Background Mobile devices such as smartphones, tablets, and laptop computers enable users to search for information and communicate with others at any place and any time. Such devices are increasingly being used at universities for teaching and learning. The use of mobile devices by students depends, among others, on the individual media literacy level and the curricular framework. Objective The objective of this study was to explore whether there were differences in media use in students from various curricula at the Faculty of Health, Witten/Herdecke University. Methods During the 2015-16 winter term, a survey was conducted at the Faculty of Health, Witten/Herdecke University, in which a total of 705 students (out of 1091 students; response rate: 705/1091, 64.61%) from 4 schools participated voluntarily: medicine (346/598), dentistry (171/204), psychology (142/243), and nursing science (46/46). The questionnaire developed for the study included 132 questions on 4 topics: (1) electronic and mobile devices (19 questions), (2) communication and organization of learning (45 questions), (3) apps/programs/websites/media (34 questions), and (4) media literacy (34 questions). The questionnaire was distributed and anonymously completed during in-class courses. Results Students from all 4 schools had at least two electronic devices, with smartphones (97.4%, 687/705) and laptops (94.8%, 669/705) being the most common ones. Students agreed that electronic devices enabled them to effectively structure the learning process (mean 3.16, SD 0.62) and shared the opinion that university teaching should include imparting media literacy (mean 2.84, SD 0.84). Electronic device ownership was the highest among medical students (mean 2.68, SD 0.86) and medical students were the only ones to use a tutorial (36.1%, 125/346). Dental students most widely used text messages (mean 3.41, SD 0.49) and social media (mean 2.57, SD 1.10) to organize learning. Psychology students considered mobile devices to be most ineffective (mean 2.81, SD 0.83). Nursing science students used emails (mean 3.47, SD 0.73) and desktop computers (39%, 18/46) most widely. Conclusions The results show that almost all students use electronic learning (e-learning) tools. At the same time, different profiles for different degree programs become apparent, which are to be attributed to not only the varying curricula and courses but also to the life circumstances of different age groups. Universities should, therefore, pay attention to the diverse user patterns and media literacy levels of students when planning courses to enable successful use of e-learning methods.

Background Nonadherence to medication is a driver of morbidity and mortality, and complex medication regimens in patients with chronic diseases foster the problem. Digital technology might help, but despite numerous solutions being developed, none are currently widely used, and acceptance rates remain low, especially among the elderly. Objective This study aimed to better understand and operationalize how new digital solutions can be evaluated. Particularly, the goal was to identify factors that help digital approaches targeting adherence to become more widely accepted. Methods A qualitative study using a conceptual grounded theory approach was conducted. We included patients aged 65 years and older who routinely took new oral anticoagulants. To generate theses about the digital competencies of the target group with daily medication intake, face-to-face interviews were conducted, recorded, and anonymized. After coding the interviews, categories were generated, discussed, and combined with several theses until saturation of the statements was reached. Results The methodological approach led to the finding that after interviews in 20 of 77 potentially available patients, a saturation of statements was reached. The average patient’s age was 75 years, and 50% (10/20) of the subjects were female. The data identified five main coding categories—Diseases and medicine, Technology, Autonomy, Patient narrative, and Attitude toward technologies—each including positive and negative subcategories. Main categories and subcategories were summarized as Adherence Radar, which can be considered as a framework to assess the potential of adherence solutions in the process of prototyping and can be applied to all adherence tools in a holistic manner. Conclusions The Adherence Radar can be used to increase the acceptance rate of digital solutions targeting adherence. For a patient-centric design, an app should be adapted to the individual patient’s needs. According to our results, this application should be based on gender and educational background as well as the individual physician-patient relationship. If used in a proper, individualized manner, digital adherence solutions could become a new cornerstone for the treatment of chronically ill individuals.

Background Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. Objective In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. Methods In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. Results The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. Conclusions The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.

