Navigating Performance-Based Assessments in Unprecedented Times

This chapter focuses on the implementation of performance-based assessments (PBAs) at the Auburn University Harrison School of Pharmacy (AUHSOP) during the COVID-19 pandemic, when shifts were made to a fully remote delivery of the pharmacy curriculum in March 2020 and then altered to a hybrid delivery in the fall semester in which students returned to campus in a limited capacity. In addition to describing adaptations made due to curriculum delivery changes for each professional year, the chapter will provide specific challenges encountered while planning and implementing PBAs with a focus on factors related to students, standardized persons (SPs), and logistics. Student and SP perceptions of remote PBA delivery will be presented as well as strategies for improvement of future PBA events.

Envisioning Post-pandemic Digital Neurological, Psychiatric and Mental Health Care

The SARS-Cov-2 pandemic placed a dramatic burden on managed healthcare and perhaps nowhere as evident as in neurological and psychiatric disease care. This said, the duration of the pandemic mandated adaptability of the entire care system and the oft-vaunted benefits of telehealth and telemedicine were subjected to deep scrutiny at scale. Positive experiences were reported by both patients and providers from routine check-ups, to use of cognitive behavioral therapy associated with mental disorders, and management of complex diseases such as multiple sclerosis and other neurological and psychiatric conditions. Integration into standard care looks likely in the post pandemic era with many healthcare systems moving to expand reimbursement categories and develop equitable incentive models for developers and providers. In this commentary we share perspective on how the future of care may evolve through hybrid delivery models, and the advent of new therapeutic approaches which can address pain points identified during the pandemic.

MPEG-H Audio System for SBTVD TV 3.0 Call for Proposals

Under the name “TV 3.0 Project”, the Brazilian Terrestrial Television System Forum (SBTVD) has issued the Call for Proposals (CfP) for a next generation Brazilian digital TV system, in July 2020. The MPEG-H Audio system, based on the open international standard ISO/IEC 23008-3, has been proposed by Fraunhofer IIS, ATEME, the Digital Broadcasting Experts Group (DiBEG) and the Advanced Television Systems Committee (ATSC). This paper provides an overview of the MPEG-H Audio system and the TV 3.0 Project requirements for the audio component. The TV 3.0 Project specifies a detailed test and evaluation procedure for verifying the fulfillment of the requirements. With wide industry support, the MPEG-H Audio system brings immersive sound, advanced interactivity, and accessibility options, as well as advanced features like hybrid delivery, consistent loudness after user interaction, connectivity options for external sound devices and seamless configuration changes. The MPEG-H Audio proponents have submitted a complete production and broadcast real-time chain to the SBTVD Forum which demonstrates the most advanced features.

Hybrid Learning Using Canvas LMS

Hybrid learning refers to the learning style where online components are used to replace some face-to-face elements of the course. In the current era, where COVID-19 pandemic has highly impacted higher education, online and remote forms of learning have become critical success factors to deliver engaging and rich teaching and learning experience to the students. With the partial return of face-to-face interaction with the students this year after easing restrictions, universities have no choice but to offer hybrid learning experience. In the journey towards this type of learning, a transition in both pedagogy and vehicle (tools) is inevitable. Hybrid learning pedagogy has been in literature for many years now and many institutions worldwide have enough experience to run courses and programs as a hybrid model. For the vehicle, a number of tools are necessary to facilitate delivery, but the most important tool is obviously the learning management system (LMS). Canvas LMS is now considered one of the most commonly used electronic learning systems, offering a large number of features and options to make teaching and learning easier and effective for both teachers and students. In this paper, two hybrid learning models are proposed. An example of implementing one of the two models using Canvas LMS and other supporting tools is provided. Anecdotal student feedback has shown that the students were highly engaged and their experience has been improved as a result of the hybrid delivery format.

Optimization of Inspection Plan for Transformer Verification Line Under Uninterrupted State

At present, transformer verification line of metering centre adopts fixed cycle inspection method manually. This method requires downtime for detection, which costs a lot of time and cost. Moreover, the inspection cycle is determined based on experience and lacks rigorous basis. To solve this problem, a hybrid delivery of inspection devices is proposed to realize non-stop detection and reduce the cost of inspection time. Considering impact of cost and false detection risk on inspection cycle, a multi-objective optimization model of inspection cycle based on inspection and false detection cost is proposed. Based on NSGA-II algorithm, perturbation population is introduced to enhance the global search ability, which aims to minimize the cost of inspection and false detection. Taking the verification line’s inspection plan of the metering centre as an example. It is solved by ENSGA-II algorithm, and feasibility of hybrid delivery mode is verified, which reduced downtime by 14.58%. A more reasonable inspection cycle is obtained, inspection cost is reduced by 29.57%, and false detection cost is reduced by 6.34%. It provides a reference for the formulation of inspection plan in the actual production process.

