scholarly journals A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10316
Author(s):  
Chi-Chin Sun ◽  
Gen-Yih Liao ◽  
Li-Ling Liao ◽  
Li-Chun Chang
Keyword(s):  
Axial Length ◽  
Interdisciplinary Collaboration ◽  
Design Development ◽  
Parents And Children ◽  
Key Stakeholders ◽  
High Satisfaction ◽  
Length Data ◽  
Development And Validation ◽  
Lens Wear

Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in myopic children. Willingness for commitment from both parents and children contributes to the success of OK treatment. We aimed to develop and assess the usability of a mobile application on OK lens wear by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). Moreover, the preliminary outcome was also evaluated in this study. The app was developed and tested using a co-design approach involving key stakeholders. Two prototype tests were conducted during the feasibility and utility assessment. The app features include self-reported compliance documentation, analytics, and personalized and generalized messages for compliance behaviors of OK lenses. After the trial period, the full usage of app functions ranged from 40% to 60% among the enrolled parents. After app implementation, the compliance with follow-up visits substantially improved. Qualitative data show that the high-satisfaction app functions reported by parents were the app’s reminder and axial length recording, although it was recommended that the number of compliance questions should be reduced to minimize the survey completion time. Additionally, who should complete the recording of the axial length data as well as the management and reminder for the follow-up visit remained controversial. This is the first app developed to improve parents of myopic children’s compliance with OK lens wear and to assist ECPs and parents in collaboratively monitoring and managing the use and care of OK lenses among myopic children. This study highlights the importance of interdisciplinary collaboration in the design, development, and validation of such an app.

A cooperative management app for parents with myopic children wearing orthokeratology lens: Mixed methods pilot study (Preprint)

2021 ◽  
Author(s):  
Chi-Chin Sun ◽  
Gen-Yih Liao ◽  
Li-Ling Liao ◽  
Li Chun Chang
Keyword(s):  
Pilot Study ◽  
Axial Length ◽  
Interdisciplinary Collaboration ◽  
Public Health Problem ◽  
Design Development ◽  
Parents And Children ◽  
System Usability Scale ◽  
Significant Difference ◽  
Time Required

BACKGROUND Myopia is an underappreciated but profound public health problem. Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in children with myopia. Willingness for a commitment from both parents and children contributes significantly to the success of the OK treatment and decreases the chance of complications due to non-compliance behaviors. OBJECTIVE The aim of this pilot study was to develop and assess the usability of a mobile application of OK lens by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). We subsequently identified and resolved individual-specific usability issues to improve future implementation of the app protocol for parents and ECPs to collaboratively manage myopic children wearing OK lens. METHODS The app was developed and tested in 2020 using a co-design approach involving target users (parents with 7-13 myopic children), ECPs, designers, and app developers. A total of 36 parents with children who were given OK lens in an ophthalmology clinic were admitted to the study. Subsequently, prototype tests, two System Usability Scale (SUS) questionnaire surveys, and app engagement and app experience interviews were conducted during the three-month feasibility and utility assessment. RESULTS The app features include self-reported compliance documentation, analytics, personalized and generalized messages for compliance behaviors of orthokeratology lens. After the three-month trial period, the app demonstrated a usage rate of approximately 40 – 60 % among the 30 enrolled parents and was most often used prior to the follow-up visit. Although after the implementation of the app, there was no significant difference in compliance of wear and care, the incidence of comorbidities as well as the compliance with follow-up visits substantially improved. The average SUS scores at the first week and the third month were 54.6 and 82.0, respectively. Qualitative data suggested that parents were most satisfied with the app’s reminder and axial length recording functions, although it was recommended that the number of compliance behavior questions should be reduced to minimize the time required to complete the survey. In addition, whether the recording of the axial length data as well as the management and reminder for the follow-up visit should be completed by parents or ECPs remained controversial. CONCLUSIONS This is the first app developed to improve the parents’ compliance of myopic children with OK lens and assist ECPs and parents to collaboratively monitor and manage the wearing and caring of OK lens among myopic children as well as their follow-up visits. The study also highlighted the importance of interdisciplinary collaboration in the design, development, and validation of such an app. CLINICALTRIAL Nil

scholarly journals The Treatment Zone Size and Its Decentration Influence Axial Length Grow in Children With Orthokeratology Treatment

