Search

We aimed to analyze the number and type of contacts involving the risk of respiratory disease transmission during football match play. We analysed 50 matches from different playing levels. Two reviewers evaluated the contacts of all players in each match. We focused on between-player contacts, crowding, actions with potentially increased aerosol and droplet production and within-player hand-to-head contacts. We categorized the duels with direct contact into frontal and other ones and measured contact duration. The number of between-player contacts were similar between playing levels (median 28.3 [IQR 22.6, 33] contacts per player-hour). Frontal contacts summed up to 8% of all contacts. Contacts involving the head occurred less than once per player and match with none lasting longer than 3 s. Crowding included between two and six players and the duration was mostly less than 10 s. Aerosol and droplet producing activities were three to four times more frequent in adult compared to youth players. Our results suggest that the risk of respiratory pathogen transmission is low during football matches. This conclusion is based on the finding that most close contact situations are of short duration and on the fact that it is an outdoor sport., (© 2022. The Author(s).)

A teacher plays a pivotal role in grooming a society and paves way for its social and economic developments. Teaching is a dynamic role and demands continuous adaptation. A teacher adopts teaching techniques suitable for a certain discipline and a situation. A thorough, detailed, and impartial observation of a teacher is a desideratum for adaptation of an effective teaching methodology and it is a laborious exercise. An automatic strategy for analyzing a teacher's teaching methodology in a classroom environment is suggested in this work. The proposed strategy recognizes a teacher's actions in videos while he is delivering lectures. In this study, 3D CNN and Conv2DLSTM with time-distributed layers are used for experimentation. A range of actions are recognized for a complete classroom session during experimentation and the reported results are considered effective for analysis of a teacher's teaching technique., Competing Interests: The authors have declared that no competing interests exist.

Objectives: There is limited knowledge about students' experiences with virtual simulation when using a video conferencing system. Therefore, the aim of this study was to explore how second-year undergraduate nursing students experienced learning through virtual simulations during the COVID-19 pandemic., Methods: The study had an exploratory design with both quantitative and qualitative approaches. In total, 69 nursing students participated in two sessions of virtual simulation during spring 2020, and 33 students answered online questionnaires at session 1. To further explore students' experiences, one focus group interview and one individual interview were conducted using a video conferencing system after session 2. In addition, system information on use during both sessions was collected., Results: Changes in the students' ratings of their experiences of virtual simulation with the Body Interact ™ system were statistically significant. The virtual simulation helped them to bridge gaps in both the teaching and learning processes. Four important aspects of learning were identified: 1) learning by self-training, 2) learning from the software ( Body Interact ™), 3) learning from peers, and 4) learning from faculty., Conclusions: We conclude that virtual simulation through a video conferencing system can be useful for student learning and feedback from both peers and faculty is important., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: PhotoVoice is a qualitative research methodology designed to engage and empower marginalized members of a community and/or to understand community needs. PhotoVoice seems aphasia-friendly because it relies on personal photographs to convey opinions regarding prespecified topics. However, PhotoVoice is based on a procedure referred to as the SHOWeD method. Participants are asked to reflect upon their photos by discussing (1) what they S ee, (2) what is H appening, (3) the relation to O ur life, (3) W hy the issue or condition e xists, and then to (4) explain what can be D one to address the issue(s) at hand. Due to the linguistic demand required to convey complex thoughts and ideas inherent in this methodology, adaptations are likely required to successfully implement with people who have aphasia., Aims: A scoping review was conducted to summarize the current literature regarding the use of PhotoVoice with people who have aphasia, to address two questions:(1) Are people with post-stroke aphasia included in PhotoVoice studies?(2) What, if any, modifications are required to address post-stroke aphasia and motor impairments?, Main Contribution: This scoping review revealed that researchers often exclude people with aphasia from post-stroke PhotoVoice research. Three studies outlined adaptations that allowed successful implementation with people who have post-stroke aphasia., Conclusions: Further inquiry regarding how best to adapt PhotoVoice for people with aphasia will facilitate their ability to be included in community-based research. This is an important step in ensuring that all post-stroke stakeholders are involved in projects related to social justice and policy for stroke survivors.

Objective: The purpose of this study was to determine staff satisfaction and technology acceptance of continuous video monitoring (CVM) in comparison to sitters., Background: Traditionally, sitters have been used to prevent falls in hospitals. Continuous video monitoring has emerged to reduce costs associated with sitters while maintaining safety., Methods: A descriptive online survey using a modified version of the Technology Acceptance Model was used to gain insight on technology acceptance and satisfaction levels of clinical staff related to CVM., Results: Only 12.73% found CVM to be as effective as sitters. Statistical significance was shown comparing sitters with CVM. A positive correlation was found with perceived ease of use and perceived usefulness of CVM., Conclusions: Understanding staff satisfaction and technology acceptance is imperative for nurse leaders and administration when implementing new technologies., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

Gender/sex and sexual diversity are increasingly understood by the public as complex. But, scientific frameworks that address the complexity of gender/sex and sexual diversity are few and not well situated for the public. Sexual configurations theory (SCT; van Anders, 2015) is one approach that provides a visual framework for understanding and measuring gender/sex and sexual diversity. But how might knowledge users and creators actually use it? To make SCT more accessible to researchers, educators, clinicians, and the general public, we created three instructional videos (individual gender/sex, gender/sex sexuality, and partner number sexuality) that explained SCT and demonstrated how to use its diagrams. Participants (N = 242) of diverse gender/sex and sexual identities, including professionals who work in gender/sex- and sexuality-related fields, watched one of the three videos, filled out the diagrams, and evaluated the video and diagrams via scaled and open-ended questions. Results demonstrated that the SCT videos were sufficient for most participants to fill out the diagrams. Participants evaluated the video generally positively, with some variation by condition, identity group, and professional status. These results indicate that instructional videos are able to translate SCT, potentially facilitating uptake of SCT by clinicians, researchers, and educators as well as increasing awareness of gender/sex and sexual diversity more broadly within the public.

Provoked Vestibulodynia (PVD) is a type of localized vulvodynia (or pain in the vulva). The estimated prevalence of this condition is about 12% of the general population and approximately 20% of women under the age of 19. Many women who live with PVD suffer in silence for years before receiving a diagnosis. Whereas cognitive behavioral therapy (CBT) was already known to be effective for managing symptoms of PVD, there has recently been a published head-to-head comparison of CBT versus mindfulness-based therapy for the primary outcome of pain intensity with penetration. The trial revealed that both treatments were effective and led to statistically and clinically meaningful improvements in sexual function, quality of life, and reduced genital pain, with improvements retained at both 6- and 12-month follow-ups. We then undertook an end-of-grant knowledge translation (KT) campaign focused on the use of social media to disseminate an infographic video depicting the findings. Social media was strategically chosen as the primary mode of dissemination for the video as it has broad reach of audience, the public can access information on social media for free, and it presented an opportunity to provide social support to the population of women with PVD who are characterized as suffering in silence by starting a sensitive and empowering dialogue on a public platform. In this paper, we summarize the social media reach of our campaign, describe how and why we partnered with social media influencers, and share lessons learned that might steer future KT efforts in this field.

