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Background: Despite promising findings regarding the safety, fidelity, and effectiveness of peer-delivered behavioral health programs, there are training-related challenges to the integration of peers on health care teams. Specifically, there is a need to understand the elements of training and consultation that may be unique to peer-delivered interventions. Methods: As part of a pilot effectiveness-implementation study of an abbreviated version of Skills Training in Affective and Interpersonal Regulation (STAIR) for posttraumatic stress disorder (PTSD), we conducted a mixed-methods process evaluation utilizing multiple data sources (questionnaires and field notes) to characterize our approach to consultation and explore relations between fidelity, treatment outcome, and client satisfaction. Results: Peer interventionists exhibited high fidelity, defined by adherence ( M = 93.7%, SD = 12.3%) and competence ( M = 3.7 “competent,” SD = 0.5). Adherence, β = .69, t (1) = 3.69, p < .01, and competence, β = .585, t (1) = 2.88, p < .05, were each associated with trial participant’s satisfaction, but not associated with clinical outcomes. Our synthesis of fidelity-monitoring data and consultation field notes suggests that peer interventionists possess strengths in interpersonal effectiveness, such as rapport building, empathy, and appropriate self-disclosure. Peer interventionists evidenced minor challenges with key features of directive approaches, such as pacing, time efficiency, and providing strong theoretical rationale for homework and tracking. Conclusion: Due to promise of peers in expanding the behavioral health workforce and engaging individuals otherwise missed by the medical model, the current study aimed to characterize unique aspects of training and consultation. We found peer interventionists demonstrated high fidelity, supported through dynamic training and consultation with feedback. Research is needed to examine the impact of consultation approach on implementation and treatment outcomes. Plain Language Summary: Peers—paraprofessionals who use their lived experiences to engage and support the populations they serve—have been increasingly integrated into health care settings in the United States. Training peers to deliver interventions may provide cost savings by way of improving efficient utilization of professional services. Despite promising findings in regard to safety, intervention fidelity, and effectiveness of peer delivery, there are important challenges that need to be addressed if peers are to be more broadly integrated into the health care system as interventionists. These include challenges associated with highly variable training, inadequate supervision, and poor delineation of peer’s roles within the broader spectrum of care. Thus, there is a need to understand the unique components of training and consultation for peers. We report key findings from an evaluation of a pilot study of an abbreviated version of Skills Training in Affective and Interpersonal Regulation (STAIR) for posttraumatic stress disorder (PTSD), adapted for peer delivery. We characterize our approach to consultation with feedback and explore relations between fidelity, treatment outcome, and client satisfaction. Our study extends the small yet growing literature on training and consultation approaches to support fidelity (adherence and competence) among peer interventionists. Organizations hoping to integrate peers on health care teams could utilize our fidelity-monitoring approach to set benchmarks to ensure peer-delivered interventions are safe and effective.

ObjectiveThis study is a non-randomized pragmatic trial to assess the feasibility and acceptability of the Primary Care Intervention for Posttraumatic stress disorder (PCIP) (Srivastava et al., 2021), an Integrated Behavioral Health Care treatment for PTSD in adolescents.MethodFollowing routine clinic procedures, youth who were suspected of having trauma-related mental health symptoms were referred by their primary care providers to integrated care social workers for evaluation. The integrated care social workers referred the first 23 youth whom they suspected of having PTSD to the research study. Twenty youth consented to the study and 19 completed the pre-assessment (17 female; mean age = 19.32, SD = 2.11; range 14-22 years). More than 40% identified as Black and a third as Hispanic/Latinx. PCIP mechanisms and clinical outcomes were assessed pre- and post-treatment, and at one-month follow-up. Participants and therapists completed post-treatment qualitative interviews to assess feasibility and acceptability, and treatment sessions were audio recorded to assess fidelity.ResultsFindings suggest high acceptability, satisfaction, and feasibility of the PCIP delivered in "real-life" safety net pediatric primary care. Integrated care social workers had high treatment fidelity. Despite the small sample size, there was significant improvement in symptom scores of anxiety (g = 0.68, p = 0.02) and substance use (g = 0.36, p = 0.04) from pre to post, and depression symptoms (g = 0.38, p = 0.04) from pre to follow-up. Qualitative data from patients who completed exit interviews and integrated social workers indicated high satisfaction with the treatment, with some participants reporting that the integrated intervention was more acceptable and less stigmatizing than seeking mental health care outside of primary care.ConclusionsThe PCIP may improve treatment engagement and access for vulnerable youth. Promising findings of high acceptability, feasibility, and initial clinical effectiveness suggest that PCIP warrants larger-scale study as part of routine care in pediatric integrated care.

