| 1. |
- Andersson, Ewa K., 1972-, et al.
(author)
-
Self-Reported eHealth literacy among nursing students in Sweden and Poland : The eNursEd cross-sectional multicentre study
- 2023
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 29:4
-
Journal article (peer-reviewed)abstract
- This study aimed to provide an understanding of nursing students’ self-reported eHealth literacy in Sweden and Poland. This cross-sectional multicentre study collected data via a questionnaire in three universities in Sweden and Poland. Descriptive statistics, the Spearman’s Rank Correlation Coefficient, Mann–Whitney U, and Kruskal–Wallis tests were used to analyse different data types. Age (in the Polish sample), semester, perceived computer or laptop skills, and frequency of health-related Internet searches were associated with eHealth literacy. No gender differences were evidenced in regard to the eHealth literacy. Regarding attitudes about eHealth, students generally agreed on the importance of eHealth and technical aspects of their education. The importance of integrating eHealth literacy skills in the curricula and the need to encourage the improvement of these skills for both students and personnel are highlighted, as is the importance of identifying students with lacking computer skills.
|
|
| 2. |
- Aryana, Bijan, 1980, et al.
(author)
-
Design for mobile mental health: Exploring the informed participation approach
- 2020
-
In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 26:2, s. 1208-1224
-
Journal article (peer-reviewed)abstract
- Mobile applications (apps) have the potential to improve mental health services. However, there is limited evidence of efficacy or responsiveness to user needs for existing apps. A lack of design methods has contributed to this issue. Developers view mental health apps as stand-alone products and dismiss the complex context of use. Participatory design, particularly an informed participation approach, has potential to improve the design of mental health apps. In this study, we worked with young mobile users and mental health practitioners to examine the informed participation approach for designing apps. Using auto-ethnography and a set of design workshops, the project focused on eliciting design requirements as a factor for successful implementation. We compared resultant ideas and designs with existing apps. Many user requirements revealed were absent in existing apps, suggesting potential advantages to informed participation. The observation of the process, however, showed challenges in engagement that need to be overcome.
|
|
| 3. |
- Golay, Diane, 1992-, et al.
(author)
-
Information Technology Use and Tasks Left Undone by Nursing Staff : A Qualitative Analysis
- 2023
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 29:4, s. 1-10
-
Journal article (peer-reviewed)abstract
- Nursing staff perceive information technology (IT) as time-consuming and impinging on direct patient care time. Despite this, researchers have directed little attention toward the interplay between IT use and tasks left undone by nursing staff. In this paper, we analyze interview and focus group data on hospital nursing staff’s experience working with IT to identify ways IT use interacts with tasks left undone. We found that tasks left undone by nursing staff can have IT-related antecedents and that IT-related tasks are also sometimes left undone. This analysis adds to the body of knowledge by showing that tasks related to the work environment and IT can be left undone and that nursing staff avoid certain IT-supported tasks because they do not know how to do them or why they ought to be done. These findings form the basis for our call for further research on the topic.
|
|
| 4. |
- Hjelm, Katarina, 1958-, et al.
(author)
-
Internet-of-Things (IoT) in healthcare and social services – Experiences of a sensor system for notifications of deviant behaviours in the home from the users’ perspective.
- 2022
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 28:1
-
Journal article (peer-reviewed)abstract
- Studies on use of IT in residential care are limited; thus, there is a need for investigations to understand both older people's and nursing staff's perspectives on experiences of new technology. 'Smart homes' provide home automation solutions, making life easier for those residing there. The aim was to explore, from the users' perspective, experiences of a sensor system installed in the home. The sensors are meant to provide notifications of deviations in behaviours or routines by the resident, requiring healthcare staff or relatives to do a supervisory visit. The sensor notification system made the users feel secure by being monitored, having control over the situation, and allowing them to become more independent in their daily lives; furthermore, they emphasised the importance of having well-functioning systems. Further development of the technology and use, in co-creation with the users, is needed. Careful preparation in installing/starting the system and repeated information about its aim are needed.
|
|
| 5. |
- Jacobsson, Martin, 1976-, et al.
