evoking of feelings which could not be resolved. CONCLUSIONS The findings suggest that for the majority of respondents art therapy was an acceptable intervention, although this was not the case for all respondents. Therefore, attention should be focussed on both identifying those who are most likely to benefit from art therapy and ensuring any potential harms are minimized. The findings provide evidence to commissioners and providers of mental health services about the value of future art therapy services. PRACTITIONER POINTS Art therapy was reported to be an acceptable treatment for the majority of respondents. Art therapy may not be a preferred treatment option for a small number of patients, emphasizing the importance of considering patient preference in choice of treatment, and selection of the most suitable patients for art therapy. Consideration should be made of adjustments to make art therapy inclusive, particularly for those with physical illnesses. Ensuring the competence of the deliverer, providing patients with additional support, such as other therapies if required, and ensuring continuity of care should be key considerations in service provision.
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Affiliation(s)
- Alison Scope
- School of Health and Related Research (ScHARR), The University of Sheffield, UK
| | - Lesley Uttley
- School of Health and Related Research (ScHARR), The University of Sheffield, UK
| | - Anthea Sutton
- School of Health and Related Research (ScHARR), The University of Sheffield, UK
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21
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Affiliation(s)
- Torsten Kolind
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Copenhagen, Denmark
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Berge MS. Telecare - where, when, why and for whom does it work? A realist evaluation of a Norwegian project. J Rehabil Assist Technol Eng 2017; 4:2055668317693737. [PMID: 31186924 PMCID: PMC6453039 DOI: 10.1177/2055668317693737] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/09/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction Evaluations of telecare demonstrate disparate results, which are of little help for understanding what the users need from further policy and development. This study aims to provide a more nuanced approach to telecare evaluations. Methods Realist evaluation is used to scrutinize what it is about telecare that works for whom, why, how and in which circumstances. Sequential interviews were conducted with telecare users and relatives at pre- and post-implementation stages. Result Some users experienced the intended effects from telecare, such as increased feeling of safety, whereas others did not. Various contextual elements influenced how people reasoned about the resources provided by telecare and affected the individual outcomes. Discussion The desire to remain in own home appeared to be a major driving force in accepting telecare. Users had surprisingly high tolerance to side effects of telecare, which might indicate that much was at stake. Some users disapproved of having telecare due to contextual reasons; however, readjustments proved successful to some. Conclusion This study illuminates how and why telecare works differently in different situations, and thus leads to different outcomes. When telecare is correctly adjusted to match the user's needs, abilities and contexts it enables them to feel safe and remain in their own homes.
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Affiliation(s)
- Mari S Berge
- School of Applied Social Science, University of Stirling, UK.,Centre of Care Research, Western Norway University of Applied Sciences
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Broomfield K, Sage K. Exploring the Perspectives of People Who Use Alternative and Augmentative Communication Aids (AAC). Stud Health Technol Inform 2017; 242:370-373. [PMID: 28873825] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper outlines the clinical doctoral research plan (funded by HEE/NIHR Integrated Clinical Academic Programme) to engage the wide range of people who use alternative and augmentative communication (AAC) to understand the perspectives of users in order to develop a Patient Reported Outcome Measure (PROM) to evaluate equipment and services.
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Raven J, van den Broek N, Tao F, Kun H, Tolhurst R. The quality of childbirth care in China: women's voices: a qualitative study. BMC Pregnancy Childbirth 2015; 15:113. [PMID: 25971553 PMCID: PMC4457993 DOI: 10.1186/s12884-015-0545-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/05/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In the context of improved utilisation of health care and outcomes, rapid socio-economic development and health system reform in China, it is timely to consider the quality of services. Data on quality of maternal health care as experienced by women is limited. This study explores women's expectations and experiences of the quality of childbirth care in rural China. METHODS Thirty five semi-structured interviews and five focus group discussions were conducted with 69 women who had delivered in the past 12 months in hospitals in a rural County in Anhui Province. Data were transcribed, translated and analysed using the framework approach. RESULTS Hospital delivery was preferred because it was considered safe. Home delivery was uncommon and unsupported by the health system. Expectations such as having skilled providers and privacy during childbirth were met. However, most women reported lack of cleanliness, companionship during labour, pain relief, and opportunity to participate in decision making as poor aspects of care. Absence of pain relief is one reason why women may opt for a caesarean section. CONCLUSIONS These findings illustrate that to improve quality of care it is crucial to build accountability and communication between providers, women and their families. Ensuring women's participation in decision making needs to be addressed.