Background: Maternal childbirth satisfaction is one of the important indicators of the quality of the care provided. The use of non-pharmacological therapies can make the childbirth process a pleasurable event for the mother. This study aimed to compare the effects of watching virtual reality videos and chewing gum on the length of delivery stages and maternal satisfaction., Methods: This clinical trial study was performed on 93 women with first and second pregnancies, who were referred to Allameh Bohlool Hospital in Gonabad and Sajjadieh Hospital in Torbat-e-Jam, Iran, for childbirth between 2018 and 2019. Pregnant women were randomly assigned to three groups of chewing gum, virtual reality, and control. Interventions were performed twice: in the active (dilation of 4-5 cm) and second (dilation of 7-8 cm) phases of parturition for 20 minutes each. Data were collected using data-gathering forms, including a demographic characteristics form, a midwifery characteristics form, and the Mackey Childbirth Satisfaction Rating Scale. The data were analyzed using SPSS, version 22, via the Chi square tests, ANOVA, Kruskal-Wallis, and Tukey's post hoc tests., Results: The difference in the mean maternal childbirth satisfaction score between the two intervention groups of virtual reality and chewing gum was not statistically significant (P=0.339), but the mean score in the intervention groups was higher than that of the control group (P<0.001(. There was no significant difference in the mean length of the active and second phases of parturition between the two intervention groups, but this value in the intervention groups was significantly lower than that of the control group., Conclusion: The thought divergence interventions of chewing gum and watching virtual reality videos enhanced childbirth satisfaction, and curtailed parturition stages in our sample of pregnant women. Trial Registration Number: IRCT20181214041963N1., (Copyright: © Iranian Journal of Medical Sciences.)

Background: Mindfulness-based art therapy (MBAT) has been shown to provide a strategy for adults with multiple sclerosis (MS) to self-manage their symptoms. There is a need for the use of an MBAT intervention that can be delivered in any setting for adults with MS. The purpose of this pilot feasibility study was to test the feasibility and acceptability of an MBAT intervention delivered via videoconference., Methods: We developed an MBAT intervention to be delivered by videoconference to adults with MS recruited from an academic center registry. We also conducted phone interviews to collect acceptability data., Results: Most of the participants (n = 5) were very positive about the MBAT video sessions and stated content as clear and easy to follow and understand. The time and delivering method were acceptable., Conclusion: Mindfulness-based art therapy sessions delivered through videoconference are acceptable and feasible for adults with MS.

The female athlete triad (triad) is prevalent among aesthetic athletes, including dancers. However, there is limited research regarding triad knowledge or triad educational interventions among collegiate dancers. This study was intended to help correct that shortage. Participants (N = 24) completed two questionnaires: one assessed demographics, triad risk, and disordered eating (DE) risk; the other measured triad knowledge before and after viewing a 10-minute triad video. Twenty-seven percent of participants were found to be at risk for DE, 27% were at risk for the triad, and 8% were at risk for both. Significant improvements in triad knowledge were observed following the educational video; 4.08 ± 1.83 pre-intervention to 6.75 ± 0.09 post-intervention out of a possible 7, p < 0.001. There were no differences in triad knowledge when comparing freshmen and sophomores to juniors, seniors, and graduate students. This research confirms that triad education should be a continuous component of collegiate dancers' curricula to promote their overall health and wellness, and that the triad video can be an effective educational tool for supporting that goal.

Competing Interests: Competing interests: None declared.

Background: Technology can enable syringe service programs (SSPs) and other community-based organizations (CBOs) operating under a harm reduction framework to work with an increased number of clients and can also enable organizations to offer services more effectively (e.g., offering HIV testing in ways participants may be more likely to accept). In the current time of COVID-19 social distancing, technology can also help organizations more safely provide services to people with compromised immune systems and to clients who might otherwise not be reached. However, technology projects implemented in harm reduction settings are frequently conceptualized and developed by researchers or technology specialists rather than by SSP staff or clients., Methods: To more effectively meet the needs of SSPs and other CBOs across the USA, our team conducted qualitative interviews with 16 individuals who have extensive backgrounds working in the field of harm reduction. Interviews were digitally recorded and professionally transcribed, and the transcripts were checked for accuracy by the interviewers. The resulting transcripts were coded and analyzed to determine emerging themes., Results: Interviewees mentioned the ability of technology to deliver consistent quality messaging to multiple clients at the same time and the potential to customize or tailor technology-based messaging to specific client populations as positive benefits. Clear barriers to technology use also emerged, in particular regarding privacy, data security, and the need to maintain client trust when discussing sensitive issues (e.g., illicit drug use)., Conclusions: Technology offers the potential to deliver consistently high-quality health communication and maintain contact with clients who may have no other access to care. If designed and managed effectively, technology can also address issues related to providing services during times when physical contact is limited due to COVID-19 social distancing measures.

Background: Rigid bronchoscopy intubation poses a significant risk of complication to patients from mechanical trauma. Despite the importance of precision in forces exerted by surgeons during intubation, no prior study has analyzed the overall forces and torques involved in rigid bronchoscopy intubation, and whether existing training modalities accurately replicate them., Methods: A bronchoscope was equipped with a 6-axis load sensor to measure forces and torques applied during rigid bronchoscopy intubation. The device was applied to measure intubation forces in low-fidelity manikins and patients by interventional pulmonologists., Results: Axial and lateral forces were measured during rigid bronchoscope intubation from the mouth to the mid-trachea. The mean axial/lateral forces recorded during manikin trials were 6.93/18.06 N, whereas those recorded during patient trials were 4.57/9.43 N. Average axial and lateral force application was therefore 51.6% and 92.6% higher in manikin, respectively. Applied axial torque averaged across all human trials was 130.5 N-mm compared with 78.3 N-mm for manikin trials, 40% lower in manikin than in human. Lateral torque application during manikin intubation showed greater variation in between trials and a greater range of SDs within trials., Conclusion: This was the first application of a rigid bronchoscope measurement device designed to measure forces applied at the handle. Force and torque discrepancies between manikin training and patient applications were found, indicating a possible mismatch between the haptic feedback received by physicians during rigid training and application. This inconsistency could be resolved via novel haptic training modalities and help increase atraumatic intubations.

Objective: Determine the effectiveness of a cognitive behavioral game design (CBGD) based mobile game as an alcohol use intervention. Materials and Methods: Experimental design with 140 participants randomly assigned to either play a mobile game ( n  = 69) or watch a video documentary ( n  = 71). Results: Both groups displayed a decrease in intent to use and an increase in knowledge. The video intervention was superior in affecting actual use. Conclusion: Mobile game affects intent to use and is superior to the video in affecting knowledge.

Despite advances in evidence-based treatment for autism spectrum disorder (ASD), disparities in service access remain a serious concern. Current treatment models may not be feasible for families who live in remote geographical regions or have limited resources. To address this, studies have begun to explore parent-implemented interventions via an online format. The current study examined a new online course designed to help parents implement Pivotal Response Treatment (PRT) for their toddler with ASD. Parents submitted videos of parent-child interactions which were coded for fidelity of implementation (FOI) and social communicative behaviors. The data indicate that PRT fidelity and child behaviors significantly improved following course participation. This suggests that an online intervention may be a feasible approach to disseminating PRT strategies.

