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There is a critical need for fall-prevention interventions to reach medically underserved, hard-to-reach, rural older adults. The evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program reduces falls in older adults. This pre-COVID-19 pandemic study assessed the feasibility and impact of a 16-week tele-TJQMBB intervention in older adults. Instructors led six tele-TJQMBB classes via Zoom for 52 older adults (mean age ± SD 68.5 ± 7.7 years) at one academic and four community sites. Nearly all (97%) planned sessions were delivered. Average attendance was 61%. There were no adverse events. Fidelity was fair to good (mean 67%). Forty-one percent of sessions experienced technical disruptions. Participants improved their gait speed, balance, lower-extremity strength, and body mass index. Tele-TJQMBB was feasible with a positive impact on outcomes. This study was the first step toward establishing an additional delivery mode that could potentially expand TJQMBB's reach and maintenance. [ABSTRACT FROM AUTHOR]

Exercise is the single most effective strategy to reduce the risk of falls. Online classes have grown in popularity, but the benefits of online classes remain unknown. Zoomers on the Go is a peer-led 12-week exercise program offered twice weekly to adults 50+ years old. The main outcome was lower body strength measured by the 30-s chair stand test. Other outcomes included dropout, attendance, balance, cardiorespiratory fitness, and perceived health. A total of 74 participants (age 66.3 ± 7.1 years) in the online group and 84 participants in the in-person group (age 67.3 ± 7.2 years) completed the program, with attendance for the online group. Both groups significantly improved their 30-s chair stand, cardiorespiratory fitness, and balance (p <.001) with no difference in functional benefits between groups. The in-person group improved their perceived health and significantly reduced levels of stress and depression, while no such changes were observed in the online group. [ABSTRACT FROM AUTHOR]

Online exercise programming has become increasingly popular in recent years, including for older adults. Instructors hold unique perspectives on such programming that could yield important insights for effective program design and delivery. The purpose of this study was to qualitatively examine instructors' perceptions and experiences teaching exercise classes online to older adults. Using qualitative description, 19 instructors from a community exercise program for seniors completed a one-on-one semistructured interview. We analyzed data using reflexive thematic analysis and generated three main themes: (a) characteristics of effective online instructors, (b) challenges to delivering online exercise programming to older adults, and (c) future of online exercise programming. Most participants enjoyed delivering online exercise classes and developing the unique skills (particularly related to fostering social experiences and engaging with participants) required to be effective online exercise instructors. Our findings speak to the importance of ensuring instructors are adequately trained to deliver online exercise to seniors. [ABSTRACT FROM AUTHOR]

Building on the embodied consumption literature, we draw on Merleau-Ponty's theory of art to consider how new modes of visibility arise in interactions between individuals online. Focusing on one particular virtual and collaborative museum programme, we use ethnomethodological analysis of interactions to analyse video recordings of virtual arts conversations. The analysis explores how participants render visible their orientation to each other and to the works of art discussed in the workshop. Thus, we can see how participants produce the sense and significance of works of art in, and through 'intercorporeal interactions' while participating in a virtual arts programme. Observations and findings from our research have significant implications for the strategic management of virtual consumer experiences. [ABSTRACT FROM AUTHOR]

BACKGROUND: Foot drop in people with multiple sclerosis (MS) commonly leads to decreased mobility and quality of life (QOL). Functional electrical stimulation (FES) of the peroneal nerve can improve the gait of people with foot drop, yet various barriers restrict widespread use. The purpose of this case series was to examine the feasibility of a telerehabilitation-monitored FES device and report changes in functional mobility and QOL in people with moderate MS-related disability. METHODS: FES use was progressed over 8 weeks via 3 telerehabilitation sessions. Feasibility of telerehabilitation was assessed by percentage of telerehabilitation visits completed and participant-reported satisfaction. At baseline and study completion, functional mobility with and without FES were assessed by the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), and 2-Minute Walk Test (2MWT), Multiple Sclerosis Impact Scale (MSIS-29), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was assessed via the Modified Fatigue Impact Scale (MFIS) before and after the intervention. RESULTS: Eleven participants (mean age = 50.4 years [SD 10.8]; 2 males) completed the study. All (33/33) telerehabilitation visits were completed and participants attained high levels of satisfaction with no adverse events. At 8 weeks, compared to baseline, there were clinically meaningful improvements on the T25FW, 2MWT, and TUG for 45%, 55%, and 82% of participants, respectively. Clinically meaningful improvements on the MSIS-29 and MSWS-12 were also recorded for 64% and 36% of participants, respectively. CONCLUSIONS: Telerehabilitation was safe and feasible for FES intervention, and improvements in functional mobility and QOL were observed. Telerehabilitation to monitor FES may improve access and reduce patient burden; therefore, studying its efficacy is warranted.

Online exercise programming has surged in popularity; however, little is known about older adults' perceptions and experiences of online exercise. The purpose of this study was to qualitatively examine older adults' (aged 59–82 years) experiences and perceptions of an online exercise program during the COVID-19 pandemic. Nineteen individuals (individuals who used the online exercise program and those who did not) completed a semistructured interview. Three main themes were generated from the data using reflexive thematic analysis: (a) can online exercise really work for older adults? (b) technology attitudes and experiences influence online participation, and (c) barriers and advantages of the online exercise program and the home environment. Most participants who took part were able to overcome initial barriers through technical support and experience. Our findings highlight ways to promote advantages and address barriers of online exercise for older adults and emphasize the importance of fostering social experiences and training online exercise instructors. [ABSTRACT FROM AUTHOR]

Purpose: Social connections are essential for the development of life skills for youth. Youth with disabilities have long faced barriers to meaningful social connections. The onset of COVID-19 increased barriers to social connections for all youth, and also led to enhanced use of virtual platforms in paediatric rehabilitation programming. Harnessing this opportunity, service providers created a suite of online programs to foster social connections and friendships. The current study explores participant and service provider experiences of such programs. Methods: This qualitative descriptive study used interviews and focus groups to explore how youth with disabilities (n = 8), their parents (n = 7), and service providers (n = 13) involved in program development and delivery experienced the programs, the accessibility of the virtual platforms, and their social connections in relation to program participation. Results: Participants were satisfied with the programs' content, accessibility and ability to meet their social needs. Qualitative themes included facilitating social connections, accessibility of virtual spaces, and recommendations for future virtual programming. Discussion: For youth with disabilities who have been historically marginalized in social spheres, the newly ubiquitous infrastructure regarding virtual programming must be supported and enhanced. A hybrid approach involving virtual/in-person options in future programming is recommended. IMPLICATIONS FOR REHABILITATION: Youth with disabilities can benefit from social connections on virtual platforms in terms of physical access to social spaces and opportunities to communicate in alternative ways For some youth with disabilities, virtual social connections can be the only feasible and readily available option for reducing social isolation due to physical barriers to access When offering virtual program options, service providers should consider the various benefits of connecting with the physical, communication-based, interaction-based, access-based and other barriers to virtual connection [ABSTRACT FROM AUTHOR]

