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Context: Physical performance tests (PPTs) and mobility tests have been widely used in sports rehabilitation. However, the feasibility of PPTs and mobility tests via telehealth is unknown. Objectives: To verify the feasibility of PPTs and mobility tests to assess athletes via telehealth. Design: This is a feasibility study. Participants: Athletes enrolled in a sports team or club for at least 2 years and with previous enrollment in a competitive league were recruited through advertisements on social media. The athletes included in this study (mean age = 25.9 y, from different sports) performed a battery of PPTs and mobility tests for the lower-extremity or upper-extremity and trunk, according to their sport modality. Main Outcome Measure: The feasibility was assessed with recruitment, success, and dropout rates. In addition, athletes' perceptions of easiness, satisfaction, and safety during the lower-extremity or upper-extremity and trunk PPTs and mobility tests were assessed. Results: Seventy-three athletes were included, between January and April 2021: 41 were allocated to the lower-extremity and 32 to the upper-extremity and trunk PPTs and mobility test, according to their sports modality. The overall dropout rate was 20.55%; >89% of the athletes agreed that the PPTs and mobility tests via telehealth were easy to perform, >78% were satisfied, and >75% felt safe during the assessments. Conclusion: This study indicated that these 2 batteries of performance and mobility tests via telehealth are feasible to assess the lower and upper-extremities, and the trunk of athletes, considering the adherence, athletes' perception of easiness, satisfaction, and safety. [ABSTRACT FROM AUTHOR]

Lack of disability awareness of fitness professionals is a well-established barrier to exercise participation among people with disabilities that is likely related to the lack of disability awareness training for group fitness instructors. The purposes of this study were to develop, implement, and evaluate a disability awareness training for group fitness instructors. A 90-min video training and resource manual were developed. We recruited 10 group fitness instructors from one recreation center to participate. Participants completed baseline, posttraining, and 2-month follow-up testing on survey-based outcomes including disability attitudes, confidence in exercise adaptations, and training satisfaction. Participants' confidence to adapt fitness classes was significantly improved; however, disability attitudes were high in the pretest and not significantly different posttraining. Semistructured interviews were conducted posttraining and revealed three themes: Formal disability training is needed, Managing inclusive class dynamics, and Training suggestions and satisfaction. This training demonstrated a feasible intervention for increasing disability awareness among community-based group fitness instructors. [ABSTRACT FROM AUTHOR]

Mobile Clinical Decision Support Systems (CDSSs) represent an increasingly utilized technology to promote clinical guideline use. We sought to explore clinician guideline use and access preferences during implementation of a mobile guideline app at a free-standing children's hospital integrating 23 guidelines. Surveys included demographic variables and access preferences among anonymous onboarded clinicians in January 2022. Response rate was 21.8% (57/261) among onboarded users, mostly attending (59.6%) and resident/fellow physicians (21.1%) in inpatient (42.1%) and emergency department (31.6%) settings. Onboarded users accessed guidelines on over half of shifts (68.4%) and quickly (80.7%, <1 minute). Overall, most users reported favorable patterns for adoption of mobile CDSSs as useful adjuncts to existing formats. Users reported more ease of access and frequent guideline usage, particularly for younger clinicians. Guidelines related to antibiotic decision-making or newer disease processes were most useful. Further study is needed on electronic health record incorporation, adherence, and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Balance dysfunction and vestibular conditions are major problems requiring significant resources. There is significant national and international variation in management pathways for such patients. Methods: This paper outlines a collaborative project run by the ENT department and two vestibular rehabilitation trained physiotherapists to establish a clinic to manage patients referred to ENT with vestibular and/or balance complaints. As part of a six-month pilot, two physiotherapy-led balance clinics were provided per week. Results: A total of 159 new patients were seen, with only 15 needing ENT consultant input. This led to the successful creation of substantive posts; the clinic has seen 698 patients in its first two years. Conclusion: Patient outcomes and experience have been positive, and accompanied by reduced waiting and in-service times. The authors discuss some of the pitfalls, challenges and opportunities of developing this type of clinic. [ABSTRACT FROM AUTHOR]

Objective: This pilot study aimed to evaluate a training programme for primary care physiotherapists focused on the assessment and management of benign paroxysmal positional vertigo. Methods: A six-month training programme and toolkit utilising the revised Standards for Quality Improvement Reporting Excellence ('SQUIRE 2.0') guidelines was developed to facilitate the learning of new knowledge and skills in the assessment and management of benign paroxysmal positional vertigo following Gagne's model of instructional design. A pre- and post-training knowledge and confidence questionnaire evaluated the impact of the training programme. Results: Eleven participants started the training programme and five completed it. On average, knowledge increased by 54 per cent (range, 41–95 per cent) and confidence increased by 45 per cent (range, 31–76 per cent). A 73 per cent improvement in practical skills acquisition was demonstrated after the initial training session. Conclusion: A structured approach to learning demonstrates improvements in knowledge, skills and confidence of physiotherapists in the evidence-based management of benign paroxysmal positional vertigo. [ABSTRACT FROM AUTHOR]