Background: The internet is a widely used source for obtaining medical information both by patients and physicians. YouTube is an essential source of information that may be a useful tool to inform the public and may improve the learning experience if used adequately. In this study, we aimed to estimate the quality and accuracy of videos about cardiopulmonary resuscitation videos aired on YouTube, which is the most popular video platform of the online world., Methods: We included the first 100 videos, in English, returned by the YouTube search engine in response to "cardiopulmonary resuscitation" keyword query to the study. The popularity of the videos was evaluated with an index called the video power index. The educational quality, accuracy, and transparency of the visual content were measured using the DISCERN questionnaire (DISCERN), Journal of American Medical Association (JAMA-BC) benchmark criteria, and Global Quality Score (GQS). The technical quality was measured by the Cardiopulmonary Resuscitation Scoring System (CPR-SS), which was utilized by three bariatric surgeons., Results: The source in 7% of the videos was medical doctors. The content in 89% of the videos was cardiopulmonary resuscitation technique. According to sources, videos uploaded by physicians had significantly higher quality, transparency, educational and technical value. Unlike, videos uploaded by physicians had a lower video power index than videos uploaded by non-medical professionals. Cardiopulmonary resuscitation technique videos had significantly higher quality, transparency, educational and technical value. Cardiopulmonary resuscitation technique videos also had higher popularity scores than "information or lecture" videos. Also, negative correlations were found between the (popularity index and transparency, education and technical quality scores., Conclusions: Online information on cardiopulmonary resuscitation is of low quality, and its contents are of unknown source and accuracy. However, the educational potential of the online video platform, YouTube, cannot be neglected., (Copyright © 2020 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this project was to develop an instructional video that demonstrates a standardized clinical examination on patients with suspected temporomandibular disorders (TMD). After viewing the video, the learner should be knowledgeable about the examination steps and application of the examination techniques. Methods: The instructional video was created by two dentists who are experienced in assessing patients with suspected TMD. Additionally, both examiners were calibrated according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The instructional video was divided into chapters. Various camera angles, key points, image enlargements, and replays were used to better depict essential aspects of the assessment. Background noise was reduced to a minimum. Results: The instructional video was modified and completed in two phases: the first by an experienced dentist and the second by a dentist specialized in TMD. The final video includes nine chapters and is 26.5 minutes in length (https://doi.org/10.5061/dryad.k8r7qc1). Conclusion: Divided into chapters, this German instructional video shows an optimally timed, standardized clinical assessment of patients with suspected TMD., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Rauch et al.)

Background: Research on the use of video-mediated technology for medical consultations is increasing rapidly. Most research in this area is based on questionnaires and focuses on long-term conditions. The few studies that have focused on physical examinations in video consultations indicated that it poses challenges for the participants. The specific activity of wound assessment through video in postsurgery consultations has not yet been studied. Furthermore, a comparative analysis of face-to-face and video settings on the moment-to-moment organization of such an activity is original., Objective: The aim of this study was to examine the impact of video technology on the procedure of postsurgery wound assessment and its limits., Methods: We recorded 22 postoperative video consultations and 17 postoperative face-to-face consultations. The primary purpose of the consultation was to inform the patient about the final pathology results of the resected specimen, and the secondary purpose was to check on the patient's recovery, including an assessment of the closed wound. The recordings were transcribed in detail and analyzed using methods of conversation analysis., Results: The way that an assessment of the wound is established in video consultations differs from the procedure in face-to-face consultations. In the consultation room, wound assessments overwhelmingly (n=15/17) involve wound showings in the context of surgeons reporting their observations formatted with evidentials ("looks neat") and subsequently assessing what these observations imply or what could be concluded from them. In contrast, wound assessments in video consultations do not tend to involve showing the wound (n=3/22) and, given the technological restrictions, do not involve palpation. Rather, the surgeon invites the patient to assess the wound, which opens up a sequence of patient and physician assessments where diagnostic criteria such as redness or swollenness are made explicit. In contrast to observations in regular consultations, these assessments are characterized by epistemic markers of uncertainty ("I think," "sounds...good") and evidentials are absent. Even in cases of a potential wound problem, the surgeon may rely on questioning the patient rather than requesting a showing., Conclusions: The impact of video technology on postoperative consultations is that a conclusive wound assessment is arrived at in a different way when compared to face-to-face consultations. In video consultations, physicians enquire and patients provide their own observations, which serve as the basis for the assessment. This means that, in video consultations, patients have a fundamentally different role. These talking-based assessments are effective unless, in cases of a potential problem, patient answers seem insufficient and a showing might be beneficial., (©Wyke J P Stommel, Harry van Goor, Martijn W J Stommel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.05.2020.)

Background: In recent years, YouTube has become a recognized source of medical information for health care consumers. Although YouTube has advantages in this context, there are potential dangers as videos may contain nonscientific, misleading, or even harmful information., Objective: As little is known about YouTube as a source of information on atopic dermatitis (AD), we investigated the content-related quality of AD videos and their perception among YouTube users., Methods: The quality of the 100 most viewed AD videos was assessed by using the Global Quality Scale (GQS) and the DISCERN instrument. Videos were classified as "useful," "misleading," and "potentially harmful," and the correlations of viewers' ratings (likes) with the GQS and DISCERN scores were assessed., Results: Among the 100 videos, 68.0% (68/100) and 62.0% (62/100) were of poor and very poor scientific quality, respectively. Additionally, 32.0% (32/100) of the videos were classified as useful, 48.0% (48/100) were classified as misleading, and 34.0% (34/100) were classified as potentially harmful. Viewers' ratings did not correlate with the GQS and DISCERN scores. Overall, 50.0% (50/100) of the videos were posted by private individuals and promoters of complementary/alternative treatments, 42.0% (42/100) by therapeutical advertisers, and only 8.0% (8/100) by nonprofit organizations/universities., Conclusions: Our study demonstrated that two-thirds of the videos analyzed were below acceptable medical quality standards and that many videos were disseminating misleading or even dangerous content. Subjective and anecdotal content was overrepresented, and viewers did not appear to be able to distinguish between high- and low-quality videos. Health promotion strategies by professional medical organizations are needed to improve their presence and visibility on YouTube., (©Simon M Mueller, Valentina N S Hongler, Pierre Jungo, Lucian Cajacob, Simon Schwegler, Esther H Steveling, Zita-Rose Manjaly Thomas, Oliver Fuchs, Alexander Navarini, Kathrin Scherer, Oliver Brandt. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.04.2020.)

