<< Background >>TO BE PART OF THE CREATION OF A COMMUNITY OF CITIZENS CONTRIBUTING TO A DIGITAL SOCIETY THAT IS SUSTAINABLE, INCLUSIVE, SUPPORTIVE AND RESPECTFUL OF THE ENVIRONMENT.With the check-ups that needed to be organised remotely, the pandemic has shown how important is that each patient takes charge of its own care, as this medical follow-up requires digital tools, leaving a large number of citizens in a difficult situation. In this context, our project, named Pragma-TIC, aims at bridging the digital divide for chronic patients suffering from digital illiteracy by giving the possibility to the frontline caregivers to become their e-health educators. To do this, Pragma-TIC will train the care staff and their patients in an innovative (blended learning) and inclusive way. The aim is to propose a solution, in order to reunite the strengths and resources that will allow each stakeholder to benefit from the work done by the group.This project will be carried out in collaboration with several European countries (Belgium, Latvia, Slovenia and Denmark). Hospitals in European countries need to implement digital support for their patients and frontline caregivers. Pragma-TIC proposes to implement a transnational educational project to address this need which will ultimately improve the health and quality of life of patients and relieve the workload of frontline carers in the long run. Through the support of Europe, Pragma-TIC will open doors that individual members of the Consortium would not have had access to on a national, regional or simply local level. It thus extends the scope and increases the visibility of the project.By responding to the KA220-ADU call, we wish to validate the competences acquired in digital literacy through non-formal certificates delivered by health institutions. Two levels of certifications will be targeted. At the level of the caregiver, the first level concerns the e-educator (involved caregivers) who will find themselves validated as educators and will use those new skills to train other patients. The second level concerns the e-educator + who will be able to train his peers. At the patient level, the first level concerns the e-patients who will find themselves assessed as capable of having a follow-up at home. The second level concerns the e-patients + who will use their new skills to train their fellow patients. The e-educator certificates will be integrated into the professional portfolio of the caregiver and those of the e-patient in patient's medical record.This project aims to meet the needs of the 3 actors of the health sector, which are the Hospital Institutions, the frontline caregivers (field staff) and the patient.HOSPITAL INSTITUTIONSare considerably short of beds, means and resources, while the number of patients is increasing exponentially. Therefore, the continuation of care in the patient's home is absolutely necessary and must be of high quality. FRONTLINE CAREGIVERS Lack the time and the means to educate their patients. Pragma-TIC will allow the patients to be trained in new learning modes, in order to evolve professionally and to be better prepared for any unforeseen circumstance, to feel involved and more valued as caregivers through a non-formal certificate.While they are looking for solutions with their project colleagues, they will be able to share through forums or exchange networks their difficulties and more. They will also create a community of carers on an international scale.The project will support the field staff in their role of therapeutic educators by implementing digital and pedagogical tools shared among peer carers. PATIENTS The chronic patients is isolated at home in the face of new technologies that they do not master.They lack the resources, the contacts, the self-confidence and the support.manage to teach the patients to be resilient by getting control back over their life project and their care (autonomy);- involve them in a learning process<< Objectives >>This project aims to meet the needs of the 3 main actors, i.e. the Hospital Institutions, the frontline caregivers and patients.The implementation of the project aims to overcome the digital divide in an inclusive way in order to access all the resources and benefits that telemonitoring offers in the health care environment. HOSPITAL INSTITUTIONSThis project will contribute to the digital and sustainable transformation of healthcare institutions while promoting savings in terms of human, material and financial resources. It should reduce the overcrowding of hospitals, which has a negative impact on the quality of care.At the same time, we want to collaborate and cooperate across the board and on all levels of competence and decision-making power, in order to facilitate the digital transition in the health sector.FRONTLINE CAREGIVERS In order to provide e-Health training in compliance with the RGPD, our values, and ethics, we want to help field staff to integrate e-Health into their daily work as educators. Therefore, it is imperative to provide them with the opportunity to develop skills through appropriate didactic and pedagogical materials. This will enable them to transfer to the patients in a sustainable way the knowledge and skill necessary to master telemonitoring so that, autonomously, the patients continue to follow their treatment in all circumstances in a secure manner and stay in contact with their care partner. PATIENTS To improve their quality of life through TELEMONITORING. It is imperative to strengthen the ability to LEARN TO TRANSMIT via the BLENDED LEARNING. Other objectives are to enable the patient to:- learn the basic techniques and knowledge (touch screen, keyboard, voice recognition, etc.) needed to use computer systems- search for and collect relevant and secure information- communicate with messaging software, chat, and on a forum with peers and carers- develop critical thinking skills in relation to digital