Objective: There is a need to characterize exposures associated with the pathogenesis of systemic lupus erythematosus (SLE). In this pilot study, we explore a hypothesis‐free approach that can measure thousands of exogenous chemicals in blood ("exposome") in patients with SLE and unaffected controls. Methods: This cross‐sectional study analyzed a cohort of patients with prevalent SLE (n = 285) and controls (n = 106). Plasma was analyzed by liquid chromatography–quadrupole time‐of‐flight mass spectrometry (LC‐QTOF/MS). Mass spectrometry features present in at least 25% of all samples were selected for association analysis (n = 2,737). Features were matched to potential chemicals using available databases. Association analysis of abundances of features with SLE status was performed, adjusting for age and sex. We also explored features associated with SLE phenotypes, sociodemographic factors, and current medication use. Results: We found 30 features significantly associated with SLE status (Bonferroni P < 0.05). Of these, seven matched chemical names based on databases. These seven features included phthalate metabolites, a formetanate metabolite, and eugenol. The abundance of acid pesticides differed between patients with SLE and controls (Bonferroni P < 0.05). Two unmatched features were associated with a history of lupus nephritis, and one with anti–double‐stranded DNA antibody production (Bonferroni P < 0.05). Seventeen features varied by self‐reported race and ethnicity, including a polyfluoroalkyl substance (analysis of variance P < 1.69 × 10−5). Eleven features correlated with antimalarials, 6 with mycophenolate mofetil, and 29 with prednisone use. Conclusion: This proof‐of‐concept study demonstrates that LC‐QTOF/MS is a powerful tool that agnostically detects circulating exogenous compounds. These analyses can generate hypotheses of disease‐related exposures for future prospective, longitudinal studies. [ABSTRACT FROM AUTHOR]

Background/Aims: Evidence-based standards are an important means for ensuring safe and effective care for birthing women. The provision of one-to-one care for women in labour is one such standard, which should be the norm in Dutch maternity care. However, no audit measures of this standard are available. This study examined the use of Birthrate Plus, a validated instrument for the measurement of patient acuity. This tool has the added benefit of allowing measurement of birth characteristics in relation to staffing numbers, providing a basis for auditing the standard of one-to-one care for women in labour in hospitals in the Netherlands. Methods: This pilot study used the Birthrate Plus tool to retrospectively examine birth characteristics and staffing levels in a 4-month period, in five hospitals in the Netherlands. Results: The review of 11 582 patient cases found that most births in the sample were classified as occurring in the higher acuity levels of Birthrate+ tool. Examination of staffing levels showed that when comparing actual staffing levels with recommended levels, hospitals had a shortfall of between 47% and 64%. Conclusions: The Birthrate Plus tool could be useful in auditing staffing levels in Dutch maternity care. Analysis of the data provided by hospitals in the sample showed that none were able to meet the Dutch standard of providing consistent one-one-one care. [ABSTRACT FROM AUTHOR]

Persistent symptoms experienced by adults following mild traumatic brain injury (mTBI) can significantly impact their daily activities. It is often difficult for them to access specialized rehabilitation services. The aim of this study is to explore this population's experience surrounding access to specialized rehabilitation services, including waiting time. This study used a qualitative phenomenological approach and was conducted using semi-structured interviews. Twelve adults with mTBI who had received specialized interdisciplinary rehabilitation services were recruited. The interviews focused on participants' recollection of their patient journey after injury, their perception of waiting, barriers and facilitators to access, and the impacts of these experiences on their condition. Participants reported experiencing symptoms such as anxiety, depression, worry, sadness, and discouragement before accessing specialized services. They all agreed that they did not receive clear information about their recovery process or the health services available to them, which exacerbated their mental health symptoms. The findings show that participants experienced uncertainty because they lacked information regarding recovery and access to health services after their injury. Education about symptoms and recovery, as well as emotional support for people with mTBI should be made available during the waiting period. Adults with persistent post-mild traumatic brain injury (mTBI) symptoms experienced many challenges in accessing health services such as long wait times, which they perceived as impacting their recovery. According to those concerned, more support from qualified health professionals is needed in the first weeks or months following the injury. Participants unanimously support free and timely access to specialized mTBI rehabilitation services. [ABSTRACT FROM AUTHOR]