2021 ◽  
Author(s):  
Weiping Lin ◽  
Na Li ◽  
Tianpu Gu ◽  
Chunyu Tang ◽  
Bei Du ◽  
...  
Keyword(s):  
Axial Length ◽  
Corneal Topography ◽  
Spherical Equivalent ◽  
Zone Size ◽  
Inclusion Criteria ◽  
Myopia Progression ◽  
Treatment Zone ◽  
Length Growth ◽  
Lens Wear

Abstract Background: To investigate whether the treatment zone size (TZS) and treatment zone decentration (TZD) will affect the axial length growth in myopic children undergoing orthokeratology treatment.Methods: A self-controlled retrospective study was conducted on 352 children who met the inclusion criteria. Axial length was measured before and at 12 months after the initial lens wear. Corneal topography was measured at baseline and at each follow-up after lens wear. The Corneal topography obtained from the 12-month visit was used to quantify TZS and TZD for each subject. Cycloplegic refraction was required for all subjects before fitting the orthokeratology lenses. Results: Axial length growth was significantly associated with age, baseline spherical equivalent (SE), TZS, and TZD with univariate linear regression. In groups with both small and large TZS, axial length growth was significantly decreased with large TZD (both P < 0.001). In groups with both small and large TZD, axial length growth was significantly decreased with small TZS (P = 0.027 for small TZD, P = 0.011 for large TZD). Age, SE, and TZD were significantly associated with axial length growth in multiple regression (all P < 0.001). Conclusion: Relatively smaller TZS and larger TZD may be beneficial in slowing myopia progression in children with orthokeratology treatment.

The rein-type arthroscopic capsular suture for triangular fibrocartilage complex foveal tears: midterm results for 90 patients

2021 ◽  
pp. 175319342110241
Author(s):  
I-Ning Lo ◽  
Kuan-Jung Chen ◽  
Tung-Fu Huang ◽  
Yi-Chao Huang
Keyword(s):  
Simple Procedure ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Joint Stability ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
High Satisfaction ◽  
Ultrasound Assessment ◽  
Triangular Fibrocartilage

We describe an arthroscopic rein-type capsular suture that approximates the triangular fibrocartilage complex to the anatomical footprint, and report the results at a minimum 12 month follow-up. The procedure involves two 3-0 polydioxanone horizontal mattress sutures inserted 1.5 cm proximal to the 6-R and 6-U portals to obtain purchase on the dorsal and anterior radioulnar ligaments, respectively. The two sutures work as a rein to approximate the triangular fibrocartilage complex to the fovea. Ninety patients with Type IB triangular fibrocartilage complex injuries were included retrospectively. The 12-month postoperative Modified Mayo Wrist scores, Disabilities of Arm, Shoulder and Hand scores and visual analogue scale for pain showed significant improvements on preoperative values. Postoperative range of wrist motion, grip strength and ultrasound assessment of the distal radioulnar joint stability were comparable with the normal wrist. The patients had high satisfaction scores for surgery. There were minor complications of knot irritation. No revision surgery for distal radioulnar joint instability was required. It is an effective and technically simple procedure that provides a foveal footprint contact for the triangular fibrocartilage complex. Level of evidence: IV

scholarly journals I’m No Superman: fostering physician resilience through guided group discussion of Scrubs

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur Holtzclaw ◽  
Jack Ellis ◽  
Christopher Colombo
Keyword(s):  
Internal Medicine ◽  
Training Programs ◽  
Low Cost ◽  
Group Discussion ◽  
Well Being ◽  
Internal Medicine Residency ◽  
Resiliency Training ◽  
High Satisfaction ◽  
Burn Out

Abstract Background Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic. Methods We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness. Results The curriculum was successfully conducted for 12 months with each session averaging 18–20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI. Conclusions This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.

scholarly journals Safety and efficacy of polydimethylsiloxane (Macroplastique®) in women with stress urinary incontinence: analysis of data from patients who completed three years follow-up

