Rapid point-of-care testing for COVID-19: quality of supportive information for lateral flow serology assays

Objective There is a lack of evidence addressing several important human factors questions pertaining to the quality of supportive information provided by commercial manufacturers that can affect the adoption and use of lateral flow serology assays in practice. We aimed to: (1) identify and assess the quality of information that commercial manufacturers provided for their point-of-care tests (POCTs) and (2) examine the implications of these findings on real-world settings. Design We used a content analysis methodology in two stages to systematically, code and analyse textual data from documents of commercial manufacturers. A deductive approach was applied using a coding guide based on the validated Point-of-Care Key Evidence Tool (POCKET) multidimensional checklist. An inductive approach was used to identify new patterns or themes generated from our textual analysis. Setting Publicly available supportive information documents by commercial manufacturers for lateral flow serology, were identified and gathered from online searches. Participants Supportive information documents retrieved from online searches over 3 months (March 2020 to June 2020). Results A total of 79 POCTs were identified that met the study inclusion criteria. Using the POCKET coding guide, we found that the quality of information varied significantly between the manufacturers and was often lacking in detail. Our inductive approach further examined these topics and found that several statements were vague and that significant variations in the level of details existed between manufacturers. Conclusions This study revealed significant concerns surrounding the supportive information reported by manufacturers for lateral flow serology assays. Information transparency was poor and human factor issues were not properly addressed to mitigate the risk of improper device use, although it should be noted that the results of our study are limited by the data that manufactures were prepared to disclose. Overall, commercial manufacturers should improve the quality and value of information presented in their supporting documentation

What e-patients want from the doctor-patient relationship: content analysis of posts on discussion boards.

People with long-term conditions are encouraged to take control and ownership of managing their condition. Interactions between health care staff and patients become partnerships with sharing of expertise. This has changed the doctor-patient relationship and the division of roles and responsibilities that traditionally existed, but what each party expects from the other may not always be clear. Information that people with long-term conditions share on Internet discussion boards can provide useful insights into their expectations of health care staff. This paper reports on a small study about the expectations that people with a long-term condition (diabetes) have of their doctors using information gleaned from Internet discussion boards

Valuing humanity: Kierkegaardian worries about Korsgaardian transcendental arguments

This paper draws out from Kierkegaard’s work a distinctive critical perspective on an influential contemporary approach in moral philosophy: namely, Christine Korsgaard’s transcendental argument for the value of humanity. From Kierkegaard’s perspective, we argue, Korsgaard argument goes too far, in attributing absolute value to humanity – but also that she is required to make this claim if her transcendental argument is to work. From a Kierkegaardian perspective, to place this sort of value in humanity is problematic since it threatens to make the relation between individuals too claustrophobic. Finally, we explore the possibility of a rival approach, in which we should view others as ethically significant because they too are related to the kind of ‘third’ which Kierkegaard argues is needed to bring stability to the structure of the self. In this way, we claim, a different and more successful transcendental argument to the value of humanity can be found in the work of Kierkegaard

The European Legal Framework on Cybercrime

This article analyzes the European legal framework on cybercrime. Initially, it argues the challenges of cybercrime to traditional criminal justice systems. Subsequently, it focuses on the criminal law framework on cybercrime with a mainly European perspective. The European legal framework provides a three-path solution: the reduction of frictions among national legislations, the introduction of new investigative powers and the facilitation of international cooperation. The article presents and discusses each solution. Further, it argues that the effective implementation of the main legal instruments does not seem to depend on the legal enforceability of these international measures. Contrarily, other, non legal, factors such as national security, politics, the economy and the public opinion appear to stimulate the spontaneous implementation of the European legal framework. In this context, the added value of the EU action is rather low, although the Treaty of Lisbon and the Stockholm Programme may improve this situation in the long ter