There is a dearth of psychological interventions for self-harm that have been tested and found acceptable by youth in low- and middle income countries. ĀTMAN (Sanskrit word meaning "self" or "self-existent essence") is one such contextually adapted psychological intervention developed in India. It has three key elements; problem-solving, emotion regulation, and social network strengthening skills. We delivered ATMAN in a series of young people who self-harm to optimize the content, structure and delivery mechanisms, and to assess their experiences of therapy and engagement. ATMAN was delivered sequentially by a psychiatrist and non-specialist counselor in 16 participants between 14 to 24 years who presented to a tertiary level public hospital in Mumbai with self-harm. Quantitative measurement tools included Beck's Scale for Suicidal Ideation (BSI), the Patient Health Questionnaire −9 (PHQ-9), Functional Assessment of Self-Mutilation, and session feedback form. Qualitative tools included PSYCHLOPS and exit interviews. Eight female and four male participants completed therapy with a mean of five sessions and an average duration of 50 min. There were no differences in module wise feedback ratings of the psychiatrist and counselor. There were significant differences in the pre- and post-therapy scores on BSI (mean difference (confidence interval)) (−16.8 (−20.2, −13.3)) and PHQ-9 (−10.8 (−14.5, −7.04)). Various content modifications were undertaken during this phase. ATMAN was acceptable to youth in India who self-harm. Modifications introduced during pilot trial phase make ATMAN better suited to the needs of the youth. ATMAN has the potential to be delivered by non- specialist counselors and to be integrated at all levels of health care settings including primary health care to reduce the burden of suicide in young people. However, an extended randomized controlled trial of ATMAN treatment with multiple counselors will help in identifying key competencies that should be developed during training and supervision, and various quality assurance measures that can be undertaken for effective implementation of ATMAN. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate safety and efficacy of the novel percutaneous interspinous device (PID) for the treatment of symptomatic degenerative lumbar spinal stenosis (DLSS) in 3 different centers. Methods: From November 2016 to March 2020, 255 patients (male 125, mean age 71.2 years old range 49–91 years old) with neurogenic claudication, confirmed by electromyography, related to mono or bi-segmental lumbar central canal and/or foraminal stenosis were enrolled in the study. Magnetic resonance (MR) and/or computer tomography (CT), physical exam, and Visual Analogue Scale (VAS) and Zurich Claudication Questionnaire (ZCQ) were performed before and 6 months after the procedure. All treatments were performed under fluoroscopic guidance with local anesthesia and mild sedation. Technical success was defined as correct placement of the Lobster® (Demetrios Medical, Firenze, Italy) PID as demonstrated by computer tomography (CT) performed immediately after treatment; spinoplasty was performed in selected patients. Results: PID placement was accomplished with a 99.6% success rate (257/258). The one device that was not implanted was due to a spinous process fracture. In 28 patients, more than 1 device was implanted in the same session (max 3 PIDs); 6 patients required a second implant in different session. A total of 172 prophylactic spinoplasties were performed (59.3%). No major complications occurred; 3 device misplacements were successfully treated with percutaneous retrieval and new device deployment. 99.6% of patients experienced clinical improvement. Conclusion: Lobster PID is an effective and safe minimally invasive decompression method for central canal and neural foraminal stenosis when patients are correctly selected. [ABSTRACT FROM AUTHOR]