2021 ◽  
Author(s):  
Gamal Ghoniem ◽  
Bilal Farhan ◽  
Mashrin Lira Chowdhury ◽  
Yanjun Chen
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Serious Adverse Events ◽  
Safety And Efficacy ◽  
Medical Centers ◽  
High Satisfaction ◽  
High Satisfaction Rate ◽  
Time Observation ◽  
The Rose

Abstract Introduction and hypothesis This study aimed to report 3-year completed follow-up of the safety and efficacy of Macroplastique® (MPQ) in women with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). Methods This is a retrospective analysis of all women who completed 3-year follow-up post-MPQ injection(s) at ten medical centers. We used the ROSE registry data report of Macroplastique® [Macroplastique® Real-time Observation of Safety and Effectiveness (ROSE) registry P040050/PAS001 on 2017]. Subjective incontinence outcome and adverse effects were assessed. Results The study included all patients (n = 70) who completed 3-year follow-up after the last MPQ injection. Twenty-four of 70 (34%) patients had two injections; 21/70 (30%) patients reported Stamey grade 0 and 28/70 (40%) reported Stamey grade 1. The overall patient satisfaction was 68% who completed 3-year follow-up. The composite success rate (I-QoL, PGI-S, and Stamey grade improvement) was 51.4%. No serious adverse events (AE) were reported within the completed 3-year follow-up. Conclusions MPQ was found to be safe and efficacious for the treatment of SUI secondary to ISD in women. The overall high satisfaction rate was sustained from baseline to 3 years post-injection. Most complications were minor and transient without sequelae.

Development and Validation of a Cognitive Reserve Index in HIV

2021 ◽  
pp. 1-9
Author(s):  
Navaldeep Kaur ◽  
Lesley K. Fellows ◽  
Marie-Josée Brouillette ◽  
Nancy Mayo
Keyword(s):  
Cognitive Reserve ◽  
Study Entry ◽  
Video Gaming ◽  
Everyday Functioning ◽  
Data Set ◽  
Multiple Indicators ◽  
And Performance ◽  
Competitive Games ◽  
Development And Validation

Abstract Objectives: In the neuroHIV literature, cognitive reserve has most often been operationalized using education, occupation, and IQ. The effects of other cognitively stimulating activities that might be more amenable to interventions have been little studied. The purpose of this study was to develop an index of cognitive reserve in people with HIV, combining multiple indicators of cognitively stimulating lifetime experiences into a single value. Methods: The data set was obtained from a Canadian longitudinal study (N = 856). Potential indicators of cognitive reserve captured at the study entry included education, occupation, engagement in six cognitively stimulating activities, number of languages spoken, and social resources. Cognitive performance was measured using a computerized test battery. A cognitive reserve index was formulated using logistic regression weights. For the evidence on concurrent and predictive validity of the index, the measures of cognition and self-reported everyday functioning were each regressed on the index scores at study entry and at the last follow-up [mean duration: 25.9 months (SD 7.2)], respectively. Corresponding regression coefficients and 95% confidence intervals (CIs) were computed. Results: Professional sports [odds ratio (OR): 2.9; 95% CI 0.59–14.7], visual and performance arts (any level of engagement), professional/amateur music, complex video gaming and competitive games, and travel outside North America were associated with higher cognitive functioning. The effects of cognitive reserve on the outcomes at the last follow-up visit were closely similar to those at study entry. Conclusion: This work contributes evidence toward the relative benefit of engaging in specific cognitively stimulating life experiences in HIV.

scholarly journals Acceptability of no-test medical abortion provided via telemedicine: analysis of patient-reported outcomes

2021 ◽  
pp. bmjsrh-2020-200954
Author(s):  
Chelsey Porter Erlank ◽  
Jonathan Lord ◽  
Kathryn Church
Keyword(s):  
Patient Reported Outcomes ◽  
Medical Abortion ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Post Procedure ◽  
High Satisfaction ◽  
First Choice ◽  
Patient Reported ◽  
At Home

