A Study on the Internet Usage Pattern of Youths in Sikkim

Internet is being used by people all over the world. It has become a part of their day-to-day activity. The smartness brought by internet and its related devices have made life of people easy. Sharing knowledge, researching, and reaching out to people are now within the reach of fingertips. This study aims to find the internet usage pattern of youth in Sikkim, India. Fourteen internet activities have been identified and through a survey. The usage of these activities was analysed for the youth population in Sikkim, India. It has been found that, more or less, all the activities are used by the youth population of Sikkim. The most popular activity is use of emails and social networking sites while blogging and video calling is not too popular. In addition, it has been found that 67% of the users use internet for more than 3 hours per day. Hence, there also is a serious risk of “internet addiction.”

Development of NLP-Integrated Intelligent Web System for E-Mental Health

As the COVID-19 pandemic continues, the need for a better health care facility is highlighted more than ever. Besides physical health, mental health conditions have become a significant concern. Unfortunately, there are few opportunities for people to receive mental health care. There are inadequate facilities for seeking mental health support even in big cities, let alone remote areas. This paper presents the structure and implementation procedures for a mental health support system combining technology and professionals. The system is a web platform where mental health seekers can register and use functionalities like NLP-based chatbot for personality assessment, chatting with like-minded people, and one-to-one video conferencing with a mental health professional. The video calling feature of the system has emotion detection capabilities using computer vision. The system also includes downloadable prescription facilities and a payment gateway for secure transactions. From a technological aspect, the conversational NLP-based chatbot and computer vision-powered video calling are the system’s most important features. The system has a documentation facility to analyze the mental health condition over time. The web platform is built using React.js for the frontend and Express.js for the backend. MongoDB is used as the database of the platform. The NLP chatbot is built on a three-layered deep neural network model that is programmed in the Python language and uses the NLTK, TensorFlow, and Keras sequential API. Video conference is one of the most important features of the platform. To create the video calling feature, Express.js, Socket.io, and Socket.io-client have been used. The emotion detection feature is implemented on video conferences using computer vision, Haar Cascade, and TensorFlow. All the implemented features are tested and work fine. The targeted users for the platform are teenagers, youth, and the middle-aged population. Mental health-seeking is still considered taboo in some societies today. Apart from basic established facilities, this social dilemma of undergoing treatment for mental health is causing severe damage to individuals. A solution to this problem can be a remote platform for mental health support. With this goal in mind, this system is designed to provide mental health support to people remotely from anywhere worldwide.

Telemedicine Preparedness Among Older Adults with Chronic Illness (Preprint)

