Remote delivery of cardiovascular rehabilitation (CR) has been vital during the COVID pandemic when restrictions have been placed on face-to- face services. In the future, CR services are likely to offer alternatives to centre- based CR, including digital options. However, little is known about the digital access and confidence of CR service users, or their CR delivery preferences. A telephone survey was conducted of those referred for CR in the London boroughs of Lambeth and Southwark (n=60) in which questions were asked about digital access and confidence, as well as current and future delivery preferences for their CR. Between March and July 2021, 60 service-users met the inclusion criteria and were recruited for a telephone survey (mean age 60 ± 11.2 years). Of those, 82% had regular access to a smartphone, 60% to a computer or laptop and 43% to a tablet device. A high proportion of service users perceived themselves to be \'extremely\' or \'somewhat\' confident to use their devices. Thirty-nine (65%) service users would currently prefer a face-to- face assessment, rising to 82% once the perceived COVID-19 threat and restrictions are less. Preferences for accessing exercise were equally split between face-to-face and remotely supported independent exercise, with low interest in digital options. Delivery preferences for education, relaxation and peer support were more heterogeneous with interest in all delivery options. In conclusion, digital access and confidence in CR service users was good. Redesigning CR services to offer more rehabilitation delivery options, aligned with patient choice may increase uptake and further trials are needed to assess the impact.

In patients who have lost their eye due to one or many of the following events, such as surgery, trauma, tumors, or birth eye defects, ocular prostheses play a very vital role in the recovery of their eye appearance and social appearance. This case report highlights the successful fitting and fabrication of a custom-made ocular prosthesis in a patient with an eye defect. The manufacturing process of the prostheses involved careful evaluation and fabrication involving a series of steps to achieve a successful prosthesis. A customized prosthesis guarantees excellent esthetic matching, more comfort, and increased patient confidence, thereby a better quality of life.

Since the Cambridge Analytica scandal, governments are increasingly concerned about the way in which citizens\' personal data are collected, processed and used during election campaigns To develop the appropriate tools for monitoring and controlling this new mode of \"data-driven campaigning\" (DDC) regulators require a clear understanding of the practices involved. This paper provides a first step toward that goal by proposing a new organizational and process-centred operational definition of DDC from which we derive a set of empirical indicators. The indicators are applied to the policy environment of a leading government in this domain - the European Union (EU) - to generate a descriptive \"heat map\" of current regulatory activity toward DDC. Based on the results of this exercise, we argue that regulation is likely to intensify on existing practices and extend to cover current \"cold spots\". Drawing on models of internet governance, we argue that this expansion is likely to occur in one of two ways. A \"kaleidoscopic\" approach, in which current legislation extends to absorb DDC practices and a more \"designed\" approach that involves more active intervention by elites, and ultimately the generation of a new regulatory regime.

Gaming avatars can influence users\' attitudes and behaviors and manifest as the proteus effect. The present study examined proteus effect profiles among 571 gamers and their associations with disordered gaming and physical activity. Latent class analysis identified three profiles: non-influenced gamers, emotion-perception influenced gamers (highest proteus effect), and emotion-behavior influenced gamers (moderate proteus effect). The high proteus effect group exhibited significantly higher gaming disorder symptoms at baseline and 6 months compared to other profiles. Proteus effect profiles did not significantly differ in physical activity levels. However, higher disordered gaming and proteus effect predicted lower activity over time. The strong proteus effect group\'s avatar immersion may increase gaming disorder risks. Minimal avatar influence for the non-influenced gamers appears protective. While proteus effect profiles do not directly relate to activity, amplified disordered gaming can reduce active lifestyles. Overall, findings demonstrate how avatars differentially affect gamers\' experiences and functioning through proteus-induced changes.

