Such harms are also mediated by excessive use, excessive money spending, and exposure to addictive content such as violence and pornography. Major stakeholders and their roles can be derived more effectively based on these conceptual models and parameters of harms. In conclusion, the context of the proposed stakeholder framework should be further optimized on the basis of two principles (1) advocating consumer rights as a general and standard approach to digital products; and (2) protecting consumers' health from harms related to addictive behaviors.A coherent framework for addressing risk arising from new technologies is needed. In proposing a framework of broad application and future focus, where empirical evidence is scarce, reliance on strong theory becomes all the more important. Some technologies are more prone to excessive engagement than others (i.e. more addictive). Some users are also more susceptible to excessive engagement than others. Impulsivity theory emphasises the importance of reinforcement magnitude in determining the risk associated with a new technology, and that an individual's sensitivity to reinforcement (reward drive) and capacity to inhibit previously reinforced behaviour (rash impulsiveness) determines their susceptibility to problematic engagement. Online gaming provides a good example of how such theory can be applied to facilitate intervention efforts and develop policy.
Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space.

Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradatbegan in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020.

Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States.

ClinicalTrials.gov NCT03678181; https//clinicaltrials.gov/ct2/show/study/NCT03678181.

DERR1-10.2196/24043.
DERR1-10.2196/24043.
In 2018, 14% of employees in the European Union had fixed-term contracts. Fixed-term contract positions are often less secure than permanent contract positions. Perceived job insecurity has been associated with increased rates of mental ill health. However, the association between fixed-term contract positions and mental ill health is uncertain. A recent review concluded that the quality of most existing studies is low and that the results of the few studies with high quality are contradictory.

This study aims to estimate the incidence rate ratios (RRs) of psychotropic drug use and psychiatric hospital treatment. These ratios will be considered, first, in relation to the contrast fixed-term versus permanent contract and, second, to fixed-term contract versus unemployment.

Interview data with baseline information on employment status from the Danish Labor Force Surveys in the years 2001-2013 will be linked to data from national registers. Participants will be followed up for up to 5 years after the interrescriptions of psychotropic drugs and 2150 incident cases of psychiatric hospital treatment for mood, anxiety, or stress-related disorders.

We expect the analyses to be completed by the end of 2021 and the results to be published in mid-2022.

The statistical power of the study will be large enough to test the hypothesis of a prospective association between fixed-term contract positions and mental illness in the general workforce of Denmark.

DERR1-10.2196/24392.
DERR1-10.2196/24392.Historically, medical trainees were educated in the hospital on real patients. Over the last decade, there has been a shift to practicing skills through simulations with mannequins or patient actors. https://www.selleckchem.com/products/way-316606.html Virtual reality (VR), and in particular, the use of 360-degree video and audio (cineVR), is the next-generation advancement in medical simulation that has novel applications to augment clinical skill practice, empathy building, and team training. In this paper, we describe methods to design and develop a cineVR medical education curriculum for trauma care training using real patient care scenarios at an urban, safety-net hospital and Level 1 trauma center. The purpose of this publication is to detail the process of finding a cineVR production partner; choosing the camera perspectives; maintaining patient, provider, and staff privacy; ensuring data security; executing the cineVR production process; and building the curriculum.
Determining a suitable dose of intravenous colistimethate is challenging because of complicated pharmacokinetics, confusing terminology, and the potential for renal toxicity. Only recently have reliable pharmacokinetic/pharmacodynamic data and dosing recommendations for intravenous colistimethate become available.

The aim of this work was to develop a clinician-friendly, easy-to-use mobile app incorporating up-to-date dosing recommendations for intravenous colistimethate in critically ill adult patients.

Swift programming language and common libraries were used for the development of an app, ColistinDose, on the iPhone operating system (iOS; Apple Inc). The compatibility among different iOS versions and mobile devices was validated. Dosing calculations were based on equations developed in our recent population pharmacokinetic study. Recommended doses generated by the app were validated by comparison against doses calculated manually using the appropriate equations.

ColistinDose provides 3 major functierface, ColistinDose provides an accurate and easy-to-use tool for clinicians to calculate dosage regimens of intravenous colistimethate in critically ill patients with varying degrees of renal function. It has significant potential to avoid the prescribing errors and patient safety issues that currently confound the clinical use of colistimethate, thereby optimizing patient treatment.
Despite steady gains in life expectancy, individuals with cystic fibrosis (CF) lung disease still experience rapid pulmonary decline throughout their clinical course, which can ultimately end in respiratory failure. Point-of-care tools for accurate and timely information regarding the risk of rapid decline is essential for clinical decision support.

This study aims to translate a novel algorithm for earlier, more accurate prediction of rapid lung function decline in patients with CF into an interactive web-based application that can be integrated within electronic health record systems, via collaborative development with clinicians.

Longitudinal clinical history, lung function measurements, and time-invariant characteristics were obtained for 30,879 patients with CF who were followed in the US Cystic Fibrosis Foundation Patient Registry (2003-2015). We iteratively developed the application using the R Shiny framework and by conducting a qualitative study with care provider focus groups (N=17).

A clini's effectiveness regarding increased communication, enhanced shared decision-making, and improved clinical outcomes for patients with CF.
Our framework for creating an interactive and visual analytics platform enables generalized development of applications to synthesize, model, and translate electronic health data, thereby enhancing clinical decision support and improving care and health outcomes for chronic diseases and disorders. A prospective implementation study is necessary to evaluate this tool's effectiveness regarding increased communication, enhanced shared decision-making, and improved clinical outcomes for patients with CF.
The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied.

The objective of this study was to assess whether an SG better reflects the clinical competence of medical students than a multiple choice questionnaire (MCQ).

Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities high-fidelity simulation (HFS), considered the gold standard for the evaluation of clinical competence, the SG Effic'Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities and the MCQ and HFS modalities. Student satisfaction was also evaluated.

Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (P=.04). Students reported significantly higher satisfaction with the SG (P<.01) than with the MCQ modality.

The SG Effic'Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Because SGs allow the assessment of more dimensions of clinical competence than MCQs, they are particularly appropriate for the assessment of medical students on situations involving symptom recognition, prioritization of decisions, and technical skills.

ClinicalTrials.gov NCT03884114; https//clinicaltrials.gov/ct2/show/NCT03884114.
ClinicalTrials.gov NCT03884114; https//clinicaltrials.gov/ct2/show/NCT03884114.
Despite excellent prediction performance, noninterpretability has undermined the value of applying deep-learning algorithms in clinical practice. To overcome this limitation, attention mechanism has been introduced to clinical research as an explanatory modeling method. However, potential limitations of using this attractive method have not been clarified to clinical researchers. Furthermore, there has been a lack of introductory information explaining attention mechanisms to clinical researchers.

The aim of this study was to introduce the basic concepts and design approaches of attention mechanisms. In addition, we aimed to empirically assess the potential limitations of current attention mechanisms in terms of prediction and interpretability performance.

First, the basic concepts and several key considerations regarding attention mechanisms were identified. Second, four approaches to attention mechanisms were suggested according to a two-dimensional framework based on the degrees of freedom and uncertainty awareness.