BACKGROUND Since the COVID-19 pandemic, telemedicine appointments have replaced many in-person healthcare visits [1 2]. However, older people are less likely to participate in telemedicine, preferring either in-person care or foregoing care altogether [3-6]. With a high prevalence of chronic conditions and vulnerability to COVID-19 morbidity and mortality through exposure to others in health care environments, (1-4), promoting telemedicine use should be a high priority for seniors. Seniors face significant barriers to participation in telemedicine, including lower internet and device access and skills, and visual, auditory, and tactile difficulties with telemedicine. OBJECTIVE Hoping to offer training to increase telemedicine use, we undertook a quality improvement survey to identify barriers to, and facilitators of telemedicine among seniors presenting to an outpatient family medicine teaching clinic which serves predominantly African American, economically disadvantaged adults with chronic illness in Cleveland, Ohio. METHODS Our survey, designated by the IRB as quality improvement, was designed based on a review of the literature, and input from our primary care providers and a digital equity expert (Figure 1). To minimize patient burden, the survey was limited to 10 questions. Because we were interested in technology barriers, data were collected on paper rather than a tablet or computer, with a research assistant available to read the survey questions. Patients presenting with needs that could be accomplished remotely were approached by a research assistant to complete the survey starting February 2021 until we reached the pre-determined sample size (N=30) in June 2021. Patients with known dementia, those who normally resident in a long-term care facility, and those presenting with an acute condition (e.g. fall or COPD exacerbation) were ineligible. Because of the small number of respondents, only univariate and bivariate tabulations were performed, in Excel. RESULTS 83% of respondents said they had devices that could be used for a telemedicine visit and that they went on the internet, but just 23% had had telemedicine visits. Few patients had advanced devices (iPhones, desktops, laptops or tablets); 46% had only a single device that was not IOS based mobile (Table 1). All participants with devices said they used them for “messaging on the internet,” but this was the only function used by 40%. No one used the internet for banking, shopping, and few used internet functions commonly needed for telemedicine (23.3% had email; 30% did video calling) (Table 1). 23.3% of respondents had had a telemedicine appointment. Many reported a loss of connection to their doctor as a concern. Participants who owned a computer or iPhone used their devices for a broader range of tasks, (Table 2 and 3), were aged 65-70 (Table 4), and were more likely to have had a telemedicine visit and to have more favorable views of telemedicine (Table 2). Respondents who had not had a telemedicine appointment endorsed a greater number of telemedicine disadvantages and endorsed less interest in future appointments (Table 2). Respondents who did not own an internet-capable device did not report using any internet functions and none had had a telemedicine appointment (Table 2). CONCLUSIONS This small survey revealed significant gaps in telemedicine readiness among seniors who said they had devices that could be used for telemedicine and that they went online themselves. No patients used key internet functions needed for staying safe during COVID, and few used internet applications that required skills needed for telemedicine. Few patients had devices that are optimal for seniors using telemedicine. Patients with more advanced devices used more internet functions and had more telemedicine experience and more favorable attitudes than others. Our results confirm previous studies [7-9] showing generally lower technological proficiency among older adults and some concerns about participating in telemedicine. However, our study is novel in pointing to subtle dimensions of telemedicine readiness that warrant further study—device capacity and use of internet in ways that build skills needed for telemedicine such as email and video calling. Before training seniors to use telemedicine, it’s important to ensure that they have the devices, basic digital skills and connectivity needed for telemedicine. Larger studies are needed to confirm our results and apply multivariate analysis to understand the relationships among age, device quality, internet skills and telemedicine attitudes. Development of validated scales of telemedicine readiness and telemedicine training to complement in-person care can help health systems offer precision-matched interventions to address barriers, facilitate increased adoption, and generally improve patients’ overall access to primary care and engagement with their primary care provider.

The emerging role of telehealth in a New Zealand ambulance service

<p>Telehealth systems – using ICT to manage health from a distance – have been developing for decades, including within the ambulance sector. The author undertook this research to better understand how telehealth could improve patient outcomes, improve effectiveness, or create efficiencies for the St John ambulance service. To achieve this, current literature was reviewed and a small group of experts were interviewed whose experience lies in either the ambulance service or the health sector. Key recommendations are described below: • It is of strategic importance to design ambulance telehealth systems with interoperability and interconnectivity – this will maximise health sector integration and governmental support. • Telehealth solutions should be based on simple, well-established, easy to use, and ubiquitous technologies. This reduces fear, limits technical challenges, enables technology adoption, and improves chances of success. Of all available technologies, video-calling provides the most opportunity at present. • Consistent with the 111 Clinical Hub model, St John should centralise specialists to provide telehealth support. This approach is cost effective as only a small number of specialists is required. It also supports effective clinical decision-making as this group routinely make complex decisions. • It is realistic for St John to integrate video-calling as a telehealth solution into the 111 Clinical Hub. As a patient-to-clinician tool, 111 Clinical Hub staff could use video connections to call back low acuity patients to perform a secondary triage. As a clinician-to-clinician tool, paramedics could video-call the 111 Clinical Hub for clinical support. This would increase the richness of communication, and enable better clinical decisions to be made. • While it is unclear the role that remote monitoring will play in improving an ambulance service, it is clear is that medical alarms will evolve to have much greater functionality, including sharing of biometric information. St John needs to make a strategic decision as to whether it wants to play the role of monitoring those with long-term conditions – and therefore being responsible for taking action when there are any signs of deterioration – or whether that should be the role of general practitioners (GPs). • When designing telehealth solutions, St John must consider whether it is creating unequal access to healthcare and, where created, take actions to mitigate these inequities. • It is important that St John clearly communicates any new telehealth interventions – resistance to change must be anticipated and therefore strong communication strategies must be part of the design process. • There is limited evidence to support telehealth solutions in terms of improved patient satisfaction, improved patient outcomes, or greater efficiencies. With the impending implementation of electronic patient report form (ePRF) there is opportunity to evaluate a telehealth solution in these terms. • It’s important to note that, regardless of the telehealth system adopted, no single solution will be effective – real improvements will require multiple integrated systems.</p>