Background:. Botulinum toxin A (BTxA) has gained popularity as a nonsurgical aesthetic treatment for skin rejuvenation. However, previous studies on intradermal BTxA have shown inconsistent results. This systematic review and meta-analysis with trial sequential analysis aimed to assess the efficacy and safety of intradermal BTxA for facial rejuvenation. Methods:. Following PRISMA guidelines, a comprehensive search was conducted in various databases from January 2008 to March 2023. Outcome measures included sebum production, pore size, skin hydration, skin texture, erythema index, facial wrinkles, and facelift. Eligible studies included human-based clinical trials and prospective cohort studies published in English, focusing on healthy populations requiring facial rejuvenation. Two authors independently screened the titles and abstracts, followed by a full-text review to determine study eligibility. Data extraction and quality assessment were performed by two authors using predefined criteria. Results:. Ten studies met the inclusion criteria, including five randomized controlled trials and five prospective cohort studies with 153 participants. Studies revealed positive effects of intradermal BTxA on various outcome measures related to facial rejuvenation. These effects included improvements in sebum production, pore size, erythema index, facial wrinkles, skin texture and elasticity, and overall facelift but not skin hydration. All failed to reach the required information size in the trial sequential analysis. Conclusions:. Findings suggest positive outcomes in multiple attributes of skin quality and facial rejuvenation. However, more high-quality research is needed to establish definitive conclusions. These findings contribute to the evidence base for nonsurgical aesthetic treatments, emphasizing the importance of ongoing research in this field.

The purpose of the research was to investigate university teachers' perceptions of information and communication technology (ICT) to enhance teaching and construct new knowledge. The objective was to determine how teachers at the University of the Gambia perceived the effectiveness of the TPACK (Technology, Pedagogy, and Content Knowledge) model in teaching through ICT and how different attributes of teachers affect their level of TPACK knowledge. This study used a questionnaire, adapted from the TPACK model, which was administered to 88 faculty selected purposively from the University of the Gambia to collect data on their level of awareness of ICT-based teaching. Descriptive analysis was first run to check the scores of all components of TPACK, then a correlational analysis was carried out to measure the relationship between the TPACK constructs. The data collected from these analyses were used to construct a structural equation model that showed the relationship between TPACK constructs as perceived by the faculty of the University of the Gambia. The results of this study showed that the individual construct (i.e., technology, pedagogy, and content) and the paired constructs (i.e. Technology and Pedagogy, Technology and Content, Pedagogy and Content knowledge) of TPACK are positively correlated with teachers’ perceived TPACK, as well as the findings are consistent with the earlier claim that ICT-based instruction may not progress as quickly in education even when it is available and teachers are not knowledgeable about it. The results contribute to earlier research that aims to develop strategies for implementing ICT-based instruction in HEIs and offer advice to educators on how to create policies including TPACK components in their teaching and learning.

Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP’s efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William–Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications.

The association between the work environment compatibility and development of musculoskeletal stress among workers is evaluated. Results indicate that poor working environment resulted in increased musculoskeletal stress and shift duties also had a role to play with the evening shift manifesting the poorest compatibility.

The reliability and validity of self-reported assessment of exposure and outcome variables were examined for manual lifting activities among ten physiotherapists. In this study, the participants evaluated the effects of five lifting variables on perceived effort, twice separated by a one-week period. One hundred and sixty-two lifting conditions were evaluated by each subject. The exposure and outcome lifting variables were described in linguistic terms. Intra-class correlation coefficient (IC[C.sub.1,1]) analysis revealed a mean value of 0.62 for all lifting activities. The self-reported assessment was cross-validated with the NIOSH lifting index by mapping the linguistic variables into numerical ranges. Moderate correlations (r = 0.54 and 0.53, p < 0.01) were obtained between perceived physical exertion/perceived risk and lifting index. The findings of this study provide preliminary indications that human-based methodologies may be further explored on experienced workers. Keywords: Reliability: Validity; Self-reported assessment; Lifting activities