(author)
-
The role of compression in large scale data transfer and storage of typical biomedical signals at hospitals
- 2023
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 29:4
-
Journal article (peer-reviewed)abstract
- In modern hospitals, monitoring patients’ vital signs and other biomedical signals is standard practice. With the advent of data-driven healthcare, Internet of medical things, wearable technologies, and machine learning, we expect this to accelerate and to be used in new and promising ways, including early warning systems and precision diagnostics. Hence, we see an ever-increasing need for retrieving, storing, and managing the large amount of biomedical signal data generated. The popularity of standards, such as HL7 FHIR for interoperability and data transfer, have also resulted in their use as a data storage model, which is inefficient. This article raises concern about the inefficiency of using FHIR for storage of biomedical signals and instead highlights the possibility of a sustainable storage based on data compression. Most reported efforts have focused on ECG signals; however, many other typical biomedical signals are understudied. In this article, we are considering arterial blood pressure, photoplethysmography, and respiration. We focus on simple lossless compression with low implementation complexity, low compression delay, and good compression ratios suitable for wide adoption. Our results show that it is easy to obtain a compression ratio of 2.7:1 for arterial blood pressure, 2.9:1 for photoplethysmography, and 4.1:1 for respiration.
|
|
| 6. |
- Lincke, Alisa, 1989-, et al.
(author)
-
A comparative study of the 2D- and 3D-based skeleton avatar technology for assessing physical activity and functioning among healthy older adults
- 2023
-
In: Health Informatics Journal. - : SAGE Open. - 1460-4582 .- 1741-2811. ; 29:4
-
Journal article (peer-reviewed)abstract
- Background: Maintaining physical activity (PA) and functioning (mobility, balance) is essential for older adults’ well-being and quality of life. However, current methods (functional tests, self-reports) and available techniques (accelerometers, sensors, advanced movement analysis systems) for assessing physical activity and functioning have shown to be less reliable, time- and resource-consuming with limited routine usage in clinical practice. There is a need to simplify the assessment of physical activity and functioning among older adults both in health care and clinical studies. This work presents a study on using Skeleton Avatar Technology (SAT) for this assessment. SAT analyzes human movement videos using artificial intelligence (AI). The study compares handy SAT based on 2D camera technology (2D SAT) with previously studied 3D SAT for assessing physical activity and functioning in older adults. Objective: To explore whether 2D SAT yields accurate results in physical activity and functioning assessment in healthy older adults, statistically compared to the accuracy of 3D SAT. Method: The mobile pose estimation model provided by Tensorflow was used to extract 2D skeletons from the video recordings of functional test movements. Deep neural networks were used to predict the outcomes of functional tests (FT), expert-based movement quality assessment (EA), accelerometer-based assessments (AC), and self-assessments of PA (SA). To compare the accuracy with 3D SAT models, statistical analysis was used to test whether the difference in the predictions between 2D and 3D models is significant or not. Results: Overall, the accuracy of 2D SAT is lower than 3D SAT in predicting FTs and EA. 2D SAT was able to predict AC with 7% Mean Absolute Error (MAE), and self-assessed PA (SA) with 16% MAE. On average MAE was 4% higher for 2D than for 3D SAT. There was no significant difference found between the 2D and the 3D model for AC and for two FTs (30 seconds chair stand test, 30sCST and Timed up and go, TUG). A significant difference was found for the 2D- and 3D-model of another FT (4-stage balance test, 4SBT). Conclusion: Altogether, the results show that handy 2D SAT might be used for assessing physical activity in older adults without a significant loss of accuracy compared to time-consuming standard tests and to bulky 3D SAT-based assessments. However, the accuracy of 2D SAT in assessing physical functioning should be improved. Taken together, this study shows promising results to use 2D SAT for assessing physical activity in healthy older adults in future clinical studies and clinical practice.
|
|
| 7. |
- Lindberg, Terese, et al.
(author)
-
Older persons' experience of eHealth services in home health care : A meta-ethnography eHealth services in home health care
- 2021
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:4
-
Journal article (peer-reviewed)abstract
- This study aimed to describe older persons' experiences of eHealth services in home health care. A meta-ethnographic approach was applied, and a systematic literature search was conducted in three databases. In total, 11 articles were included and analysed, which resulted in two themes and six sub-themes. The results show that for older persons to use the eHealth services, they must provide some additional value compared to current contacts with healthcare professionals. Those with regular healthcare contact do not experience the eHealth service as adding anything to the care they already receive. The introduction of eHealth services involves learning how to use the new technology, and some older persons experience the technology as motivating and inspiring. The eHealth service makes some feel safer while some do not trust the technology. In order to make the best use of eHealth services, it is important that the services are adjusted not only to each person's needs but also to their personal capabilities and resources, while the older person must feel valued as an active partner in the care process. Thus, when using eHealth services, the older person's perspective needs to be given priority and decisions should not only be based on organizational considerations.
|
|
| 8. |
- Moll, Jonas, 1982-, et al.
(author)
-
Oncology health-care professionals' perceived effects of patient accessible electronic health records 6 years after launch : A survey study at a major university hospital in Sweden
- 2020
-
In: Health Informatics Journal. - : Sheffield Academic Press. - 1460-4582 .- 1741-2811. ; 26:2, s. 1392-1403
-
Journal article (peer-reviewed)abstract
- Patient accessible electronic health records have been launched in many countries, and generally, health-care professionals have had strong initial concerns related to the areas patient contact, documentation practices and quality of care. Especially, oncology care was discussed in media when launching patient accessible electronic health records in Sweden. However, few studies have investigated clinician-perceived effects several years after the launch. A survey covering these areas, as well as supposed effects for patients, was distributed to oncology health-care professionals 6 years after the launch of patient accessible electronic health records and answered by N = 176. Results show that patient accessible electronic health records have had small effects within the covered areas, and that the area most affected was documentation practices. Very few significant differences could be found between physicians and nurses. A comparison with results from interviews and surveys conducted shortly after the launch of patient accessible electronic health records clearly indicates that the experienced negative effects are not as big as originally feared.
|
|
| 9. |
- Möller U, Olsson, et al.
(author)
-
Modern technology against falls – A description of the MoTFall project
- 2021
-
In: Health Informatics Journal. - : SAGE Publications Ltd. - 1460-4582 .- 1741-2811. ; 27:2
-
Journal article (peer-reviewed)abstract
- To meet future challenges from an older and physically less active population innovative solutions are needed. Modern Technology against Falls (MoTFall) aims to prevent falls, increase physical activity and improve self-rated health among older people by means of an information and communication technology based system. The project has developed technology-based solutions, focusing on person-centred care. A participatory research design was applied in the development of a mobile application, a wearable inertial movement measurement unit (IMMU), called the Snubblometer (‘snubbla’ is ‘stumble’ in Swedish) and a web-based education programme for health care professionals. The mobile application includes a fall risk index, exercises and information related to falls prevention. By linking the app to the IMMU, person-centred interventions can be developed and implemented in various health care settings and with different target populations. The IMMU has shown good validity and reliability for measuring postural sway and high sensitivity and specificity for measuring a near fall. The education programme is directed at non-graduate health care professionals in nursing homes and home care. The technical solutions have potential for use in research and in clinical practice. © The Author(s) 2021.
|
|
| 10. |
- Nurgalieva, Leysan, et al.
(author)
-
‘I do not share it with others. No, it’s for me, it’s my care’ : On sharing of patient accessible electronic health records
- 2020
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:4, s. 2554-2567
-
Journal article (peer-reviewed)abstract
- This study explores patients’ perspectives on sharing their personal health data, which is traditionally shared through discussions with peers and relatives. However, other possibilities for sharing have emerged through the introduction of online services such as Patient Accessible Electronic Health Records (PAEHR). In this article, we investigate strategies that patients adopt in sharing their PAEHR. Data were collected through a survey with 2587 patients and through 15 semi-structured interviews with cancer patients. Results show that surprisingly few patients share their information, and that older patients and patients with lower educational levels share more frequently. A large majority of patients trust the security of the system when sharing despite the high sensitivity of health information. Finally, we discuss the design implications addressing identified problems when sharing PAEHR, as well as security and privacy issues connected to sharing.
|
|
| 11. |
- Olsson Möller, Ulrika, et al.
(author)
-
Modern technology against falls : A description of the MoTFall project
- 2021
-
In: Health Informatics Journal. - 1460-4582 .- 1741-2811. ; 27:2, s. 1-10
-
Journal article (peer-reviewed)abstract
- To meet future challenges from an older and physically less active population innovative solutions are needed. Modern Technology against Falls (MoTFall) aims to prevent falls, increase physical activity and improve self-rated health among older people by means of an information and communication technology based system. The project has developed technology-based solutions, focusing on person-centred care. A participatory research design was applied in the development of a mobile application, a wearable inertial movement measurement unit (IMMU), called the Snubblometer ('snubbla' is 'stumble' in Swedish) and a web-based education programme for health care professionals. The mobile application includes a fall risk index, exercises and information related to falls prevention. By linking the app to the IMMU, person-centred interventions can be developed and implemented in various health care settings and with different target populations. The IMMU has shown good validity and reliability for measuring postural sway and high sensitivity and specificity for measuring a near fall. The education programme is directed at non-graduate health care professionals in nursing homes and home care. The technical solutions have potential for use in research and in clinical practice.
|
|
| 12. |
- Peng, Cong, et al.
(author)
-
A literature review of current technologies on health data integration for patient-centered health management
- 2020
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:3, s. 1926-1951
-
Research review (peer-reviewed)abstract
- Health data integration enables a collaborative utilization of data across different systems. It not only provides a comprehensive view of a patient’s health but can also potentially cope with challenges faced by the current healthcare system. In this literature review, we investigated the existing work on heterogeneous health data integration as well as the methods of utilizing the integrated health data. Our search was narrowed down to 32 articles for analysis. The integration approaches in the reviewed articles were classified into three classifications, and the utilization approaches were classified into five classifications. The topic of health data integration is still under debate and problems are far from being resolved. This review suggests the need for a more efficient way to invoke the various services for aggregating health data, as well as a more effective way to integrate the aggregated health data for supporting collaborative utilization. We have found that the combination of Web Application Programming Interface and Semantic Web technologies has the potential to cope with the challenges based on our analysis of the review result.
|
|
| 13. |
- Qvarfordt, Maria, 1982-, et al.
(author)
-
Web-based education of the elderly improves drug utilization literacy : a randomized controlled trial
- 2021
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:1, s. 1-15
-
Journal article (peer-reviewed)abstract
- The aim of this study was to explore the effects of web-based education in the field of drug utilization on elderly individuals’ knowledge of, concerns about and self-assessed understanding of drug utilization. The 260 included participants were randomized to a control group or an intervention group. To assess drug utilization literacy, we used a questionnaire containing 20 multiple-choice questions on drug utilization and ten statements about drug utilization (to which participants graded their response using a Likert scale: two about common concerns and eight about their self-assessed understanding of drug utilization). The Beliefs about Medicines Questionnaire-General was also used. The intervention group scored higher on the knowledge questions (p < 0.001) and on six of the eight statements about self-assessed understanding of drug utilization at the first check after 2 weeks (p < 0.05). At a second check 6 months later, the difference remained for the knowledge questions, but there was no difference in self-assessed understanding of drug utilization between the groups. There were no differences in the concerns about drug utilization or beliefs about medication at any time. We conclude that a web-based education can improve drug utilization literacy in elderly individuals and might contribute to the safer use of medications.
|
|
| 14. |
- Rahman Jabin, MD Shafiqur, et al.
(author)
-
Characterizing healthcare incidents in Sweden related to health information technology affecting care management of multiple patients
- 2022
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 28:2
-
Journal article (peer-reviewed)abstract
- This study aimed to examine health information technology-related incidents and identify risks associated with multiple patients' management. Sources of information comprised interviews with healthcare professionals and three small sets of local voluntary incident reports using two sampling strategies, purposive and snowball sampling. Incident reports, in the form of free-text narratives, were aggregated for analysis using the Health Information Technology Classification System and thematic analysis. Of 95 incidents, 176 issues were identified, comprising 77% (n=136) technical issues, and 23% (n=40) use or human-related issues. Human issues were over two times more likely to harm patients (OR 2.25, 95% CI 1.01 - 4.98) than technical issues. Incidents that affected multiple patients' care accounted for 70% (n=66) of the total sample, and large-scale events comprised 39% (n=26) of the incidents that affected multiple patients' care. Systematically identifying and characterizing such incidents should be prioritized for health information technology implementations.
|
|
| 15. |
- Rexhepi, Hanife, 1984-, et al.
(author)
-
Cancer patients’ information seeking behavior related to online electronic healthcare records
- 2021
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:3, s. 1-12
-
Journal article (peer-reviewed)abstract
- Patients’ online access to their EHR together with the rapid proliferation of medical information on the Internet has changed how patients use information to learn about their health. Patients’ tendency to turn to the Internet to find information about their health and care is well-documented. However, little is known about patients’ information seeking behavior when using online EHRs. By using information horizons as an analytical tool this paper aims to investigate the information behavior of cancer patients who have chosen to view their EHRs (readers) and to those who have not made that option (non-readers). Thirty interviews were conducted with patients. Based on information horizons, it seems that non-reading is associated with living in a narrower information world in comparison to readers. The findings do not suggest that the smallness would be a result of active avoidance of information, or that it would be counterproductive for the patients. The findings suggest, however, that EHRs would benefit from comprehensive linking to authoritative health information sources to help users to understand their contents. In parallel, healthcare professionals should be more aware of their personal role as a key source of health information to those who choose not to read their EHRs.
|
|
| 16. |
- Rexhepi, Hanife, 1984-, et al.
(author)
-
Do you want to receive bad news through your patient accessible electronic health record? : A national survey on receiving bad news in an era of digital health
- 2021
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:3
-
Journal article (peer-reviewed)abstract
- Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patient’s preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of, for example medical diagnosis, age and educational level. This study, based on a national patient survey in Sweden (N = 2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women (p = 0.001), and the same goes for those who are not working/have worked in healthcare (p = 0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.
|
|
| 17. |
- Rexhepi, Hanife, 1984-, et al.
(author)
-
Online electronic healthcare records : Comparing the views of cancer patients and others
- 2020
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:4, s. 2915-2929
-
Journal article (peer-reviewed)abstract
- This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.
|
|
| 18. |
- Smeulders, Bart, et al.
(author)
-
Data and Optimization Requirements for Kidney Exchange Programs
- 2021
-
In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 27:2
-
Journal article (peer-reviewed)abstract
- Kidney Exchange Programs (KEP) are valuable tools to increase the options of living donor kidney transplantation for patients with end-stage kidney disease with an immunologically incompatible live donor. Maximising the benefits of a KEP requires an information system to manage data and to optimise transplants. The data input specifications of the systems that relate to key information on blood group and Human Leukocyte Antigen (HLA) types and HLA antibodies are crucial in order to maximise the number of identified matched pairs while minimising the risk of match failures due to unanticipated positive crossmatches. Based on a survey of eight national and one transnational kidney exchange program, we discuss data requirements for running a KEP. We note large variations in the data recorded by different KEPs, reflecting varying medical practices. Furthermore, we describe how the information system supports decision making throughout these kidney exchange programs.
|
|
| 19. |
- Stathakarou, N., et al.
(author)
-
Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?
- 2021
-
In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 27:4
-
Journal article (peer-reviewed)abstract
- Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams' competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.
|
|
| 20. |
- Stevenson-Ågren, Jean, Senior lecturer, et al.
(author)
-
User-centred iterative design to develop an evidence-based communication application for maternity care
- 2021
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:2
-
Journal article (peer-reviewed)abstract
- A record number of immigrants, many Arabic speaking, arrived in Sweden during the years 2015/2016. Immigrant women have a higher risk of pregnancy complications than native European women and cultural and communicative problems have been identified as a cause of such disparities. Maternity services are under pressure because of language and cultural barriers. Language translation programmes are sometimes used but these are not evidence-based so are not considered safe for use in maternity care. The aim of this research was to create an evidence-based app for communication with Arabic-speaking women in maternity care. User-centred iterative design was used to develop an evidence-based, fit-for-purpose app. Data were collected from midwives in a focus group interview, field observations and workshops. The iterative approach resulted in an evidence-based prototype that is currently being tested in the field.
|
|
| 21. |
- Sönnerfors, Pernilla, et al.
(author)
-
Use of an eHealth tool for exercise training and online contact in people with severe chronic obstructive pulmonary disease on long-term oxygen treatment : A feasibility study
- 2020
-
In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:4, s. 3184-3200
-
Journal article (peer-reviewed)abstract
- Technology developments and demand for flexibility in health care and in contact with the health care system are two factors leading to increased use of eHealth solutions. The use of eHealth has been shown to have positive effects in people with chronic obstructive pulmonary disease, but the full potential for this group needs to be explored. Therefore, the aim was to evaluate the feasibility of an eHealth tool used for exercise training and online contacts for people with severe chronic obstructive pulmonary disease. The 10-week intervention included an eHealth tool for exercise training in home environment and regular online contacts, as well as weekly e-rounds for health care professionals. Seven of the nine participants completed the study. The eHealth tool was found to be feasible for e-rounds, exercise training and online contacts. Participants could manage the tool and adhere to training; positive effects were shown, and no adverse events occurred. Technical functions need to be improved.
|
|
| 22. |
|
|
| 23. |
|
|
