The COVID-19 Pandemic contributed to accelerating the process of using information and communication technologies and digital technologies in healthcare management and delivery within healthcare systems. At that time, the Czech healthcare system faced the same problems as other European systems and struggled with a temporary limitation of direct provision of healthcare services. It was solved by switching to telemedicine. The Czech healthcare system used telemedicine to a minimal extent until then. Despite adopting the law on healthcare digitisation, it is still one of the countries with a lower level of digitisation of healthcare processes. The article presents the results of an exploratory expert investigation focused on the implementation and development of telemedicine in the Czech Republic. The conducted research aimed to identify problems related to the implementation of telemedicine in practice, place them in the broader framework of the healthcare system and structure them, propose possible solutions, and identify the future challenges of telemedicine in the Czech Republic. We based our study on the results of a three-phase QUAL-QUAN-QUAL research. Data collection in the first phase took the form of individual semi-structured interviews with patients (25) with practical experience in the field of telemedicine, followed by the second quantitative phase of the questionnaire survey with patients (650). The third qualitative phase included semi-structured interviews with experts (17) with practical experience in telemedicine. The introduction and expansion of telemedicine require several fundamental changes. These include adjustments to the legislative environment and changes to the technological infrastructure, organisation of care and work. Several barriers have been identified at the healthcare system level, healthcare providers, healthcare professionals and patients.

• MeSH
• COVID-19 * epidemiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Pandemics * MeSH
• Delivery of Health Care organization & administration   MeSH
• Surveys and Questionnaires MeSH
• Interviews as Topic MeSH
• SARS-CoV-2 MeSH
• Aged MeSH
• Telemedicine * organization & administration   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: This study examines the perspectives of individuals with coronary heart disease (CHD) on a nurse-led eHealth cardiac rehabilitation (NeCR) program, which included a website, tele-monitoring device, and social media chatroom. METHODS: Using a descriptive qualitative approach, semi-structured interviews were conducted with 18 participants to capture their feedback and experiences with the NeCR program. RESULTS: Participants found the NeCR program valuable in addressing gaps in cardiac rehabilitation services in China, empowering them to make behavioral changes and enhancing their social motivation. However, they also highlighted the need for a more user-friendly website, better symptom management during exercise, and stronger privacy protections in the peer networking chatroom. The study concludes that the NeCR program is feasible in providing accessible rehabilitative services at home post-discharge. Recommendations include improving the self-monitoring platform for ease of use, incorporating immediate symptom management guidance during exercise, and ensuring a secure environment for online peer support. CONCLUSIONS: These findings offer crucial insights for developing patient-centered eHealth cardiac rehabilitation services, emphasizing the importance of user-friendly design, effective symptom management features, and privacy protection in promoting participant engagement with e-platforms. TRIAL REGISTRATION: ChiCTR1800020411 (http://www.chictr.org.cn/showprojen.aspx?proj=33906).

• MeSH
• Adult MeSH
• Cardiac Rehabilitation * methods   MeSH
• Coronary Disease rehabilitation   nursing   MeSH
• Qualitative Research * MeSH
• Middle Aged MeSH
• Humans MeSH
• Interviews as Topic MeSH
• Aged MeSH
• Telemedicine * MeSH
• Feedback MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• China MeSH

BACKGROUND: The online environment provides adolescents with vast amounts of health-related information; however, navigating this effectively requires high levels of eHealth literacy to avoid misinformation and harmful content. Parental guidance is often considered a crucial factor in shaping adolescents' online health behaviors; however, there is limited longitudinal research examining how parental eHealth literacy mediation influences adolescents' development of eHealth literacy over time. OBJECTIVE: This study aims to examine the reciprocal relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. It also investigates whether parental education moderates this relationship, specifically exploring whether higher levels of parental education enhance the effectiveness of eHealth literacy mediation in improving adolescents' eHealth literacy. METHODS: A 3-wave longitudinal study was conducted, collecting data from 2500 adolescent-parent pairs. A random intercept cross-lagged panel model was applied to assess the reciprocal effects between parental eHealth literacy mediation and adolescents' eHealth literacy across the 3 waves. Parental education was included in the model as a potential moderating variable to examine whether it influences the strength of the relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. RESULTS: The findings revealed no significant within-person effects, indicating that changes in parental eHealth literacy mediation over time did not lead to corresponding changes in adolescents' eHealth literacy (T1→T2 β=-.03, P=.65; T2→T3 β=.01, P=.84), and vice versa (T1→T2 β=.02, P=.71; T2→T3 β=-.07, P=.19). Furthermore, the data did not support a moderating effect of parental education, suggesting that higher educational attainment does not enhance the impact of parental eHealth literacy mediation. However, a significant between-person association was observed: adolescents with higher levels of eHealth literacy tend to have parents who engage more frequently in eHealth literacy mediation (r=0.30, P<.001). CONCLUSIONS: This study contributes to the understanding of parental involvement in shaping adolescents' eHealth literacy. Contrary to expectations, parental eHealth literacy mediation does not appear to have a significant longitudinal impact on the development of adolescents' eHealth literacy, nor does higher parental education strengthen this relationship. These findings suggest that additional factors beyond parental mediation and education may play a critical role in supporting adolescents' ability to navigate online health information effectively.

• MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Adolescent MeSH
• Parents * MeSH
• Telemedicine * MeSH
• Parent-Child Relations * MeSH
• Health Literacy * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: The increasing complexity of mass casualty incidents (MCIs) necessitates highly effective training for emergency responders. Traditional training methods, while effective in teaching core skills, often fail to replicate the dynamic, high-pressure environments responders face in real-world crises. Virtual reality (VR) offers a novel approach to emergency training, providing an immersive, controlled setting that can simulate real-life scenarios. This study explores the effectiveness of VR in training paramedic students for MCIs and compares the outcomes to those from conventional training methods. METHODS: A comparative study was conducted with 37 paramedic students who underwent either VR-based training or conventional training using mannequins and real-world equipment. The VR application simulated a mass casualty car accident, focusing on triage and patient management. Both groups were assessed based on their performance in key areas, including the accuracy of situational reporting (METHANE), patient triage, heart rate monitoring, and perceived demand using the NASA Task Load Index (NASA-TLX). RESULTS: The VR group demonstrated significantly lower mental demand (p < 0.001) and frustration levels (p = 0.021) compared to traditional training. However, task completion times were slower in the VR setting (p < 0.001), likely due to the interface's unfamiliarity. Accuracy in situational reporting was higher in VR (p = 0.002), while heart rate monitoring did not reveal a significant difference between the groups (p = 0.516). Although VR did not reduce temporal demand (p = 0.057), it showed potential for improving focus and precision in training. Error rates in triage were similar across both training methods (p = 0.882), indicating comparable performance levels in patient classification. CONCLUSIONS: VR presents a promising tool for training emergency responders, particularly in situations that require rapid upskilling, such as crises or wars. The ability to simulate realistic, high-pressure scenarios in a controlled environment can enhance both cognitive and emotional preparedness. Further research is necessary to optimize VR systems and interfaces, making them more efficient for real-time decision-making. As VR technology advances, it holds potential as a key component in future emergency preparedness strategies.

• MeSH
• Adult MeSH
• Emergency Responders * education   psychology   MeSH
• Mass Casualty Incidents * MeSH
• Humans MeSH
• Disaster Planning methods   MeSH
• Triage methods   MeSH
• Virtual Reality * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Immersive Virtual Reality (iVR) presents a promising avenue for treating acrophobia through Virtual Reality Exposure Therapy (VRET). This paper explores the current state of VRET for acrophobia, identifying significant technological and practical barriers that limit its effectiveness and hinder widespread adoption. Key challenges include the need for more advanced and realistic user experiences, and for the integration of biofeedback mechanisms. Additionally, the role of therapists remains crucial, as therapist-led VRET sessions demonstrate better outcomes compared to automated interventions. The potential of Collaborative Immersive Virtual Environments (CIVEs) to enhance VRET by simulating real-life interactions and improving patient-therapist engagement is also discussed. Future research should focus on developing comprehensive guidelines for CIVE design and evaluating integrated VRET and CIVE systems for treating phobias, including acrophobia. Addressing these issues will enhance the therapeutic experience, making VRET a more effective and accessible tool for treating acrophobia.