technology (understanding the benefits of the Internet and its risks).OBJECTIVES1.Developing flexible and innovative education that promotes patients’ INCLUSION in digital literacy, so that they can acquire a minimal digital skill basis while evaluating them on a regular basis allowing them to use the Internet safely, health apps and medical devices. Developing or improving adult, and particularly elderly, patients’ Digital Health Literacy to empower them to manage their health.2. Using technology to engage in A DIGITAL PEDAGOGY adapted to their PTS, CGS could contribute to the design and development of toolkits, participate in a clinical study that aims to assess the usefulness of the toolkits for PTS, and exchange good, digitalized practices with peers and PTS.3. Building a PATIENT-ORIENTED digital learning platform in health (Pragma-TIC) as an intervention method to gain autonomy and eventually reintegrate in society after a pathology. It will help patients take responsibility (respecting their choices), understand their disease, change their behavior, apply their treatment (observance) and use tele-health tools. It will host a training catalog, digital support (in all partner languages + English) in digital health education co-created by the project partners and validated by the PT Committee of the partner hospitals.The other objectives we want to achieve are the following:- ensuring that the frontline caregivers are capable of accompanying the TELEMONITORING of chronic patients by facilitating their autonomy;- to make the patient feel secure by the support provided; - to acquire a sufficient base of techniques and knowledge to conduct educational activities and analyse the results;- to be part of an international community of caregivers; - to apply safety rules and good practice guidelines;- to provide clear, constructive and supportive feedback to patients and peers<< Implementation >>For 24 months, 20 frontline/field nurses from 4 hospitals will contribute to the development of digital health literacy skills for nearly 200 chronic patients (whose health condition requires daily care and are vulnerable) so that they can become more autonomous thanks to remote monitoring.IMPLEMENTATION: METHODOLOGY USED The implementation of the project consists in developing a simple, practical e-learning platform (in English and in the 4 languages of the Consortium), favouring through the blended-learning method the better understanding of the Web, medical devices tools, health Apps and other classic telecommunication tools.This platform will offer educational toolkits co-constructed and validated by the caregivers on the basis of their pedagogical tutorials. It will also provide access to places ideal for exchanges between patients, caregivers and their international peers, such as forums, messaging server, etc. The anonymization and RGPD will be guaranteed.PLANNING FOR THE CREATION OF THIS PLATFORMThe Co-CREATION of this platform will be organised over 2 years in 4 steps.Step 1Conceptualisation and requirements for the project, research, studies, analysis, reporting and co-creation of a learning tutorial repository validated by pedagogy specialists. Step 2Development and/or reinforcement of adult-friendly pedagogy and e-learning among frontline health workers who will participate in the study. They will get a better grasp of the e-Health tools with hybrid learning methods, either in self-taught or group settings. Their objective will be to build their own training plan for their patient. In order to experiment and readjust it, they will also train groups of digitally compromised patients by immersing them directly in digital learning via groups or individual sessions, via synchronous or asynchronous webinars. During this period, the carers will create their dashboard in which they will enter data that will be used to assess the benefits of this method.The caregivers will evaluate the results, readjust their training plan, model it and then MAKE IT SUBSTAINABLE AND SHARE IT WITH THEIR PAIRS. Patients from this first pool will also be very closely involved in the process and will complete satisfaction and self-assessment questionnaires. The caregivers will adjust their working methods based on the answers collected and update the contents of the platform.After step 2, all participants (caregivers and patients) will form a committee with the associated partners to establish the sustainability of the project.Step 3 A second pool of patients will be recruited. The group will be accompanied by the first pool of field staff in order to reinforce or readjust the process. Step 4 Preparation and presentation of the guidelines and recommendations on our platform which will be presented at the transnational closing meeting of the project and accessible to all interested parties.<< Results >>RESULTS and OTHER EXPECTED OUTCOMES 1.To relieve for overloaded hospital institutions and very expensive emergency departments.2.To lessen the risk of contracting nosocomial diseases. 3.To return or keep the patient at home with an economic and psychological impact on his health.4.To open new possibility of life goals with an impact on the patients’ acceptance of their treatment and on the positive evolution of their health condition. 5.To create a community of peer carers internally and internationally, as well as be part of it. 6. To harmonise the remote follow-up of the chronic patient and maintain the therapeutic link EVEN ABROAD or in remote rural areas.7.To strengthen the patient's ability to keep learning while developing a critical mind towards the digital world.8.To give access to the patient staff to training in an ATYPICAL environment reinforcing LIFELONG LEARNING.9.To reduce the carbon impact by cutting out any unnecessary travel to the hospital. 10.To reduce the carbon impact with fewer hospital visits. SUSTAINIBILITY through its TRANSFERABILITY to other institutions or sectors.

