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The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

The European Union (EU) Medical Device Regulations (MDR) 2017/745 entered into force on May 2021 with changes related to strengthening the clinical evaluation requirements, particularly for high-risk devices. This study aims to investigate the impact of these strengthened requirements on medical device manufacturers by investigating the challenges they encounter while generating an MDR-compliant clinical evaluation report.

A systematic literature review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method of peer-reviewed literature and various government jurisdictional reports and legislation.

The findings from the study understanding what constitutes sufficient clinical evidence poses the biggest challenge to the generation of an MDR-compliant clinical evaluation report. Resulting from the challenges they are facing, manufacturers of certain CE-marked medical devices are planning to remove (and have removed) devices from the EU market upon expiration of their certificate, and in the case of new and innovative devices, some manufacturers are planning to launch in other markets ahead of the EU. These challenges will lead to a potential shortage of certain medical devices in the EU and a delay in access to new devices, thereby negatively impacting patients’ quality of life.

This study provides a unique insight into the challenges currently experienced by medical device manufacturers as they transition to the MDR clinical evaluation requirements and the subsequent impact on the continued availability of medical devices in the EU. A limitation is the lack of literature analysing the regulations and their effects.

This study has both theoretical contributions in that, to the best of the authors’ knowledge, it is the first detailed and systematic review of the new MDR Regulations and has implications for practice as manufacturers and policymakers can leverage it alike to understand the challenges of the new MDR.

Despite the fact that shame is recognized as a significant factor in clinical encounters, it is under-recognized, under-researched and under-theorized in health prevention, assessment and cross-cultural contexts. Thus, this study aims to investigate the psychometric properties of the most widely used scale, the “Other as Shamer Scale” (OAS), to assess the risk and proclivities of external shame in adults. As in health care, there is a barrier between what is known through research in one culture and what is acceptable in practice in another culture.

The Urdu version was prepared using the standard back-translation method, and the study was conducted from June 2021 to January 2022. The translation and adaptation were completed in four steps: forward translation, adaptation and translation, back translation, committee approach and cross-language validation. The sample, selected through the purposive sampling method, is comprised of 200 adults (men = 100 and women = 100), with an age range of 18–60 years (M = 28, SD = 5.5), spanning all stages of life. The Cronbach's alpha reliability and factorial validity of the OAS were assessed through confirmatory factor analysis and Pearson correlation analyses. Internal consistency and test–retest reliability (at a two-week interval) were used to evaluate the reliability. Statistical analyses were performed using Statistical Package for Social Sciences (version 22) software.

Preliminary analysis revealed that the overall instrument had good internal consistency (Urdu OAS a = 0.91; English OAS a = 0.92) as well as test–retest correlation coefficients for 15 days (r = 0.88). The factor loading of all items ranged from 0.69 to 0.9, which explained the significant level and indicated the model's overall goodness of fit.

Findings suggest that this scale has significant psychometric properties and the potential to be used as a valid, reliable and cost-effective clinical and research instrument. This study contributes to scientific knowledge and helps to develop and test indigenous cross-cultural instruments that can be used to examine external shame in Pakistani people.

By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

This case study sought to investigate the relationship between pre-service teachers’ participation in designing and delivering one-on-one literacy intervention lessons to beginning readers and their own evolving self-efficacy in literacy instruction.

The study was embedded within a 4000-level course in the elementary education major where pre-service teachers learn to administer, analyze and interpret a variety of literacy assessments. Based on the results of these assessments, pre-service teachers designed and implemented literacy lessons (twice a week, 30-min sessions) that addressed the beginning readers' specific instructional needs. Through collecting pre/post data with their first-grade intervention students, and participating in reflective “check-ins” (surveys, a focus group and end-of-course written reflection), a portrait of increased pre-service teacher self-efficacy in literacy instruction comes into focus.

The data showed, primarily through the thematic analysis of qualitative data, that the experience of conducting a one-on-one intervention with a striving reader impacted pre-service teachers’ self-efficacy positively.

The methodology of this study was limited by the small sample size and the low participant response rate on the quantitative survey measure.

This paper highlights one aspect in which clinically-rich field experiences can make a difference in the literacy instruction self-efficacy of pre-service teachers.

This study adds to the support for authentic instructional applications of course content in educator preparation programs, specifically in Professional Development School (partner school system) contexts. The aspect of observing and measuring intervention student progress was one lens through which pre-service teachers viewed their efficacy. Further investigations focusing on other assessment-instruction cycles could provide additional insights.

This study aims to examine the influence of brand awareness on brand equity with the mediating role of brand association and perceived quality.

This research is applied in terms of the objective and descriptive survey in terms of methodology because its objective is to describe the studied conditions or phenomena and also the relationship between research variables that have been conducted in the field method.

The results explained that 53% of respondents are female and 47% of respondents are male. Most respondents are between 30 and 40 years old, and the youngest respondents are less than 30 years old. Most respondents were specialists, and the 134 respondents were subspecialists. The results explained that the significance level of the Kolmogorov–Smirnov test for research variables is less than 0.05 and has an abnormal distribution. The abnormality of the data in this study directed the authors to use PLS software to analyze the data.

To the best of the authors’ knowledge, it is the first time that research is prepared to study the impact of these marketing parameters on dentists’ prescription behavior.

The purpose of this paper is to understand the customer sentiment towards telemedicine apps and also to apply machine learning algorithms to analyse the sentiments in the adoption during the COVID-19 pandemic.

Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like support vector machine (SVM) and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix.

The paper explores the customer sentiment towards telemedicine apps and their adoption during the COVID-19 pandemic. Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like SVM and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix. The customers who used telemedicine apps have positive sentiment as well as negative sentiment towards the telemedicine apps. Some of the customers have concerns about the medicines delivered, their delivery time, the quality of service and other technical difficulties. Even a small percentage of doctors feel uncomfortable in online consultation through the application.

The primary value of this paper lies in providing an overview of the customers’ approach towards the telemedicine apps, especially during the COVID-19 pandemic.

In the present era, digital technology can be used responsibly to provide developed and developing countries with high-quality health-care services to nations. This study aims to explore Saudi Arabia’s intentions to adopt digital health-care practices.

To be consistent with previous studies, this study used a quantitative methodology to collect the data from health-care professionals working in Saudi Arabia’s public and private health institutes. Consequently, this study’s findings are based on 306 valid samples.

On the one hand, the path analysis reveals that health-care professionals believe in perceptions relating to the use of e-health and technology (PEHT) and experiences regarding internet use (ERIU) and that these have positive and significant effects on attitudes toward the use of e-health and technology (ATEHT) and intentions to use e-health services (ITUES). On the other hand, barriers to using e-health (BUEH) negatively impact ATEHT and ITUES. Finally, ATEHT also has a positive and significant effect on ITUES.

This study’s findings will help Saudi Arabia’s policymakers and the country’s health ministry to develop policies to provide e-services that health-care professionals can use to improve the quality of the country’s health care, patients’ human rights and social care. Furthermore, this study’s findings are helpful in developing attitudes and intentions toward either e-health or digital health to provide better health facilities to serve Saudi Arabia’s citizens.

This study empirically confirms among Saudi Arabia’s health-care professionals the PEHT, ERIU and BUEH toward ATEHT and ITUES.

With the soaring rise in popularity of social media platforms in recent decades, the use of website posts for the expression of work-related views has also increased. Despite websites being extensively used, there has been no examination of the views and concerns expressed by frontline workers through website posts. The present research aims to contribute to the “voice literature” first by evaluating how frontline workers utilize anonymous media platforms to express their views and work-related concerns and, second, by demonstrating how anonymous voice systems can encourage frontline health workers in providing feedback and dissatisfaction.

The study utilizes the thematic analysis method to analyze the content of posts by psychologists on a collaborative consultation website administrated by Israel’s Ministry of Health, discussing their perceptions of work-related concerns.

The analysis identified three work-related themes through the employees' voices. These include insufficient support from management, conflicts and excessive occupational demands. The workers expressed their apprehension with regard to organizational pressures, deficient budget allocations, excessive workloads, lack of recognition and work–life imbalances.

The application of thematic analysis method to anonymous open-public data should be viewed as an effective, affordable, genuine and unique research method for data analysis. Anonymous platforms can generate unique insights that may not be possible through traditional means. This can provide practitioners with a comprehensive understanding of various issues and challenges and be a useful tool for identifying shortcomings within health settings.

This study aims to study the distribution characteristics of antibiotic resistance in direct-eating food and analysis of Citrobacter freundii genome and pathogenicity. Residual antibiotics and antibiotic resistance genes (ARGs) in the environment severely threaten human health and the ecological environment. The diseases caused by foodborne pathogenic bacteria are increasing daily, and the enhancement of antibiotic resistance of pathogenic bacteria poses many difficulties in the treatment of disease.

In this study, six fresh fruits and vegetable samples were selected for isolation and identification of culturable bacteria and analysis of antibiotic resistance. The whole genome of Citrobacter freundii isolated from cucumber was sequenced and analyzed by Oxford Nanopore sequencing.

The results show that 270 strains of bacteria were identified in 6 samples. From 12 samples of direct food, 2 kinds of probiotics and 10 kinds of opportunistic pathogens were screened. The proportion of Citrobacter freundii screened from cucumber was significantly higher than that from other samples, and it showed resistance to a variety of antibiotics. Whole genome sequencing showed that Citrobacter freundii was composed of a circular chromosome containing signal peptides, transmembrane proteins and transporters that could induce antibiotic efflux, indicating that Citrobacter freundii had strong adaptability to the environment. The detection of genes encoding carbohydrate active enzymes is more beneficial to the growth and reproduction of Citrobacter freundii in crops. A total of 29 kinds of ARGs were detected in Citrobacter freundii, mainly conferring resistance to fluoroquinolones, aminoglycosides, carbapenem, cephalosporins and macrolides. The main mechanisms are the change in antibiotic targets and efflux pumps, the change in cell permeability and the inactivation of antibiotics and the detection of virulence factors and ARGs, further indicating the serious risk to human health.

The detection of genomic islands and prophages increases the risk of horizontal transfer of virulence factors and ARGs, which spreads the drug resistance of bacteria and pathogenic bacteria more widely.