Background We evaluated the hydrostatic pressure of the renal pelvis (RPP) as a radiation-free alternative to fluoroscopic nephrostogram to assess ureteral patency after percutaneous nephrolithotomy (PCNL). Methods Retrospective non-inferiority study analyzing 248 PCNL-patients (86 female (35%) and 162 males (65%)) between 2007 and 2015. Postoperatively, RPP was measured using a central venous pressure manometer in cmH2O. The primary endpoint was to assess RPP depending on the patency of the ureter and the nephrostomy tube removal. Secondary, the upper limit of normal RPP of $$\le$$ ≤ 20 cmH2O was assessed as an indicator of an unobstructed patency. Results The median procedure duration was 141 min (112–171.5) with a stone free rate of 82% (n = 202). RPP was significantly higher in patients with obstructive nephrostogram with 25.0 mmH2O (21.0–32.0) versus 20.0 mmH2O (16.0–24.0; p < 0.001). The pressure was lower in successful nephrostomy removal with 18 cmH2O (15–21) versus 23 cmH2O (20–29) in the leakage group (p < 0.001). The analysis of a cut-off of $$\le$$ ≤ 20 cmH2O showed a sensitivity of 76.9% (95% CI [60.7%; 88.9%]) and a specificity of 61.5% (95% CI [54.6%; 68.2%]). The negative predictive value was 93.4% (95% CI: [87.9%; 97.0%]) and the positive predictive value 27.3% (95% CI [19.2%; 36.6%]). The accuracy of the model showed an AUC = 0.795 (95% CI [0.668; 0.862]). Conclusion The hydrostatic RPP seems to allow a bedside evaluation of ureteral patency after PCNL.

BACKGROUND Nonadherence to medication is a driver of morbidity and mortality, and complex medication regimens in patients with chronic diseases foster the problem. Digital technology might help, but despite numerous solutions being developed, none are currently widely used, and acceptance rates remain low, especially among the elderly. OBJECTIVE This study aimed to better understand and operationalize how new digital solutions can be evaluated. Particularly, the goal was to identify factors that help digital approaches targeting adherence to become more widely accepted. METHODS A qualitative study using a conceptual grounded theory approach was conducted. We included patients aged 65 years and older who routinely took new oral anticoagulants. To generate theses about the digital competencies of the target group with daily medication intake, face-to-face interviews were conducted, recorded, and anonymized. After coding the interviews, categories were generated, discussed, and combined with several theses until saturation of the statements was reached. RESULTS The methodological approach led to the finding that after interviews in 20 of 77 potentially available patients, a saturation of statements was reached. The average patient’s age was 75 years, and 50% (10/20) of the subjects were female. The data identified five main coding categories—Diseases and medicine, Technology, Autonomy, Patient narrative, and Attitude toward technologies—each including positive and negative subcategories. Main categories and subcategories were summarized as Adherence Radar, which can be considered as a framework to assess the potential of adherence solutions in the process of prototyping and can be applied to all adherence tools in a holistic manner. CONCLUSIONS The Adherence Radar can be used to increase the acceptance rate of digital solutions targeting adherence. For a patient-centric design, an app should be adapted to the individual patient’s needs. According to our results, this application should be based on gender and educational background as well as the individual physician-patient relationship. If used in a proper, individualized manner, digital adherence solutions could become a new cornerstone for the treatment of chronically ill individuals.

BACKGROUND Mobile devices such as smartphones, tablets, and laptop computers enable users to search for information and communicate with others at any place and any time. Such devices are increasingly being used at universities for teaching and learning. The use of mobile devices by students depends, among others, on the individual media literacy level and the curricular framework. OBJECTIVE The objective of this study was to explore whether there were differences in media use in students from various curricula at the Faculty of Health, Witten/Herdecke University. METHODS During the 2015-16 winter term, a survey was conducted at the Faculty of Health, Witten/Herdecke University, in which a total of 705 students (out of 1091 students; response rate: 705/1091, 64.61%) from 4 schools participated voluntarily: medicine (346/598), dentistry (171/204), psychology (142/243), and nursing science (46/46). The questionnaire developed for the study included 132 questions on 4 topics: (1) electronic and mobile devices (19 questions), (2) communication and organization of learning (45 questions), (3) apps/programs/websites/media (34 questions), and (4) media literacy (34 questions). The questionnaire was distributed and anonymously completed during in-class courses. RESULTS Students from all 4 schools had at least two electronic devices, with smartphones (97.4%, 687/705) and laptops (94.8%, 669/705) being the most common ones. Students agreed that electronic devices enabled them to effectively structure the learning process (mean 3.16, SD 0.62) and shared the opinion that university teaching should include imparting media literacy (mean 2.84, SD 0.84). Electronic device ownership was the highest among medical students (mean 2.68, SD 0.86) and medical students were the only ones to use a tutorial (36.1%, 125/346). Dental students most widely used text messages (mean 3.41, SD 0.49) and social media (mean 2.57, SD 1.10) to organize learning. Psychology students considered mobile devices to be most ineffective (mean 2.81, SD 0.83). Nursing science students used emails (mean 3.47, SD 0.73) and desktop computers (39%, 18/46) most widely. CONCLUSIONS The results show that almost all students use electronic learning (e-learning) tools. At the same time, different profiles for different degree programs become apparent, which are to be attributed to not only the varying curricula and courses but also to the life circumstances of different age groups. Universities should, therefore, pay attention to the diverse user patterns and media literacy levels of students when planning courses to enable successful use of e-learning methods.

BACKGROUND The interest in digital technologies in health care is increasing and can be a way of relieving the burden on health care professionals. This relief can lead on the one hand to higher job satisfac-tion an on the other hand to a higher attractiveness of the nursing profession. Social robots are regarded as a special form of technology that can be usefully applied in nursing because of their focus on interpersonal contacts. They differ from service robots by their additionally brought forward empathetic behavior during the execution of activities. The implementation of robots raises ethical questions. While the implementation progresses slowly there is a need for the de-bate about concepts and applications. OBJECTIVE In addition to existing studies with a focus on societal attitudes to social robots there is a need for concepts and evaluation of the potential of social robots in nursing. This elaboration enables to channel scientific findings and developments. It is important to take the perspectives of health care professionals and patients into account. METHODS An expert workshop with 88 participants (health care professionals and educators, (PhD-) stu-dents of medicine, health care, nursing and technology, patient advocates, software developers, representatives from government, and research fellows) from Austria, Germany and Switzer-land was held in February 2020. The workshop included group discussions, presentations on social robots and short plays of different future scenarios. These four future scenarios served as a basis for the discussions and showed the possibility of analogue nursing, completely robotic nursing, teams of robots and nursing staff (Deep Care) as well as nurses supported by robots (Smart Care). RESULTS In the discussions most groups opted for Smart Care. The experts saw a need for implementa-tion through skills labs and multidisciplinary development teams. However, the discussions also revealed that there is a strong need for the development of eHealth literacy in society, a change in the training of nurses and concepts that transcend sector boundaries. CONCLUSIONS It became clear that the decision for or against a scenario was strongly dependent on one’s own experiences and values. Therefore, there is a strong need to ascertain the wishes of society re-garding the future of care.

Zusammenfassung Ziel der Studie Über die Zusammenarbeit verschiedener Akteur:innen der Gesundheitsversorgung in der Pandemie ist – insbesondere im Hinblick auf die Aufgabenteilung zwischen Sektoren – wenig bekannt. Exemplarisch für eine Region in Baden-Württemberg sollte unter Verwendung einer expertengestützten Visualisierungsmethode der Austausch relevanter Akteur:innen angeregt werden, um sich auf Zuständigkeiten, Prioritäten und Zielsetzungen zu verständigen. Methodik Die Erarbeitung eines Gesamtbildes („Mapping“) zur Pandemiesituation in Ulm/Alb-Donau-Kreis erfolgte in Anlehnung an die Methode „Knowledge Visualization“ in mehreren Phasen. Zunächst wurden semi-strukturierte Interviews mit lokalen Akteur:innen der Gesundheitsversorgung geführt und visualisiert. In einer gemeinsamen Video-Konferenz wurden diese Einzelperspektiven vorgestellt, diskutiert und bei Bedarf modifiziert. Es folgte ein moderierter, durch einen Visualisierungs-Experten („Visionom“) begleiteter Austausch mit dem Ziel, sich auf gemeinsame Strategien für die Versorgung in der Pandemie zu verständigen. Dieser Prozess wurde als Mapping zur Pandemiesituation professionell dokumentiert. Ergebnisse Alle Teilnehmenden zeigten große Motivation und empfanden es als interessant und wertvoll, die Perspektiven anderer Akteur:innen näher kennenzulernen. Die iterative Visualisierung wirkte stark aktivierend und regte Reflexionsprozesse an. Personelle Zuständigkeiten erwiesen sich als nicht immer klar, Kommunikationsprobleme wurden offengelegt. Es besteht der Wunsch nach Fortsetzung des begonnenen Prozesses. Schlussfolgerung Iterative Visualisierungen können den Impuls geben, Implikationen auf Handlungsebene, Metastrukturen und Entscheidungsgremien einzuleiten. Wir empfehlen diese Methode auch für andere Fragestellungen in Bezug auf lokale bzw. regionale Strukturen.