Gels made from clay could provide an environment able to stimulate stem-cells due to their ability to bind biological molecules. That molecules stick to clay has been known by scientists since the 1960s. Doctors observed that absorption into the blood stream of certain drugs was severely reduced when patients were also receiving clay-based antacid or anti-diarrhoeal treatments. This curious phenomenon was realized to be due to binding of the drugs by clay particles. This interaction is now routinely harnessed in the design of tablets to carefully control the release and action of a drug. Dr Dawson now proposes to use this property of clay to create micro-environments that could stimulate stem cells to regenerate damaged tissues such as bone, skin, heart, spinal cord, liver, pancreas and cornea. The rich electrostatic properties of nano (1 millionth of a millimetre) -scale clay particles which mediate these interactions could allow two hurdles facing the development of stem-cell based regenerative therapies to be overcome simultaneously. The first challenge - to deliver and hold stem cells at the right location in the body - is met by the ability of clays to self-organise into gels via the electrostatic interactions of the particles with each other. Cells mixed with a low concentration (less than 4%) of clay particles can be injected into the body and held in the right place by the gel, eliminating, in many situations, the need for surgery. Clay particles can also interact with large structural molecules (polymers) which are frequently used in the development of materials (or 'scaffolds'), designed to host stem cells. These interactions can greatly improve the strength of such structures and could be applied to preserve their stability at the site of injury until regeneration is complete. While several gels and scaffold materials have been designed to deliver and hold stem cells at the site of regeneration, the ability of clay nanoparticles to overcome a second critical hurdle facing stem-cell therapy is what makes them especially exciting. Essential to directing the activity of stem-cells is the carefully controlled provision of key biological signalling molecules. However, the open structures of conventional scaffolds or gels, while essential for the diffusion of nutrients to the cells, means their ability to hold the signalling molecules in the same location as the cells is limited. The ability of clay nano-particles to bind biological molecules presents a unique opportunity to create local environments at a site of injury or disease that can stimulate and control stem-cell driven repair. Dr Dawson's early studies investigated the ability of clay gels to stimulate the growth of new blood vessels by incorporating a key molecular signal that stimulates this process, vascular endothelial growth factor (VEGF). In a manner reminiscent of the observations made in the 60s, Dr Dawson and colleagues observed that adding a drop of clay gel to a solution containing VEGF caused, after a few hours, the disappearance of VEGF from the solution as it became bound to the gel. When placed in an experimental injury model, the gel-bound VEGF stimulated a cluster of new blood vessels to form. These exciting results indicate the potential of clay nanoparticles to create tailor-made micro-environments to foster stem cell regeneration. Dr Dawson is developing this approach as a means of first exploring the biological signals necessary to successfully control stem cell behaviour for regeneration and then, using the same approach, to provide stem cells with these signals to stimulate regeneration in the body. The project will seek to test this approach to regenerate bone lost to cancer or hip replacement failure. If successful the same technology may be applied to harness stem cells for the treatment of a whole host of different scenarios, from burn victims to those suffering with diabetes or Parkinson's.