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BACKGROUND: It is difficult for families to navigate and access services for their children with autism. Barriers to service access are compounded among families from low-resourced backgrounds. OBJECTIVE: The purpose of our study was to explore the development of an app to facilitate access to services among families of children with autism from low-resourced backgrounds. Our specific aims were to explore feedback from an advisory board about the app and to explore feedback from navigators about the app. METHODS: Via a multistage codevelopment process, we elicited feedback from 5 key parties: the research team, a community organization, the app development team, the advisory board, and family navigators. Collectively, 36 individuals provided feedback about the development of the app via individual interviews, focus groups, observations, and surveys. The key features of the app included a dashboard showing the service needs of the family and related resources, a messaging feature between the family, the navigator, and the supervisor, and a fidelity checklist and evaluation feature. RESULTS: The advisory board provided feedback about the app to increase its user-friendliness, include the ability to develop an action plan, improve the identification of needed services, and add information about service providers. Navigators suggested that the app should connect navigators to one another, have a clearer purpose for the notes section, and reflect an easier log-in process. Navigators also wanted training to role-play using the app. After participating in a role play using the app, navigators reported significantly more satisfaction with the app and greater usefulness (P

This article focuses on the methodological experiences that emerged from a study investigating how teachers valued their daily encounters with children in early childhood education. Early childhood teachers often balance the demands of documentation with time spent with children, so have little time to reflect on their practice. Furthermore, participation in research projects tends to be both time-consuming and distracting from the practitioners' perspective, without providing immediate opportunities for professional development. The purpose of this article is to elaborate on the use of a mixed-methods approach that combines a quantitative digital tool (an application) for collecting data with the use of short qualitative interviews in order to explore methodological aspects in educational research. The pros of this mixed-methods approach include flexibility, the instant overview of data, and the reflective potential offered to the participants, as well as the researchers. The teachers had the opportunity to 'set the agenda' when giving their own definitions of valuable encounters and then reflect on their experiences in their own words. This gave them a strong voice. The main risks of this method concern the dependence on technical devices and software. The authors argue that there is potential in the reflective methodology used in this study to bring research and practice closer in comprehensive knowledge creation. This methodology offers a respectful way to gather information from practice and simultaneously provide opportunities to change. [ABSTRACT FROM AUTHOR]

Background/Objectives: Populations in Mediterranean countries are abandoning the traditional Mediterranean diet (MD) and lifestyle, shifting towards unhealthier habits due to profound cultural and socioeconomic changes. The SWITCHtoHEALTHY project aims to demonstrate the effectiveness of a multi-component nutritional intervention to improve the adherence of families to the MD in three Mediterranean countries, thus prompting a dietary behavior change. Methods: A parallel, randomized, single-blinded, and controlled multicentric nutritional intervention study will be conducted over 3 months in 480 families with children and adolescents aged 3–17 years from Spain, Morocco, and Turkey. The multi-component intervention will combine digital interactive tools, hands-on educational materials, and easy-to-eat healthy snacks developed for this study. Through the developed SWITCHtoHEALTHY app, families will receive personalized weekly meal plans, which also consider what children eat at school. The engagement of all family members will be prompted by using a life simulation game. In addition, a set of activities and educational materials for adolescents based on a learning-through-playing approach will be codesigned. Innovative and sustainable plant-based snacks will be developed and introduced into the children's dietary plan as healthy alternatives for between meals. By using a full-factorial design, families will be randomized into eight groups (one control and seven interventions) to test the independent and combined effects of each component (application and/or educational materials and/or snacks). The impact of the intervention on diet quality, economy, and the environment, as well as on classical anthropometric parameters and vital signs, will be assessed in three different visits. The COM-B behavioral model will be used to assess essential factors driving the behavior change. The main outcome will be adherence to the MD assessed through MEDAS in adults and KIDMED in children and adolescents. Conclusions: SWITCHtoHEALTHY will provide new insights into the use of sustained models for inducing dietary and lifestyle behavior changes in the family setting. It will facilitate generating, boosting, and maintaining the switch to a healthier MD dietary pattern across the Mediterranean area. Registered Trial, National Institutes of Health, ClinicalTrials.gov (NCT06057324). [ABSTRACT FROM AUTHOR]

Introduction: Human growth hormone (hGH) therapy in children can be administered by subcutaneous injection using either a manual non-connected device, which is a portable injection pen loaded with a pre-filled cartridge, or an electronic connected device. The electronic device is connected to a platform where adherence data is recorded and available for health care professionals (HCPs) and patient support programs. Real-world data used in the clinic, includes regular monitoring of adherence data which are shared with families during patients' visits and aim to determine the root causes of poor adherence. This study aimed to identify whether there are differences in growth during the first four years of treatment depending on the device, i.e. non-connected versus connected devices. Methods: This retrospective study reports treatment of either GH deficiency or short stature secondary to birth size small for gestational age (SGA) in 174 pediatric patients attending Miguel Servet Hospital, Zaragoza, Spain. hGH treatment was administered with manual non-connected devices in 87 patients and 87 patients used connected devices. Height was followed for 4 years after start of hGH therapy. Results: In total, 57% of subjects had GHD and 43% were SGA. Height standard deviation score (HSDS) at treatment start was higher (p<0.001) in the non-connected device group compared to the connected device group. Change of HSDS in the connected device group was significantly higher in the second (+0.13), third (+0.20) and fourth (+0.23) year of treatment compared to the non-connected group after adjustment for age and HSDS at treatment start, sex, indication, dose and Tanner stages during treatment, and timing of measurements. Discussion: These results support the use of the connected device for hGH treatment of pediatric growth disorders. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods Results Conclusion The study aims to assess the feasibility of developing cognitive tools and integrating the cloud‐enabled mobile‐based technology into routine clinical practice for psychotic patients. Furthermore, it aims to investigate the correlation between the results obtained using developed tools and established clinical measures, offering valuable insights into tools for enhancing the accuracy, efficiency and ease of administration of cognitive evaluation.A total of 160 participants were recruited (83 outpatients with early course of schizophrenia (SZs) and 77 healthy controls [HCs]). The participants were subjected to cognitive assessments, and the data were collected by cognitive assessment digital smart tool (CADST) and PGI memory scale (PGIMS) to assess attention (ATT) and working memory (WM). Outcome measures of these parameters were digit span (score,time) for ATT and delayed recall (score,time) for WM.The total average score in HCs was significantly higher than in SZs for ATT and WM, and CADST was significantly correlated with PGIMS for evaluating ATT and WM. Furthermore, test completion times for ATT and WM were observed more in SZs although most of SZs had achieved scores as high as that of HCs.The potential of CADST as a valuable addition to the conventional cognitive assessment method is highlighted, showing promising feasibility and strong correlations with the established tool. The importance of integrating time parameters suggests broader implications for understanding cognitive function beyond conventional scoring metrics. It demonstrates the effective and accurate approach for large‐scale screening of cognitive parameters in public service settings. [ABSTRACT FROM AUTHOR]

