Adapting to change: Clalit's response to the COVID-19 pandemic

Selection of software agile practices using Analytic hierarchy process

Context

The increasing use of software and information technology in modern society requires that the deployment of IT solutions should be more efficient and controlled. In this sense, agile methodologies are essential to achieve this goal, but a relevant question arises: Which is the right methodology for reaching that goal?

Objective

The purpose of the research was to study the prioritization of agile practices and improvement objectives in the context of software development, using the Analytic Hierarchy Process (AHP) method. For this purpose, 42 agile practices, 16 improvement objectives, 4 organizations dedicated to software development in Colombia and 40 professionals in the area of information and communication technologies in the same country were considered.

Method

ology: The methodological approach used was mixed. On the one hand, we applied a quantitative approach for the treatment of data with the AHP method and, on the other hand, a qualitative analysis by consulting experts through a digital survey to validate the prioritization of the improvement objectives. Questionpro was used as a support tool for multicriteria comparison.

Results

The main results show that applying AHP allowed us to prioritize 6 improvement objectives and 5 agile practices, where it is highlighted that the prioritization does not discard the other objects of comparison but allows us to put into practice the prioritized elements to favor their progressive implementation. The non-prioritized elements could be part of future iterations of multicriteria comparison that go hand in hand with capacity development and organizational maturity models in the context of global software development.

Conclusion

It is highlighted that, although there is evidence of the application of multi-criteria comparison methods in the software development industry, this work applies such methods in the context of four different agile methodologies, which translates into a precedent for the conformation of hybrid methodological approaches.

A collagen-based theranostic wound dressing with visual, long-lasting infection detection capability

Continuous wound monitoring is one strategy to minimise infection severity and inform prompt variations in therapeutic care following infection diagnosis. However, integration of this functionality in therapeutic wound dressings is still challenging. We hypothesised that a theranostic dressing could be realised by integrating a collagen-based wound contact layer with previously demonstrated wound healing capability, and a halochromic dye, i.e. bromothymol blue (BTB), undergoing colour change following infection-associated pH changes (pH: 5-6 ➔ >7). Two different BTB integration strategies, i.e. electrospinning and drop-casting, were pursued to introduce long-lasting visual infection detection capability through retention of BTB within the dressing. Both systems had an average BTB loading efficiency of 99 wt% and displayed a colour change within 1 min of contact with simulated wound fluid. Drop-cast samples retained up to 85 wt% of BTB after 96 h in a near-infected wound environment, in contrast to the fibre-bearing prototypes, which released over 80 wt% of BTB over the same time period. An increase in collagen denaturation temperature (DSC) and red shifts (ATR-FTIR) suggest the formation of secondary interactions between the collagen-based hydrogel and the BTB, which are attributed to count for the long-lasting dye confinement and durable dressing colour change. Given the high L929 fibroblast viability in drop-cast sample extracts (92 %, 7 days), the presented multiscale design is simple, cell- and regulatory-friendly, and compliant with industrial scale-up. This design, therefore, offers a new platform for the development of theranostic dressings enabling accelerated wound healing and prompt infection diagnosis.

Tale of two countries: attitudes towards older persons in Italy and Israel during the COVID-19 pandemic as seen through the looking-glass of the media

The COVID-19 pandemic has exposed the many challenges and difficulties of healthcare systems caring for older frail people. This public health crisis has indeed jeopardised the concept of the welfare state, in particular the right of older people to uncompromised healthcare. Together with the clinical challenges facing the geriatric patient and the organisational difficulties of the healthcare systems, sociocultural factors may have also played a substantial role in the strategies that countries have applied in coping with the pandemic. In this opinion article, we report attitudes towards the older populations of two countries, Italy and Israel, during the COVID-19 pandemic as viewed through the looking-glass of the media.

Factors Associated with Using Telemedicine in the Primary Care Clinics during the COVID-19 Pandemic in Israel

BACKGROUND

The COVID-19 pandemic generated an extraordinary need for telemedicine.

OBJECTIVE

To identify the factors and multi-way interactions associated with telemedicine use in primary healthcare during the COVID-19 pandemic.

METHODS

This population-based study included all members (2,722,773) aged ≥18 years of the largest healthcare organization in Israel who used primary care clinic services between 1 March 2020 and 31 December 2021. Individuals were classified as telemedicine users (≥1 phone/video visits or asynchronous encounters) or non-telemedicine users (only in-person encounter/s).

RESULTS

Ethnicity was the most discriminative variable associated with telemedicine use, with 85% and 52% users among Jews and Arabs, respectively. Higher odds for telemedicine utilization were observed among women, residents of urban areas, those confined to home, individuals with high level of technology literacy, residents of the central area (in Jews only), young Jews, and older Arabs. Based on decision tree analysis, the segments of the population with the lowest telemedicine use were characterized by lower primary care needs and comorbidities, as well as low technology literacy. The proportion of telemedicine use in these groups was 56% and 27% in Jews and in Arabs, respectively.

CONCLUSION

A proactive intervention program should be applied among populations who are less likely to use telemedicine in the primary care clinics, including Arabs, Jews who live in the distant periphery, and individuals with low technology literacy.

A Novel Methodology for the Synchronous Collection and Multimodal Visualization of Continuous Neurocardiovascular and Neuromuscular Physiological Data in Adults with Long COVID

Background: Reports suggest that adults with post-COVID-19 syndrome or long COVID may be affected by orthostatic intolerance syndromes, with autonomic nervous system dysfunction as a possible causal factor of neurocardiovascular instability (NCVI). Long COVID can also manifest as prolonged fatigue, which may be linked to neuromuscular function impairment (NMFI). The current clinical assessment for NCVI monitors neurocardiovascular performance upon the application of orthostatic stressors such as an active (i.e., self-induced) stand or a passive (tilt table) standing test. Lower limb muscle contractions may be important in orthostatic recovery via the skeletal muscle pump. In this study, adults with long COVID were assessed with a protocol that, in addition to the standard NCVI tests, incorporated simultaneous lower limb muscle monitoring for NMFI assessment. Methods: To conduct such an investigation, a wide range of continuous non-invasive biomedical sensing technologies were employed, including digital artery photoplethysmography for the extraction of cardiovascular signals, near-infrared spectroscopy for the extraction of regional tissue oxygenation in brain and muscle, and electromyography for assessment of timed muscle contractions in the lower limbs. Results: With the proposed methodology described and exemplified in this paper, we were able to collect relevant physiological data for the assessment of neurocardiovascular and neuromuscular functioning. We were also able to integrate signals from a variety of instruments in a synchronized fashion and visualize the interactions between different physiological signals during the combined NCVI/NMFI assessment. Multiple counts of evidence were collected, which can capture the dynamics between skeletal muscle contractions and neurocardiovascular responses. Conclusions: The proposed methodology can offer an overview of the functioning of the neurocardiovascular and neuromuscular systems in a combined NCVI/NMFI setup and is capable of conducting comparative studies with signals from multiple participants at any given time in the assessment. This could help clinicians and researchers generate and test hypotheses based on the multimodal inspection of raw data in long COVID and other cohorts.