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
INTRODUCTION: Investigator-initiated trials (IITs) bridge the gap between applied clinical research and everyday clinical practice. However, they require the skilled multidisciplinary teams from different backgrounds but all with clinical trial training to ensure trials are designed, conducted and reported according to best practice and regulatory standards. The availability of trainings to fulfil these needs is limited. The CONSCIOUS II project facilitated to expand the supply of such programmes. The objective is to describe the curriculum designed for PhD students and early-career researchers, and evaluate participants' perceptions and feedback after completion of the training. METHODS: The curriculum was developed according to key principles that underpin building of competencies relevant to quality IITs and transdisciplinary skills. A multidisciplinary team created the curriculum, elaborated a comprehensive set of study materials, including the training platform. This team also conducted an international, collaborative pilot course. The effectiveness of the educational materials for the target audience was assessed through questionnaires administered after the pilot course. Additionally, all learning materials, including the video recordings of the pilot course, were externally evaluated. RESULTS: A 12-chapter thoroughly revised curriculum was developed for asynchronous preparation and served as a pre-class reading for a 3-month pilot course. The chapters, along with supplementary materials, and recordings of the pilot course are freely accessible on the CONSCIOUS II training platform. This platform facilitates the dissemination and implementation in the existing curricula. The feedback from both the pilot course participants and the stakeholders was uniformly positive across all survey aspects. CONCLUSION: This remote programme which combines asynchronous and synchronous components with international and interprofessional collaboration effectively addresses the gap in developing core competencies for the 21st -century clinical researchers. The implementation of this curriculum has the potential to improve the quality of IITs.
INTRODUCTION: This study explored patient and clinician perspectives on a new fixed-dose combination of macitentan and tadalafil (M/T FDC) in a once-daily single tablet for treatment of pulmonary arterial hypertension (PAH). METHODS: Qualitative semi-structured interviews were conducted during the open-label period of the global, phase 3 A DUE clinical trial that evaluated M/T FDC. A subset of enrolled patients (N = 26) and site investigators (N = 18 clinicians) were interviewed. Patients received four tablets during double-blind treatment and could be in one of three arms (macitentan + placebo; tadalafil + placebo; M/T FDC + placebo) followed by M/T FDC (one tablet) during the open-label period. Patients and clinicians were asked to share their experience of pre-trial PAH medication, double-blind treatment, and open-label M/T FDC. Thematic analysis was conducted on blinded data. RESULTS: Patients preferred the M/T FDC tablet (open-label) over the four tablets during double-blind treatment. Patients were satisfied with M/T FDC, highlighting its positive impact on their psychological well-being, through reducing stress associated with managing multiple pills. All patients indicated that having a single, once-a-day pill for PAH was more convenient and associated with greater treatment adherence. Clinicians highlighted that their patients have a high daily pill burden for PAH and other comorbidities, and prefer treatments with an oral mode of administration that reduce the number of daily pills required. Clinicians felt that M/T FDC would be well received in clinical practice and potentially assist in implementing guideline-recommended combination treatment of PAH. CONCLUSIONS: In this qualitative analysis, all 26 patients and 18 clinicians provided positive feedback on M/T FDC treatment, which was consistent across countries. Reducing the number of pills needed to treat PAH, through use of single-tablet M/T FDC, is highly valued by patients and endorsed by clinicians, who both felt the single-tablet combination therapy could have a positive effect on patients' well-being and increase treatment adherence.
- MeSH
- Adaptive Clinical Trials as Topic MeSH
- Antihypertensive Agents * administration & dosage therapeutic use MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Drug Combinations MeSH
- Phosphodiesterase 5 Inhibitors administration & dosage therapeutic use MeSH
- Clinical Trials, Phase III as Topic MeSH
- Qualitative Research MeSH
- Middle Aged MeSH
- Humans MeSH
- Multicenter Studies as Topic MeSH
- Pulmonary Arterial Hypertension * drug therapy MeSH
- Hypertension, Pulmonary * drug therapy MeSH
- Pyrimidines * administration & dosage therapeutic use MeSH
- Randomized Controlled Trials as Topic MeSH
- Interviews as Topic MeSH
- Aged MeSH
- Patient Satisfaction MeSH
- Sulfonamides * administration & dosage therapeutic use MeSH
- Tablets MeSH
- Tadalafil * administration & dosage therapeutic use MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
A good knowledge of the theoretical foundations of medicine helps students and physicians to better recognize and treat patients with complex medical conditions, including sepsis and septic shock. The article describes the authors' experience in implementing the analysis of sepsis and septic shock using a high-fidelity simulated clinical scenario in the course of pathological physiology for preclinical medical students. The unique aspect of our approach is the integration of core physiology concepts, such as homeostasis, causality, structure-function relationships, and fundamental pathophysiology concepts (e.g., etiology, pathogenesis, cell and tissue damage, inflammation, symptoms, and syndromes) in the analysis of the patient's condition on the high-fidelity simulator with preclinical medical students. According to the students' feedback, the use of a high-fidelity simulator to analyze the sepsis and septic shock scenario increased their interest in the class, improved their motivation to learn the material, and helped them adapt in a safe environment to making decisions based on a large amount of data about a complex patient condition in a time-sensitive situation.NEW & NOTEWORTHY The authors applied core theoretical concepts of physiology and the fundamental concepts of pathological physiology for teaching sepsis and septic shock clinical scenarios on the high-fidelity simulator in the course of pathological physiology for preclinical medical students. It elevated students' interest and motivation, enhanced the educational experience, and prepared students better for real-world clinical decision-making. We consider that this idea might be an inspiration to colleagues and invite further discussion.