IntroductionThe English government approved both stages of early medical abortion (EMA), using mifepristone and misoprostol under 10 weeks’ gestation, for at-home use on 30 March 2020. MSI Reproductive Choices UK (MSUK), one of the largest providers of abortion services in England, launched a no-test telemedicine EMA pathway on 6 April 2020. The objectives of this study were to report key patient-reported outcome measures and to assess whether our sample was representative of the whole population receiving no-test telemedicine EMA.MethodsA sample of all MSUK’s telemedicine EMA patients between April and August 2020 were invited to opt in to a follow-up call to answer clinical and satisfaction questions. A total of 1243 (13.7% of all telemedicine EMAs) were successfully followed-up, on average within 5 days post-procedure.ResultsPatients reported high confidence in telemedicine EMA and high satisfaction with the convenience, privacy and ease of managing their abortion at home. The sample responding were broadly equivalent to the whole population receiving telemedicine. No patient reported that they were unable to consult privately. The majority (1035, 83%) of patients reported preferring the telemedicine pathway, with 824 (66%) indicating that they would choose telemedicine again if COVID-19 were no longer an issue.ConclusionsTelemedicine EMA is a valued, private, convenient and more accessible option that is highly acceptable for patients seeking an abortion, especially those for whom in-clinic visits are logistically or emotionally challenging. Evidence that this pathway would be a first choice again in future for most patients supports the case to make telemedicine EMA permanent.

scholarly journals Development and Validation of an Interpretable Artificial Intelligence Model to Predict 10-Year Prostate Cancer Mortality

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3064
Author(s):  
Jean-Emmanuel Bibault ◽  
Steven Hancock ◽  
Mark K. Buyyounouski ◽  
Hilary Bagshaw ◽  
John T. Leppert ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Cancer Mortality ◽  
Treatment Strategies ◽  
Gradient Boosting ◽  
Prostate Cancer Treatment ◽  
Prospective Data ◽  
Prostate Cancer Mortality ◽  
Development And Validation

Prostate cancer treatment strategies are guided by risk-stratification. This stratification can be difficult in some patients with known comorbidities. New models are needed to guide strategies and determine which patients are at risk of prostate cancer mortality. This article presents a gradient-boosting model to predict the risk of prostate cancer mortality within 10 years after a cancer diagnosis, and to provide an interpretable prediction. This work uses prospective data from the PLCO Cancer Screening and selected patients who were diagnosed with prostate cancer. During follow-up, 8776 patients were diagnosed with prostate cancer. The dataset was randomly split into a training (n = 7021) and testing (n = 1755) dataset. Accuracy was 0.98 (±0.01), and the area under the receiver operating characteristic was 0.80 (±0.04). This model can be used to support informed decision-making in prostate cancer treatment. AI interpretability provides a novel understanding of the predictions to the users.

The acceptance of hearing aids for children with otitis media with effusion

1999 ◽  
Vol 113 (4) ◽  
pp. 314-317 ◽  
Author(s):  
A. H. Jardine ◽  
M. V. Griffiths ◽  
E. Midgley
Keyword(s):  
Otitis Media ◽  
Hearing Aids ◽  
Otitis Media With Effusion ◽  
Binaural Hearing ◽  
Long Term Effects ◽  
Non Invasive ◽  
Parents And Children ◽  
Binaural Hearing Aids

AbstractConservative treatment for otitis media with effusion (OME) led us to consider the use of hearing aids as a way of managing the associated hearing loss. This study aimed to assess the compliance of patients and acceptance of hearing aids for the management of children with OME.Thirty-nine children who had been given binaural hearing aids to manage OME were assessed at routine follow-up after six months. A clinician who did not prescribe the aid administered a questionnaire to assess compliance, change in symptoms and acceptance of the aids.Thirty-eight parents thought the aids were easy to use and 25 (66 per cent) were completely satisfied with the management. Aided hearing improved by a mean of 17 dB (Range 10–30) over three frequencies, 0.5, 1.0, 2.0 Khz and all parents reported subjective hearing improvement in their children. The stigma of an aid was reported as minimal under the age of seven.Hearing aids provide a non-invasive way of managing the problems associated with OME which is acceptable to certain parents and children. Long-term effects of using aids need to be evaluated before they can be recommended.

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