We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Inadequate recruitment and retention impede clinical trial goals. Emerging decentralized clinical trials (DCTs) leveraging digital health technologies (DHTs) for remote recruitment and data collection aim to address barriers to participation in traditional trials. The ACTIV-6 trial is a DCT using DHTs, but participants’ experiences of such trials remain largely unknown. This study explored participants’ perspectives of the ACTIV-6 DCT that tested outpatient COVID-19 therapeutics.
Methods:
Participants in the ACTIV-6 study were recruited via email to share their day-to-day trial experiences during 1-hour virtual focus groups. Two human factors researchers guided group discussions through a semi-structured script that probed expectations and perceptions of study activities. Qualitative data analysis was conducted using a grounded theory approach with open coding to identify key themes.
Results:
Twenty-eight ACTIV-6 study participants aged 30+ years completed a virtual focus group including 1–4 participants each. Analysis yielded three major themes: perceptions of the DCT experience, study activity engagement, and trust. Participants perceived the use of remote DCT procedures supported by DHTs as an acceptable and efficient method of organizing and tracking study activities, communicating with study personnel, and managing study medications at home. Use of social media was effective in supporting geographically dispersed participant recruitment but also raised issues with trust and study legitimacy.
Conclusions:
While participants in this qualitative study viewed the DCT-with-DHT approach as reasonably efficient and engaging, they also identified challenges to address. Understanding facilitators and barriers to DCT participation and DHT interaction can help improve future research design.
Estimation of intravascular volume status by clinical examination and static measurements such as central venous pressure and pulmonary capillary wedge pressure do not predict fluid responsiveness. Current evidence indicates that dynamic monitoring of arterial pressure and derived indices are the most sensitive and specific means of determining fluid responsiveness, especially in mechanically ventilated patients. Several monitors that automate and embellish this approach, a few of which are noninvasive, are now commercially available and they are gradually being incorporated into intensive and perioperative care practice. This chapter reviews the physiologic underpinnings of how and why the arterial pressure waveform can be used to determine fluid responsiveness and gives an overview of the devices incorporating these principles.
During panendoscopy, the anesthesiologist and surgeon must share the airway, with different objectives. The anesthesiologist must deliver oxygen, remove carbon dioxide, provide anesthesia and protect the airway from soiling or aspiration. The surgeon requires an immobile, unobstructed surgical field and adequate time for diagnostic evaluation and intervention. Some patients requiring panendoscopy will present with critical airway obstruction and in these circumstances the safest approach is to proceed to elective tracheostomy under local anesthesia prior to any further endoscopic evaluation. Ventilation techniques can be considered in terms of open and closed systems. A closed system implies ventilation via a cuffed endotracheal tube (ETT). An open system without an ETT is more commonly used for panendoscopy. Panendoscopy is a brief yet highly stimulating procedure that requires deep anesthesia, obtunded hemodynamic reflexes, an immobile surgical field and rapid emergence with early return of protective airway reflexes.
This chapter addresses the issue of how specific educational events are remembered, and how they influence the lives of college students and alumni. Mainstream psychological and educational researchers have rarely looked at the impact of specific college events on students. Rather, research has focused on learning and retention of course content, as assessed by exams, written assignments, standardized tests, and graduation rates. Acquiring general knowledge is seen as paramount, not remembering the specifics of how or when the knowledge was acquired. Endel Tulving (1983, p. 51), perhaps the world's leading authority on episodic memory, stated that “children and people of all ages go to school in order to learn skills and knowledges that they need for life. They do not go to school in order to acquire a storehouse of temporally dated personal memories.”
Educational psychologists are not alone in their neglect of the specific. The primary focus in educational research on general rather than episodic learning is consistent with dominant research strategies in cognitive psychology. Tulving (1983) commented that episodic memory “has received little direct attention from psychologists or other scientists” (p. 1), and that “experiments done in the past can be interpreted as episodic- rather than semantic-memory experiments … but they were not designed as part of a grand plan to understand how people remember personal experiences” (p. 129). This situation is changing. Once one accepts the idea that people's subjective experience of memory, and the belief systems associated with memory, are topics worthy of study in their own right, then research can address areas of personal experience for which controlled experimentation is not possible.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.