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This study critically examines the public\'s perception of Florence Nightingale\'s legacy through a critical discourse analysis (CDA) of digital media, specifically podcasts and YouTube. Nightingale, who is often remembered as \"The Lady with the Lamp\", holds a complex identity within modern narratives that is celebrated for her pioneering contributions to nursing and public health, even if there are some disagreements about her, given the colonialist setting that may have shaped some of her opinions and decisions. This research employed CDA to analyze 25 podcasts and 18 YouTube videos, which were systematically included according to a priori inclusion criteria. The study synthesized how these media products portray Nightingale and, by extension, shape public discourse about the nursing profession. The findings reveal five thematic representations of Nightingale: as a legendary figure, a modern feminist, a dedicated statistician, a pioneer in public health, and a pivotal STEM contributor. These portrayals challenge traditional nursing stereotypes by emphasizing Nightingale\'s role as a rigorous scientist and reformer, suggesting broader perceptions of nurses that encompass leadership, analytical skills, and strategic thinking. The study supports the hypothesis that digital narratives significantly influence the public\'s understanding and appreciation of nursing, advocating for a more nuanced professional identity that integrates traditional caregiving roles with critical and analytical capabilities.

UNASSIGNED: Little is known about how best to reach people with social marketing messages promoting use of clinical HIV and sexually transmitted infection (STI) services.
UNASSIGNED: We evaluated a multiplatform, digital social marketing campaign intended to increase use of HIV/STI testing, treatment, and prevention services among gay, bisexual, and other men who have sex with men (MSM) at an LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and/or questioning) community health center.
UNASSIGNED: We evaluated engagement with a social marketing campaign launched by Open Door Health, the only LGBTQ+ community health center in Rhode Island, during the first 8 months of implementation (April to November 2021). Three types of advertisements encouraging use of HIV/STI services were developed and implemented on Google Search, Google Display, Grindr, and Facebook. Platforms tracked the number of times that an advertisement was displayed to a user (impressions), that a user clicked through to a landing page that facilitated scheduling (clicks), and that a user requested a call to schedule an appointment from the landing page (conversions). We calculated the click-through rate (clicks per impression), conversion rate (conversions per click), and the dollar amount spent per 1000 impressions and per click and conversion.
UNASSIGNED: Overall, Google Search yielded the highest click-through rate (7.1%) and conversion rate (7.0%) compared to Google Display, Grindr, and Facebook (click-through rates=0.4%-3.3%; conversion rates=0%-0.03%). Although the spend per 1000 impressions and per click was higher for Google Search compared to other platforms, the spend per conversion-which measures the number of people intending to attend the clinic for services-was substantially lower for Google Search (US $48.19 vs US $3120.42-US $3436.03).
UNASSIGNED: Campaigns using the Google Search platform may yield the greatest return on investment for engaging MSM in HIV/STI services at community health clinics. Future studies are needed to measure clinical outcomes among those who present to the clinic for services after viewing campaign advertisements and to compare the return on investment with use of social marketing campaigns relative to other approaches.