• Publication type
• Journal Article MeSH

BACKGROUND: Over the past 25 years, the development of multiuser applications has seen considerable advancements and challenges. The technological development in this field has emerged from simple chat rooms through videoconferencing tools to the creation of complex, interactive, and often multisensory virtual worlds. These multiuser technologies have gradually found their way into mental health care, where they are used in both dyadic counseling and group interventions. However, some limitations in hardware capabilities, user experience designs, and scalability may have hindered the effectiveness of these applications. OBJECTIVE: This systematic review aims at summarizing the progress made and the potential future directions in this field while evaluating various factors and perspectives relevant to remote multiuser interventions. METHODS: The systematic review was performed based on a Web of Science and PubMed database search covering articles in English, published from January 1999 to March 2024, related to multiuser mental health interventions. Several inclusion and exclusion criteria were determined before and during the records screening process, which was performed in several steps. RESULTS: We identified 49 records exploring multiuser applications in mental health care, ranging from text-based interventions to interventions set in fully immersive environments. The number of publications exploring this topic has been growing since 2015, with a large increase during the COVID-19 pandemic. Most digital interventions were delivered in the form of videoconferencing, with only a few implementing immersive environments. The studies used professional or peer-supported group interventions or a combination of both approaches. The research studies targeted diverse groups and topics, from nursing mothers to psychiatric disorders or various minority groups. Most group sessions occurred weekly, or in the case of the peer-support groups, often with a flexible schedule. CONCLUSIONS: We identified many benefits to multiuser digital interventions for mental health care. These approaches provide distributed, always available, and affordable peer support that can be used to deliver necessary help to people living outside of areas where in-person interventions are easily available. While immersive virtual environments have become a common tool in many areas of psychiatric care, such as exposure therapy, our results suggest that this technology in multiuser settings is still in its early stages. Most identified studies investigated mainstream technologies, such as videoconferencing or text-based support, substituting the immersive experience for convenience and ease of use. While many studies discuss useful features of virtual environments in group interventions, such as anonymity or stronger engagement with the group, we discuss persisting issues with these technologies, which currently prevent their full adoption.

• MeSH
• Mental Disorders therapy   MeSH
• Mental Health MeSH
• Humans MeSH
• Mental Health Services * MeSH
• Telemedicine MeSH
• Videoconferencing MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Systematic Review MeSH

There is growing interest in virtual reality (VR) training among competitive athletes and casual sports players alike as a tool to supplement real-life play within a highly controlled, intellectually stimulating environment. We examined data from a commercially available, recently released VR software for tennis for changes in and correlates of performance. Two most frequently used tasks were evaluated-Baseline Center and Quick Volley, which include Efficiency (both), Concentration (both), and Reaction Time (Quick Volley only) subtasks. In all, 1,124 (Baseline Center) and 745 (Quick Volley) users met inclusion criteria (completed more than four trials; active sometime between November 2022 and July 2023). We found that most users were male adults and were about evenly split between advanced/pro users and intermediate/beginner users. Two or three trajectories emerged across the subtasks. Performance gains were most pronounced on movement efficiency, especially early on. Adult users generally exhibited more improvement than junior users. Additionally, women and right-handed users improved more on Baseline Center subtasks, and advanced/pro users did better than intermediate/beginner users on Quick Volley subtasks. We discuss that, despite strong performance gains within VR environment, VR training may still reflect in better real-world performance, may increase confidence and accuracy of relevant movement, lower risk of injury, and present a welcome diversion from a potential monotony of performing sport-related tasks in purely real-world settings. Future research should explore the extent to which VR training transfers to real-world performance.

• MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Psychomotor Performance physiology   MeSH
• Athletic Performance * physiology   MeSH
• Tennis * MeSH
• Virtual Reality * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Many biological agents are epidemic or pandemic in nature (Ebola 2013, Spanish influenza 1918, Russian influenza 1989, SARS-CoV-2 2019). Recognising the onset of the spread of epidemics and pandemics remains a major challenge even in the 21st century despite the technologies and scientific knowledge at our disposal, as is the successful management of such situations. The reason concerns the existence of biological diversity and the laws that govern it, which are very difficult to predict and which are virtually uncontrollable. It is gradually becoming apparent that the current spread of SARS-CoV-2 that causes COVID-19 (9 million deaths since the beginning of the pandemic according to WHO) is characterised by very different characteristics (e.g. the exposure, transmission and spread of the viral infectious agent) in different populations and risk groups.Social services workers in the Czech Republic have been on the frontline for the duration of the pandemic and have been required to work in a high-risk infectious environment. This has led to the need for changes in their established working practices and approaches. Considerable creativity had to be employed particularly in the first year of the pandemic due to the scarcity of information on the new viral agent, the availability of which increased only slowly as the scientific community studied and analysed the various factors involved. Globally, the scientific community released its experimental data as soon as it became available; however, unfortunately, due to the nature of biomedical research, the release of the outputs failed to match the time requirements for their necessity in practice.Based on qualitative and quantitative research, the following text provides an analysis of the specific measures and the related difficulties, and the struggle to find solutions, that providers of selected types of social services faced during the spread of the COVID-19 pandemic.The survey results revealed that the issues in question had a common thread across the various types of social services, as well as a number of common features and challenges. The analysis of the results showed a noticeable shift between the initial period, which was characterised by the rapid onset of the spread of the pandemic, and the situation after 18 months of life under pandemic conditions, which was characterised by the lower incidence of problems and difficulties. One of the major outcomes of the study concerns the identification of the need for social service providers to be provided with a unified, clear and centrally managed process that is able to provide individualised methodological support. The results are based on a study conducted as part of "The Changes in Selected Social Services for People with Disabilities during the State of Emergency Instigated by a Viral Disease" project.