Existential Communication and Leadership

The aim of this article is to introduce and explain a number of important existentialist philosophers and concepts that we believe can contribute to a critical approach to leadership theory. Emphasis is placed on understanding the nature of communication from an existentialist perspective and so Jaspers' conceptualization of existential communication is introduced along with important related concepts that may be regarded as important facets of leader communication including Being-in-the-world, the Other, intersubjectivity, dialogue and indirect communication. Particular attention is paid to Buber's ideas on communication as relationship and dialogue. Throughout, reference is made to contemporary, and what is often regarded as orthodox, thinking regarding the centrality of communication to leadership practice as a means by which to highlight the salience of an existentialist analysis

Trafficking

In cities the world over we are able to determine stability in daily existence, to identify with our social spaces, because modes of transport have become essential components of subjective autonomy. But would it not be just as accurate to say that in transit modern life puts the self in abeyance? I argue that the ways we allow ourselves to be moved around in ‘traffic space’ creates a passivity that renders almost invisible the complex mechanics of movement, which we only become alert to at the moment of breakdown, precisely when they become a threat to autonomy. Our trafficking, I conclude, has an almost narcotic effect, rendering us immobile against the continual movements that constitute urban life, one that also magnifies out of all proportion the accidents or aberrations that sometimes disturb our traffic space, making it seem as if we may easily descend into an uncontrollable chaos

The holistic phase model of early adult crisis

The objective of the current study was to explore the structural, temporal and experiential manifestations of crisis episodes in early adulthood, using a holistic-systemic theoretical framework. Based on an analysis of 50 interviews with individuals about a crisis episode between the ages of 25 and 35, a holistic model was developed. The model comprises four phases: (1) Locked-in, (2) Separation/Time-out, (3) Exploration and (4) Rebuilding, which in turn have characteristic features at four levels—person-in-environment, identity, motivation and affect-cognition. A crisis starts out with a commitment at work or home that has been made but is no longer desired, and this is followed by an emotionally volatile period of change as that commitment is terminated. The positive trajectory of crisis involves movement through an exploratory period towards active rebuilding of a new commitment, but ‘fast-forward’ and ‘relapse’ loops can interrupt Phases 3 and 4 and make a positive resolution of the episode less likely. The model shows conceptual links with life stage theories of emerging adulthood and early adulthood, and it extends current understandings of the transitional developmental challenges that young adults encounter

Mechanisms of recovery after neck‐specific or general exercises in patients with cervical radiculopathy

Background The mechanisms of action that facilitate improved outcomes after conservative rehabilitation are unclear in individuals with cervical radiculopathy (CR). This study aims to determine the pathways of recovery of disability with different exercise programs in individuals with CR. Methods We analysed a dataset of 144 individuals with CR undergoing conservative rehabilitation. Eleven variables collected at baseline, 3, 6 and 12 months follow‐up were used to build a Bayesian Network (BN) model: treatment group (neck‐specific vs. general exercises), age, sex, self‐efficacy, catastrophizing, kinesiophobia, anxiety, neck–arm pain intensity, headache pain intensity and disability. The model was used to quantify the contribution of different mediating pathways on the outcome of disability at 12th months. Results All modelled variables were conditionally independent from treatment groups. A one‐point increase in anxiety at 3rd month was associated with a 2.45‐point increase in 12th month disability (p <.001). A one‐point increase in head pain at 3rd month was associated with a 0.08‐point increase in 12th month disability (p <.001). Approximately 83% of the effect of anxiety on disability was attributable to self‐efficacy. Approximately 88% of the effect of head pain on disability was attributable to neck–arm pain. Conclusions No psychological or pain‐related variables mediated the different treatment programs with respect to the outcome of disability. Thus, the specific characteristics investigated in this study did not explain the differences in mechanisms of effect between neck‐specific training and prescribed physical activity. The present study provides candidate modifiable mediators that could be the target of future intervention trials. Significance Psychological and pain characteristics did not differentially explain the mechanism of effect that two exercise regimes had on disability in individuals with cervical radiculopathy. In addition, we found that improvements in self‐efficacy was approximately five times more important than that of neck–arm pain intensity in mediating the anxiety‐disability relationship. A mechanistic understanding of recovery provides candidate modifiable mediators that could be the target of future intervention trials. Trials registration ClinicalTrials.gov identifier: NCT01547611