Background: Patients seek information from numerous sources before choosing a primary care provider; two of the most popular sources are providers' own online biographies and patient rating websites. However, prior research has generally only examined how these sources influence patients' decisions in isolation., Objective: This study aimed to determine how primary care providers' online biographies and online patient ratings interact to affect patients' decision making, especially in the face of negative reviews., Methods: An 8-condition online experiment (n=866) was conducted, manipulating patient ratings and the timing of viewing a provider's online biographical video (pre- or postrating viewing)., Results: When participants were shown a short video introduction of a provider after reading predominantly negative reviews a positive expectancy violation occurred, which was also related to more positive perceptions of the provider. When exposed to all negative reviews, 43% of participants indicated they would still choose to make an appointment with the provider, with many indicating that the video provided the evidence needed to help make up their own minds., Conclusions: These findings are especially relevant to health care organizations seeking to combat a recent rise in fake patient reviews. Providing patients with realistic expectations of the care that clinicians can offer via their own online biographical videos can help counteract negative patient comments online., (©Evan K Perrault, Grace M Hildenbrand. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.04.2020.)

Although voluntary blood donation is important in terms of sustainable blood supply, voluntary blood donation rates in the world and in our country are behind the desired target. University students are an important group in achieving the goal. The study was planned among 551 university students between 19-21 March 2018.It was planned as a single-blind randomized controlled study in order to evaluate the factors affecting students' blood donation decision and the effect of brochure and video information on fear, anxiety and intention. The data obtained by using Blood Donation Questionnaire and State Anxiety Scale and p ≤ 0.05 was accepted as significant. As a result of the study, 37.9 % of the students reported that they did not give blood due to health reasons, 26 % insecurity and 24.1 % fear. The increase in after the intervention knowledge level was mostly in the group of videos and improved brochures (p < 0.001).There was no difference between the groups in terms of the State Anxiety Scale mean scores p> 0.05). In after the intervention, those who intend to give blood have higher knowledge and their fear and anxiety scores less than those not intend to give blood (p < 0.05). There was no difference between the groups in terms of intention to give blood after the intervention (p> 0.05). As a result, it was found that the information given through the developed brochures and videos increased the level of knowledge, had no effect on the anxiety level and it can be said that the improved brochure has positive effects on intent and fear., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Teaching strategies to promote experiential learning in the classroom are important to facilitate students' clinical reasoning abilities. Using video to simulate unfolding patient scenarios in the classroom has the potential to engage students through active learning and to enhance their ability to connect theory to practice., Objectives: Study objectives were to: (1) Evaluate nursing students' satisfaction and self-confidence in learning and perceptions of the design of a simulated patient scenario delivered via video in the classroom and (2) Compare findings to students' satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulation experiences in the laboratory., Design: A quasi-experimental approach was used., Setting: The study setting was a nursing classroom at a University in the southeast United States., Participants: Convenience sampling was utilized and 54 students in their final semester of a pre-licensure baccalaureate nursing program participated., Methods: The intervention was an unfolding video patient scenario delivered in the classroom. Prior to the intervention, participants completed two measurement tools to collect information about their satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulations. After the intervention, these tools were administered again to collect data about the video simulation experience in the classroom., Results: Participants had a higher level of satisfaction (p = 0.002) and self-confidence (p < 0.001) following the classroom intervention than for prior high-fidelity simulations in the laboratory. Student perceptions of the simulation design were more favorable for the classroom intervention than for prior laboratory simulations (p < 0.001)., Conclusions: Use of unfolding video patient scenarios in the classroom can promote student engagement in learning. Nurse educators should consider this teaching strategy that provides students with opportunities to connect and apply classroom content to patient care., Competing Interests: Declaration of competing interest There are no conflicts of interest to report., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Obstructive sleep apnea is a common childhood disorder which can lead to serious health problems if left untreated. Enlarged adenoid and tonsils are the commonest causes, and adenotonsillectomy is the recommended first line of treatment. Obstructive sleep apnea poses as an anesthetic challenge, and it is a well-known risk factor for perioperative adverse events. The presence and severity of an obstructive sleep apnea diagnosis will influence anesthesia, pain management, and level of monitoring in recovery period. Preoperative obstructive sleep apnea assessment is necessary, and anesthetists are ideally placed to do so. Currently, there is no standardized approach to the best method of preoperative screening for obstructive sleep apnea. Focused history, clinical assessments, and knowledge regarding the strengths and limitations of available obstructive sleep apnea assessment tools will help recognize a child with obstructive sleep apnea in the preoperative setting., (© 2019 John Wiley & Sons Ltd.)

Objective: The objective of the study was to identify the probability of establishing a diagnosis based on the duration of video-electroencephalogram (VEEG) monitoring. Additional aims were to determine whether there is a relationship between clinical characteristics of epilepsy monitoring unit (EMU) patients and VEEG results., Methods: We studied EMU length of stay and assessed the utility of prolonging studies in patients who had not yet received a diagnosis. Clinical characteristics in 212 consecutive patients admitted for scalp VEEG monitoring were recorded. We collected data including reason for admission, frequency of seizures/spells, gender, age, age at seizure onset, handedness, family history, history of neurologic disease, current and past antiepileptic drugs (AEDs), and prior work-up. Subjects were categorized into five diagnostic groups: epileptic seizures (Epi), nonepileptic events (NEE), mixed epileptic and nonepileptic events (Mixed), nonepileptic events from a physiologic cause (NEEP), and nondiagnostic study without results recorded (ND)., Results: The most diagnoses were made during the first day of admission (45%), and by day 3, 82 patients remained without a diagnosis. On day 3, 25 of these patients (33%) received a diagnosis, on day 4, seven (22%) additional patients received a diagnosis, on day 5, 5 patients (35%) received a diagnosis, and by day 6, only one additional patient (11%) was given a diagnosis. Significant differences were found between diagnostic groups for admission reason, duration of EMU stay, age at seizure onset, duration of epilepsy, seizure frequency, and number of current and previously tried AEDs., Conclusions: Our findings show that the majority of patients are diagnosed in the first 2 days of admission, and we found a limited benefit of prolonging nonsurgical inpatient VEEG studies beyond 5 days for spell/seizure classification. Additionally, patient demographics were significantly different for patients depending on VEEG diagnosis, which can help predict the utility of completing VEEG studies in individual patients., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Videographic material of animals can contain inapparent signals, such as color changes or motion that hold information about physiological functions, such as heart and respiration rate, pulse wave velocity, and vocalization. Eulerian video magnification allows the enhancement of such signals to enable their detection. The purpose of this study is to demonstrate how signals relevant to experimental physiology can be extracted from non-contact videographic material of animals., Results: We applied Eulerian video magnification to detect physiological signals in a range of experimental models and in captive and free ranging wildlife. Neotenic Mexican axolotls were studied to demonstrate the extraction of heart rate signal of non-embryonic animals from dedicated videographic material. Heart rate could be acquired both in single and multiple animal setups of leucistic and normally colored animals under different physiological conditions (resting, exercised, or anesthetized) using a wide range of video qualities. Pulse wave velocity could also be measured in the low blood pressure system of the axolotl as well as in the high-pressure system of the human being. Heart rate extraction was also possible from videos of conscious, unconstrained zebrafish and from non-dedicated videographic material of sand lizard and giraffe. This technique also allowed for heart rate detection in embryonic chickens in ovo through the eggshell and in embryonic mice in utero and could be used as a gating signal to acquire two-phase volumetric micro-CT data of the beating embryonic chicken heart. Additionally, Eulerian video magnification was used to demonstrate how vocalization-induced vibrations can be detected in infrasound-producing Asian elephants., Conclusions: Eulerian video magnification provides a technique to extract inapparent temporal signals from videographic material of animals. This can be applied in experimental and comparative physiology where contact-based recordings (e.g., heart rate) cannot be acquired.