Background and objective: Tools to accurately and efficiently measure dietary intake in Nigeria are lacking. We aimed to develop and assess the usability of a new online dietary assessment tool for Nigeria—myfood24 West Africa. Methods: We developed the myfood24 West Africa database using data from existing food composition tables, packaged foods labels and research articles. The development followed seven steps: identified data sources, selected foods, processed/cleaned the data, calculated the nutrient content of recipes, created and allocated portion sizes, quality-checked the database and developed food accompaniments. To pilot the tool, we recruited 179 university staff in Nigeria using a cross-sectional design. Usability was assessed using a questionnaire that included the System Usability Scale (SUS) and a feedback session. Results: The database included 924 foods, with up to 54 nutrients and 35 portion-size images allocated to foods. Sixty percent of the data were sourced from the 2019 West Africa Food Composition Table, 17% from back-of-pack labels of packaged foods, 14% from the 2017 Nigerian Food Composition Table, 5% from generated recipes and 4% from the published literature. Of the participants, 30% (n = 53) self-recorded their food intake, with a total of 1345 food and drink entries from both self- and interviewer-collected data. The mean SUS score of 74 (95% CI: 68,79) indicated good usability. The feedback showed that the tool was user-friendly, educational and included a variety of local foods. Conclusions: This new tool will enhance the dietary assessment of the Nigerian population. More work will expand coverage to include more foods from the region. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionThe use of digital healthcare technologies to enhance healthcare delivery has seen significant growth. However, a notable a notable research gap exists in the application of clinical scales for menopause management by general practitioners (GPs). This study aims to investigate willingness of GPs to use specific menopausal scale tools in the care of females for menopause management.An anonymous online survey was developed, which received responses from 348 French GPs in 2023. Multiple backward logistic regression was performed to identify the factors influencing the willingness to use a practical menopause management scale.In total, 87.93% of GPs are not familiar with the Greene Climacteric Scale and 90.52% are not familiar with the Menopause Quick 6 scale. In contrast, 90.52% would be interested in having access to such scales. The willingness to use a menopause management scale is associated with caring for menopausal females (odds ratio [OR] = 6.13, 95% confidence interval [CI] [2.08–18.08], p = 0.001), less experience (OR = 7.10, 95% CI [2.05–25.22], p = 0.002), the importance of health prevention in daily practice (comparing ‘very important’ to ‘not’, OR = 12.98, 95% CI [1.68–97.60], p = 0.004) and the use of a digital scale in daily practice for menopausal management (OR = 2.13, 95% CI [1.04–5.83], p = 0.014).Future research is essential in representative population to confirm these findings in menopause management. [ABSTRACT FROM AUTHOR]

Introduction: Digital health technologies (DHTs) have the potential to alleviate challenges experienced in clinical trials through more objective, naturalistic, and frequent assessments of functioning. However, implementation of DHTs come with their own challenges, including acceptability and ease of use for study participants. In addition to acceptability, it is also important to understand device proficiency in the general population and within patient populations who may be asked to use DHTs for extended periods of time. We thus aimed to provide an overview of participant feedback on acceptability of DHTs, including body-worn sensors used in the clinic and a mobile application used at-home, used throughout the duration of the Wearable Assessments in the Clinic and at Home in Parkinson's Disease (WATCH-PD) study, an observational, longitudinal study looking at disease progression in early Parkinson's Disease (PD). Methods: 82 participants with PD and 50 control participants were enrolled at 17 sites throughout the United States and followed for 12 months. We assessed participants' general device proficiency at baseline, using the Mobile Device Proficiency Questionnaire (MDPQ). The mean MDPQ score at Baseline did not significantly differ between PD patients and healthy controls (20.6 [2.91] vs 21.5 [2.94], p = .10). Results: Questionnaire results demonstrated that participants had generally positive views on the comfort and use of the digital technologies throughout the duration of the study, regardless of group. Discussion: This is the first study to evaluate patient feedback and impressions of using technology in a longitudinal observational study in early Parkinson's Disease. Results demonstrate device proficiency and acceptability of various DHTs in people with Parkinson's does not differ from that of neurologically healthy older adults, and, overall, participants had a favorable view of the DHTs deployed in the WATCH-PD study. [ABSTRACT FROM AUTHOR]

Background: Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals' handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools. Research aim: This study aimed to explore healthcare leaders' expectations of using a digital tool for ethical reflection among their home nursing care staff. Research design: A qualitative research design with vignettes and focus group interviews was used. The data were analyzed using reflexive thematic analysis. Participants and Research Context: The sample comprised ten healthcare leaders from municipal long-term care in Norway. Ethical Considerations: Participation was voluntary and based on informed consent. The Norwegian Agency for Shared Services in Education and Research approved this study. Findings: The analysis resulted in the development of three themes representing leaders' expectations of the tool: (i) giving staff a voice, (ii) revealing ethics in practice, and (iii) keeping the pot boiling. Discussion: Leaders must be informed about the ethical issues experienced to engage in supportive measures for their staff. Digital channels can increase the democratization, safety, and efficiency of communication between employees and leaders and increase awareness of ethical aspects in daily care work. The leaders had positive expectations of employees' activities and benefits from using the tool for ethical reflection. However, they admitted that realizing the tool's potential to ensure continuity in ethics work requires considerable organizational and leader involvement. Conclusions: This study shows that healthcare leaders are open to digital solutions for managing ethics work in home nursing care. Both opportunities and important prerequisites for successfully implementing the digital tool were identified. [ABSTRACT FROM AUTHOR]

