Digital literacy as a potential barrier to implementation of cardiology tele-visits after COVID-19 pandemic: the INFO-COVID survey

BACKGROUND During the COVID-19 pandemic,the implementation of telemedicine has represented a new potential option for outpatient care.The aim of our study was to evaluate digital literacy among cardiology outpatients.METHODS From March to June 2020,a survey on telehealth among cardiology outpatients was performed.Digital literacy was investigated through six main domains:age;sex;educational level;internet access;availability of internet sources;knowledge and use of teleconference software programs.RESULTS The study included 1067 patients,median age 70 years,41.3%females.The majority of the patients(58.0%)had a secondary school degree,but among patients aged≥75 years old the most represented educational level was primary school or none.Overall,for internet access,there was a splitting between"never"(42.1%)and"every day"(41.0%),while only 2.7%answered"at least 1/month"and 14.2%"at least 1/week".In the total population,the most used devices for internet access were smartphones(59.0%),and WhatsApp represented the most used app(57.3%).Internet users were younger compared to non-internet users(63 vs.78 years old,respectively)and with a higher educational level.Age and educational level were associated with nonuse of internet(age-per 10-year increase odds ratio(OR)=3.07,95%CI:2.54-3.71,secondary school OR=0.18,95%CI:0.12-0.26,university OR=0.05,95%CI:0.02-0.10).CONCLUSIONS Telemedicine represents an appealing option to implement medical practice,and for its development it is important to address the gaps in patients’digital skills,with age and educational level being key factors in this setting.

Understanding barriers to BIM implementation:Their impact across organizational levels in relation to BIM maturity

This multiple case study of a contracting firm contributes to understanding the barriers that organizations face during the implementation of building information modeling(BIM)by providing insights into the impact of these barriers across different organizational levels(i.e.,from top management to project teams)and by relating these barriers to different degrees of BIM maturity.First,we observe the dominance of barriers related to the motivation,competence,and time capacity of people across all levels of an organization.Second,the cluster of barriers at the middle-management level highlights the important role of this level in reducing these barriers.Third,only those cases with a low level of BIM maturity have struggled with lack of top management support,thereby highlighting the importance of such support in achieving BIM maturity growth.High BIM maturity situations are more prone to externally oriented barriers in attempting to further leverage the benefits of BIM.Our study provides insights on where to focus BIM implementation measures and how to enhance organizational BIM maturity.

AMERICAN CONTINUOUS-INSTALLMENT OPTIONS OF BARRIER TYPE

This paper analyzes and values an American barrier option with continuous payment plan written on a dividend paying asset under the classical Black-Scholes model.The integral representation of the initial premium along with the delta hedge parameter for an American continuous-installment down-and-out call option are obtained by using the decomposition technique.This offers a system of nonlinear integral equations for determining the optimal exercise and stopping boundaries,which can be utilized to approximate the option price and delta hedge parameter.The implementation is based on discretizing the quadrature formula in the system of equations and using the Newton-Raphson method to compute the two optimal boundaries at each time points.Numerical results are provided to illustrate the computational accuracy and the effects on the initial premium and optimal boundaries with respect to barrier.