The objective of this study was to test the feasibility of video discharge education to improve self-efficacy in dealing with medication barriers around hospital discharge. We conducted a single-arm intervention feasibility trial to evaluate the use of video education in participants who were being discharged home from the hospital. The scores of pre- and post-intervention self-efficacy involving medication barriers were measured. We also assessed knowledge retention, patient and nursing feedback, follow-up barrier assessments, and hospital revisits. A total of 40 patients participated in this study. Self-efficacy scores ranged from 5 to 25. Median pre- and post-intervention scores were 21.5 and 23.5, respectively. We observed a median increase of 2.0 points from before to after the intervention (p = 0.046). In total, 95 percent of participants reported knowledge retention and 90 percent found the intervention to be helpful. Video discharge education improved patient self-efficacy surrounding discharge medication challenges among general medicine inpatients. Patients and nurses reported satisfaction with the video discharge education.

Background: Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso., Objective: The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings., Methods: Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors., Results: We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video's protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted., Conclusions: Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions., (©Jasmin Isler, N Hélène Sawadogo, Guy Harling, Till Bärnighausen, Maya Adam, Moubassira Kagoné, Ali Sié, Merlin Greuel, Shannon A McMahon. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 11.11.2019.)

The ability to express emotions is a protective factor for infant development. Despite the multimodal nature of emotion expression, research has mainly focused on facial expressions of emotions. The present study examined motor activity and spatial proximity in relation to positive and negative infant facial expressions and maternal postpartum depression during face-to-face interactions at four months. Video cameras and a motion capture system recorded mother-infant interactions. Repeated measures ANOVAs were conducted to analyze the effect of micro-coded infant positive and negative facial affect and maternal depression diagnosis on automatically extracted measures of motor activity and spatial proximity, including speed of mothers' arm movements (nondepressed = 32; PPD = 16), and infants' arm movements (nondepressed = 29; PPD = 17), and head distance (nondepressed = 45; PPD = 27). Results showed that the speed of infants' arm movements and head distance were greater during negative compared to positive infant affect. Further, the results demonstrated that the speed of PPD mothers' arm movements was slower than the speed of nondepressed mothers' arm movements. In the discussion, it is suggested that increased speed of infant arm movements during negative affect functions to elicit faster caregiving responses, and that increased head distance during negative infant affect functions to decrease the intensity of the interaction. Finally, the slower speed of arm movements in PPD mothers suggests psychomotor retardation, which is proposed to limit these mothers' abilities to engage their infants during the interaction., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Ciliary motility depends on both the precise spatial organization of multiple dynein motors within the 96 nm axonemal repeat and the highly coordinated interactions between different dyneins and regulatory complexes located at the base of the radial spokes. Mutations in genes encoding cytoplasmic assembly factors, intraflagellar transport factors, docking proteins, dynein subunits, and associated regulatory proteins can all lead to defects in dynein assembly and ciliary motility. Significant progress has been made in the identification of dynein subunits and extrinsic factors required for preassembly of dynein complexes in the cytoplasm, but less is known about the docking factors that specify the unique binding sites for the different dynein isoforms on the surface of the doublet microtubules. We have used insertional mutagenesis to identify a new locus, IDA8/BOP2 , required for targeting the assembly of a subset of inner dynein arms (IDAs) to a specific location in the 96 nm repeat. IDA8 encodes flagellar-associated polypeptide (FAP)57/WDR65, a highly conserved WD repeat, coiled coil domain protein. Using high resolution proteomic and structural approaches, we find that FAP57 forms a discrete complex. Cryo-electron tomography coupled with epitope tagging and gold labeling reveal that FAP57 forms an extended structure that interconnects multiple IDAs and regulatory complexes.

Background: Compelling evidence supports multiple benefits of physical activity (PA) even in small bursts. Less than 50% of Americans achieve recommended PA levels, lower still for individuals living with chronic illness or disease., Purpose: The purpose of this study was to develop and evaluate the feasibility and preliminary effects of 3-min follow-along video scenarios to promote brief episodes of low-moderate levels of PA among individuals with chronic diseases., Methods: Guided by our previous studies and self-efficacy theory, the program (WellMe in 3© for Patients) was modeled after another program developed for healthcare staff. An advisory panel and a health and fitness expert guided the creation of twelve 3-min video scenarios that included two individuals living with chronic illness and a fitness leader who guided the PA scenarios and how to adapt them based on limitations. The 12 scenarios included 3 min of aerobic activities, stretching, or balance. Preliminary pilot effects were measured among 39 patients living with chronic conditions for one month. Standardized instruments were used to measure PA levels, PA self-efficacy (SE), and quality of life (QoL); usability and satisfaction were assessed using researcher-developed tools. Descriptive and inferential statistics were used to evaluate change over time., Results: Twelve video scenarios were created tailored to persons with chronic illness. Thirty-nine participants piloted the program, reporting an average of two chronic conditions. Baseline QoL scores were lower than normative data, self-efficacy scores were low-to-moderate, and PA levels were very low. Participants averaged using one video per day. 62% of participants provided complete self-reported pre- and post-QoL and SE data and 41% provided pre- and post-PA (accelerometer) data. Significant improvements were found for general health and energy scores, and trends were found for self-efficacy scores. PA levels were highly variable with nonsignificant increases from baseline. Effect sizes were low-moderate for several measures. About 79% of participants rated program "Very good"; all recommended the program., Linking Evidence to Action: Physical activity has multiple health benefits for all people including those living with chronic conditions. Even short bouts of physical activity have health benefits. A program of 3-min follow-along PA videoclips for individuals living with chronic disease holds promise for clinicians and researchers., (© 2019 Sigma Theta Tau International.)

Background: The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child's inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources., Objective: The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants., Methods: Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor's information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study., Results: We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis., Conclusions: Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation., (©Lu-Lu Huang, Yang-Yang Wang, Li-Ying Liu, Hong-Ping Tang, Meng-Na Zhang, Shu-Fang Ma, Li-Ping Zou. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 12.09.2019.)