Background: The individualized PREdiction of DIsease Control using digital sensor Technology (iPREDICT) program was developed for asthma management using digital technology. Devices were integrated into daily lives of patients to establish a predictive model of asthma control by measuring changes from baseline health status with minimal device burden. Objectives: To establish baseline disease characteristics of the study participants, detect changes from baseline associated with asthma events, and evaluate algorithms capable of identifying triggers and predicting asthma control changes from baseline data. Patient experience and compliance with the devices were also explored. Design: This was a multicenter, observational, 24-week, proof-of-concept study conducted in the United States. Methods: Patients (⩾12 years) with severe, uncontrolled asthma engaged with a spirometer, vital sign monitor, sleep monitor, connected inhaler devices, and two mobile applications with embedded patient-reported outcome (PRO) questionnaires. Prospective data were linked to data from electronic health records and transmitted to a secure platform to develop predictive algorithms. The primary endpoint was an asthma event: symptom worsening logged by patients (PRO); peak expiratory flow (PEF) < 65% or forced expiratory volume in 1 s < 80%; increased short-acting β2-agonist (SABA) use (>8 puffs/24 h or >4 puffs/day/48 h). For each endpoint, predictive models were constructed at population, subgroup, and individual levels. Results: Overall, 108 patients were selected: 66 (61.1%) completed and 42 (38.9%) were excluded for failure to respond/missing data. Predictive accuracy depended on endpoint selection. Population-level models achieved low accuracy in predicting endpoints such as PEF < 65%. Subgroups related to specific allergies, asthma triggers, asthma types, and exacerbation treatments demonstrated high accuracy, with the most accurate, predictive endpoint being >4 SABA puffs/day/48 h. Individual models, constructed for patients with high endpoint overlap, exhibited significant predictive accuracy, especially for PEF < 65% and >4 SABA puffs/day/48 h. Conclusion: This multidimensional dataset enabled population-, subgroup-, and individual-level analyses, providing proof-of-concept evidence for development of predictive models of fluctuating asthma control. [ABSTRACT FROM AUTHOR]

Objective: In Sweden, the prevalence of daily smoking has decreased substantially over the past few decades. However, a socioeconomic divide is evident, contributing to health inequities. The current study focuses on the needs, facilitators, and barriers in relation to quitting smoking among individuals in disadvantaged areas and explores their perception of digital tools for smoking cessation. Method: Semi-structured interviews were conducted with 30 participants in Stockholm County between 2022 and 2023. Participants were recruited through health care centres, dental clinics, and civil society actors. A thematic analysis was performed. Results: Two cross-cutting main themes were identified; 1) Motivational factors and barriers in smoking cessation, including the subthemes “health, concern for loved ones and economic aspects” and “emotional, environmental, and cultural barriers” and 2) Benefits and limitations of a digital tool for smoking cessation, including the subthemes”important/relevant features in a digital app” and “limitations of digital support”. Conclusions: The results reveal that most participants want to quit smoking but perceive it as difficult. The study highlights the importance of addressing social disparities in smoking and the need for accessible smoking cessation support. While mobile apps are viewed as promising for smoking cessation by some of the participants, scepticism exists among others. Moving forward, personalized approaches that integrate digital tools with traditional methods for smoking cessation can be important to reduce smoking prevalence. Ensuring accessibility of effective smoking cessation support for all is a key public health interest.

In order to assist learners in scientific writing, encompassing genres such as dissertations, theses, and research articles, we developed a digital lexical tool based on a resource of the transdisciplinary scientific lexicon (TSL). This lexicon-genre-specific in scientific discourse-transcends disciplines and serves key discursive functions. The lexical tool, designed for autonomous use, provides semantic, syntactic, phraseological and discursive information about the LST, aiding in its decoding and encoding. An experiment with Chinese-speaking learners assessed the tool’s practicality in written production. The experiment involved scientific writing training, where learners used the tool for writing tasks. The objectives were to test the tool’s usability and to help learners acquire methodological and lexical scientific knowledge. Screen video capture technology recorded tool manipulations to objectively observe interactions between the tasks, learners, and the tool. A questionnaire gathered learners’ assessments of the tool. The analysis of the video captures and questionnaires provides insights into the tool’s integration in the English classroom. This is our result: the effective use of the tool not only depends on the design of a user-friendly interface, but also on the development of learners' lexical knowledge.

For many teachers, the need to switch to distance learning during the lockdown period enabled them to discover and/or use digital tools. Once the lockdown was over, teachers were able to return to face-to-face teaching and familiar teaching-learning situations and were therefore more relaxed. But what about the digital tools used during this period? Have teachers transferred the pedagogical approaches used in their online courses to their face-to-face courses? Do online digital applications retain their legitimacy when teachers return to the classroom? By means of a questionnaire and interviews with teachers about their experiences during and after the period of confinement, this research aims to study the digital tools used during distance learning and their functions, and then to observe the follow-up to their use.

In contrast to traditional public participation methods in planning, digital tools need to be developed by information technology experts which means the public cannot customise their approaches to participation without IT expertise. This study examines the effectiveness of a user-centred design approach in developing a planning support system for collaborative urban planning. The findings show that tool developers play a crucial role in shaping the tool, while users could provide inputs through user research conducted by the researchers. A systemic challenge between tool developers, users, researchers, and funders is revealed.