Objective Nationwide, obstetric clinics modified prenatal care to include telehealth visits in response to the coronavirus disease 2019 (COVID-19) pandemic, enabling the opportunity to investigate its impact on patient outcomes. We hypothesized that use of prenatal telehealth visits would increase the number of prenatal visits, decrease the frequency of urgent triage/emergency department (ED) visits, and improve perinatal outcomes. This study aimed to determine the impact of telehealth on number of obstetric prenatal visits and urgent triage/ED visits amidst the COVID-19 pandemic. Study Design This is a retrospective cohort of patients from a federally qualified health center in central Texas. Patients with a singleton gestation who delivered after 32 weeks were included. Comparison groups were made between those patients who delivered between May 2020 and December 2020 (presumed modified prenatal visit schedule with in-person and telehealth) and those patients delivering between June 2019 and February 2020 (the traditional care model with in-person visits only). Multivariable linear and logistic regression models were used to estimate differences in the number of prenatal visits and unscheduled triage/ED visits. Results A total of 1,654 patients were identified with 801 (48.4%) patients undergoing modified prenatal care and 853 (51.6%) patients receiving traditional care during the study period. No significant differences were seen in overall prenatal attendance or triage/ED presentations. However, when stratified by parity, multiparous patients undergoing modified prenatal care were less likely to experience an urgent triage/ED presentation (8.7 vs. 12.7%; odds ratio, 1.69; 95% confidence interval, 1.10–2.61). Conclusion When compared with a traditional prenatal visitation cohort prepandemic, patients who received modified telehealth prenatal care during the COVID-19 pandemic had similar prenatal attendance and unscheduled emergency presentations. However, multiparous patients experienced a decreased rate of unscheduled emergency presentations. Supplementing prenatal care with telehealth may provide overall comparable prenatal care delivery. Key Points Use of telehealth has the potential to improve prenatal care. The COVID-19 pandemic allowed for comparison to traditional prenatal care. Multiparous patients had a decreased frequency of ED visits. Similar prenatal attendance was seen between both prenatal models. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 pandemic restrictions necessitated changes in conduct of the interview process for the selection of candidates in paediatric dentistry residency programs. Aims: To examine the experiences and attitudes of paediatric dentistry program directors and residents regarding the virtual interview process during the 2020/2021 application cycle. Design: A survey was sent to 82 directors and 416 postdoctoral members of the American Academy of Pediatric Dentistry with data collected from individuals interviewed during the 2020/2021 cycle. Results: Response rates for directors and residents were 27% (N = 22/82) and 17% (N = 72/416), respectively. Seventy‐three percent of directors (N = 16) believed that virtual interviews were not an adequate substitute for in‐person interviews and made it difficult to present facilities, observe applicant interactions, and assess personality. Fifty‐nine percent of the directors (N = 13) were not interested in using virtual interviews if restrictions were lifted. Residents reported that virtual interviews were accommodating but were unable to observe interpersonal interactions, assess the location and facilities, and understand the program culture. Sixty‐one percent of residents (N = 44) prefer to interview in‐person. Conclusion: The majority of program directors (73%) felt that virtual interviews could not substitute for in‐person interviews and 59% would not be interested in using virtual interviews in the future. Residents (94%) reported inability to evaluate the location and facilities, and 61% prefer to interview in‐person for future interviews. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate facilitator's tools and actions in promoting interaction in virtual co-development. Design/methodology/approach: In virtual environments, facilitation plays a crucial role. However, research does not provide many examples of tools and practices of virtual facilitation of co-development. To collect data, two virtual co-development processes were conducted. The data consisted of discussions during virtual workshops and was analyzed using both theory- and data-driven content analysis. Findings: The discussions during the virtual co-development processes related on the topic and script of co-development and the use of digital technology. In co-development, both the facilitators and the participants take responsibility on the topic and the progression of the session. The facilitator needs to balance between offering the participants tools, supporting interaction and leaving empty space for the participants' initiatives to enhance their agency. Originality/value: The study underlines the importance of the script and tools in virtual facilitation as well as flexibility in the execution of co-development processes. [ABSTRACT FROM AUTHOR]

This paper explores the telemedicine possibilities available to astronauts during spaceflight, focusing on the possible utilization of medical avatars for continuous health monitoring. Various types and sources of telemedicine are examined, along with their applications in deep space travel to address the challenges faced by astronauts and facilitate timely intervention in case of injuries and illnesses. The use of medical avatars presents a promising solution to mitigate risks and ensure effective healthcare delivery in the absence of immediate physical medical support. Furthermore, potential terrestrial applications of telemedicine and virtual medical avatars are discussed, highlighting the wider implications and benefits beyond space exploration. By leveraging advanced technologies and innovative approaches, telemedicine in conjunction with medical avatars offers a compelling avenue for enhancing healthcare practices both in space and on Earth. [ABSTRACT FROM AUTHOR]

Background: Community-based eating disorder (ED) treatment frequently includes manualized group-based psychoeducation facilitated by a mental health clinician. Body Brave, a non-profit ED organization, developed a novel, participant-guided, community-based virtual healthcare provider (HCP)-facilitated support program called On the Journey (OtJ). The program was designed for people with longstanding EDs who had previously participated in group or individual ED programs but require continued support in their recovery. The purpose of the study was to describe the development and components of OtJ and to understand participant perceptions of the program and its effect on their recovery. Methods: Using a formative and community-engaged research design, we conducted semi-structured interviews with three OtJ facilitators and focus groups with twelve OtJ clients. Transcripts were analyzed using Braun and Clarke's six-stage approach to reflexive thematic analysis. Results: Four main themes were generated from the data (1) "Designing and Evolving OtJ" (2) "Is OtJ a Treatment or Support Group?" (3) "Fostering a Safe Environment throughout Program Delivery" and (4) "The Power of Lived Experience." Clients noted several strengths of the OtJ program: fostering a sense of community, valuing client autonomy, and providing accessible ED support. Conclusions: Key considerations for other organizations looking to offer programming similar to OtJ include having skilled and clinically trained facilitators and prescreening discussion topics to ensure that conversations are productive towards recovery. OtJ supports people with longstanding EDs, and other organizations could consider adopting a similar model of care. This study contributes to the growing body of including lived ED experience in research. Plain language summary: On the Journey (OtJ) is a community-based eating disorder (ED) support program that is facilitated by healthcare providers. It was created by Body Brave, a non-profit organization from Hamilton, Ontario, Canada. This program is for people who have had an ED for at least two years and want low barrier support from a qualified clinician and others facing similar struggles as they continue to recover. This study describes the creation and implementation of OtJ and describes themes from interviews of clinicians and focus groups with clients of the program. Four main themes were identified (1) "Designing and Evolving OtJ" (2) "Is OtJ a Treatment or Support Group?" (3) "Fostering a Safe Environment throughout Program Delivery" and (4) "The Power of Lived Experience." Other ED organizations could consider implementing a similar program for their clients with longstanding EDs looking who are seeking accessible support. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionsThe Multiple Mini Interview (MMI) is a widely used method for evaluating non-cognitive skills of applicants to health professions training programs. The COVID-19 pandemic prompted a swift transition to virtual MMIs (vMMIs), with initial indications of their feasibility and acceptability. This novel study describes the implementation and evaluation of a large-scale vMMI model for selection into undergraduate medical, dental, and oral health degrees within an Australian university.A vMMI process was implemented in November 2022, comprising onsite interviewers (n = 450) and remote applicants (n = 1001). Using the online platform Zoom, applicants rotated through six to eight 10-min virtual stations. Acceptability of the virtual process was evaluated using online surveys, completed by interviewers (n = 396) and applicants (n = 255).Overall, interviewers (98%) and applicants (96%) reported the vMMI as a positive experience, citing clear information, suitable interview questions, Zoom use, diversity of interviewers, and lack of gender and cultural bias as strengths of the process. Challenges included difficulties with rapport building and the disturbance of background noise.A large-scale vMMI for three health programs was successfully implemented and positively evaluated. As the uptake of virtual interviews are likely to increase, this study can provide guidance for institutions planning to implement comparable vMMI processes. [ABSTRACT FROM AUTHOR]