- MeSH
- Physiology education MeSH
- Humans MeSH
- Sepsis * physiopathology therapy MeSH
- Students, Medical * MeSH
- Education, Medical, Undergraduate methods MeSH
- Teaching MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: Randomized clinical trials informing clinical practice (e.g., like large, pragmatic, and late-phase trials) should ideally mostly use harmonized outcomes that are important to patients, family members, clinicians, and researchers. Core outcome sets for specific subsets of ICU patients exist, for example, respiratory failure, delirium, and COVID-19, but not for ICU patients in general. Accordingly, we aimed to develop a core outcome set for adult general ICU patients. DESIGN: We developed a core outcome set in Denmark following the Core Outcome Measures in Effectiveness Trials Handbook. We used a modified Delphi consensus process with multiple methods design, including literature review, survey, semi-structured interviews, and discussions with initially five Danish research panels. The core outcome set was internationally validated and revised based on feedback from research panels in all countries. SETTING: There were five Danish research panels and 17 panels in 13 other countries. Interviews and the three-round Delphi survey was conducted in Denmark, followed by validation of the core outcome set across 14 countries in Europe, Australasia, and India. SUBJECTS: Adult ICU survivors, family members, clinicians, and researchers. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified 329 published outcomes, of which 50 were included in the 264 participant Delphi survey. In semi-structured interviews of 82, no additional outcomes were added. The first Delphi survey round was completed by 249 (94%) participants, and 202 (82%) contributed to the third and final round. The initial core outcome set comprised six outcomes. International validation involved 217 research panel members and resulted in the final core outcome set comprising survival, free of life support, free of delirium, out of hospital, health-related quality of life, and cognitive function. CONCLUSIONS: We developed and internationally validated a core outcome set with six core outcomes to be used in research, specifically clinical trials involving adult general ICU patients.
- MeSH
- Delphi Technique * MeSH
- Adult MeSH
- Outcome Assessment, Health Care MeSH
- Intensive Care Units * organization & administration MeSH
- Humans MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Denmark MeSH
INTRODUCTION: In health care, effective communication enhances teamwork and safety by minimizing adverse events. Evidence suggests that ongoing education should include communication skills training, as interprofessional communication relies on tools that facilitate seamless interaction. OBJECTIVE: This project aimed to improve communication practices among nurses in a long-term care unit by promoting evidence-based recommendations. METHODS: This project followed the seven phases proposed by the JBI Evidence Implementation Framework. This framework is grounded in an audit, feedback, and re-audit process, along with a structured approach to addressing barriers to compliance with best practices. JBI's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) approach were also used. RESULTS: A baseline audit was conducted focusing on three audit criteria. Compliance was measured by observing 250 handovers and administering a questionnaire to 14 nurses. After analyzing the results, the nursing team identified barriers and designed strategies to promote change, such as educational sessions and a focus group. The results of the follow-up audit showed significant improvements across all criteria. Nurses received training in communication for Criterion 1, which improved from 0% to 78%. For Criterion 2, training in teamwork and conflict management improved from 21% to 50%. For Criterion 3, the use of a structured communication tool (ISBAR) during handovers improved from 43.6% to 91%. CONCLUSIONS: The nursing team's involvement enabled effective change. Adapting ISBAR to a long-term care unit was an unexpected goal. The next objective is to refine and share it with similar units. Integrating communication training into health care institutions' priorities is crucial, and future audits will ensure sustainability. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A295.
- MeSH
- Long-Term Care * MeSH
- Interprofessional Relations * MeSH
- Communication * MeSH
- Evidence-Based Practice MeSH
- Humans MeSH
- Patient Handoff standards MeSH
- Surveys and Questionnaires MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1: Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2: The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3: A trainee's principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4: Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5: Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6: EUS training should follow a structured syllabus to guide the learning program. 7: A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8: Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9: A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10: Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated.