• MeSH
• COVID-19 * prevention & control   MeSH
• Humans MeSH
• Access to Information MeSH
• Surveys and Questionnaires MeSH
• Social Work organization & administration   MeSH
• Social Workers * statistics & numerical data   MeSH
• Statistics as Topic MeSH
• Focus Groups MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: The non-intoxicating plant-derived cannabinoid, cannabidiol (CBD), has demonstrated therapeutic potential in a number of clinical conditions. Most successful clinical trials have used relatively high (≥300 mg) oral doses of CBD. Relatively few studies have investigated the efficacy of lower (<300 mg) oral doses, typical of those available in over-the-counter CBD products. METHODS: We present a protocol for a randomised, double-blind, placebo-controlled, parallel-group clinical trial investigating the effects of a low oral dose (150 mg) of CBD on acute psychosocial stress, situational anxiety, motion sickness and cybersickness in healthy individuals. Participants (n=74) will receive 150 mg of CBD or a matched placebo 90 min before completing three virtual reality (VR) challenges (tasks) designed to induce transient stress and motion sickness: (a) a 15 min 'Public Speaking' task; (b) a 5 min 'Walk the Plank' task (above a sheer drop); and (c) a 5 min 'Rollercoaster Ride' task. The primary outcomes will be self-reported stress and nausea measured on 100 mm Visual Analogue Scales. Secondary outcomes will include salivary cortisol concentrations, skin conductance, heart rate and vomiting episodes (if any). Statistical analyses will test the hypothesis that CBD reduces nausea and attenuates subjective, endocrine and physiological responses to stress compared with placebo. This study will indicate whether low-dose oral CBD has positive effects in reducing acute psychosocial stress, situational anxiety, motion sickness and cybersickness. ETHICS AND DISSEMINATION: The University of Sydney Human Research Ethics Committee has granted approval (2023/307, version 1.6, 16 February 2024). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12623000872639).

• MeSH
• Double-Blind Method MeSH
• Cannabidiol * therapeutic use   MeSH
• Motion Sickness * drug therapy   MeSH
• Humans MeSH
• Nausea drug therapy   MeSH
• Stress, Psychological MeSH
• Randomized Controlled Trials as Topic MeSH
• Anxiety drug therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial Protocol MeSH
• Geographicals
• Australia MeSH

Telemedicine is a way to improve healthcare outcomes with greater efficiency for both patients and care providers. The great potential of digital technologies also lies in strengthening the patient-centered approach. The early successes and benefits of telemedicine in the Czech Republic, amplified by the COVID-19, have contributed to the fact that wider implementation of telemedicine is already generally supported at the expert and public levels. Our research focuses on the identification of key issues in the implementation of telemedicine and the challenges of telemedicine in the future, from the perspective of patients and other stakeholders. The study is based on a qualitative research approach, combining focus groups with key stakeholders, patient panels and expert panels (2021-2022). The lack of rules and uncoordinated development of various activities proved to be the main barriers to the integration of telemedicine in the health system. This regulatory uncertainty can generate a number of problems in the patient-doctor relationship in practice, including ethical ones, and can also lead to inequalities in access to healthcare and affect the overall quality of care provided. Furthermore, it has been shown that patients' interests in the implementation of telemedicine are: 1. a predictable and reliable framework that guarantees them certainty and security in the provision of telemedicine services, 2. telemedicine solutions that increase the availability and efficiency of the care provided while bringing comfort, and 3. user-friendly and simple solutions. At the same time, patients want to understand the new environment and be active participants in the process of digital innovation, including the practical implementation of telemedicine. The research team has developed recommendations for further developments in the implementation of telemedicine that reflect the patient's interest and can be implemented at three levels - the health system, institutional, and community level. In countries with a well-developed and institutionalized patient movement, the community level can be represented by patient organizations, thus becoming the link between telemedicine policy making and implementation at the individual level of healthcare provision. For the further development of telemedicine, the development of a national strategy involving all key stakeholders, including patients, in the implementation has proven essential.

• MeSH
• COVID-19 * epidemiology   MeSH
• Humans MeSH
• Patients MeSH
• Delivery of Health Care MeSH
• Telemedicine * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH