Technological adjuncts to increase adherence to therapy: a review

This paper identified and reviewed technological adjuncts to increase client adherence to therapy. Three areas of adherence were identified, namely treatment dropout and non-attendance, engagement during and between therapy sessions, and aftercare. Database searches were conducted in each of these areas to identify relevant studies published between the years of 1990 and 2010. Adjuncts designed to replace or reduce direct therapist contact, change the medium of communication between the client and therapist, or alter the content or style of the therapy were not included in this review. Adjuncts were reviewed in light of theories of adherence, including Self Determination Theory, the Transtheoretical Model, and the Theory of Planned Behaviour. Adjuncts reviewed included appointment reminders, exercises and monitoring delivered by mobile phone, and exercises and data collection delivered by computer. Limitations and directions for future research were addressed and discussed.     

Utility of mobile technology in medical interpretation: A literature review of current practices

ObjectivesLanguage barriers limit healthcare access. However, professional interpretation usage is infrequent due to high cost and poor interpreter availability. Healthcare-oriented mobile applications are becoming more accepted and may help alleviate this burden. This literature review aims to better understand the utility of mobile technology in healthcare interpretation. Specifically, the objective of this review is to synthesize the feasibility, outcome, and challenges of implementing technological medical interpretation services.Patient involvementNo patients were involved for this review.MethodsIn December 2019, MEDLINE (Ovid) was systematically searched according to PRISMA guidelines. All articles discussing the utility of technology in healthcare interpretation encounters were included.ResultsTwo major themes emerged: 1) comparing video and phone interpretation with in-person interpretation and 2) assessing direct translation software in healthcare settings. Phone and video interpretation help reduce overall patient wait-times. Both patients and clinicians preferred in-person or video interpretation over interpretation by phone. Chief benefits of using direct translation software include immediate access, low costs, and sustainability. Several studies discussed potential translation inaccuracies and the importance of having professional interpreters in medico-legal discussions.ConclusionMobile applications may be used to facilitate access to medical interpreters with high clinician and patient satisfaction. Direct in-app translations facilitate access but risk inaccuracies with important medico-legal considerations.Practical valueMobile applications are available at low costs and can improve access to interpreters though video and phone calls. Mobile software can also provide direct translation and facilitate clinical care. Clinicians should prioritize face-to-face encounters with professional medical interpreters, whenever possible. In a time of social distancing amidst the current COVID-19 pandemic, there is crucial value in elucidating the best telehealth interpretation practices.     

A review and a framework of handheld computer adoption in healthcare

Wide adoption of mobile computing technology can potentially improve information access, enhance workflow, and promote evidence-based practice to make informed and effective decisions at the point of care. Handheld computers or personal digital assistants (PDAs) offer portable and unobtrusive access to clinical data and relevant information at the point of care. This article reviews the literature on issues related to adoption of PDAs in health care and barriers to PDA adoption. Studies showed that PDAs were used widely in health care providers' practice, and the level of use is expected to rise rapidly. Most care providers found PDAs to be functional and useful in areas of documentation, medical reference, and access to patient data. Major barriers to adoption were identified as usability, security concerns, and lack of technical and organizational support. PDAs offer health care practitioners advantages to enhance their clinical practice. However, better designed PDA hardware and software applications, more institutional support, seamless integration of PDA technology with hospital information systems, and satisfactory security measures are necessary to increase acceptance and wide use of PDAs in healthcare.     

Trends on the application of serious games to neuropsychological evaluation: A scoping review

BackgroundThe dramatic technological advances witnessed in recent years have resulted in a great opportunity for changing the way neuropsychological evaluations may be performed in clinical practice. Particularly, serious games have been posed as the cornerstone of this still incipient paradigm-shift, as they have characteristics that make them especially advantageous in trying to overcome limitations associated with traditional pen-and-paper based neuropsychological tests: they can be easily administered and they can feature complex environments for the evaluation of neuropsychological constructs that are difficult to evaluate through traditional tests. The objective of this study was to conduct a scoping literature review in order to map rapidly the key concepts underpinning this research area during the last 25 years on the use of serious games for neuropsychological evaluation.MethodsMEDLINE, PsycINFO, Scopus and IEEE Xplore databases were systematically searched. The main eligibility criteria were to select studies published in a peer-reviewed journal; written in English; published in the last 25 years; focused on the human population, and classified in the neuropsychological field. Moreover, to avoid risk of bias, studies were selected by consensus of experts, focusing primarily in psychometric properties. Therefore, selected studies were analyzed in accordance with a set of dimensions of analysis commonly used for evaluating neuropsychological tests.ResultsAfter applying the selected search strategy, 57 studies —including 54 serious games— met our selection criteria. The selected studies deal with visuospatial capabilities, memory, attention, executive functions, and complex neuropsychological constructs such as Mild Cognitive Impairment (MCI). Results show that the implementation of serious games for neuropsychological evaluation is tackled in several different ways in the selected studies, and that studies have so far been mainly exploratory, just aiming at testing the feasibility of the proposed approaches.DiscussionIt may be argued that the limited number of databases used might compromise this study. However, we think that the finally included sample is representative, in spite of how difficult is to achieve an optimum and maximum scope. Indeed, this review identifies other research issues related to the development of serious games beyond their reliability and validity. The main conclusion of this review is that there is a great interest in the research community in the use of serious games for neuropsychological evaluation. This scoping review is pertinent, in accordance with the increasing number of studies published in the last three years, they demonstrate its potential as a serious alternative to classic neuropsychological tests. Nevertheless, more research is needed in order to implement serious games that are reliable, valid, and ready to be used in the everyday clinical practice.     

Virtual reality as a patient education tool in healthcare: A scoping review

ObjectiveTo explore what is currently known about the use of virtual reality (VR) as a patient education tool in healthcare.MethodsArksey and O’Malley’s scoping review method and the PRISMA-ScR Checklist were employed. Four peer-reviewed databases were searched (Medline, Embase, PsychINFO, the Cochrane library). Pre-defined selection criteria identified 18 studies for inclusion. Results were synthesized using a narrative approach.ResultsVR as an educational tool in healthcare is feasible and acceptable, and may improve patient’s knowledge about their illness and satisfaction with treatment. Most studies used the Oculus VR glasses or headset, educated patients though the use of 3D 360° VR anatomical models, and were conducted with people affected with cancer. Opportunities exist for exploring unintended consequences, and the role of VR in educating populations with lower health literacy.ConclusionVR could assist in communicating medical information and knowledge to patients, but more research is needed, particularly to identify for whom and in what situations this method is most useful and to improve understanding about the potential unintended consequences.Practice implicationsHealth professionals should consider using VR to educate their patients, and researchers can use this as a road map on how to address knowledge gaps in this field.     

The use of virtual reality in patient education related to medical somatic treatment: A scoping review

ObjectiveTo map the available evidence on the context, content and outcome of VR in patient education in situations related to preparation for medical somatic treatment.MethodsA Scoping review. In October 2020, the Embase, CINAHL, MEDLINE and PsycINFO databases were searched with the terms ‘Virtual Reality’ and ‘Patient Education’. The literature was synthesised and mapped with a narrative approach.Results17 studies published between 2015 and 2020 were included in the qualitative synthesis.VR was applied in (paediatric) surgery and radiation therapy treatment. VR interventions were heterogeneous regarding technical applications, context of implementation, guidance by healthcare professionals and integration in education sessions. Anxiety reduction was demonstrated significantly in some studies. Patients experienced VR education useful; it enhanced understanding, improved communication with healthcare professionals and encouraged treatment compliance.ConclusionsThe application of VR in patient education is a promising technology. Patients are highly satisfied and experience enhanced understanding. VR education was not effective in reducing all anxiety, pain and stress and improving preparedness for treatment.Practice implicationsIt is important to develop VR interventions profoundly. The application of a methodological framework for VR development is recommended. Involve patients, educationalists and technology professionals in the development of technology interventions.     

Adaptive control: a review of the ability to acquire and maintain high sensorimotor performance

When the relationship which relates us to the environment through vision, often named visual mapping, is durably modified, our behaviour is altered at sensory, motor and cognitive levels. The brain has the ability through the so-called adaptive control to progressively decrease the motor errors despite visual image alteration. Adaptive control in both the visuo-manual and the vestibulo-ocular systems is reviewed. A parallel is tentatively made between adaptation to ordinary optical alterations (resulting from the use of refraction-corrective glasses) in the visual mapping of these two systems and the adaptation to more complex visuo-motor relationships experienced by people working in virtual environments.     

Image-guided,stereotactic perforator flap surgery: a prospective comparison of current techniques and review of the literature

Background  Image-guided stereotaxy is a recent advancement in imaging technology, allowing computer guidance to aid surgical planning and accuracy. Despite the use of multiple techniques for patient registration in several surgical specialities, only fiducial marker registration has been described for use in soft tissue reconstructive surgery. The current study comprises an evaluation of the current techniques available for this purpose. Methods  A cohort of nine consecutive patients planned for elective free flaps were recruited, with the first five patients (four for the abdominal wall and one anterolateral thigh donor site) undergoing fiducial marker registration with a variable number of fiducial markers in order to determine the optimal number of fiducial markers to be used. Four subsequent patients undergoing perforator flap surgery underwent registration using three available registration modalities: fiducial marker registration, surface matching pointer/landmark and surface matching laser registration. Results  For the abdominal wall, registration was not able to be achieved with five fiducial markers, and was successfully achieved in all cases with either six or seven fiducial markers. For the anterolateral thigh, registration was achieved with either nine or ten markers. The four patients who also underwent surface-landmark registration and ‘Z-touch’ laser surface matching registration all failed the registration process. Conclusion  Stereotactic navigation is a useful adjunct to the preoperative imaging of perforator flaps. Fiducial marker registration was able to be achieved in all cases, can be successfully achieved with a low and predictable number of fiducial markers, is highly accurate, and was the only reliable registration process in our experience. W. M. Rozen and A. Buckland are equal first authors. Ethical Approval : Institutional Ethical Approval was obtained through Melbourne Health HREC #2006.231.     

Roots and routes to resilience and its role in psychotherapy: a selective,attachment-informed review

Developmental research on resilience is summarised and illustrated with a case example. Self-reflection, positive relationships, and agency foster resilience in the face of adversity. Attachment and resilience are related categories. The different patterns of attachment – secure, insecure-organised and insecure-disorganised – are manifest in different patterns of resilience, depending on prevailing environmental conditions. However, the greater the environmental adversity, the less will the resilience factors emerge. Clients tend to present for psychotherapy when resilience strategies have failed. The therapeutic relationship has neurochemical and relational characteristic mirroring the secure mother–infant bond. These foster mentalising, stress innoculation, affect co-regulation, self-esteem, and agency, forming the basis for enduring and more flexible resilience strategies.     

The anatomy in relation to injury of the lateral collateral ligaments of the ankle: a current concepts review

Injuries to the lateral ligament complex of the ankle are common problems in acute care practice. We believe that a well-developed knowledge of the anatomy provides a foundation for understanding the basic mechanism of injury, diagnosis, and treatment, especially surgical treatment, of lateral collateral ankle ligament injury. To address this issue we performed this review with regard to the anatomy of the lateral collateral ankle ligaments.