Voula Gkatzidou

The eSexual Health Clinic system for management, prevention, and control of sexually transmitted infections: exploratory studies in people testing for Chlamydia trachomatis

BACKGROUND Self-directed and internet-based care are key elements of eHealth agendas. We developed a complex online clinical and public health intervention, the eSexual Health Clinic (eSHC), in which patients with genital chlamydia are diagnosed and medically managed via an automated online clinical consultation, leading to antibiotic collection from a pharmacy. Partner notification, health promotion, and capture of surveillance data are integral aspects of the eSHC. We aimed to assess the safety and feasibility of the eSHC as an alternative to routine care in non-randomised, exploratory proof-of-concept studies. METHODS Participants were untreated patients with chlamydia from genitourinary medicine clinics, untreated patients with chlamydia from six areas in England in the National Chlamydia Screening Programmes (NCSP) online postal testing service, or patients without chlamydia tested in the same six NCSP areas. All participants were aged 16 years or older. The primary outcome was the proportion of patients with chlamydia who consented to the online chlamydia pathway who then received appropriate clinical management either exclusively through online treatment or via a combination of online management and face-to-face care. We captured adverse treatment outcomes. FINDINGS Between July 21, 2014, and March 13, 2015, 2340 people used the eSHC. Of 197 eligible patients from genitourinary medicine clinics, 161 accessed results online. Of the 116 who consented to be included in the study, 112 (97%, 95% CI 91-99) received treatment, and 74 of those were treated exclusively online. Of the 146 eligible NCSP patients, 134 accessed their results online, and 105 consented to be included. 93 (89%, 95% CI 81-94) received treatment, and 60 were treated exclusively online. In both groups, median time to collection of treatment was within 1 day of receiving their diagnosis. 1776 (89%) of 1936 NCSP patients without chlamydia accessed results online. No adverse events were recorded. INTERPRETATION The eSHC is safe and feasible for management of patients with chlamydia, with preliminary evidence of similar treatment outcomes to those in traditional services. This innovative model could help to address growing clinical and public health needs. A definitive trial is needed to assess the efficacy, cost-effectiveness, and public health impact of this intervention. FUNDING UK Clinical Research Collaboration.

Investigating the appropriateness and relevance of mobile web accessibility guidelines

The Web Accessibility Initiative (WAI) of the World Wide Web Consortium (W3C) develop and maintain guidelines for making the web more accessible to people with disabilities. WCAG 2.0 and the MWBP 1.0 are internationally regarded as the industry standard guidelines for web accessibility. Mobile testing sessions conducted by AbilityNet document issues raised by users in a report format, relating issues to guidelines wherever possible. This paper presents the results of a preliminary investigation that examines how effectively and easily these issues can be related by experts to the guidelines provided by WCAG 2.0 and MWBP 1.0.

Exploring the Development of Adaptable Learning Objects. A Practical Approach

Changes in legislation, an emphasis on widening participation and the increasing reliance on online techniques for learning and teaching have contributed to improved opportunities for students with disabilities. The need to cater for the needs and preferences of the individual learner is presenting significant challenges for the learning designer. This research suggests a solution that is based on the principle that learning content can be generated from adaptable aggregations of learning objects and media components. This paper describes the concept of an authoring tool (LOTTI) that supports the design of adaptable, reusable and pedagogically rich learning objects using proven learning patterns and capitalises upon the recent focus of metadata standards for adaptability. We explore its potential within an accessibility service that maps the learners’ profiles requirements against the learning objects features.

O22.4 What Are Young People’s Perceptions of Using Electronic Self-Tests For STIs Linked to Mobile Technology For Diagnosis and Care (eSTI2)?

Background UK rates of sexually transmitted infections (STI) are sustained or rising, particularly among young people aged 16–24, despite decreases in patient waiting times within traditional services. Modern advances in communication and diagnostic technologies offers the potential of electronic self-testing and diagnosis for STIs (eSTI2), linked to Internet/mobile-App based clinical management and support, which could be accessed wherever people find convenient and safe. We aimed to explore opinions on using eSTI2 among a sample of potential users. Methods Twenty-five semi-structured interviews were conducted with a purposive sample of sexually active young people aged 16–24 years enrolled in London further education colleges. Analysis was based on the Framework method. Results Participants were 64% male (n = 16), 36% female (n = 9). Mean age was 19. They described their ethnicity as Black 84% (n = 21), mixed race 12% (n = 3), Asian 4% (n = 1). Including those screened via the National Chlamydia Screening Programme (NCSP), the majority of participants (92%, n = 23) had previously screened for STIs at least once. The young people in our sample were highly conversant in mobile technology but had limited experience of using it to access health-related services. Participants reported struggling between desire to access services out of concern for their sexual health and repercussions from being discovered by family and peers at testing centres. These barriers were seen to be mitigated by using eSTI2. Participants expressed the importance of eSTI2 being embedded within NHS services, incorporating personal support from clinicians when necessary. Conclusions Concern around long waits and lack of privacy within traditional settings created a barrier to STI testing for these young people. Electronic self-testing for STIs, linked to Internet/mobile-App based clinical management and support (eSTI2) and embedded within NHS services appears highly acceptable to this group of high-risk young people and could increase their access to STI testing and care.