IntroductionHuman growth hormone (hGH) therapy in children can be administered by subcutaneous injection using either a manual non-connected device, which is a portable injection pen loaded with a pre-filled cartridge, or an electronic connected device. The electronic device is connected to a platform where adherence data is recorded and available for health care professionals (HCPs) and patient support programs. Real-world data used in the clinic, includes regular monitoring of adherence data which are shared with families during patients’ visits and aim to determine the root causes of poor adherence. This study aimed to identify whether there are differences in growth during the first four years of treatment depending on the device, i.e. non-connected versus connected devices.MethodsThis retrospective study reports treatment of either GH deficiency or short stature secondary to birth size small for gestational age (SGA) in 174 pediatric patients attending Miguel Servet Hospital, Zaragoza, Spain. hGH treatment was administered with manual non-connected devices in 87 patients and 87 patients used connected devices. Height was followed for 4 years after start of hGH therapy.ResultsIn total, 57% of subjects had GHD and 43% were SGA. Height standard deviation score (HSDS) at treatment start was higher (p

Abstract Introduction The efficacy of diagnostic and monitoring tools in ophthalmology is significantly influenced by patient engagement levels. This presents a notable challenge, especially in the context of developing tools designed for telemedicine applications. Ensuring consistent patient engagement is therefore crucial for the accurate and reliable utilization of these technologies. This study assesses patient perceptions and experiences after using a purpose-built web application, called PocDoc. Methods A cross-sectional questionnaire-based survey was conducted among 440 patients recruited from general and specialist eye clinics between March 2022 and October 2023, both before and after using the PocDoc app. Results Pre-test findings revealed that 86.8% of patients thought that a remote eye monitoring application would have use, while 70.9% anticipated frequent usage. Only 16.4% found it overly complex, and 55.2% perceived it as easy to use. Additionally, 34.5% foresaw the need for technical support, while 72.5% believed they would quickly grasp its use. In the post-test questionnaire, 63.3% of patients still expressed intent for frequent PocDoc usage. The perception of complexity decreased to 20.4%, with 79.3% finding it easy to use. The belief in the need for technical support decreased to 36.5%, while 89.9% felt confident in mastering the application quickly. Moreover, 77.3% found the application's functions well-integrated, and 64.6% were very confident using PocDoc. Conclusions Results suggest patient receptivity to web-based applications, confirming their viability for specific patient groups. Overall, our study contributes to the growing body of evidence indicating that greater exposure to digital health tools can significantly influence patient acceptance and perceived ease of use, an insight that has important implications for the implementation and design of these technologies in clinical settings.

Abstract Background About 40% of people respond to stress by consuming more unhealthy foods. This behavior is associated with increased energy intake and the risk of obesity. As mobile health (mHealth) applications (apps) have been shown to be an easy-to-use intervention tool, the characterization of potential app users is necessary to develop target group-specific apps and to increase adherence rates. Methods This cross-sectional online survey was conducted in the spring of 2021 in Germany. Sociodemographic data and data on personality (Big Five Inventory, BFI-10), stress-eating (Salzburg Stress Eating Scale, SSES), and technology behavior (Personal Innovativeness in the Domain of Information Technology, PIIT; Technology Acceptance Model 3, TAM 3) were collected. Results The analysis included 1228 participants (80.6% female, mean age: 31.4 ± 12.8 years, mean body mass index (BMI): 23.4 ± 4.3 kg/m2). Based on the TAM score, 33.3% (409/1228) of the participants had a high intention to use a hypothetical mHealth app to avoid stress-overeating. These persons are characterized by a higher BMI (24.02 ± 4.47 kg/m2, p

Introduction: The efficacy of diagnostic and monitoring tools in ophthalmology is significantly influenced by patient engagement levels. This presents a notable challenge, especially in the context of developing tools designed for telemedicine applications. Ensuring consistent patient engagement is therefore crucial for the accurate and reliable utilization of these technologies. This study assesses patient perceptions and experiences after using a purpose-built web application, called PocDoc. Methods: A cross-sectional questionnaire-based survey was conducted among 440 patients recruited from general and specialist eye clinics between March 2022 and October 2023, both before and after using the PocDoc app. Results: Pre-test findings revealed that 86.8% of patients thought that a remote eye monitoring application would have use, while 70.9% anticipated frequent usage. Only 16.4% found it overly complex, and 55.2% perceived it as easy to use. Additionally, 34.5% foresaw the need for technical support, while 72.5% believed they would quickly grasp its use. In the post-test questionnaire, 63.3% of patients still expressed intent for frequent PocDoc usage. The perception of complexity decreased to 20.4%, with 79.3% finding it easy to use. The belief in the need for technical support decreased to 36.5%, while 89.9% felt confident in mastering the application quickly. Moreover, 77.3% found the application's functions well-integrated, and 64.6% were very confident using PocDoc. Conclusions: Results suggest patient receptivity to web-based applications, confirming their viability for specific patient groups. Overall, our study contributes to the growing body of evidence indicating that greater exposure to digital health tools can significantly influence patient acceptance and perceived ease of use, an insight that has important implications for the implementation and design of these technologies in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates how seventh-grade students experience online collaborative writing, its support in writing poems, and how collaboratively and individually written poems differ. Methods: The educational design research method was used in this mixedmethods study, which was conducted in natural classroom settings to investigate students' individual and collaborative poetry writing. Results: The quantitative analysis of questionnaires and qualitative thematic analysis of postexperimental interviews show that the students enjoyed collaborative writing more and found it more accessible than individual writing. They experienced that it supported them in writing better poems and increased their writing confidence. They also appreciated the support of teamwork, although individual writing gave them more liberty to explore various aspects of poetry and express their feelings. Discussion: From a pedagogical point of view, the students need to be provided with opportunities for collaborative poetry writing to make the writing process easier and more enjoyable. Online collaborative writing supports the process of poetry writing. [ABSTRACT FROM AUTHOR]