The emerging role of telehealth in a New Zealand ambulance service

<p>Telehealth systems – using ICT to manage health from a distance – have been developing for decades, including within the ambulance sector. The author undertook this research to better understand how telehealth could improve patient outcomes, improve effectiveness, or create efficiencies for the St John ambulance service. To achieve this, current literature was reviewed and a small group of experts were interviewed whose experience lies in either the ambulance service or the health sector. Key recommendations are described below: • It is of strategic importance to design ambulance telehealth systems with interoperability and interconnectivity – this will maximise health sector integration and governmental support. • Telehealth solutions should be based on simple, well-established, easy to use, and ubiquitous technologies. This reduces fear, limits technical challenges, enables technology adoption, and improves chances of success. Of all available technologies, video-calling provides the most opportunity at present. • Consistent with the 111 Clinical Hub model, St John should centralise specialists to provide telehealth support. This approach is cost effective as only a small number of specialists is required. It also supports effective clinical decision-making as this group routinely make complex decisions. • It is realistic for St John to integrate video-calling as a telehealth solution into the 111 Clinical Hub. As a patient-to-clinician tool, 111 Clinical Hub staff could use video connections to call back low acuity patients to perform a secondary triage. As a clinician-to-clinician tool, paramedics could video-call the 111 Clinical Hub for clinical support. This would increase the richness of communication, and enable better clinical decisions to be made. • While it is unclear the role that remote monitoring will play in improving an ambulance service, it is clear is that medical alarms will evolve to have much greater functionality, including sharing of biometric information. St John needs to make a strategic decision as to whether it wants to play the role of monitoring those with long-term conditions – and therefore being responsible for taking action when there are any signs of deterioration – or whether that should be the role of general practitioners (GPs). • When designing telehealth solutions, St John must consider whether it is creating unequal access to healthcare and, where created, take actions to mitigate these inequities. • It is important that St John clearly communicates any new telehealth interventions – resistance to change must be anticipated and therefore strong communication strategies must be part of the design process. • There is limited evidence to support telehealth solutions in terms of improved patient satisfaction, improved patient outcomes, or greater efficiencies. With the impending implementation of electronic patient report form (ePRF) there is opportunity to evaluate a telehealth solution in these terms. • It’s important to note that, regardless of the telehealth system adopted, no single solution will be effective – real improvements will require multiple integrated systems.</p>