From a Personal Learning Environment to an Adaptable Personal Learning Environment: Meeting the Needs and Preferences of Disabled Learners

Researchers and educational technologists are striving to achieve e-learning solutions that offer choice and flexibility in the time, place and mode of learning. Developments that centre on user preference and personalisation have yet to make a significant impact on institutional learning environments and this limitation has given rise to the concept of the Personal Learning Environment. This paper considers a system that takes this concept one step further to cater for the needs and preferences of disabled learners – an Adaptable Personal Learning Environment.

A Transformation, Augmentation, Substitution Service (TASS) to Meet the Needs and Preferences of the Individual Learner

The accessibility community is responding to the challenges of Web 2.0 by adopting a more holistic approach to the provision of inclusive e-learning. It is based on the premise that an equivalent learning outcome, rather than a universally accessible single resource, meets the needs of individual learners more appropriately. This research suggests a solution to the creation of learning resources, which is based on the principle that learning content can be generated from adaptable aggregations of learning objects and media components using proven learning patterns. A transformation, augmentation, substitution service (TASS) encompasses methods to retrieve a learning object upon request by a user, adapt it and deliver it to the learning in the form in which it is required.

Widgets to Support the Concept of an Adaptable Personal Learning Environment

There is a growing acceptance of the need to move beyond the concept of the traditional virtual learning environment towards a Personal Learning Environment. This paper presents an approach to personalised development of learning applications tp support disabled students. Supported by a community of practice, we produced bespoke open source widgets freely available for use and adaptation by the wider community.

Exploring a Standards-based Approach to the Design and Delivery of Adaptable Learning Content: A Case Study

The current trend towards a personalised educational landscape requires a standards-based adaptation approach that responds flexibly to learner needs and shapes new learning environments, pedagogies, tools and media for learning. We present a set of simple tools to allow for the provision of an accessible relationship between the users needs and the learning resources capabilities. This paper demonstrates the potential of the tools and our adaptation approach through a case study that examines the authoring of an adaptable learning object and highlights the process of its adaptation to match the needs and preferences of a variety of learners.

Using a Rich Pictures Approach for Gathering Students and Teachers Digital Education Requirements

The increasing pervasiveness of mobile technologies and the advent of Web 2.0 technologies such as ubiquitous digital media, networked communications and social media have transformed the way young people access information, create and share knowledge between each other. Twenty four co-design workshops were conducted (290 total participants) with one age-stratified sample (13–17 year olds) of young people from Higher Education establishments in three European countries. These workshops explored young people’s views with regard to the design of cross-platform interactive learning frameworks that allow for ubiquitous, flexible and non-linear learning. A novel co-design workshop method was adopted that draws principles from participatory design, future workshop techniques and rich pictures. The data capture from the co-design workshops with young people were analysed using thematic analysis. Four over-arching design domain emerged: in-class interaction, home interaction, content creation and reporting affordances. From these design domains, 14 user design needs for future technology are described.

Measuring and comparing the reliability of the structured walkthrough evaluation method with novices and experts

Effective evaluation of websites for accessibility remains problematic. Automated evaluation tools still require a significant manual element. There is also a significant expertise and evaluator effect. The Structured Walkthrough method is the translation of a manual, expert accessibility evaluation process adapted for use by novices. The method is embedded in the Accessibility Evaluation Assistant (AEA), a web accessibility knowledge management tool. Previous trials examined the pedagogical potential of the tool when incorporated into an undergraduate computing curriculum. The results of the evaluations carried out by novices yielded promising, consistent levels of validity and reliability. This paper presents the results of an empirical study that compares the reliability of accessibility evaluations produced by two groups (novices and experts). The main results of this study indicate that overall reliability of expert evaluations was 76% compared to 65% for evaluations produced by novices. The potential of the Structured Walkthrough method as a useful and viable tool for expert evaluators is also examined.