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Affiliation(s)
- Joanna Raven
- Department for International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Nynke van den Broek
- Centre of Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, Hefei, China.
| | - Huang Kun
- School of Public Health, Anhui Medical University, Hefei, China.
| | - Rachel Tolhurst
- Department for International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
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Brady M, Tolley E. Aligning product development and user perspectives: social-behavioural dimensions of multipurpose prevention technologies. BJOG 2014; 121 Suppl 5:70-8. [PMID: 25335843 DOI: 10.1111/1471-0528.12844] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2014] [Indexed: 11/30/2022]
Abstract
Multipurpose prevention technologies provide a compelling response to the multiple and reinforcing sexual and reproductive health risks faced by women globally. To ensure that this potential is realised, product-specific characteristics and their social-behavioural correlates must be considered early in the product development process. This paper provides an overview of the key user-related social and behavioural dimensions of three broad categories of multipurpose prevention technologies: 1) sustained release vaginal rings, 2) pericoital vaginal products, and 3) co-formulated or co-administered injectables. The authors build upon the broad parameters of Target Product Profiles for such products, aligning them with user perspective considerations.
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Affiliation(s)
- M Brady
- Population Council, New York, NY, USA
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Rygaard M, Godskesen B, Jørgensen C, Hoffmann B. Holistic assessment of a secondary water supply for a new development in Copenhagen, Denmark. Sci Total Environ 2014; 497-498:430-439. [PMID: 25150737 DOI: 10.1016/j.scitotenv.2014.07.078] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/12/2014] [Accepted: 07/20/2014] [Indexed: 06/03/2023]
Abstract
Increasing stress on water resources is driving urban water utilities to establish new concepts for water supply. This paper presents the consequences of proposed alternative water supply options using a unique combination of quantitative and qualitative methods from different research fields. A former industrial harbor area in Copenhagen, Denmark, is currently under development and all infrastructure will be updated to accommodate 40,000 inhabitants and 40,000 jobs in the future. To reduce stress on water resources it has been proposed to establish a secondary water supply in the area as an alternative to the conventional groundwater-based drinking water supply. Four alternative concepts for a secondary water supply have been considered: 1) slightly polluted groundwater for use in toilets and laundry, 2) desalinated brackish water for use in toilets, laundry, and dishwashers, 3) desalinated brackish water for all uses, including drinking water, and 4) local reclamation of rain and gray water for use in toilets and laundry. The concepts have been evaluated for their technical feasibility, economy, health risks, and public acceptance, while the concepts' environmental sustainability has been assessed using lifecycle assessment and freshwater use impact methods. The holistic assessment method exposes conflicting preference solutions depending on assessment criteria, and reveals multi-faceted consequences for choices in urban water management. Not one concept turns out unambiguously positive based on the evaluation criteria included here, but the systematic evaluation will leave decision-makers informed on the consequences of their choices.
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Affiliation(s)
- M Rygaard
- Technical University of Denmark, Department of Environmental Engineering, Miljoevej 113, DK-2800 Kgs. Lyngby, Denmark.
| | - B Godskesen
- HOFOR, Ørestads Boulevard 35, DK-2300 København S, Denmark.
| | | | - B Hoffmann
- Aalborg University, Department of Development and Planning, A.C. Meyers Vænge 15, 2450 København SV, Denmark.
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Abstract
Telecare is often regarded as a win/win solution to the growing problem of meeting the care needs of an ageing population. In this paper we call attention to some of the ways in which telecare is not a win/win solution but rather aggravates many of the long-standing ethical tensions that surround the care of the elderly. It may reduce the call on carers' time and energy by automating some aspects of care, particularly daily monitoring. This can release carers for other caring activities. On the other hand, remote and impersonal monitoring seems to fall short of providing care. Monitoring may be used to help elderly users retain independence. But it may also increase the amount of information which flows from users to carers, which can result in a form of function-creep that actually undermines independence.
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Abstract
BACKGROUND Small families adopting family planning are usually considered happy families. They are expected to lead a better qualitative life. Quality-of-life (QOL) is routinely assessed for knowing patients' health status. Recently, the QOL concept has become increasingly popular for evaluating the impact of public health interventions. Hitherto, QOL is usually assessed by means of program achievements or indicators, which may sometimes be misleading. Hence, the new culture of QOL assessment by means of user perspectives is now becoming popular. RESEARCH QUESTIONS 1) Is the quality-of-life of family planning (FP) adopters better than that of non-FP adopters? 2) Are the user perspectives helpful in QOL assessment? MATERIALS AND METHODS A cross-sectional descriptive study was carried out among 50 FP adopting families and 50 non-FP adopting families from the village of Vutoor and the city of Karimnagar in Andhra Pradesh. SAMPLING METHODS: Random sampling, Proportions and Chi square test. RESULTS Program perspectives revealed a better standard of living for FP adopters because they have amenities like housing, television, and vehicles and less mortality and morbidity (P < 0.001). However, they lack positive feelings towards life, general adaptation, personal relationships, and leisure opportunities. Finally, self-assessment by FP adopters themselves revealed no significant increase in their qualitative life after family planning (P = 0.05). CONCLUSIONS While assessing the impact of a health program on quality-of-life, multiple methods of assessments including user perspectives are better than program indicators alone.
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Affiliation(s)
- Kameswararao Avasarala
- Department of Community Medicine, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India
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