The Nominal Group Technique (NGT) has been used to establish clinical priorities and generate guidelines within healthcare since its creation over fifty years ago. It is characterised by its five distinct stages; introduction, silent idea generation, 'round robin', clarifications and rating or ranking. A key element traditionally has been the inclusion of face-to-face discussion, however in the context of COVID-19 innovations were required. This article provides a case study illustrating an adaptation of the NGT to a virtual format (vNGT) and outlines the processes involved in a virtual NGT (vNGT), using an illustrative study exploring the rehabilitation of stroke survivors. The vNGT offers opportunities for global collaborations without the constraints of geography or incurred costs. Future studies should evaluate it's acceptability for stroke survivors to enable their participation within research. Summary statement 1. This study provides a guide for the use of virtual nominal group technique (vNGT), using a freely available video-conferencing platform 2. vNGT increases opportunities for global collaborations whilst incurring minimal costs. 3. It remains unclear how feasible this procedure is with patient populations who have potentially less digital confidence and access. This work was supported by NIHR ARC-East Midlands, Grant number NIHR200171. [ABSTRACT FROM AUTHOR]

Informal settlements are a feature of many cities worldwide, yet information about their social and spatial conditions is often limited to what can be obtained from external observation. Remote sensing and landscape photography are used to acquire information about informal settlements, but images taken from the air or at a distance obscure their complexity, advancing a reductionist imaginary of informality in the minds of outsiders. As part of a project in an informal settlement in Johannesburg, this paper explores the potential of 360-degree imagery as a realist form of spatial representation, towards highlighting the diverse spatial forms, contexts, and lived realities of the informal city. Findings demonstrate the benefits of 360-degree imagery in comparison to other spatial and visual representation methods. Findings also reveal the need for more research into the impacts of this technology on viewer perspectives and perceptions, both visual-cognitive and in terms of intersubjectivity and power relations. [ABSTRACT FROM AUTHOR]

During Covid-19, most in-person intergenerational service-learning programs were halted or transitioned to virtual formats due to social-distancing guidelines. This study qualitatively examined in-person and virtual versions of the Lives Well Lived program, which matches older adults (OAs) with undergraduate students to participate in a mutual interviewing, life review project. Post-test data from open-ended questions were analyzed to compare themes regarding program outcomes. Recognition of OA interindividual differences, intergenerational relationship's value, and decreased fear of aging themes developed in both program versions but there were also differences. Participants in the virtual version regretted not engaging in person, did not mention altruism/empathy, expressed appreciation of peer relationships in addition to OA relationships, and disliked writing reflection papers. Recommendations are given for ensuring similar learning outcomes when engaging in virtual programming, whether due to COVID-19 or in additional situations to pandemics, such as rural settings, lack of transportation/mobility, or time limitations. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the experiences of older adults and counsellors involved in virtual motivational interviewing (MI). This study was part of the Virtual Motivational INTerviewing (VIMINT) feasibility trial of virtual MI for physical activity in older adults. A descriptive qualitative design utilized content analysis. Seven older adults and three counsellors were interviewed. Four categories were developed: (i) Benefits and limitations of using technology (ii) Relationships between older adults and counsellors (iii) MI skills and spirit and (iv) Effects of virtual MI. Older adults and counsellors reported that receiving/delivering MI virtually was convenient and flexible. They described reduced non-verbal communication in virtual MI. Virtual MI facilitates interpersonal relationships, and counsellors reported that MI skills and spirit can be applied virtually. This study showed that virtual MI offers potential benefits with some limitations. The findings could inform future research involving virtual delivery of MI. [ABSTRACT FROM AUTHOR]

Examine the appeal of a virtual avatar-led nutrition education program among youth-serving community partners in North Carolina. We surveyed community partners using the Diffusion of Innovation Theory constructs of relative advantage, compatibility, and complexity. Logistic regression evaluated the appeal and likelihood of the program's future use. Community partners (n = 100) agreed that the program was an innovative (87%) and convenient (85%) way for youth and parents to learn about nutrition. Partners who perceived the program as a relative advantage to current programs had significantly higher odds of future use intention (P = 0.005). Those who found it compatible with organizational and personal values had significantly higher odds of future use (P < 0.001). A nutrition education virtual avatar program is of interest to youth-engaged community partners. Future research examining the potential integration of this type of program within community organizations is warranted. [ABSTRACT FROM AUTHOR]

Background: Nursing education has shifted to online learning environments due to rapid advancements in technology and the COVID-19 pandemic. Some nursing educators and students misunderstand that online learning is isolating and lonely. Method: This literature review explores the impact of online learning on students' emotional well-being and challenges the belief that it is inherently lonely. It examines global events, the growth of online nursing programs, and the myth of online nursing education as isolating and depressing. Results: Online learning is a popular and effective education method that caters to diverse learners and contexts. The instructor's role is crucial in ensuring student satisfaction and engagement, fostering community and interaction among online learners. Conclusion: Online learning is a rich and rewarding experience, with supportive instructors. This series will explore ways to break the myth of loneliness and foster community in the online environment. [ABSTRACT FROM AUTHOR]

The shortage of adequately trained healthcare providers (HCPs) able to treat adults who have experienced childhood interpersonal trauma (CIT) is a pressing concern. This study explored HCPs’ training needs for a trauma-focused psychoeducational group intervention and the potential barriers and facilitators to accessing such training. Three 1-hour focus group sessions were conducted with HCPs (n = 17) from two urban and one rural community healthcare organization serving diverse populations in Ontario, Canada, including under-housed people, women struggling with mental health and addiction, and LGBTQ+ populations. On average, participants had 2.4 years in their current role and 18.1 years of mental health field experience. Thematic analysis revealed key findings: a strong clinical need for trauma services, accessible training programs, and broadly applicable interventions relevant for diverse populations. Notably, participants emphasized the clinical advantages and increased accessibility of a virtual training programs focused on psychoeducational treatment interventions, particularly within community-based healthcare settings. This study highlights the potential of a virtual psychoeducational training programs for HCPs to address this critical gap in healthcare provision for individual with CIT. It also underscores the need to move beyond training program development and focus on implementation and sustainability of interventions in clinical practice. [ABSTRACT FROM AUTHOR]

Reference points provide crucial spatial information for people with visual disabilities, and existing literature categorizes and describes their functions. However, these studies still adhere to a geographical pointillist logic that perceives points as fixed and stable entities and overlooks corporeal processes through which reference points are created. Utilizing concepts from Deleuze-Guattarian philosophy and drawing from sit-down and go-along interviews with visually disabled people, this article answers the question of how to conceptualize reference points from a non-pointillist perspective. By elucidating how reference points need to be actualized through affirmative bodily acts of complex spatio-temporal assemblages, it dismantles their seemingly disembodied and static nature. Consequently, the text explores reference points interwoven with diverse assemblages and examines scenarios in which suitable assemblages could not be assembled, nor could reference points, therefore, be actualized. Thus, the article departs from conceiving of points solely as nouns and presents them in verbal terms, effectively reconciling stability with dynamism. [ABSTRACT FROM AUTHOR]

