C3-Cloud personalised care plan development platform for addressing the needs of multi-morbidity and managing poly-pharmacy : protocol for a pilot technology trial

Background: There is an increasing need to organise the care around the patient and not the disease, as well as taking into account the complex realities of multiple physical, psycho-social conditions and polypharmacy. Integrated patient-centred care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced ICT solutions. Objective: The C3-Cloud project has developed two collaborative computer platforms for patients and members of the Multi-Disciplinary Team and deployed these in three different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients, informal caregivers, healthcare professionals and, in extend, healthcare systems. Methods: This paper describes the protocol for conducting an evaluation of the user-centred design, user experience, acceptability, and usefulness of the platforms. For this, four ‘testing and evaluation’ phases have been defined, involving multiple qualitative methods, and advanced impact modelling. Results: The technology trial in this 4-year funded project (2016-2020) is currently in its execution phase. The testing and evaluation phase 1 and 2 have been completed with satisfying results on system component tests, and promising results on application and usability tests. The pilot technology trial for evaluation phase 3 and 4 was launched in August 2019. Data collection for these phases is underway and results are forthcoming, approximately in April 2020. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. Conclusions: Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalised care plan platforms for patients and collaboration platforms for members of Multi-Disciplinary Teams can help to tackle the specific challenges of clinical guideline reconciliation for multimorbid patients and improved the management of poly-pharmacy. The initial evaluative phases have indicated promising results of platform usability. The phased methodology has shown useful results in the first two phases, while results of phase 3 and 4 are pending. Clinical Trial: https://www.clinicaltrials.gov/ct2/show/NCT0383420

Correction to: Is diet partly responsible for differences in COVID-19 death rates between and within countries?

An amendment to this paper has been published and can be accessed via the original article

Correction to: Is diet partly responsible for differences in COVID-19 death rates between and within countries?

An amendment to this paper has been published and can be accessed via the original article

ICF-Based Disability Survey in a Rural Population of Adults and Older Adults Living in Cinco Villas, Northeastern Spain: Design, Methods and Population Characteristics

Background: This article describes the methods of a door-to-door screening survey exploring the distribution of disability and its major determinants in northeastern Spain. This study will set the basis for the development of disability-related services for the rural elderly in northeastern Spain. Methods: The probabilistic sample was composed of 1,354 de facto residents from a population of 12,784 Social Security card holders (age: 6 50 years). Cognitive and disability screenings were conducted (period: June 2008-June 2009). Screening instruments were the MMSE and the World Health Organization Disability Assessment Schedule. Participants screened positive for disability underwent an assessment protocol focusing on primary care diagnoses, disability, lifestyle, and social and health service usage. Participants screened positive for cognitive functioning went through in-depth neurological evaluation. Results: The study sample is described. Usable data were available for 1,216 participants. A total of 625 individuals (51.4%) scored within the positive range in the disability screening, while 135 (11.1%) scored within the positive range of the cognitive screening. The proportion of positively screened individuals was higher for women and increased with age. Conclusions: Screening surveys represent a feasible design for examining the distribution of disability and its determinants among the elderly. Data quality may benefit from methodological developments tailored to rural populations with a low education level. Copyright (C) 2010 S. Karger AG, Base

Enabling patient adherence via personalised, just-in time adaptive interventions in ADLIFE architecture

Chronic diseases introduce challenges for the patients to continuously be involved in their care activities and manage the changing requirements of their disease. Patient empowerment activities are a critical component to assist patients in their long-term care journey. In the ADLIFE project (H2020, SC1-DTH-11-2019, 875209), an integrated care planning approach is used where patients are assigned various care plan activities by multidisciplinary care teams. To increase patients’ adherence to the care plan, a continuous behavioral monitoring architecture is developed for delivering digital personalised, just-in time adaptive interventions

UPRIGHT, a resilience-based intervention to promote mental well-being in schools: study rationale and methodology for a European randomized controlled trial

Background: Adolescence is crucial period for laying the foundations for healthy development and mental wellbeing. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention.Methods: UPRIGHT project is a research and innovation project funded by the European Union's Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning. Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods.Discussion: We expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being.Trial registration: ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019