Encouraging better evaluation in digital health: guidance, training and community development

Abstract Digital health have the potential to deliver effective interventions on a wide scale. However, digital health products and services need better evaluations. There are significant barriers to this. Public Health England wanted to understand and tackle pragmatically the problem of evaluating digital health. This is particularly important in the time of COVID-19, when a large number of digital interventions are being developed and introduced at pace. It assembled a multidisciplinary team including service designers, academics, and public health professionals. They employed user-centred design methods, including qualitative research, and engagement with end-users and stakeholders. They used the findings to identify opportunity areas, develop concepts, test prototypes, and plan service implementation. This work led to the Evaluating Digital Health Products resource on GOV.UK which includes practical guidance, a methods library with digital case studies, and workshop templates for teams. It is intended to help anyone developing or running a digital health intervention. This resource launched to the public in 2020 but the service is still being improved and developed. The aim of this presentation is to introduce the online resource, describe its comprehensive iterative development, and present the evaluation training models. We will also describe the immediate next steps, which include development of an evaluation community, user testing of new content, and plans for developing a sustainable workshop model. Funding: This project is funded by Public Health England

Multiphase elastic homogenization, and the mechanics of tendon-to-bone attachment

Estimates of the effective stiffness of a composite containing multiple types of inclusions are needed for the design and study of functionally graded systems in engineering and biologic materials. One important stiffening mechanism in biologic systems is the accumulation of a high volume fraction of mineral inclusions within and upon collagen fibers. Modeling of this mechanism is critical for understanding how stresses are transmitted from tendon to bone and for designing improvements to surgical procedures for reattaching tendon to bone. The latter is a critical need because failure rates following surgical reattachment are as high as 94% in some populations. Modeling of such material remains difficult Because of a number of physiological and mathematical challenges. A range of methods have been described in the literature for estimating the effective elastic properties of composites containing low volume fractions of different inclusion types. Here, we provide an estimate of the effective elastic responses of composites containing high volume fractions of different, ellipsoidal and anisotropic inclusion types. The homogenization estimate compared well against numerical simulation and available experimental data. The method out-performed all methods of which we are aware for modeling of numerical simulations of the mechanical response of the graded attachment of tendon to bone. The method is a good candidate for the characterization of composites with multiple types of anisotropic inclusions, even if these inclusions have moderate volume fractions and a variety of aspect ratios

Effect of Blended Learning Approach on Student Nurses’ Attitudes and Academic Achievement

Although  various blended approaches that integrate online components into traditional classes continue to grow rapidly, they still remain at an early stage of development. Consequently, developers and deliverers of online learning need more understanding of how students perceive and react to elements of e-learning (since student perception and attitude is critical to motivation and learning) along with how to apply these approaches most effectively to enhance learning. The Aim: aim of the current study was to examine the effect of blended learning  approach on student nurses’ attitudes and academic achievement in Medical Surgical Nursing course compared to traditional teaching method modules. Setting: A The sample consisted of 62 female students their age range from 19 to 20 years at 5th., level  recruited from 5th., level in faculty of nursing, King Khaled University   Tools: 3  tools used to collect data for the study: 1. student attitude scale toward blended learning approach 2.A Constructed Motivational Scale. and The Achievement Test, they are developed by the researchers. Results: The study findings revealed that,  the Study Group subjects (blended learning Group ) had higher Mean Of attitude  Subscales And Total Scores, achievement test Scores, and Mean Of Motivational Subscales And Total Scores than  Control Group (traditional), in addition, there were  statistically significant differences were found between the two groups in relation to previously mentioned variables. Therefore, this study recommended an educational programs for academic staff for teaching using  blended learning approach. Keywords: E-learning, Online learning, traditional, Attitudes, Blended Learning, Academic Achievement

U-Pb Geochronology, Sr–Nd Geochemistry, Petrogenesis and Tectonic Setting of Gandab Volcanic Rocks, Northeast Iran

This paper addresses U-Pb geochronology, Sr-Nd geochemistry, petrogenesis and tectonic setting in the Gandab volcanic rocks. The Gandab volcanic rocks belong to the Sabzevar zone magmatic arc (northeastern Iran). Petrographically, all the studied volcanic rocks indicate porphyritic textures with phenocrysts of plagioclase, K-feldespar, hornblende, pyroxene, and magnetite which are embedded in a fine to medium grained groundmass. As well, amygdaloidal, and poikilitic textures are seen in some rocks. The standard chemical classifications show that the studied rocks are basaltic trachyandesite, trachyandesite, trachyte, and trachydacite. Major elements reveal that the studied samples are metaluminous and their alumina saturation index varies from 0.71 to 1.02. The chondrite-normalized rare-earth element and mantle-normalized trace-element patterns show enrichment in light rare-earth elements (LREE) relative to heavy rare-earth elements (HREE) and in large ion lithophile elements (LILE) relative to high field strength elements (HFSE). As well they show a slightly negative Eu anomaly (Eu/Eu* = 0.72 – 0.97). The whole-rock geochemistry of the studied rocks suggests that they are related to each other by fractional crystallization. LA-MC-ICP-MS U-Pb analyses in zircon grains from two volcanic rock samples (GCH-119 and GCH-171) gave ages ranging of 5.47 ± 0.22 Ma to 2.44 ± 0.79 Ma, which corresponds to the Pliocene period. In four samples analysed for Sr and Nd isotopes 87Sr/86Sr ratios range from 0.704082 to 0.705931 and εNd values vary between +3.34 and +5. These values could be regarded to as representing mantle derived magmas. Taking into account the comparing rare earth element (REE) patterns, an origin of the parental magmas in enriched lithospheric mantle is suggested. Finally, it is concluded that Pliocene Gandab volcanic rocks are related to the post-collision environment that followed the Neo-Tethys subduction