Objective: To determine the validity, reliability, feasibility and applicability of a neonatal intubation scoring instrument., Design: Prospective observational study., Setting: Simulation-based research and training centre (Center for Advanced Pediatric and Perinatal Education), California, USA., Subjects: Forty clinicians qualified for neonatal intubation., Interventions: Videotaped elective intubations on a neonatal patient simulator were scored by two independent raters. One rater scored the intubations twice. We scored the preparation of equipment and premedication, intubation performance, tube position/fixation, communication, number of attempts, duration and successfulness of the procedure., Main Outcome Measures: Intraclass correlation coefficients (ICC) were calculated for intrarater and inter-rater reliability. Kappa coefficients for individual items and mean kappa coefficients for all items combined were calculated. Construct validity was assessed with one-way analysis of variance using the hypothesis that experienced clinicians score higher than less experienced clinicians. The approximate time to score one intubation and the instrument's applicability in another setting were evaluated., Results: ICCs for intrarater and inter-rater reliability were 0.99 (95% CI 0.98 to 0.99) and 0.89 (95% CI 0.35 to 0.96), and mean kappa coefficients were 0.93 (95% CI 0.85 to 1.01) and 0.71 (95% CI 0.56 to 0.92), respectively. There were no differences between the more and less experienced clinicians regarding preparation, performance, communication and total scores. The experienced group scored higher only on tube position/fixation (p = 0.02). Scoring one intubation took approximately 15 min. Our instrument, developed in The Netherlands, could be readily applied in the USA., Conclusions: Our scoring instrument for simulated neonatal intubations appears to be reliable, feasible and applicable in another centre. Construct validity could not be established., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The process of ageing begins after 60 years of age and is referred to as presbyphonia (Vox senium). The causes include functional or organic voice disorders, often coexisting with dry upper respiratory tract infection., Introduction: The aim of the study is the use of high-speed camera and acoustic voice analysis in diagnostics of the clinical form of presbyphonia. M aterials and methods: The study included a group of 50 men, non-smokers, age from 51 to 72, who do not use their voice professionally. High-Speed Digital Imaging and HS camera have been used, allowing evaluation of real vibrations of vocal folds, along with acoustic voice analysis using a software by DiagNova Technologies., Results: VHI questionnaire has been used for self-assessment of voice disability. Visualizations of the larynx enabled recognition of hypofunctional dysphonia or atrophy of vocal folds that cause voice disorders. This was confirmed by parameters of voice acoustic evaluation: F0, NHR, narrowband spectrography. The pathological value of NHR and the presence of nonharmonic components in the range of high frequency levels indicated glottal insufficiency, recorded with the visualization technique of the larynx by HS camera. A significant shortening of maximum phonation time in relation to the control group has also been recorded., Discussion: The objective examination of voice pathology is crucial in diagnosis and rehabilitation, however, subjective assessment of the patient is important in the scope of the procedure used. The patient's subjective self-rating assessment (VHI) confirmed the sense of voice disorders in elderly men, indicating the need for rapid and accurate clinical diagnosis.

Objective: To explore how support impacted on mothers' breastfeeding experiences in the first few weeks following birth., Design: A qualitative approach explored real-time experiences of breastfeeding captured by five first-time mothers in the South of England on camcorder as video diaries. A multi-dimensional approach involving thematic analysis ensured both the audio and visual elements of the data were analysed., Findings: Mothers felt 'under surveillance' by the biomedical approach to support from the healthcare team. At best mothers felt reassured that they were 'on the right track'. When mothers felt their breastfeeding was constantly being examined, criticised and threatened they felt 'scrutinised, judged and sabotaged'. When they found it difficult to access healthcare support, or they avoided it altogether to circumvent further scrutiny, they felt 'abandoned and alone'., Key Conclusions: Collecting audio-visual data in real-time adds fresh insights into how support impacts mothers' experiences of breastfeeding. The biomedical approach to support for breastfeeding is not effective. Scrutinising, judging and/or sabotaging mothers' attempts to breastfeed can have long-lasting effects on maternal emotional wellbeing., Implications for Practice: Breastfeeding support might be improved by adopting a more social model of care. Future research needs to explore how relationship-based support can be provided by the health service., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: We aimed to develop and feasibility test an educational video culturally targeted to African American (AA) patients regarding kidney allocation., Methods: We iteratively refined an animated video for AAs with multiple stakeholder input and conducted a one-group, pre-post study with 50 kidney transplant candidates to assess video feasibility and acceptability. A mixed population was chosen to obtain race-specific acceptability data and efficacy estimates for a larger study., Results: Median participant age was 56 years, and 50% were AA. Comparing pre-post video scores, large knowledge effect sizes were found for the cohort (r = 0.7) and in the context of AA race (r = 0.8), low health literacy (r = 0.6), low educational achievement (r = 0.7), age >55 years (r = 0.6), dialysis vintage ≥1 year (r = 0.8), low income (r = 0.7) and low technology access (r = 0.8). Over 87% of participants provided positive ratings on each of the seven acceptability items. The frequency of positive responses increased pre-post video for kidney allocation understanding (78% vs 94%, P = 0.008), decisional self-efficacy (64% vs 88%, P < 0.001) and belief in fairness (76% vs 90%, P = 0.02)., Conclusions: In collaboration with key stakeholders, a culturally targeted educational video was developed that was well received. Results are promising to impact kidney allocation knowledge among AA and non-AA kidney transplant candidates., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Research on simulation in nursing education has demonstrated the positive impact active, experiential learning has on student satisfaction, self-confidence, and knowledge. As a result, simulation laboratories with high-fidelity human patient simulators have become a common adjunct to clinical teaching. It is important to also promote active learning in the classroom setting; however, there is limited evidence on using video simulations in large classrooms., Objectives: This study sought to determine if using a video simulated unfolding case study as part of the didactic classroom, as compared to a traditional written case study, improved students' satisfaction, self-confidence, and knowledge., Design: A two-group, quasi-experimental design was used., Settings: The study occurred at a University in the southeastern United States., Participants: A total of 165 baccalaureate nursing students participated., Methods: The control group received a written case study, while the intervention group received video simulation of the same case study and student satisfaction, self-confidence, and knowledge were measured upon completion. Data analysis used descriptive statistics and t-tests. Qualitative comments were also provided by students and analyzed for themes., Results: There were no statistically significant differences, with both groups reporting a high level of satisfaction and self-confidence. The percent of knowledge questions answered correctly was higher for the video simulation group for all seven questions. Four themes were identified from participant words: A better understanding, Able to apply learning to a patient scenario, Engaged in learning, and Visualizing it helps., Conclusions: Results suggest the use of video simulation in the classroom may deepen students' understanding of classroom content and provide an additional mode for learning to enhance classroom lecture. Use of video simulation to augment classroom teaching is suggested as a strategy for engaging learners., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Since 1980, many studies have evaluated whether stair-use prompts increased physical activity by quantifying changes in stair use. To more completely evaluate changes in physical activity, this study addressed the often-overlooked assessment of climbing up escalators by evaluating the degree to which stair-use sign prompts increased active ascent-defined as stair use or escalator climbing. Over 5 months, at an airport stairs/escalator point of choice, we video-recorded passersby (N = 13,544) who ascended either stairs or escalators, on 10 days with signs and 10 days without signs. Ascenders using the stairs, standing on the escalator, and climbing the escalator were compared on days with versus without signs using multivariable logistic regression. The percentage of ascenders on days with versus without signs were as follows: stair use, 6.9 versus 3.6 percent; escalator standing, 75.2 versus 76.0 percent; and escalator climbing, 18.5 versus 20.4 percent. Signs more than doubled the odds of stair use (vs. escalator use; OR = 2.25; 95% CI = 1.90-2.68; p < .001). Signs decreased the odds of escalator climbing (vs. escalator standing or stair use); OR = 0.90; 95% CI = 0.82-0.99; p = .028). Signs increased the odds of active ascent versus escalator standing by 15 percent (OR = 1.15; 95% CI = 1.05-1.25; p = .002). Although stair-use prompts increased stair use more than twofold (125%), they increased active ascent by only 15 percent, partly because escalator climbing-a behavior not targeted by the intervention-decreased. Although our results corroborated the established consensus that point-of-choice prompts increase stair use, future studies should test interventions designed to increase active ascent., (© Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To investigate the benefits of the Working Memory Training on DVD for the elderly., Methods: Sixteen volunteers aged over 60 years (67.43 years on average), without hearing loss complaint nor neurological or psychiatric disorders participated in this study. All participants were evaluated by the MMSE and a dedicated working memory assessment. Among these, four participants, unable to go to the University formed the control group, while the other twelve were included in the experimental group. The participants in the experimental group were exposed to the first three DVDs with exercises, having been periodically reassessed by the dedicated working memory assessment. The control group participants were submitted only to the reassessments at the same periods as the experimental group., Results: The assessments of the control group did not present any changes, while those in the experimental group significantly improved their results after exposure to the DVDs. Moreover, the experimental group participants reported the benefits of the training for their daily life activities., Conclusion: The present study demonstrates the benefits of the Working Memory Training on DVD for the elderly. These results indicate that the cognitive working memory training may be a promising tool for new longitudinal studies with larger populations.

Medical educators have not reached widespread agreement on core content for a U.S. medical school curriculum. As a first step toward addressing this, five U.S. medical schools formed the Robert Wood Johnson Foundation Reimagining Medical Education collaborative to define, create, implement, and freely share core content for a foundational medical school course on microbiology and immunology. This proof-of-concept project involved delivery of core content to preclinical medical students through online videos and class-time interactions between students and facilitators. A flexible, modular design allowed four of the medical schools to successfully implement the content modules in diverse curricular settings. Compared with the prior year, student satisfaction ratings after implementation were comparable or showed a statistically significant improvement. Students who took this course at a time point in their training similar to when the USMLE Step 1 reference group took Step 1 earned equivalent scores on National Board of Medical Examiners-Customized Assessment Services microbiology exam items. Exam scores for three schools ranged from 0.82 to 0.84, compared with 0.81 for the national reference group; exam scores were 0.70 at the fourth school, where students took the exam in their first quarter, two years earlier than the reference group. This project demonstrates that core content for a foundational medical school course can be defined, created, and used by multiple medical schools without compromising student satisfaction or knowledge. This project offers one approach to collaboratively defining core content and designing curricular resources for preclinical medical school education that can be shared.

The pericarp of monogerm sugar beet seed is rubbed off during processing in order to produce uniformly sized seeds ready for pelleting. This process can lead to mechanical damage, which may cause quality deterioration of the processed seeds. Identification of the mechanical damage and classification of the severity of the injury is important and currently time consuming, as visual inspections by trained analysts are used. This study aimed to find alternative seed quality assessment methods by evaluating a machine vision technique for the classification of five damage types in monogerm sugar beet seeds. Multispectral imaging (MSI) was employed using the VideometerLab3 instrument and instrument software. Statistical analysis of MSI-derived data produced a model, which had an average of 82% accuracy in classification of 200 seeds in the five damage classes. The first class contained seeds with the potential to produce good seedlings and the model was designed to put more limitations on seeds to be classified in this group. The classification accuracy of class one to five was 59, 100, 77, 77 and 89%, respectively. Based on the results we conclude that MSI-based classification of mechanical damage in sugar beet seeds is a potential tool for future seed quality assessment., Competing Interests: The authors declare no conflict of interest.

Web-based learning, on its own or in combination with traditional teaching methods, has become a consolidated practice in many countries, and has been described as a valid and effective method that supports practical learning in undergraduate nursing students. The aim of this study was to explore the perception and effectiveness of web-based learning in facilitating the development of clinical skills in undergraduate nursing students. A qualitative descriptive study was conducted including online videos in three nursing schools of a university in Northern Italy. The participants were 26 undergraduate nursing students. A dedicated website was built including four videos and the respective checklists of four nursing techniques: insertion of a urinary catheter; insertion of a nasogastric tube; taking a blood sample; and the insertion of a peripheral intravenous line. Three Focus Groups were conducted, one for each nursing school. Thanks to its ease of use and unlimited access, web-based learning effectively supported students' clinical learning process by offering additional virtual visual support. Web-based learning could be effectively used to reduce the gap between theory and practice, and even as an upgrade for already qualified nurses., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Each year up to 2.6 million people die prematurely from household air pollution (HAP) due to cooking with polluting fuels such as wood and charcoal, particularly in low and middle-income countries (LMICs). The World Health Organisation recommends scaling the adoption of clean fuels to improve maternal and child health. Liquefied Petroleum Gas (LPG) represents a scalable clean fuel that provides health and environmental benefits when used for household energy in LMICs. In Cameroon, over 70% of people rely on biomass for cooking, and the Government aims to increase LPG use from <20% to 58% by 2030. Supporting households make this transition requires involvement of multiple stakeholders and an understanding of perspectives from the community's perspective. We used visual participatory methods 'Photovoice' to explore households' perceptions of factors influencing the uptake of LPG for cooking in South-West Cameroon. Two groups of participants from rural (n = 7) and peri-urban (n = 8) areas photographed subjects they identified as preventing and facilitating LPG uptake in their communities. Subsequently, individual interviews (n = 15) and group discussions (n = 5) explored participants' reflections on the photographs. Thematic analysis was conducted using NVivo 10 software. The main barriers identified included difficulty in affording the initial LPG equipment and ongoing refills, scarcity of LPG retail shops and refills, and safety concerns. Facilitators included (i) increasing awareness of the benefits of LPG (e.g. health), (ii) increasing retail outlet density in rural areas, (iii) addressing safety concerns (e.g. replacing damaged cylinders), and (iv) reducing the price of LPG refills. Participants presented their photos at a public exhibition, which generated discussions with key stakeholders (e.g. government ministries) about how best to assist communities in this transition. Photovoice was found to be an innovative and effective approach for exploring how to advance equitable access to LPG from a community perspective and successfully engage with key stakeholders., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Telerehabilitation in older adults is most needed in the patient environments, rather than in formal ambulatories or hospitals. Supporting such practices brings significant advantages to patients, their family, formal and informal caregivers, clinicians, and researchers. This paper presents a focus group with experts in physiotherapy and telerehabilitation, debating on the requirements, current techniques and technologies developed to facilitate and enhance the effectiveness of telerehabilitation, and the still open challenges. Particular emphasis is given to (i) the body-parts requiring the most rehabilitation, (ii) the typical environments, initial causes, and general conditions, (iii) the values and parameters to be observed, (iv) common errors and limitations of current practices and technological solutions, and (v) the envisioned and desired technological support. Consequently, it has been performed a systematic review of the state of the art, investigating what types of systems and support currently cope with telerehabilitation practices and possible matches with the outcomes of the focus group. Technological solutions based on video analysis, wearable devices, robotic support, distributed sensing, and gamified telerehabilitation are examined. Particular emphasis is given to solutions implementing agent-based approaches, analyzing and discussing strength, limitations, and future challenges. By doing so, it has been possible to relate functional requirements expressed by professional physiotherapists and researchers, with the need for extending multi-agent systems (MAS) peculiarities at the sensing level in wearable solutions establishing new research challenges. In particular, to be employed in safety-critical cyber-physical scenarios with user-sensor and sensor-sensor interactions, MAS are requested to handle timing constraints, scarcity of resources and new communication means, crucial to providing real-time feedback and coaching. Therefore, MAS pillars such as the negotiation protocol and the agent's internal scheduler have been investigated, proposing solutions to achieve the aforementioned real-time compliance., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Storytelling is a powerful form of communication which can improve attention and lead to lasting behavioural changes. Addressing the need to incorporate patient safety teaching into undergraduate medical curricula, it was hypothesized that medical students could benefit from hearing clinician stories of medical error. The medium of animation was considered to be a potentially engaging means of presenting stories of error to a large audience., Methods: Three animated videos were developed to accompany audio recordings of junior doctors describing their experiences of a serious incident or near-miss event. The videos were delivered to 200 final-year medical students with a subsequent large-group discussion directed at understanding contributory factors. An evaluative questionnaire exploring learners' reactions and modification of beliefs and perception was distributed. The questionnaire included questions rated on a modified Likert scale and a free-text box. A mixed-methods analysis was conducted with descriptive statistics and qualitative content analysis of the free-text responses., Results: Of the 200 students who attended, 104 completed the questionnaire and 83 completed free-text feedback. Most students responded positively to hearing stories of medical error and felt that the animated videos improved their engagement while the voice recordings helped bring the cases to life. The majority of students agreed the session would impact on their future practice., Conclusion: This pilot study confirmed that undergraduate students consider animated, personal stories of medical error an effective, engaging means of learning about patient safety. Longitudinal studies are required to confirm if measurable behaviour change is achieved.