Background About 40% of people respond to stress by consuming more unhealthy foods. This behavior is associated with increased energy intake and the risk of obesity. As mobile health (mHealth) applications (apps) have been shown to be an easy-to-use intervention tool, the characterization of potential app users is necessary to develop target group-specific apps and to increase adherence rates. Methods This cross-sectional online survey was conducted in the spring of 2021 in Germany. Sociodemographic data and data on personality (Big Five Inventory, BFI-10), stress-eating (Salzburg Stress Eating Scale, SSES), and technology behavior (Personal Innovativeness in the Domain of Information Technology, PIIT; Technology Acceptance Model 3, TAM 3) were collected. Results The analysis included 1228 participants (80.6% female, mean age: 31.4±12.8 years, mean body mass index (BMI): 23.4±4.3 kg/m2 ). Based on the TAM score, 33.3% (409/1228) of the participants had a high intention to use a hypothetical mHealth app to avoid stress-overeating. These persons are characterized by a higher BMI (24.02±4.47 kg/m2 , p<0.001), by being stress-overeaters (217/409, 53.1%), by the personality trait “neuroticism” (p<0.001), by having specific eating reasons (all p<0.01), and by showing a higher willingness to adopt new technologies (p<0.001). Conclusion This study suggests that individuals who are prone to stress-overeating are highly interested in adopting an mHealth app as support. Participants with a high intention to use an mHealth app seem to have a general affinity towards new technology (PIIT) and appear to be more insecure with conflicting motives regarding their diet. Trial registration This survey was registered in the German Clinical Trials Register (Registration number: DRKS00023984). [ABSTRACT FROM AUTHOR]

This article focuses on training in the use of ICT while organizing the distance learning part of Blended Language Learning (BLL) courses set up in the aftermath of the Covid-19 pandemic. It seeks to determine how, in the context of French as a Foreign Language classes at Rennes 2 University (CIREFE), educational engineering must work to best encourage the reinvestment of skills often acquired in a state of emergency in 2020 while inviting them to be developed. The aim is that the post-pandemic training offer takes advantage, by fully integrating these new educational practices, of the upheavals of the 2019 health crisis. The study is based on an internal professional development system prior to the pandemic, which tries to best adapt its content to new teaching-learning habits. It relies on current scientific work in the field and follows a precise observation protocol of the evolution of this professional development offering, in order to determine whether it has been able to meet the needs of teaching staff. To do this, it uses anonymous field surveys, the results of which are presented, then analyzed, and the conclusions reached by the reflection make it possible to define exploitable perspectives in the training of language teachers.

Contamination of fresh produce with Listeria monocytogenes can occur throughout the supply chain, including at retail, where Listeria spp., including L. monocytogenes, may be introduced and spread via various routes. However, limited tools are available for retailers to assess practices that can enhance control of Listeria transmission to fresh produce. Therefore, we developed an agent-based model that can simulate Listeria transmission in retail produce sections to optimize environmental sampling programs and evaluate control strategies. A single retail store was used as a model environment, in which various routes of Listeria introduction into and transmission between environmental surfaces were modeled. Model prediction (i.e., Listeria prevalence) was validated using a published longitudinal study for all surfaces that were included in both the model and the validation data. Sensitivity analysis using the Partial Rank Correlation Coefficient showed that (i) initial Listeria concentration from incoming produce, (ii) transfer coefficient from produce to employee’s hands, and (iii) transfer coefficient from consumer to produce were the top three parameters that were significantly (p

IntroductionDigital health technologies (DHTs) have the potential to alleviate challenges experienced in clinical trials through more objective, naturalistic, and frequent assessments of functioning. However, implementation of DHTs come with their own challenges, including acceptability and ease of use for study participants. In addition to acceptability, it is also important to understand device proficiency in the general population and within patient populations who may be asked to use DHTs for extended periods of time. We thus aimed to provide an overview of participant feedback on acceptability of DHTs, including body-worn sensors used in the clinic and a mobile application used at-home, used throughout the duration of the Wearable Assessments in the Clinic and at Home in Parkinson's Disease (WATCH-PD) study, an observational, longitudinal study looking at disease progression in early Parkinson's Disease (PD).Methods82 participants with PD and 50 control participants were enrolled at 17 sites throughout the United States and followed for 12 months. We assessed participants' general device proficiency at baseline, using the Mobile Device Proficiency Questionnaire (MDPQ). The mean MDPQ score at Baseline did not significantly differ between PD patients and healthy controls (20.6 [2.91] vs 21.5 [2.94], p = .10).ResultsQuestionnaire results demonstrated that participants had generally positive views on the comfort and use of the digital technologies throughout the duration of the study, regardless of group.DiscussionThis is the first study to evaluate patient feedback and impressions of using technology in a longitudinal observational study in early Parkinson's Disease. Results demonstrate device proficiency and acceptability of various DHTs in people with Parkinson's does not differ from that of neurologically healthy older adults, and, overall, participants had a favorable view of the DHTs deployed in the WATCH-PD study.

Abstract Background Explainer animations are a means to communicate aspects of clinical trials to participants in a more engaging and accessible way. Delivered well these have the potential to enhance recruitment and retention. The range of media technology used to deliver this material is expanding rapidly but is highly fragmented. Usage of explainer animations across the UK is unknown, the aim of this research was to determine current usage across the 52 registered UK Clinical Research Collaboration (UKCRC) Clinical Trials Units (CTUs) to understand the current landscape and any barriers that could be preventing wider uptake of this functionality. Methods A survey link was emailed to all UKCRC CTU Directors and Trial Management Leads to ascertain current usage of explainer animations within their CTU. The survey ran between 01 February 2023 and 07 March 2023. Results Responses were received from 35 CTUs—representing a response rate of 67%. 24 CTUs (69%) reported that they had created/used at least one explainer animation within their unit, although the usage, cost, length and production activities varied among the units. Conclusions The survey showed that a high proportion of the UKCRC CTUs have used explainer animations to provide information to participants about clinical studies. For those not using the technology yet, the most common reasons cited were a lack of expertise, lack of resources and costs to produce them. One of the desired outcomes of this project is the creation of a free-to-use library of animations to encourage wider uptake and avoid duplication.