Introduction: Adult and pediatric ECMO procedures have been increasingly established as conventional life-saving modalities in critical care services across the world. Since 2017, a multidisciplinary team of program advisors for our perfusion education program have aimed to increase cardiovascular perfusion (CVP) student ECMO exposure and improve clinical decision-making. In this QI intervention, the use of 3D computer-based simulation was assessed in establishing a standardized process to improve the diagnosis and treatment of adult ECMO complications among first year CVP students. Methods: The Califia 3D Patient Simulator was incorporated into the curriculum for first year CVP students (n = 26) along with traditional lecture for the adult ECMO complication laboratory session. Pre-class knowledge assessments using de-identified polling software were compared to post-class assessments following the first assigned learning activity. Assessments from students that received simulation before lecture (SIM, n = 15) were compared to students receiving lecture before simulation (LEC, n = 11). User experience questionnaires (UEQ) consisting of 26 questions for six scales of simulation instruction were administered to measure the comprehensive impression of the student experience. Results: Overall median [IQR] pre- and -post knowledge assessment scores were 74% [11] and 84% [11], respectively (p = 0.01). There were no significant differences in pre-class assessment scores between the SIM and LEC groups (74.0% and 74.0%, respectively, p = 0.959). The LEC group achieved higher median post-assessment scores than the SIM group (84% vs 79%, p = 0.032). Among the 26 UEQ survey scales, 23 were positively evaluated (>0.8), and three were a neutral evaluation (−0.8 to 0.8). Cronbach Alpha-Coefficients of >0.78 were measured for attractiveness, perspicuity, efficacy, and stimulation. The coefficient for dependability was 0.37. 25 (96.2%) students indicated that 3D simulation was beneficial to improving ECMO clinical decision-making. Conclusions: In this QI intervention, the implementation of computer-based 3D simulation following lecture was perceived by learners to help improve the diagnosis and treatment of ECMO-related complications. [ABSTRACT FROM AUTHOR]

Background: Following the outbreak of the Covid‐19 pandemic and associated social distancing requirements, Pain Services were no longer able to deliver face‐to‐face Pain Management Programmes (PMP). As an alternative, the Bury Integrated Pain Service developed an interactive, online programme, delivered via Microsoft Teams videoconferencing technology. However, the efficacy of such programmes is unclear. The aim of this project was to assess whether comparable results were observed with online PMPs as with face‐to‐face PMPs. Methods: A non‐inferiority study comparing patients attending an online PMP to a historical cohort of patients attending face‐to‐face PMPs. Analyses of variance were performed to assess between group differences and chi squared tests to compare the proportion of patients making clinically meaningful changes in pain, musculoskeletal health, anxiety, depression and self‐efficacy. Results: 24% of patients (n = 9) deemed suitable for the online PMP were unable to participate due to technological difficulties. This resulted in 28 people attending the online PMP. Greater mean reductions in anxiety (GAD‐7 mean difference = 1.9; p < 0.05) and depression (PHQ‐9 mean difference 3.3; p < 0.05) were observed with face‐to‐face PMP and a greater proportion of patients made clinically meaningful improvements in musculoskeletal health (face‐to‐face = 13; online = 5), anxiety (face‐to‐face = 7; online = 1), and depression (face‐to‐face = 11; online = 2). Conclusions: Some patients appear to obtain significant benefit from online PMPs, but this appeared to be to a lesser extent than face‐to‐face PMPs. It is possible that factors related to the experience of the pandemic influenced these results. However, online PMPs appear to show some promise and further research is warranted to explore the value of online PMPs. [ABSTRACT FROM AUTHOR]

Background: Virtual reality modeling (VRM) is a 3-dimensional simulation created from patient-specific 2-dimensional (2D) imaging. VRM creates a more accurate representation of the patient anatomy and can improve anatomical perception. We surveyed surgeons on their operative plan in complex pediatric oncology cases based on review of 2D imaging and subsequently after review of VRM. We hypothesized that the confidence level would increase with the use of virtual reality and that VRM may change the operative plan. Methods: Patients were selected and enrolled based on age (<18) and oncological diagnosis. VRM was created based on the 2D imaging. Surgeons identified surgical plans based on 2D imaging and again after VRM. A blinded surgeon not involved with the case also gave opinions on surgical plans after viewing both the 2D and the VRM imaging. These assessments were compared with the actual operation. Results: A total of 12 patients were enrolled. Diagnoses included six neuroblastomas, two Wilms tumors, one Ewing's sarcoma, one pseudopapillary tumor of the pancreas, one rhabdomyosarcoma, and one mediastinal germ cell tumor. VRM increased the operating surgeon's confidence 63% of the time. The operative plan changed 8.3% of the time after VRM. Conclusion: VRM is useful to help clarify operative plans for more complex pediatric cases. [ABSTRACT FROM AUTHOR]

Background: Stimulant‐related overdoses have increased dramatically, with almost 50% of overdoses in the United States now involving stimulants. Additionally, harm‐reduction approaches are increasingly seen as key to reducing the negative impact of substance use. Contingency management (CM), the provision of financial incentives for abstinence, is the most effective treatment for stimulant use disorder, but historically has not been widely implemented. Many recent, large‐scale implementation efforts have relied upon foundational CM protocols that may not sufficiently account for recent increases in the prevalence and lethality of stimulant use nor the growing preference for harm reduction versus abstinence‐only frameworks. Argument: We argue the need to (1) consider whether and how CM protocols might be modified to address rising stimulant use and harm reduction frameworks and (2) make CM widely accessible so that it can reduce population‐level stimulant use while ensuring that it is delivered with fidelity to its basic principles. Proposed changes include changing CM reinforcement schedules to emphasize treatment engagement and reductions in use in addition to abstinence, changing guidelines on the duration of and re‐engagement in CM, investing in research on virtual CM, incentivizing providers and health systems to deliver CM, making it easier to purchase and use point‐of‐care drug screens, using direct‐to‐consumer marketing to increase demand for CM and adapting CM to the community in which it is being implemented. Conclusions: Our proposed modifications to contingency management (CM) protocols and accessibility may more effectively address rising stimulant use and align CM more closely with harm‐reduction frameworks. Given the urgent need to reduce overdose deaths, developing and testing modified CM protocols may need to rely upon methods other than randomized controlled trials. Efforts to disseminate CM widely to reduce population‐level stimulant use must be balanced with the need to maintain fidelity to CM's basic principles. [ABSTRACT FROM AUTHOR]

Mindfulness strategies can have a large impact on emotional regulation, emotional intelligence, and interpersonal relationships. Parents of children on the autism spectrum may experience greater stress, depression, and strained interpersonal relationships than those with typically developing children or those with children experiencing other developmental delays. The purpose of the current study was to evaluate the feasibility, acceptability, and initial effects of a virtual Mindful Self-Compassion workshop for parents of children on the autism spectrum and the impact on stress, self-compassion, parenting self-efficacy, and mindfulness. This pilot study used a mixed-method approach to test this hypothesis. Participants completed surveys before and after the brief workshop and participated in a 1-hr focus group within 1 week of completing the surveys. The findings indicate that a short, 3-day virtual workshop may be effective toward improving parents' mindfulness and self-compassion. Parents reported feeling more mindful in their day-to-day life, more self-compassionate during difficult times, and more patient with themselves and other people in their family. A brief, virtual workshop may be effective for short-term improvements in outcomes for parents of children on the autism spectrum. [ABSTRACT FROM AUTHOR]