Introduction: In 2012 safety strategies were defined in five intervention areas to improve patient safety in Austria. Regarding policy development, patient safety should be mandatory part of education of all healthcare sectors, and measures to improve hygiene standards are to be included in organizational development. The aim of this project was to achieve sustained improvement in routine procedures and anchor patient safety in the undergraduate medical curriculum by making online instructional videos on clinical skills and hygiene procedures permanently available as preparation for the first clinical clerkship. Method: Short films explaining how to insert urinary catheters in women and men were produced and provided online. These videos were shown to medical students shortly before the practical Objective Structured Clinical Examination (OSCE). After viewing the videos, all of the students were surveyed using an online questionnaire with 15 questions regarding quality and acceptance. The effect of the videos on learning success was determined by the assessment outcome through red cards in the practical exam. A red card for behavior endangering the doctor or others meant zero points and discontinuation of the assessment at that particular OSCE station. Results: A total of 647 students viewed one of the two videos on urinary catheters, 623 responded to the online Moodle questionnaire completly. 551 (85.2%) reported being better able to recall individual steps and procedures, 626 students (96.7%) positively rated the fact that instructional videos were available on the Medical University of Vienna's website. More than half of the respondents (56.6%) were better able to remember critical hygiene practices. The comparison of the assessment outcomes on the OSCE for 2016 and 2013, a year in which the instructional videos were not yet available, shows no significant (chi 2 =3.79; p>0.05) but a trend towards improvement. The chance of getting a red card in 2013 was 3.36 times higher than in 2016. Conclusion: Even if our study was unable to show significant improvements in the OSCE as a result of viewing the videos, it appears that clearly imparting medical skills and hygiene standards-including in visual form-is still important prior to the first clerkship to ensure the highest level of patient safety possible. The combination of teaching and learning formats, such as videos on online platforms with textbooks or lecture notes, is well suited to increase effectiveness and efficiency in learning. There is a need for further studies to investigate and analyze the effects of instructional videos in more detail., Competing Interests: The authors declare that they have no competing interests.

Background: Although averaging across multiple examiners' judgements reduces unwanted overall score variability in objective structured clinical examinations (OSCE), designs involving several parallel circuits of the OSCE require that different examiner cohorts collectively judge performances to the same standard in order to avoid bias. Prior research suggests the potential for important examiner-cohort effects in distributed or national examinations that could compromise fairness or patient safety, but despite their importance, these effects are rarely investigated because fully nested assessment designs make them very difficult to study. We describe initial use of a new method to measure and adjust for examiner-cohort effects on students' scores., Methods: We developed video-based examiner score comparison and adjustment (VESCA): volunteer students were filmed 'live' on 10 out of 12 OSCE stations. Following the examination, examiners additionally scored station-specific common-comparator videos, producing partial crossing between examiner cohorts. Many-facet Rasch modelling and linear mixed modelling were used to estimate and adjust for examiner-cohort effects on students' scores., Results: After accounting for students' ability, examiner cohorts differed substantially in their stringency or leniency (maximal global score difference of 0.47 out of 7.0 [Cohen's d = 0.96]; maximal total percentage score difference of 5.7% [Cohen's d = 1.06] for the same student ability by different examiner cohorts). Corresponding adjustment of students' global and total percentage scores altered the theoretical classification of 6.0% of students for both measures (either pass to fail or fail to pass), whereas 8.6-9.5% students' scores were altered by at least 0.5 standard deviations of student ability., Conclusions: Despite typical reliability, the examiner cohort that students encountered had a potentially important influence on their score, emphasising the need for adequate sampling and examiner training. Development and validation of VESCA may offer a means to measure and adjust for potential systematic differences in scoring patterns that could exist between locations in distributed or national OSCE examinations, thereby ensuring equivalence and fairness., (© 2018 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Objective: The objective of this study was to investigate the incidence of sudden unexpected death in epilepsy (SUDEP) in a tertiary epilepsy center in the years 1981-2016 with an emphasis on patient supervision and nursing intervention in different departments., Methods: We identified 14 SUDEP cases (probable, definite, definite plus). Patient-years (PY) and incidence were calculated for the periods of six years for the general epileptology wards (adults and children) and, in addition, for the epilepsy monitoring unit (EMU) since 1990., Results: The incidence of SUDEP showed a decreasing trend over time (r = -0.81; p = 0.053, two-sided; Pearson correlation coefficient). This is especially true in children (no SUDEP occurred in pediatric general epileptology since 1992). Additionally, in the EMU (314 PY since the start of 1990), no SUDEP occurred. Sudden unexpected death in epilepsy incidence was highest (6.8/1000 PY) in the early time periods (1981-1992) and lowest (1.7/1000 PY) in the later time periods (1999-2010). In the general epileptology wards (3579 PY), the overall incidence was 3.9 per 1000 PY (95% confidence interval (CI): 2.1-6.6)., Conclusions: We assume that the decreased SUDEP incidence is an effect of better supervision by the use of technical means (e.g., video cameras, pulse oximeters, seizure detection systems) and rooming-in of parents or family., (Copyright © 2018 Elsevier Inc. All rights reserved.)