Abstract Background Young adult caregivers (YACs, aged 18–25) who take care of a loved one may juggle between caregiving responsibilities and other life areas such as education and social life, leading to an imbalance in their lives. The web-based tool ‘MantelzorgBalans’ aims to support informal caregivers (ICGs) in balancing caregiving tasks and activities in other life areas. However, this tool was designed to support ICGs of loved ones receiving palliative care and is not yet tailored to the needs of YACs. In order to do so, in this study we aim to explore (i) challenges and support needs of YACs in caregiving, (ii) their needs towards the content of the ‘MantelzorgBalans’ tool, and (iii) issues they encountered in using the tool and their preferences for adaptation of the tool. Method We conducted semi-structured interviews and usability testing with 13 student YACs in the Netherlands. Within usability testing, we used three approaches: (i) a thinking-aloud approach (verbalizing thoughts while using the tool), (ii) a task-based performance approach (scoring task completion rate), and (iii) questionnaires. We used thematic analysis to synthesize the qualitative data. For the quantitative data, we calculated frequencies and mean scores. Results Our findings suggest that the majority of YACs faced challenges in balancing caregiving with life areas such as education and social life. They needed support from healthcare professionals who could listen to them without judging them. With respect to the MantelzorgBalans tool, YACs needed more information on how to provide emotional support to their loved one and the emotional support that is available for them. In regards to the aesthetics, they preferred bright colours and more visuals in the tool. Overall, they were satisfied with the information presented in the tool, but they were neutral in their willingness to use it in the future. Conclusion From this study, we learn that YACs may experience specific challenges and needs in general, and towards a web-based tool in specific. In the near future, it will be important to develop digital tools to support YACs that match their specific needs. This may enable healthcare professionals to offer targeted and personalized digital support to YACs in future.

To explain successful subject matter learning with digital tools, the specification of mediating cognitive processes is crucial for any empirical investigation. We introduce a cognitive process framework for the mechanisms of learning with digital tools (CoDiL) that combines core ideas from the psychology of instruction (utilization-of-learning-opportunity framework), cognitive psychology (knowledge-learning-instruction framework), and domain-specific research on learning and instruction. This synthesizing framework can be used to theoretically ground, firstly, the design of digital tools for learning, and secondly, the empirical analysis of students’ learning activities in digitally enriched educational settings via the analysis of specific student-tool interactions. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of the present study were to qualitatively investigate nursing home caregivers' acceptance of, and experiences with, a new digital intervention for oral healthcare after a period of real‐life testing in three nursing homes located in Rogaland county, Norway. Background: Nursing home caregivers report numerous barriers when it comes to provision of adequate oral care for care‐dependent older adults. Among the reported barriers are lack of knowledge and skills, care‐resistant behaviours, lack of adequate routines and documentation systems for oral health, a high workload, and unclear responsibilities. To overcome these barriers, a digital tool named SmartJournal was developed to assist caregivers in preserving nursing home residents' oral health. Materials and methods: Semistructured interviews were performed with selected caregivers (n = 12) taking part in SmartJournal testing. A theory‐driven thematic analysis based on technology acceptance model was conducted. Results: SmartJournal was generally described as a userfriendly and useful tool. The initial reaction of the participants was mixed; some were positive, some had concerns, but many seemed to have a neutral stance to the intervention. Both barriers and facilitating factors for SmartJournal usage were revealed. Interestingly, the usage gradually changed from norm‐based to routine‐based behaviour during the test period. Although the tool was well‐accepted, as demonstrated with study participants' willingness to use it in the future, they had several suggestions for improvements to further adapt it to a nursing home setting. Conclusion: Results from the present study provide valuable information on questions about SmartJournal acceptance and intervention delivery, thereby preparing the ground for a larger scale evaluation study assessing measurable effects of SmartJournal usage in nursing homes. [ABSTRACT FROM AUTHOR]

Background: Pragmatic skills allow children to use language for social purposes, that is, to communicate and interact with people. Most children with neurodevelopmental disorders (NDDs) face pragmatic difficulties during development. Nevertheless, pragmatic skills are often only partially assessed because the existing instruments usually focus on specific aspects of pragmatics and are not always adapted to children with communication difficulties. In this sense, digital tools (e.g., apps) are an optimal method to compensate for some difficulties. Moreover, there is a lack of pragmatic tools measuring the receptive domain. Therefore, the present study aims to validate PleaseApp as a digital instrument that measures eight pragmatic skills by presenting the design of the assessment tool and its psychometric properties. Methods: PleaseApp was designed based on previous empirical studies of developmental pragmatics in children with and without NDD. PleaseApp assesses eight receptive pragmatic skills: figurative language, narrative, reference, indirect speech acts, visual and verbal humor, gesture-speech integration, politeness, and complex intentionality. The study involved 150 typically developing children between 5 and 12 years of age. Results: A confirmatory factor analysis proposes an eight-factor model with no underlying factor structure. The eight tests that compose PleaseApp have obtained a model with a good fit and with adequate reliability and validity indices. Discussion: PleaseApp is an objective, valid, and reliable tool for assessing pragmatic skills in children with NDD. In this sense, it helps to assess whether a child has acquired pragmatic skills correctly according to his/her age and clarify the specific problems a child has in eight different components to plan personal and personalized interventions. [ABSTRACT FROM AUTHOR]