Study Protocol: A Hybrid Delivery of Home-Based Cluster Set Resistance Training for Individuals Previously Treated for Lung Cancer

Background: Symptom burden remains a critical concern for individuals with non-small cell lung cancer (NSCLC) following the completion of treatment. The most common symptom clusters, dyspnea (shortness of breath) and fatigue,can contribute to physical decline, reductions in quality of life, and a higher risk of comorbidities and mortality. Dyspnea is a primary limiter of exercise capacity in individuals with lung cancer, resulting in exercise avoidance and an accelerated physical decline. As such, designing resistance training with cluster sets to mitigate symptoms of dyspnea and fatigue may result in improved exercise tolerance. Thus, maintainingthe exercise stimulus via cluster sets, combined with improved tolerance of the exercise, could result in maintenance of physical function and quality of life. The purpose of this study is to investigate the feasibility and preliminary efficacy of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC. Methods: Individuals with NSCLC (n=15), within 12-months of completion of treatment will be recruited to participate in this single arm feasibility trial. Participants will complete 8-weeks of home-based resistance training designed to minimizedyspnea and fatigue. The hybrid-delivery of the program will include supervised sessions in the participants’ home, and virtual supervision via video conferencing. The primary outcome of feasibility will be quantifiedby recruitment rates, retention, acceptability, and intervention fidelity. Exploratory outcomes (dyspnea, fatigue, quality of life, physical function, and body composition) will be assessed pre- and post- intervention. Discussion: This study will provide important data on the feasibility of delivering this intervention and inform procedures for a future randomized controlled trial. Trial Registration: Record not yet public

Bridging the gap by providing access to oncology care to rural communities: A hybrid delivery model combining in-person visits with Telehealth.

e18528 Background: Americans who live in rural areas experience unique barriers to access healthcare such as limited transportation, shortages in oncology providers, limited access to advanced services which contribute to poor health outcomes. The current COVID-19 pandemic has provided a catalyst for rapid adoption of telehealth. A regional cancer center has established a novel rural health partnership program that utilizes a hybrid model of on-site visits and telehealth to increase access to advanced oncology care for patients in rural communities. Here we describe the collaboration and benefits of this model. Methods: The rural health hybrid delivery model utilizes a combination of in-person and telehealth visits to provide immediate access to the regional center’s oncology care team and specialized services such as advanced surgeries, radiation, precision medicine, and clinical trials. Speed to care was built into the model as a key feature, offering initial appointments within 3 business days from the time of the referral, wherein treatment plans are developed facilitating immediate start. The model is a collaborative partnership, ensuring a coordinated care process driven by the regional oncologists working in coordination with the local provider to meet the needs of the patient. The patient is able to decrease transportation time, cost, and obtain care closer to their support system by keeping the patient in their community for basic needs. For more complex requirements, on-site visits are coordinated. This allows access to the regional center’s specialty oncology care services not available locally, while keeping the patient engaged with their local provider, which increases service utilization and expands the patient base. Leveraging telehealth visits at the local hospital ensures access to adequate broadband and technology capabilities to facilitate continuity of patient care. Results: This model provides the patient with timely access to specialty cancer care in their local community. Partnerships with two rural health systems were implemented in July and November 2020. 14 patients are enrolled in the program to date with a 100% retention rate. The turnaround time from treatment plan to treatment is 6 business days. There was a total of 62 oncology telehealth appointments, reducing patient travel by 12,705 driving miles, 310 travel hours, saving $7,380 in travel costs and accommodation. Conclusions: Telehealth provides a bridge to the rural health access gap, and advances health equity by offering specialized care to patients in their local communities. Improving access to best practice treatment strategies for all cancer patients moves us closer to resolving disparities in outcomes. Applications of this hybrid model of care to other rural sites is a promising strategy to reduce rural-urban disparities in cancer care.

Tinnitus Management: The Utilization of a Hybrid Telehealth and In-Person Delivery Model

Telehealth, or the delivery of healthcare services from a distance, has historically been used to provide care to underserved populations and to those unable to visit a healthcare center. During the ongoing global COVID-19 pandemic, some providers of tinnitus healthcare services incorporated telehealth into their clinical protocols to allow for continued care for their patients while adhering to social distancing guidelines and safety measures. Bothersome tinnitus can negatively impact one's quality of life. Telehealth has been instrumental in treating this debilitating problem in a time when in-person care has not been easily available. The case of a patient with tinnitus is examined to demonstrate the use of a hybrid delivery model utilizing telehealth and in-person interactions to assess and manage her bothersome tinnitus. In-person services were used for audiological assessments and fitting of treatment devices, while telehealth was utilized for counseling, education, and remote programming of her treatment devices. This combined approach, which has allowed the patient to continue receiving care safely during the pandemic, can be continued for future care. Telehealth offers several advantages to patients and providers alike. While the COVID-19 pandemic will hopefully come to an end, telehealth services for tinnitus management may be here to stay.