Synthesis, physical characterization, antifungal and antibacterial activity of oleic acid-capped nanomagnetite and cobalt-doped nanomagnetite

Nanoparticles, 10-14 nm, consisting of either Fe3O4 or Co0.2Fe2.8O4 stabilized with oleic acid, were prepared using solution combustion. Their structural and magnetic properties were examined using X-ray diffractometry, scanning electron microscopy, vibrating sample magnetometry, and Fourier-transform infrared spectroscopy. The properties of both sets of materials are similar except the cobalt-doped particles are considerably less magnetic. The in vitro inhibitory activities of the nanoparticles were assessed against pathogenic bacteria Shigella dysenteriae, Klebsiella pneumoniae, Acinetobacter baumannii, Streptococcus pyogenes, and pathogenic fungi and molds Candida albicans, Fusarium oxysporum and Aspergillus fumigatus. The magnetite nanoparticles were moderately effective against all tested pathogens, but the activity of the cobalt-doped nanoparticles was significantly lower, possibly due to an interruption of the Fenton reaction at the bacterial membrane. This work suggests that potentially doping magnetite with stronger metal oxidants may instead enhance their antimicrobial effects

The Concentration of Stress at the Rotator Cuff Tendon-to-Bone Attachment Site Is Conserved across Species

The tendon-to-bone attachment site integrates two distinct tissues via a gradual transition in composition, mechanical properties, and structure. Outcomes of surgical repair are poor, in part because surgical repair does not recreate the natural attachment, and in part because the mechanical features that are most critical to mechanical and physiological function have not been identified. We employed allometric analysis to resolve a paradox about how the architecture of the rotator cuff contributes to load transfer: whereas published data suggest that the mean muscle stresses expected at the tendon-to-bone attachment are conserved across species, data also show that the relative dimensions of key anatomical features vary dramatically, suggesting that the amplification of stresses at the interface between tendon and bone should also vary widely. However, a mechanical model that enabled a sensitivity analysis revealed that the degree of stress concentration was in fact highly conserved across species: the factors that most affected stress amplification were most highly conserved across species, while those that had a lower effect showed broad variation across a range of relative insensitivity. Results highlight how micromechanical factors can influence structure-function relationships and cross-species scaling over several orders of magnitude in animal size, and provide guidance on physiological features to emphasize in surgical and tissue engineered repair of the rotator cuff

An evaluation of the effectiveness of a reproductive health education program for nonmedical students in Iran: A quasi-experimental pre-test, post-test research

Background: Young people age 10 - 25 are an important population to evaluate the female youth educational program essential to the prevention of issues related to reproductive health. Objectives: This study evaluated the effectiveness of the education program for improving university student�s reproductive health. Patients and Methods: This quantitative study was conducted in Iran from July 2014 to March 2015. The questionnaire addressed socio-demographic features, knowledge of reproductive problems, and attitudes. Program effectiveness was examined using a quasi-experimental research design with pre-intervention and post-intervention. Data from questionnaires was collected preintervention and post-intervention from 150 female students. Results: In this study, results showed that an intervention and education program had a significant effect on several issues related to reproductive health. Most participants stressed the need to provide reproductive health services for young girls. Conclusions: The results of this study suggest that the reproductive health education program improved the students� knowledge and attitudes about sexuality and decision-making after the program and that these educational programs are important for youths. © 2016, Shiraz University of Medical Sciences

Do hands-free cell phone conversation while driving increase the risk of cognitive distraction among drivers? A cross-over quasi-experimental study

Background: Background: Conversation over the cell phone while driving is a known risk factor for road traffic crash. Using handsfree to talk on the cell phone may remove visual and manual distraction yet not the cognitive distraction. Objectives: The purpose of this study was to better understand the mechanisms of cognitive distraction due to hands-free cell phone conversation (HFPC) while driving. Methods: Twelve male and 12 female University students in Tehran, Iran, were selected via the consecutive convenient sampling method, and randomly assigned to one of the following administrations of cross-over quasi-experimental study design, during year 2016: Administration 1, participants performed the tests while involved in HFPC, took rest for 60 minute, and then performed the tests another time without HFPC; Administration 2, participants performed the tests without HFPC, took rest, and then performed the tests another time with HFPC. Each participant moved to the other administration after 7 to 10 days. The Vienna test system (VTS) was used to measure simple and choice reaction time, selective attention, visual orientation, and visual memory. Linear regression analysis was used to study the change in test scores due to HFPC. Results: The mean age of participants was 27.1±5.3 years. A history of road traffic crash (regardless of severity) was reported among 9 (37.5) participants in the previous year. Hands-free cell phone conversation while driving was directly associated with mean time correct rejection score (P < 0.01) (selective attention), omitted response (P < 0.01) and median reaction time (P < 0.01) (choice reaction time), and mean reaction time (P < 0.01) (Simple reaction time). Moreover, HPFC was inversely associated with sum hits (P = 0.05) (selective attention), incorrect (P < 0.02) and correct response (P < 0.01) (choice reaction time), score based on viewing and working time (P < 0. 01) (visual orientation), and visual memory performance (P < 0.01). Conclusions: Using hands-free devices to converse during driving, impaired reaction time, selective attention, visual orientation and visual memory, which are essential for safe driving. Thus, the use of these devices does not preclude cognitive distraction and should be restricted. © 2018, Iranian Red Crescent Medical Journal