Maker education provides the perfect context for young learners to develop 21st-century skills. However, research is inconclusive on how these skills could be assessed. Namely, the complex nature of 21st-century skills requires different types of assessments, not necessarily relying on paper-and-pencil or multiple-choice tests, but rather drawing on the learners' perspective in the form of self-assessment and reflection. Prior studies highlighted several challenges of situating self-assessment in makerspace contexts, such as the lack of dedicated technology for documentation, distractions caused by noise or group work, and the lack of skills and motivation to practice self-assessment. This paper presents an exploratory case study aimed at an in-depth investigation of the use of a digital self-assessment tool of 21st-century skills in makerspace contexts. The authors converged qualitative data collected mainly from interviews with teachers and students. Researcher observations and tool log files (e.g., student work in the digital tool) were used as triangulation sources. Although challenges emerged, the study presents encouraging findings regarding the use of the digital tool for raising students' awareness of their development of 21st -century skills and engaging them in self-assessment and reflection. The results of the study provide rich insights to guide future research on the topic. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study examined student and caregiver preference for school communication and explored the feasibility and acceptability of a digital tool to assist with communication about school meal program between schools and families. METHODS: The study used qualitative methodology through youth focus groups and caregiver semi‐structured phone interviews. The study was conducted in 4 high schools in a large, urban city. The phenomenon of interest included the exploration of preferences regarding communication around school meal programs and feasibility and acceptability of a digital tool for communication and promoting the ordering of healthful foods in the school environment. Interviews were transcribed, coded, and analyzed through NVivo qualitative software using thematic analysis approach to examine themes. RESULTS: Forty‐seven students (ages 14‐21, grades 9‐12) participated in 7 focus groups and 24 caregivers participated in semi‐structured phone interviews. Three themes emerged around (1) communication preferences, (2) accessibility, and (3) extrinsic motivational factors for engagement in healthy eating behaviors. CONCLUSION: Results indicated that communication methods could potentially influence motivation and engagement in youth school meal participation. [ABSTRACT FROM AUTHOR]

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Based on Statistics Finland's Quality of Work Life Survey 2018, this paper seeks how Finnish employees' use of digital tools differs from each other, what sociodemographic and work contextrelated factors these differences are connected to, and how differences in usage are reflected in the effects of digitalisation on employees' work. The research identified five user groups. Nearly half of the employees are classified as Skilled Users, which are typically of a young age. Challenges for other groups include deficiencies in digital skills, problems in learning to use digital tools, routine-like usage, low learning demands at work, and a high workload and learning pressure arising from intensive use of digital tools. The results support the sequential and compound digital exclusion arguments derived from previous literature, but do not fully support the stratification argument. The paper shows that among employees there are digital divides of various types. Narrowing these gaps requires different policies and customised solutions. [ABSTRACT FROM AUTHOR]

The relevance of the research lies in the growing need of future teachers for effective and productive tools for teaching design, which can significantly reduce the time of learning new progressive software tools. With the development of technology and increasing competition in the market, speed and quality of design are becoming critical success factors. The purpose of the study is to study the effectiveness and productivity of using SolidWorks in the process of teaching design, as well as to determine its advantages over other CAD programs. The article analyzes the use of SolidWorks in the modern engineering and pedagogical process, highlights its advantages compared to other CAD programs, and emphasizes its importance for educators in the process of creating and learning new products and technologies. SolidWorks is positioned as an innovative design program that has numerous advantages due to the interface and a wide set of tools that allow you to significantly increase the efficiency and productivity of learning for the work of future educators. The program also provides the ability to perform various analyzes and simulations, which contributes to the improvement of product quality, allowing to identify potential problems in the early stages of design and reduce costs and risks in design. In general, the use of SolidWorks during the educational process provides ample opportunities for training future teachers. This software significantly increases the efficiency and quality of the educational process, making it an integral part of modern pedagogical education. Future innovations and developments in SolidWorks promise to further improve the competitiveness of design at various stages of the educational process. [ABSTRACT FROM AUTHOR]

Background: The reasons for mental health consultations are becoming increasingly relevant in primary care. The Catalan health care system is undergoing a process of digital transformation, where eHealth is becoming increasingly relevant in routine clinical practice. Objective: This study aimed to analyze the approach to depressive episodes and the role of eHealth in the Catalan health care system from 2017 to 2022. Methods: A retrospective observational study was conducted on diagnostic codes related to depressive episodes and mood disorders between 2017 and 2022 using data from the Catalan Institute of Health. The sociodemographic evolution and prevalence of depression and mood disorders in Catalonia were analyzed between 2017 and 2022. Sociodemographic variables were analyzed using absolute frequency and percentage. The prevalence of depressive episodes was calculated, highlighting the year-to-year changes. The use of eHealth for related consultations was assessed by comparing the percentages of eHealth and face-to-face consultations. A comparison of sociodemographic variables based on attendance type was conducted. Additionally, a logistic regression model was used to explore factors influencing face-to-face attendance. The analysis used R software (version 4.2.1), with all differences examined using 95% CIs. Results: From 2017 to 2022, there was an 86.6% increase in the prevalence of depression and mood disorders, with women consistently more affected (20,950/31,197, 67.2% in 2017 and 22,078/33,169, 66.6% in 2022). In 2022, a significant rise in depression diagnoses was observed in rural areas (difference 0.71%, 95% CI 0.04%-1.43%), contrasting with a significant decrease in urban settings (difference --0.7%, 95% CI --1.35% to --0.05%). There was a significant increase in antidepressant use in 2022 compared to 2017 (difference 2.4%, 95% CI 1.87%-3.06%) and the proportion of eHealth visits rose from 4.34% (1240/28,561) in 2017 to 26.3% (8501/32,267) in 2022. Logistic regression analysis indicated that men (odds ratio [OR] 1.06, 95% CI 1.04-1.09) and younger individuals had a higher likelihood of eHealth consultations in 2022. Furthermore, individuals using eHealth consultations were more likely to use antidepressants (OR 1.54, 95% CI 1.50-1.57) and anxiolytics (OR 1.06, 95% CI 1.03-1.09). Conclusions: The prevalence of depression in Catalonia has significantly increased in the last 6 years, likely influenced by the COVID-19 pandemic. Despite ongoing digital transformation since 2011, eHealth usage remained limited as of 2017. During the lockdown period, eHealth accounted for nearly half of all health care consultations, representing a quarter of consultations by 2022. In the immediate aftermath of the COVID-19 pandemic, emerging evidence suggests a significant role of eHealth in managing depression-related consultations, along with an apparent likelihood of patients being prescribed antidepressants and anxiolytics. Further research is needed to understand the long-term impact of eHealth on diagnostic practices and medication use. [ABSTRACT FROM AUTHOR]