Background: Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD. Objective: This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT. Methods: Participants (n e-CBT = 45; n check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation. Results: Both treatments demonstrated statistically significant reductions in GAD—7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups. Conclusions: The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD. Plain Language Summary Title: Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder—A Randomized Controlled Trial Plain Language Summary: Generalized anxiety disorder (GAD) is a prevalent psychiatric condition that leads to symptoms like uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is a common psychotherapy used for GAD since it has been shown to reduce symptoms. However, traditional CBT that is in person can have barriers such as being inaccessible and costly, and therefore electronically delivered CBT (e-CBT) is a viable alternative since previous studies have shown its efficacy in reducing symptoms and being similar compared to face-to-face CBT. Previous studies have also shown reductions in GAD symptomology through the use of checking in on people and their mental health. Therefore, this study aimed to compare e-CBT to a check-in condition and had a total of 45 individuals in e-CBT and 51 participants in the check-in condition. Participants in the e-CBT condition completed 12 weeks of predesigned e-CBT modules, homework and received personalized feedback from a care provider. In contrast, individuals in the check-in condition completed 12 weeks of unstructured asynchronous messaging with a care provider. Results from the study showed that both the e-CBT and check-in condition demonstrated statistically significant improvements in GAD-7 across time, but when comparing the groups there was no significant difference. The results show the efficacy of e-CBT and checking in on people's mental health to reduce GAD and future research should examine the 2 conditions combined. [ABSTRACT FROM AUTHOR]

Aim: Young women with type 1 diabetes are a high‐risk population for eating disorders (ED). Prevention programs are lacking. In young women without diabetes, the Body Project has produced reductions in ED risk factors, ED symptoms and future ED onset. Therefore, the Body Project was adapted to type 1 diabetes, the Diabetes Body Project (DBP). In this protocol, we describe the multi‐site randomized controlled trial (RCT) to evaluate efficacy of the DBP. Methods: This is an ongoing RCT with four sites (Europe and US). In total 280, 14–35 year‐old, women with type 1 diabetes ≥1 year and some level of body image concerns will be recruited in 2023. Participants are randomized to either virtual DBP groups or an educational control. The study constitutes 5 measurement points distributed over 2 years. The primary aim is to test if DBP will produce significantly greater reductions in ED behaviours, ED symptoms and future ED onset. The secondary aim is to test if DBP has significantly greater improvements in diabetes distress, quality of life and glycaemic outcomes. Results: We expect that DBP will be more efficacious in reducing ED behaviours, ED symptoms and ED onset compared to the control condition. Additionally, we hope to gain new knowledge on how DBP may affect diabetes‐related outcomes. Conclusions: If DBP proves efficacious, it has potential for immediate, clinical implementation at low‐cost and may contribute to broad prevention of future ED onset among young women with type 1 diabetes. ClinicalTrials.gov Identifier: NCT05399446. [ABSTRACT FROM AUTHOR]

The use of a facilitator is a growing phenomenon in K-12 remote teaching contexts. The aim of this study is to analyse aspects of facilitating students' learning and interaction, with a special focus on the role of the facilitator. Frame factor theory was used as an analytical framework, including different educational conditions. The following research questions were posed: (1) How do different frame factors condition remote teaching? (2) How do these frame factors influence the role of the facilitator in remote teaching? Data were generated from observations (12 h) and interviews with remote teachers and facilitators (N = 18). Results show that frame factors seem to create two types of classroom context that condition the role, task, and responsibility of the facilitator. In the larger classroom context, the facilitator was a threefold resource - practical, pedagogical, and social in an ongoing collaboration with the teacher, whereas in the small classroom context, the facilitator mainly was a practical resource when needed. [ABSTRACT FROM AUTHOR]

Objective Elevated rates of social difficulties are evident for children and adolescents with neurofibromatosis type 1 (NF1) but the effects of social skills interventions have not been investigated for this population. The Program for the Education and Enrichment of Relational Skills (PEERS®), a widely established social skills intervention in autism spectrum disorders with expansion to other conditions, was recently modified to be offered virtually. This study examined the feasibility and acceptability of this telehealth intervention. Methods 27 adolescents with NF1 with social skills difficulties and at least 1 caregiver enrolled in the study. 19 of those participants (M age = 14.21 years, SD  =   1.63; 7 females; 79% White) completed PEERS® via telehealth in a single-arm pilot study. Dropout rates, attendance records, helpfulness of the curriculum topics and caregiver-reported acceptability, including ratings on the Treatment Acceptability Questionnaire, were examined. Results Low study drop out (30% of enrolled participants; 14% of participants who began the intervention) and high attendance rates were observed. Caregivers found sessions related to common, everyday interactions most helpful. Adolescents indicated sessions related to having get-togethers and social nuances (e.g. humor) as most helpful. Caregiver ratings indicated acceptability of the intervention. Conclusions This investigation supported the feasibility and acceptability of telehealth PEERS®, a social skills intervention program, among adolescents with NF1 and their caregivers based on attendance patterns as well as appraisal of the curriculum and telehealth modality. [ABSTRACT FROM AUTHOR]

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Wildlife populations are plummeting worldwide and captivity, of at least some, species is increasingly being challenged from an ethical perspective. When captivity serves human entertainment, poor treatment as well as unequal power-relationships are problematic. Particularly for wildlife ecotourism then, we ask: is the future virtual? Taking a posthumanist approach, this conceptual manuscript considers whether presenting technologically created images to tourists can equitably foreground non-human rights, welfare, and agency. We highlight examples of tourism involving wildlife in virtual settings to explore possible advantages and disadvantages of this type of experience for human and non-human stakeholders. This enables us to explore how the virtual experience fits with the concept of ecotourism. The argument is made that the ideals of wildlife ecotourism can best, and perhaps only, be met virtually – but only if we use images of non-human animals who are represented with dignity and respect. [ABSTRACT FROM AUTHOR]

The field of ergonomics has been significantly shaped by the advent of evolving technologies linked to new industrial paradigms, often referred to as Industry 4.0 (I4.0) and, more recently, Industry 5.0 (I5.0). Consequently, several studies have reviewed the integration of advanced technologies for improved ergonomics in different industry sectors. However, studies often evaluate specific technologies, such as extended reality (XR), wearables, artificial intelligence (AI), and collaborative robot (cobot), and their advantages and problems. In this sense, there is a lack of research exploring the state of the art of I4.0 and I5.0 virtual and digital technologies in evaluating work-related biomechanical risks. Addressing this research gap, this study presents a comprehensive review of 24 commercial tools and 10 academic studies focusing on work-related biomechanical risk assessment using digital and virtual technologies. The analysis reveals that AI and digital human modelling (DHM) are the most commonly utilised technologies in commercial tools, followed by motion capture (MoCap) and virtual reality (VR). Discrepancies were found between commercial tools and academic studies. However, the study acknowledges limitations, including potential biases in sample selection and search methodology. Future research directions include enhancing transparency in commercial tool validation processes, examining the broader impact of emerging technologies on ergonomics, and considering human-centred design principles in technology integration. These findings contribute to a deeper understanding of the evolving landscape of biomechanical risk assessment. [ABSTRACT FROM AUTHOR]