- MeSH
- Endoscopic Ultrasound-Guided Fine Needle Aspiration MeSH
- Endosonography methods MeSH
- Endoscopy, Gastrointestinal * education MeSH
- Curriculum * MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Despite the implementation of antibullying policies, schools in the United Arab Emirates (UAE) witnessed an increase in bullying prevalence. The aim of our study was to assess bullying victimization in schools in the UAE, types of bullying, and factors and outcomes related to bullying behavior. METHODS: A cross-sectional survey was conducted in randomly selected private and public schools in Al Ain City. A structured, self-administered questionnaire was used to collect data from students in grades 6-8 (Ages 10-15). We adapted the US CDC 'Bully Survey' for cultural relevance in the UAE through feedback from focus group meetings with teachers. Data analysis, conducted using R software, involved stratified analysis by school type and utilized Chi-Squared and Fisher's exact tests to identify factors associated with school bullying. RESULTS: The study sample consisted of 723 students of whom 68% were males, and 58% were Emirati nationals. The overall prevalence of bullying victimization in schools was 37%, with 40% in private schools and 35% in public schools. Cyberbullying was more prevalent in private schools (37%). Physical bullying was reported by 20% and verbal bullying by 12%, with a higher prevalence of physical bullying in private schools (24%) and among males (23%). The study's findings showed significant emotional and academic impacts of bullying, including feelings of sadness and learning difficulties, contributing to a rise in school absenteeism. CONCLUSIONS: The study reveals widespread bullying victimization in UAE schools, mainly in classrooms, with group exclusion and verbal abuse as key forms. It underscores bullying's psychological impact and the greater awareness of parents compared to teachers. The effective intervention strategies should not only involve students, teachers, and school staff, but also actively engage parents by fostering stronger communication channels between schools and families, and providing parents with resources and training to recognize and address bullying. These strategies should aim to create a cohesive network involving the entire school community, thus fostering a safer and more inclusive environment for students. The findings stress the need for inclusive antibullying programs involving the entire school community to foster a safer environment.
- MeSH
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Crime Victims * statistics & numerical data psychology MeSH
- Prevalence MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Bullying * statistics & numerical data psychology MeSH
- Schools * MeSH
- Students psychology statistics & numerical data MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- United Arab Emirates MeSH
BACKGROUND: Online learning has the potential to increase accessibility to high quality and cost-effective resources in prevention of risk behaviors. The aim of this pilot study was to assess the experience of university students with the comprehensive online course on prevention. METHODS: In this pilot study, an online questionnaire was administered to 51 Czech and 31 Ukrainian university students who completed the online Introduction to Evidence-based Prevention (INEP) full semester course between February 2022 and February 2023. Students were asked about their experience with INEP represented by 17 distinct features. Data were analyzed by descriptive statistics and mean comparisons tests. RESULTS: Students reported high overall satisfaction with INEP and with its respected features. The Structure and the Relevance features of INEP have been especially appreciated, while the Quizzes feature was perceived as only average by most students. INEP seemed to encourage most students (82%) to take other e-learning courses. CONCLUSION: The online INEP course received favorable feedback from university students across two distinct settings. INEP holds potential for broader integration into university study programs. These findings add to the ongoing discourse regarding enhancements in the education of future prevention professionals, making them relevant to practitioners, policymakers, and university-level decision-makers.
BACKGROUND: The Spondyloarthritis Research Consortium of Canada (SPARCC) developers have created web-based calibration modules for the SPARCC MRI sacroiliac joint (SIJ) scoring methods. We aimed to test the impact of applying these e-modules on the feasibility and reliability of these methods. METHODS: The SPARCC-SIJ RETIC e-modules contain cases with baseline and follow-up scans and an online scoring interface. Visual real-time feedback regarding concordance/discordance of scoring with expert readers is provided by a colour-coding scheme. Reliability is assessed in real time by intraclass correlation coefficient (ICC), cases being scored until ICC targets are attained. Participating readers (n=17) from the EuroSpA Imaging project were randomised to one of two reader calibration strategies that each comprised three stages. Baseline and follow-up scans from 25 cases were scored after each stage was completed. Reliability was compared with a SPARCC developer, and the System Usability Scale (SUS) assessed feasibility. RESULTS: The reliability of readers for scoring bone marrow oedema was high after the first stage of calibration, and only minor improvement was noted following the use of the inflammation module. Greater enhancement of reader reliability was evident after the use of the structural module and was most consistently evident for the scoring of erosion (ICC status/change: stage 1 (0.42/0.20) to stage 3 (0.50/0.38)) and backfill (ICC status/change: stage 1 (0.51/0.19) to stage 3 (0.69/0.41)). The feasibility of both e-modules was evident by high SUS scores. CONCLUSION: The SPARCC-SIJ RETIC e-modules are feasible, effective knowledge transfer tools, and their use is recommended before using the SPARCC methods for clinical research and tria.
- MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Reproducibility of Results MeSH
- Sacroiliac Joint * diagnostic imaging pathology MeSH
- Spondylarthritis * diagnosis pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Canada MeSH