The construction engineering and management sector is facing rapid technological disruption due to the extensive adoption of digital tools. The main aim of this research was to assess the accuracy and usefulness of web-based instruments used for the evaluation and mensuration of built environment characteristics. Through on-site visits and two web-based tools, a digital management system based on fuzzy logic was used to evaluate the functional service life of two heritage timber buildings in Valdivia (Chile). The assessments of 40 professional experts (4 on-site visual inspections and 36 virtual inspections) were compared to evaluate the relative accuracy and usefulness of the on-site and web-based instruments. Web-based audits, which used Google Street View and Google Maps, tended to agree strongly with on-site audits on the functional degradation of the timber structures (vulnerabilities and external hazard affections). While web-based tools do not offer a perfect substitute for on-site audits, they do allow for preliminary audits to be performed accurately from remote locations, potentially saving time and cost and increasing the effectiveness of subsequent on-site visits. The study findings may be useful to industry stakeholders in understanding the early impacts of the use of new remote digital inspection tools on the construction industry. [ABSTRACT FROM AUTHOR]

Effective waste management is crucial for sustainable industrial operations. This paper introduces a state-of-the-art digital tool designed for the circular economy. Primarily it pinpoints and quantifies symbiotic possibilities between industries with liquid waste streams, emphasising the most lucrative inter-industry connections. In practice, the tool takes in data such as waste stream volumes, material concentrations within these streams, market prices of materials, and industries’ raw material consumption rates. Utilising these, its algorithm identifies and assesses the most profitable material exchanges among the specified industries. This assessment considers the market value of materials and the costs associated with recovering those materials from liquid waste streams. One of the major challenges, the estimation of recovery costs, is addressed using an innovative Sherwood plot analysis. This analysis draws a correlation between a material’s recovery cost and its concentration within a liquid medium. The tool’s output provides a detailed list of potential transactions complemented by illustrative graphs that detail mass flows, profit margins, and environmental advantages for each industry. Collectively, these details offer insights both for individual industries and the industrial ecosystem as a whole. One of the tool’s most significant revelations is its ability to uncover potential “bridges” linking industrial waste streams to resource needs, unearthing previously unnoticed economic and ecological gains. By calculating economic and environmental benefits of “waste” reuse, this tool offers a compelling rationale for the adoption of industrial symbiosis. Ultimately, it uncovers the transformative potential of aligning industrial activities with a balance that fosters both economic growth and ecological responsibility.

IntroductionThis study investigates how seventh-grade students experience online collaborative writing, its support in writing poems, and how collaboratively and individually written poems differ.MethodsThe educational design research method was used in this mixed-methods study, which was conducted in natural classroom settings to investigate students’ individual and collaborative poetry writing.ResultsThe quantitative analysis of questionnaires and qualitative thematic analysis of postexperimental interviews show that the students enjoyed collaborative writing more and found it more accessible than individual writing. They experienced that it supported them in writing better poems and increased their writing confidence. They also appreciated the support of teamwork, although individual writing gave them more liberty to explore various aspects of poetry and express their feelings.DiscussionFrom a pedagogical point of view, the students need to be provided with opportunities for collaborative poetry writing to make the writing process easier and more enjoyable. Online collaborative writing supports the process of poetry writing.

Construction is a sector characterized by a high likelihood of accidents, among the factors that have the potential to reduce such accidents, the design stage is important to reduce risks in the life cycle of the enterprise. The need to reduce risks on the construction site early and proactively has fostered the development of digital tools for designs. This study aimed to conduct a systematic review of the literature on the development and application of digital tools capable of identifying security risks in designs and examine them to point out their characteristics and limitations. The review of the literature was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The research showed that although the use of digital tools has great potential for impact on risk mitigation in the design stage, they are still little used and have not reached their maximum potential. In addition, this systematic review indicates possibilities of use, which include the automation of risk verification and provision of security measures, as well as limitations, as the absence of consideration of the dynamism of the work in digital tools. Therefore, the present work presents a basis to help structure future applied research in the area.

Abstract It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self‐assessment provides a potential solution for person‐centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8–17 years of age. A multi‐site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish‐speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think‐aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8–17 years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well‐validated tool to strengthen the child's voice within healthcare.

Abstract Background Stroke is a leading cause of disability among adults worldwide. A timely structured follow-up tool to identify patients’ rehabilitation needs and develop patient-tailored rehabilitation regimens to decrease disability is largely lacking in current stroke care. The overall purpose of this study is to evaluate the effectiveness of a novel digital follow-up tool, Rehabkompassen®, among persons discharged from acute care settings after a stroke. Methods This multicentre, parallel, open-label, two-arm pragmatic randomized controlled trial with an allocation ratio of 1:1 will be conducted in Sweden. A total of 1106 adult stroke patients will have follow-up visits in usual care settings at 3 and 12 months after stroke onset. At the 3-month follow-up, participants will have a usual outpatient visit without (control group, n = 553) or with (intervention group, n = 553) the Rehabkompassen® tool. All participants will receive the intervention at the 12-month follow-up visit. Feedback from the end-users (patient and health care practitioners) will be collected after the visits. The primary outcomes will be the patients’ independence and social participation at the 12-month visits. Secondary outcomes will include end-users’ satisfaction, barriers and facilitators for adopting the instrument, other stroke impacts, health-related quality of life and the cost-effectiveness of the instrument, calculated by incremental cost per quality-adjusted life year (QALY). Discussion The outcomes of this trial will inform clinical practice and health care policy on the role of the Rehabkompassen® digital follow-up tool in the post-acute continuum of care after stroke. Trial registration ClinicalTrials.gov NCT04915027. Registered on 4 June 2021. ISRCTN registry ISRCTN63166587. Registered on 21 August 2023.