Background: Research suggests that comics are effective at conveying narratives, promoting literacy, empowerment, and as a therapeutic intervention. However, there is a gap in research on the use of comics in art therapy. Aims: This study explored the potential of comics within an art therapy and narrative therapy framework. The primary research question explored the effectiveness of comics compared to single images in evoking narratives from past problems. The secondary research question examined differences in the representation of an event between the two formats. To address these questions, the process of depicting a past problem as a single image was compared to depicting the same problem as a comic. Methods: This study recruited 15 adult participants through convenience sampling. This was a non-clinical population consisting of individuals with no known psychological difficulties or history of psychological disorders. Participants evaluated the formats through a survey and verbal interview. Quantitative and qualitative data were analysed to determine the formats' effectiveness. Participants' artwork was analysed for unique characteristics the comic evoked. Results: Data analysis indicated participants responded positively to the comic, which seemed especially effective at facilitating the narrative therapy technique of deconstructing. Artwork analysis indicated the comic evoked increased word inclusion, and unique representations of time and movement. Conclusions: These results support the hypothesis that comics are at least as effective than single images in eliciting narratives from past problems, and evoke unique characteristics. Implications: This study suggests the potential of comics in art therapy, encouraging further research and application. Plain-language summary: Research has suggested the effectiveness of comic creation as a means of communication and empowerment. However, there is a gap in research on the use of comic creation as an art therapy intervention. This study explored the potential of comics as an art therapy tool by comparing the process of depicting a past problem as a single image to the process of depicting the same problem as a comic. This was done in order to determine the effectiveness of creating a comic compared to creating a single image in depicting a past problem, particularly in eliciting a narrative from the problem. This study also explored how the representation of an event might differ in a comic versus a single image format. This study worked with 15 adult participants who had no prior history of psychological disorders. Participants first depicted a past problem as a comic and a single image and then completed a survey and a verbal interview comparing these two formats. Results indicated that participants responded positively to the comic format and that it appeared especially effective in helping participants break down the origins, impacts and actions involved in the problem. Examining participants' artwork also suggested that the comic format brought about unique representations of time and movement. The findings of this study suggest that comic or sequential art have potential for use in an art therapy setting. This study hopes to spark further research and encourage the use of comics in therapeutic settings. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess impingement-free internal rotation (IR) in a virtual reverse shoulder arthroplasty simulation using a Statistical Shape Model based on scapula size. Methods: A database of over 10,000 scapulae utilized for preoperative planning for shoulder arthroplasty was analyzed with a Statistical Shape Model to obtain 5 scapula sizes including the mean and 2 standard deviations. For each scapula model, one glenosphere size (33-42 mm) was selected as the best fit based on consensus among 3 shoulder surgeons. Virtual implantation variables included 1) lateral offset (0-12 mm in 2-mm increments), 2) inferior eccentricity (0, 2.5, 5, and 7.5 mm), and 3) posterior eccentricity (0, 2.5, and 5 mm). The neck shaft angle was fixed at 135° with an inlay design humeral prosthesis. IR at the side (IR0) and in abduction (IRABD) were then simulated. Results: Maximum impingement-free IR0 was reached with increasing inferior offset in combination with increasing lateralization. Lateralization was the most important variable in increasing impingement-free IRABD. Maximum IRABD was reached at 4-6 mm of lateralization with smaller scapula (−2 to 0 standard deviation). Increasing lateralization up to 12 mm continues to increase IRABD for larger-sized scapula (+1 to +2 standard deviation). Optimal inferior offset and lateralization to maximize IR did have a small loss of external rotation in neutral abduction. There was no loss of external rotation in 60° of abduction. Conclusion: In a virtual model, the glenosphere position required to maximize IR varied by scapula size. For smaller scapulae, maximum IR0 was reached with a combination of 2.5-mm inferior offset and 0- 4 mm of lateralization. For larger scapulae, maximum IR0 was reached with a combination of 2.5 mm of inferior offset and 4 mm of lateralization. The amount of lateralization required to maximize IRABD also varies by scapula size. Maximum IRABD was reached in smaller scapula with 4-6 mm of lateralization and at least 12 mm of lateralization in larger scapula. These findings may be applied in the clinical decision-making process knowing that impingement-free IR and IRABD can be maximized with combinations of inferior offset and lateralization based on scapula size with minimal effect on external rotation and external rotation in 60° of abduction.

Abstract Background Community-based eating disorder (ED) treatment frequently includes manualized group-based psychoeducation facilitated by a mental health clinician. Body Brave, a non-profit ED organization, developed a novel, participant-guided, community-based virtual healthcare provider (HCP)-facilitated support program called On the Journey (OtJ). The program was designed for people with longstanding EDs who had previously participated in group or individual ED programs but require continued support in their recovery. The purpose of the study was to describe the development and components of OtJ and to understand participant perceptions of the program and its effect on their recovery. Methods Using a formative and community-engaged research design, we conducted semi-structured interviews with three OtJ facilitators and focus groups with twelve OtJ clients. Transcripts were analyzed using Braun and Clarke’s six-stage approach to reflexive thematic analysis. Results Four main themes were generated from the data (1) “Designing and Evolving OtJ” (2) “Is OtJ a Treatment or Support Group?” (3) “Fostering a Safe Environment throughout Program Delivery” and (4) “The Power of Lived Experience.” Clients noted several strengths of the OtJ program: fostering a sense of community, valuing client autonomy, and providing accessible ED support. Conclusions Key considerations for other organizations looking to offer programming similar to OtJ include having skilled and clinically trained facilitators and prescreening discussion topics to ensure that conversations are productive towards recovery. OtJ supports people with longstanding EDs, and other organizations could consider adopting a similar model of care. This study contributes to the growing body of including lived ED experience in research.

Abstract The Nominal Group Technique (NGT) has been used to establish clinical priorities and generate guidelines within healthcare since its creation over fifty years ago. It is characterised by its five distinct stages; introduction, silent idea generation, ‘round robin’, clarifications and rating or ranking. A key element traditionally has been the inclusion of face-to-face discussion, however in the context of COVID-19 innovations were required. This article provides a case study illustrating an adaptation of the NGT to a virtual format (vNGT) and outlines the processes involved in a virtual NGT (vNGT), using an illustrative study exploring the rehabilitation of stroke survivors. The vNGT offers opportunities for global collaborations without the constraints of geography or incurred costs. Future studies should evaluate it’s acceptability for stroke survivors to enable their participation within research. Summary statement 1. This study provides a guide for the use of virtual nominal group technique (vNGT), using a freely available video-conferencing platform 2. vNGT increases opportunities for global collaborations whilst incurring minimal costs. 3. It remains unclear how feasible this procedure is with patient populations who have potentially less digital confidence and access. This work was supported by NIHR ARC-East Midlands, Grant number NIHR200171.

Pamuk üretimi üzerine yapılan çalışmalar, pamuk yetiştiriciliğinin yüksek su tüketimine sahip olduğunu dolayısıyla, özellikle kurak bölgelerde su kaynaklarının sürdürülebilirliği üzerinde olumsuz bir etkiye sahip olduğunu göstermektedir. Pamuk sulamasında ihtiyaç duyulan suyun az olduğu bölgelerin tespit edilmesi, ülke bazında su kaynaklarının korunması adına önem arz etmektedir. Bu çalışmanın temel amacı, Türkiye'deki pamuk üretiminin yeşil ve mavi su kullanımı üzerinde derinlemesine bir analiz sunarak su ve tarım yönetimi çalışmalarına katkı sağlamaktır. Bu bağlamda ulusal iklim ve bitki verileri sanal su (SS) ve su ayak izi (SA) metodu kapsamında analiz edilmiştir. ArcMap 10.7 yazılımı ve alansal interpolasyon araçları kullanılarak ülke genelinde ekimi yapılan pamuğun yeşil ve mavi su ayak izi yüksek mekânsal ve zamansal çözünürlükle hesaplanmış, sonuçlar 24 il ve 141 ilçe genelinde görselleştirilmiştir. Buna göre, 2019-2023 yılları arasındaki üretim verileri dikkate alındığında Türkiye genelinde yıllık kütlü pamuk üretimine yaklaşık 3.68 milyar m3 mavi suyun harcandığı görülmektedir. Tarladaki pamuğun birim yeşil ve mavi su ayak izleri ise ortalama 205 ve 1641 m3/ton olarak bulunmuştur. Hali hazırda Şanlıurfa, Diyarbakır ve Aydın illeri, ülke için en önemli pamuk ekim merkezleri olup, pamuk yetiştiriciliği için tüketilen suyun yarıya yakını Şanlıurfa ilinde kullanılmaktadır. Bu çalışmanın sonuçlarına göre, pamuk üretiminde kullanılan birim mavi su (m3/ton), bazı bölgelerde iki katına kadar çıkmakta, bu durum özellikle toprak neminin az olduğu kurak bölgelerde aşırı miktarda su tüketilmesine sebep olmaktadır. Buna göre, Türkiye’deki pamuk yetiştiriciliğinin Güneydoğu bölgesinden Çukurova bölgesine kaydırılması, ülkenin su kaynaklarının korunması adına önemli bir strateji olacaktır. Bu çalışmada pamuğun su tüketimini azaltmaya yönelik stratejiler de tartışılmıştır.

The American Association of Physicists in Medicine began the Medical Physics Leadership Academy Journal Club in the fall of 2020. The initiative was launched to provide a forum for medical physicists to learn about leadership topics using published material, discuss and reflect on the material, and consider incorporating the discussed skills into their professional practice. This report presents the framework for the MPLA Journal Club program, describes the lessons learned over the last 2 years, summarizes the data collected from attendees, and highlights the roadmap for the program moving forward.

Deleuze's monograph on Foucault is often construed as a 'metaphysical fiction' (Frédéric Gros), which would attribute to Foucault a metaphysics of Deleuze's own issue. Notably, Paul Patton has argued that Deleuze thereby deeply mischaracterises Foucault's concepts of actuality, history, power and philosophy itself. Against this view, I argue that Deleuze's interpretation in Foucault clarifies the virtual force ontology that the two thinkers effectively developed in common. This ontological framework not only resolves Patton's specific objections; it also outlines a philosophy of the event demonstrating the conceptual consistency between Foucault and Deleuze on fundamental questions of philosophical critique and political agency. [ABSTRACT FROM AUTHOR]

Background: Yoga may reduce negative cancer- and treatment-related effects and help improve a range of outcomes, including flexibility, mindfulness, and quality of life among adults affected by cancer. Yet there is little evidence for the role of yoga among young adults (18-39 years) affected by cancer. Purpose: The purpose of this study was to explore the experiences of young adults affected by cancer in an 8-week yoga intervention delivered by videoconference. Methods: Young adults who were diagnosed with cancer between the ages of 18 and 39 years, at any stage of the cancer trajectory, who were living in Canada, and who completed an 8-week yoga intervention were approached to complete a semi-structured interview. A social constructivist paradigm was adopted. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Results: Twenty-eight young adults (Mean age = 34.67±5.11 years; n=25 female) with varied cancer diagnoses participated. Participants' perspectives were represented across 6 themes: (1) I was juggling a number of challenges and changes throughout the yoga intervention; (2) I noticed some improvements in my mental and physical health; (3) I made time to discover new strategies to take care of myself; (4) I was able to see what my body is capable of; (5) I was held accountable and I appreciated that, and; (6) I was able to be around similar others in a safe (virtual) space. Conclusions: Findings suggest that an 8-week yoga intervention may offer some benefits for young adults affected by cancer. Self-care, self-compassion, mindfulness, feelings of physical competence, establishing a routine, and being around similar others were viewed as important components of the intervention and may have contributed to the benefits experienced. Findings underscore the potential utility of yoga as a supportive care intervention for young adults affected by cancer. [ABSTRACT FROM AUTHOR]

Introduction: This study compares pharmacy students' performance using face-to-face (FTF) team-based learning (TBL) vs. virtual TBL across multiple courses and different academic levels while accounting for student demographic and academic factors. Methods: The study included pharmacy students from different academic levels (P1-P3) who were enrolled in three didactic courses taught using FTF TBL and virtual TBL. Multiple generalized linear models (GLMs) were performed to compare students' performance on individual readiness assurance tests (iRAT s), team readiness assurance tests (tRAT s), team application exercises (tAPPs), summative exams, and total course scores using FTF TBL vs. virtual TBL, adjusting for students' age, sex, race, and cumulative grade point average (cGPA). Results: The study involved a total of 356 pharmacy students distributed across different academic levels and learning modalities: P1 students [FTF TBL (n = 26), virtual TBL (n = 42)], P2 students [FTF TBL (n = 77), virtual TBL (n = 71)], and P3 students [FTF TBL (n = 65), virtual TBL (n = 75)]. In the P1 cohort, the virtual TBL group had higher iRAT and tRAT scores but lower tAPP scores than the FTF TBL group, with no significant differences in summative exams or total course scores. For P2 students, the virtual TBL group had higher iRAT and tRAT scores but lower summative exam scores and total course scores than the FTF TBL group, with no significant differences in tAPP scores. In the P3 student group, the virtual TBL group had higher iRAT, tRAT, tAPP, summative exam, and total course scores than the FTF TBL group. Conclusions: Students' performance in virtual TBL vs. FTF TBL in the pharmacy didactic curriculum varies depending on the course content, academic year, and type of assessment. [ABSTRACT FROM AUTHOR]

Abstract Introduction Studies have reported different results of evaluation methods of clinical competency tests. Therefore, this study aimed to design, implement, and evaluate a blended (in-person and virtual) Competency Examination for final-year Nursing Students. Methods This interventional study was conducted in two semesters of 2020–2021 using an educational action research method in the nursing and midwifery faculty. Thirteen faculty members and 84 final-year nursing students were included in the study using a census method. Eight programs and related activities were designed and conducted during the examination process. Students completed the Spielberger Anxiety Inventory before the examination, and both faculty members and students completed the Acceptance and Satisfaction questionnaire. Findings The results of the analysis of focused group discussions and reflections indicated that the virtual CCE was not capable of adequately assessing clinical skills. Therefore, it was decided that the CCE for final-year nursing students would be conducted using a blended method. The activities required for performing the examination were designed and implemented based on action plans. Anxiety and satisfaction were also evaluated as outcomes of the study. There was no statistically significant difference in overt, covert, and overall anxiety scores between the in-person and virtual sections of the examination (p > 0.05). The mean (SD) acceptance and satisfaction scores for students in virtual, in-person, and blended sections were 25.49 (4.73), 27.60 (4.70), and 25.57 (4.97), respectively, out of 30 points, in which there was a significant increase in the in-person section compared to the other sections. (p = 0.008). The mean acceptance and satisfaction scores for faculty members were 30.31 (4.47) in the virtual, 29.86 (3.94) in the in-person, and 30.00 (4.16) out of 33 in the blended, and there was no significant difference between the three sections (p = 0.864). Conclusion Evaluating nursing students’ clinical competency using a blended method was implemented and solved the problem of students’ graduation. Therefore, it is suggested that the blended method be used instead of traditional in-person or entirely virtual exams in epidemics or based on conditions, facilities, and human resources. Also, the use of patient simulation, virtual reality, and the development of necessary virtual and in-person training infrastructure for students is recommended for future research. Furthermore, considering that the acceptance of traditional in-person exams among students is higher, it is necessary to develop virtual teaching strategies.

This study analyzes and explores disaster village tourism and life situation communication, clarifies the form and virtual scenarios, determines building blocks, and suggests sufficient functional requirements to develop virtual tourism scenarios. The questionnaire survey method is direct and effective for identifying questions; the case analysis method surveys the situation of the disaster village tourist attraction; and the theoretical analysis method discusses theories related to Digital Photo Book. The results indicate that tourists are interested in using Digital Photo Book as an information guide. Digital Photo Book's contribution to tourist information is more significant than conventional information, with 77% of tourists believing that the information provided greatly influenced their interest in the future. 70% of respondents stated that the impact of the information provided reached a satisfactory level. Digital Photo Book is more easily accepted and appreciated by tourists and is more suitable to be applied globally in the aspect of tourism, especially in areas with limited access.

Elexis Hollingsworth,1,2 Benjamin H Shields,2,&ast; Christopher Rutter,2,3,&ast; Lynn Fox,4 Kelly N Evans,5 Jay Paul Willging,6 Amelia F Drake2 1School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 2Department of Otolaryngology/Head and Neck Surgery, UNC Hospitals, Craniofacial Center, University of North Carolina, Chapel Hill, NC, USA; 3University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA; 4Adams School of Dentistry, UNC Craniofacial Center, University of North Carolina, Chapel Hill, NC, USA; 5Division of Craniofacial Medicine, Seattle Children’s Hospital, Seattle, WA, USA; 6Division of Pediatric Otolaryngology - Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA&ast;These authors contributed equally to this workCorrespondence: Elexis Hollingsworth, UVA Health, Department of Anesthesiology, 1215 Lee St. Box 800710, Charlottesville, VA, 22908‐0816, USA, Fax +1 434‐982‐0019, Email eh6cm@uvahealth.orgObjective: In the USA, the American Cleft Palate Association-Craniofacial Association (ACPA-CPF) specifies guidelines to ensure craniofacial teams function in a multidisciplinary fashion to provide care in a sequence that mirrors the patient’s needs. Among these guidelines is the expectation that teams hold regular multidisciplinary team meetings to discuss patient care. The purpose of this study was to identify factors that contribute to optimal team functioning during these meetings. The impact of the virtual format on meetings was also evaluated.Design: One-hour semi-structured interviews of craniofacial team members, queried on current and ideal team meetings, were conducted from December 2020 – January 2021. Interviews were recorded, transcribed, and coded to identify common themes until thematic saturation was achieved.Setting/Participants: Sixteen team members from three major American craniofacial centers were interviewed virtually.Results: Three major categories were identified as integral to successful meetings: (1) meeting content, (2) meeting processes, and (3) team dynamics. Within these categories are several factors that participants reported as important to optimize their multidisciplinary meetings: key content for discussions, integration of patient perspective, recognition of collaboration in determining proper sequence of treatments, an attentive discussion leader promoting equitable discussions, managing absences, and team diversity. Participants also identified benefits and pitfalls of hosting meetings in the virtual setting, including lack of engagement and awkward communication.Conclusion: Diverse groups of disciplines are expected to come together during craniofacial multidisciplinary meetings to formulate intricate care plans for complex patients. In this study, craniofacial team members have identified several key factors to optimize these meetings. The research group used these factors to propose a self-evaluation instrument for meeting quality improvement, provided in printable format. Further studies should evaluate how implementation of these factors affects meetings and ultimately guides patient care.Keywords: cleft lip-palate, multidisciplinary, interdisciplinary, teamwork, self-evaluation, virtual

This comprehensive text explores the intricate interplay of memory, virtuality, consciousness, and personhood in shaping the human experience. Memory is depicted as a core process integral to identity formation, transcending mere recollection to become a reflective exercise in self-discovery. The advent of the digital age raises concerns about the impact of virtual connections on authentic encounters and the preservation of individual autonomy amid algorithmic homogenizations. In examining consciousness and experience, the inseparability of life and consciousness is emphasized, alongside the significance of corporeality in self-awareness. Abduction is proposed as a mode of creative reasoning that expands our comprehension of the human mind and its relationship with the universe. Furthermore, the text delves into the notion of personhood, highlighting the complexity of identity formation through interaction with the world, others, and history. Through a reflective and pluralistic approach, traditional conceptions of being are challenged, inviting a deeper understanding of the multifaceted human condition.

La figura del tutor ha sido importante en la formación virtual, su rol se vuelve aún más crucial en tiempos de crisis o pandemias. El artículo tiene como propósito propiciar claves para una formación efectiva de tutores virtuales desde el Centro de Investigaciones Educativas de la Universidad Nacional Experimental Rafael María Baralt. Se trabajó con enfoque cualitativo, paradigma crítico reflexivo, se aplicó el modelo de Elliot. Para la recogida de información se emplearon la técnica de la observación participante y el diario del investigador. El instrumento una entrevista no estructurada. Para el procesamiento de la información se utilizó la triangulación de fuentes. Los resultados aseguran la andragogía y recursos adecuados generan un aprendizaje personalizado e ideal para los docentes. Las claves para la formación docente por parte del CIE UNERMB tuvo un impacto positivo en varios aspectos: fortaleció la autonomía y el empoderamiento de los docentes, desarrolló la capacidad de enfrentar retos y tomar decisiones, generó confianza y consolidó la práctica del tutor virtual.

Abstract Background Early post-discharge assessments for newborns are recommended. Virtual care has become more prevalent during the pandemic, providing an opportunity to better understand its impact on the quality of post-discharge newborn care. The objective of this study was to understand whether primary care visit modality (in-person vs. virtual) is associated with early newborn hospital readmissions and emergency department (ED) visits. Methods We conducted a population-based, case-control study using linked health administrative databases between September 1, 2020 and March 31, 2022 in Ontario, Canada. We compared the modality of primary care visits among cases (hospital readmission within 14 days of life) and controls (newborns without a readmission), matched on infant sex, gestational age, and maternal parity. We included an alternative definition of cases as a composite of either a newborn hospital readmission or emergency department (ED) visit or in-hospital death within the first 14 days of life. Conditional logistic regression models were used to model odds ratios (ORs), comparing those exposed to a virtual visit versus in-person visit, adjusting for infant birth weight, birth hospitalization length of stay, neighbourhood level material deprivation, rurality and presence of active maternal comorbidities. Results Among 73,324 eligible newborns, 2,220 experienced a hospital readmission within 14 days of life and were matched to 8,880 controls. Jaundice was the primary reason for readmission (75% of readmissions). Compared to newborns who were seen in-person post-discharge, newborns who were seen virtually had higher odds of hospital readmission (adjusted odds ratio [aOR] 1.41 (95% CI 1.09, 1.83); the magnitude of effect was not different using the composite outcome (aOR 1.35, 95% CI 1.05, 1.75). Conclusions Newborns who receive a virtual post-discharge visit are more likely than those who receive an in-person visit to require hospital readmission.

Abstract Background Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to recognize disease features and how (and when) to refer to specialist care. The aim of this paper is to highlight the need for better access to health care, review the essential role that education and virtual care play to address unmet need in low resource areas and especially to expand workforce capacity. Using collaborative partnerships, virtual platforms, and innovative assessment methods, musculoskeletal care and education can be delivered to reach a greater audience than ever before. Increased awareness through multiple initiatives and readily available resources are imperative to improve global rheumatology care. Conclusion The needs of children with rheumatic diseases and musculoskeletal conditions are vastly underserved around the world resulting in preventable morbidity and mortality. Expanded implementation of virtual education and e-health care platforms provides an opportunity to increase access to care for children globally.