How we handled COVID crisis? Experience of an Indian tertiary level NICU

Background: Coronavirus disease (COVID-19) has imposed several challenges in clinical care. With rapid increase in the disease, there has been lot of incidences of COVID-19 positive exposure among the healthcare workers resulting in major crisis. Aim: The aim of the study was to emphasize various methods that can be used to manage COVID-19 crisis due to accidental exposure. Methods: An unprecedented exposure occurred to a COVID-19 positive healthcare worker in the Neonatal Intensive Care Unit (NICU), which led to quarantine of almost 90% of the primary staff. The methods undertaken included communication and continuation of clinical care through teleconsultation (video calling, zoom meetings for clinical decision, telecharting of daily prescription, and facilitating manpower from allied departments [only one pediatric resident each day], and restoration of services with come back). Results: There were total 11 babies at the time of exposure. Two babies were on respiratory support. The parents were counseled through teleconsultation. Nine babies could be discharged during quarantine period and there was no significant deterioration in the clinical condition of the two babies on respiratory support. All the babies were tested for COVID-19 as per post-exposure protocol and remained negative. Conclusion: With the help of teleconsultation and support from allied specialties and other health facilities, the crisis of COVID-19 exposure can be handled well.

PENGGUNAAN APLIKASI ZOOM MEETING UNTUK EFEKTIFITAS PEMBELAJARAN DARING PADA MADRASAH IBTIDAIYAH MUHAMMADIYAH 01 PEKANBARU

The pandemic that has hit the world has forced us to do learning indirectly or is often referred to as online (Daring). Online teaching and learning process requires some adjustments both on the teacher's side and the student's side. One of the adjustments is the need to seek technology and adaptation using technology. The currently widely used technology is online meeting services, such as the Zoom Meeting application, Google Meet, Video Calling via the Massager application, or other similar applications. To adapt to the technology, teachers at Madrasah Ibtidaiyah Muhammadiyah 01 Pekanbaru strongly desire to deepen ownership of the Zoom application as one of the media used for online learning. This training aims to provide an understanding and hands-on practice of using Zoom Meeting technology to increase learning effectiveness.

Interconnection In the Convergence Era (IP-BASED Interconnection Regulation Challenges)

The IP age of networks and services is increasing very quickly. Starting from its VoIP, NGN, and IMS to today's IP services landscape, which includes fixed and mobile high-definition (HD) voice, HD video calling, unified communications (UC), video conferencing, and telepresence, cooperation, instant messaging (IM), and the rich communication suite (RCS). Convergence is one of the most significant current trends in the ICT sector. It has changed the way services are delivered and obscured the distinction between fixed and mobile services. The transition to Next-Generation Networks (NGN) is the most important next phase in the ICT sector's convergence-driven evolution. In the realms of NGN, VoIP, and IMS, there is no PSTN equivalent; instead, there are "IP islands " that locate the total value of an IP service. The next basic step is to expand the arrive of those services across a totally interconnected cross-network premise in order to maximize their overall esteem among their target audiences. The liberalization of infrastructure services depends on managing the interconnection interface between the competitive and regulated sectors. These paper outlines regulation issues raised by IP-based interconnection and examine the current practices and procedural ways that being developed to address these concerns.

Phenomenological Study: Marriage Satisfaction on Wife Who Has Long-Distance Marriage

This study was conducted to describe marital satisfaction in wives who run distant marriages. This research focuses on the marital satisfaction of the wife who undergoes a foreign marriage because her husband works outside Java. This research is qualitative research with a phenomenological approach, data collection using in-depth interview techniques on the main subject. The credibility of data using research extension and data triangulation. Participants have two wives with the criteria that a wife and husband work outside Java. The results of research conducted on 2 participants show that despite undergoing long-distance marriages, participants N and S can communicate well via telephone or chat and are open to each other in communication with their partners. Participants take advantage of their free time with quality time with their partners. Participant S is not satisfied with applying religious values, while Participant N is satisfied with their partner's religious values. Participant N and Participant S resolve conflicts by being creative and finding solutions together. Participants are open to each other in financial matters. Long-distance marriages support participants to fulfill their sexual needs by calling or video calling, showing affection for each other, and being open about sexual issues. Participants have a reasonably good relationship with family and friends due to frequent visits. Parenting is still carried out together by the participants both near and far. Participants can accept and respect each other's personality differences. Participants can receive the roles that must be carried out, such as being child protectors and independent when their husbands have to be away.