BACKGROUND: Controlling smartphone addiction and procrastination among nurses is crucial for enhancing the productivity of both nursing and the healthcare system. Critical care nurses are highly vulnerable to smartphone addiction and procrastination behaviors than other groups. They may purposefully delay their tasks, a practice known as active procrastination, or inadvertently delay them, a practice known as passive procrastination.
OBJECTIVE: This study was designed to assess the prevalence of smartphone addiction and procrastination behavior among nurses, examine the effect of smartphone addiction on the active and passive procrastination behaviors, and explore the correlation between active and passive procrastination behaviors among nurses.
METHODS: This is a descriptive correlational exploratory study that was conducted at 23 critical care units of one large educational hospital in Egypt. Data were collected from 360 nurses who were conveniently selected using three tools: the Smartphone Addiction Inventory, the New Active Procrastination Scale, and the Unintentional Procrastination Scale. Correlation and regression analyses were conducted to test the hypothetical relationship among the study variables.
RESULTS: This study revealed that 55.0%, 80.0%, and 45.3% of nurses had a moderate perceived level of smartphone addiction, active procrastination behavior, and passive procrastination behavior, respectively. There is a significant positive correlation between smartphone addiction and both nurses\' active and passive procrastination behaviors. Smartphone addiction accounts for 25% of the variance in nurses\' active procrastination behavior and 18% of the variance in their passive procrastination. Furthermore, there is a moderately significant negative correlation between nurses\' active procrastination behavior and their passive procrastination behavior.
CONCLUSIONS: Nurses are exhibiting moderate levels of smartphone addiction and procrastination, which is a significant threat to the healthcare industry and nursing productivity. This requires technological, educational, and organizational interventions that foster active procrastination and combat passive procrastination behaviors among nurses.
CONCLUSIONS: Continuous training programs are required to enhance time management skills among nurses and increase the awareness of nurse managers with the symptoms of smartphone addiction among nurses. Nurse leaders should early detect and address the addictive use of smartphones among nurses, identify potential procrastinators, and provide counseling to eradicate these behaviors in the workplace.

BACKGROUND: A logbook system is essential to ensure standardized competency in medical education. This survey will provide the first overview of our current logbook and can serve as an initial proposal for improvement to a more relevant and valuable tool to assess our postgraduate training programme.
METHODS: This survey was conducted among all Universiti Kebangsaan Malaysia (UKM) anaesthetic trainees. The data for this survey was collected by using Google Forms. A link to the form was distributed to all UKM anaesthetic trainees. The survey questionnaire consisted of five sections, demographic data, strengths and weaknesses of logbook content, evaluation of logbook usage experience, perception of the feedback received regarding the logbook performance, and potential improvements that can be made.
RESULTS: 107 anaesthetic trainees participated in this study. All of the sections in the logbook were deemed relevant by more than 60% of the trainees except for the on-call section which was seen as relevant only by 37.4% of them. 53.3% agreed that the logbook is useful for learning during the course. However, only 43.9% of them perceived that the logbook was easy and convenient to use. Only 59 respondents received feedback regarding their logbook performance. The analysis of open-ended answers highlights the necessity of transitioning to a fully digitalized logbook system for easy accessibility. It also reveals the need to re-evaluate specific logbook contents and incorporate additional teaching and learning tools to enhance the overall training process. Moreover, the findings emphasize the importance of effectively implementing feedback mechanisms within the logbook system to optimize student learning.
CONCLUSIONS: Serving as a foundational step towards developing a more efficient and structured educational tool, this research provides valuable insights for future advancements in medical education, particularly in anaesthesiology.

Uncertainties on the intensive care unit (ICU) regarding the eligibility of a patient to be a potential deceased organ donor may prevent their referral and enrolment in the pathway for organ donation. Healthcare staff may exclude potential donors for medical reasons, which are no longer applicable. Hence, Swisstransplant implemented a digital donor evaluation tool (DET) in 2021, which allows the local hospital\'s organ donation coordinator to send a direct request to medical advisors (MA) of the organ procurement organization before excluding potential donors. All 156 requests entered in 2022 were analyzed. 117 patients (75.0%) were primarily accepted by the MA as potential donors. Of those 60 patients (51.3%) became actual organ donors. Main reasons for using the DET were questions regarding malignancies (n = 33, 21.2%), infectious diseases (n = 35, 22.4%) and age/co-morbidities (n = 34, 21.8%). The average age of the actual \"DET donor\" compared to the regularly enrolled, actual \"Non-DET donor\" was 65.3 ± 15.8 vs. 56.8 ± 17.5 years, respectively (p = 0.008). On average 1.9 ± 1.1 organs compared to 3.2 ± 1.3 organs were retrieved from DET vs. Non-DET donors. In summary, this new digital donor evaluation tool supports reporting and facilitates eligibility decisions in uncertain, complex donor cases, potentially increasing the number of organ donations.