Introduction: Intraoperative indocyanine green fluorescence angiography (ICGFA) aims to reduce colorectal anastomotic complications. However, signal interpretation is inconsistent and confounded by patient physiology and system behaviours. Here, we demonstrate a proof of concept of a novel clinical and computational method for patient calibrated quantitative ICGFA (QICGFA) bowel transection recommendation. Methods: Patients undergoing elective colorectal resection had colonic ICGFA both immediately after operative commencement prior to any dissection and again, as usual, just before anastomotic construction. Video recordings of both ICGFA acquisitions were blindly quantified post hoc across selected colonic regions of interest (ROIs) using tracking-quantification software and computationally compared with satisfactory perfusion assumed in second time-point ROIs, demonstrating 85% agreement with baseline ICGFA. ROI quantification outputs detailing projected perfusion sufficiency-insufficiency zones were compared to the actual surgeon-selected transection/anastomotic construction site for left/right-sided resections, respectively. Anastomotic outcomes were recorded, and tissue lactate was also measured in the devascularised colonic segment in a subgroup of patients. The novel perfusion zone projections were developed as full-screen recommendations via overlay heatmaps. Results: No patient suffered intra- or early postoperative anastomotic complications. Following computational development (n = 14) the software recommended zone (ROI) contained the expert surgical site of transection in almost all cases (Jaccard similarity index 0.91) of the nine patient validation series. Previously published ICGFA time-series milestone descriptors correlated moderately well, but lactate measurements did not. High resolution augmented reality heatmaps presenting recommendations from all pixels of the bowel ICGFA were generated for all cases. Conclusions: By benchmarking to the patient's own baseline perfusion, this novel QICGFA method could allow the deployment of algorithmic personalised NIR bowel transection point recommendation in a way fitting existing clinical workflow. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study to investigate the safety and effectiveness of performing the hanging arm test during surgical treatment for elbow varus posteromedial rotatory instability (VPMRI) to assess elbow stability and determine whether to repair the lateral ulnar collateral ligament (LUCL). Methods: In a retrospective study from August 2014 to March 2019, 27 patients with VPMRI who had a negative result in the hanging arm test after fixation of coronoid fracture were selected. Intraoperative bleeding, operative time, elbow range of motion (ROM), and complications were recorded. Elbow function was evaluated with the Mayo elbow performance score (MEPS) and the disabilities of the arm, shoulder, and hand (DASH) score. Results: The operation time was 85.9 ± 11.06 min (range 65–110). The intraoperative blood loss was 70.7 ± 9.31 ml (range 60–100). At the last follow-up, the elbow joint averaged 73.8° ± 2.931° in pronation, 78.9° ± 2.941° in supination, 7.2° ± 3.207° in extension, and 123.3° ± 6.651° in flexion. The MEPS score was 90.7 ± 4.36 (range 74–95), and the DASH score was 9.8 ± 2.58 (range 6.67–13.3). One patient presented with symptoms of ulnar nerve entrapment 2 months after operation and was treated with ulnar nerve release. The symptom of numbness went away completely 1 week after operation. No complications such as wound infection, arthritis, or chronic instability of the elbow were found in the other patients. Conclusion: Our findings suggest that not all VPMRI patients need the LUCL to be repaired, and the hanging arm test is a safe and reliable method to assess whether to repair the LUCL in the treatment of elbow VPMRI. Level of evidence: Level IV; Retrospective studies [ABSTRACT FROM AUTHOR]

Background: Edema in some subjects worsens over time and wraps help to reduce the leg volume. Material and methods: An adjustable compression wrap was tried on volunteers for 5 h and volumes measured in each limb before and after wrapping using a 3D surface scanner (HandySCAN 3D®) to estimate the volume of the leg. The contralateral leg was used as control. Results: We observed a significant decrease in volume in the wrap legs and an increase in the control legs (p <.001), both in the lower part of leg (p =.001) and in the upper part (p =.001). Conclusions: Using the Readywrap® for 5 hours significantly reduces the leg volume. This study enables Readywrap to be studied in a population that is easy to observe in the context of a research program. The Handyscan3D® was shown accurate and reproducible to assess leg volume in future studies. [ABSTRACT FROM AUTHOR]

Internalising disorders are one of the most common mental health problems in children under 12 years, yet mixed findings exist for current treatment options. This pilot involves a novel 10-session intervention, BEST-Foundations, to treat internalising symptoms in children using a family-inclusive model. Initial findings and feasibility using a mixed-methods approach are reported. Twenty-two participants from eight families (n = 8 children; n = 8 mothers; n = 6 fathers) participated in an uncontrolled single treatment design. Included children (aged 3–11 years) reported clinical-level internalising symptoms on the Child Behaviour Checklist. Data were collected across four timepoints: baseline, pre-intervention, post-intervention, and 4-weeks follow-up. As predicted, mothers reported large improvements in child internalising symptoms pre-post (SMD = −.83; 95% CI = 50.58–70.42) and maintained pre to follow-up (SMD = −.92; 95% CI = 50.14–69.11). Sustained improvements were also found in externalising problems and total problems. Qualitative analysis indicated families reported positive improvements in targeted areas including parent confidence and parent–child relationships. Findings demonstrate initial feasibility data and effect size estimates comparable to previous trials using the "BEST" framework, and larger than CBT-based interventions. Results are considered preliminary due to the small sample. Further evaluation is warranted, showing the value of family-inclusive interventions to treat child internalising problems. What is already known about this topic: Modifiable family-based risk and protective factors influence internalising symptoms in children. Currently, inconclusive support exists for targeted treatment options for child internalising symptoms, highlighting the need to explore novel, feasible, evidence-based approaches for children under 12 years. Parental involvement in treatment is considerably heterogeneous, and the inclusion of fathers is lacking. What this topic adds: The BEST-Foundations intervention translates from theory to practice, demonstrating initial feasibility with families in improving internalising symptoms in children under 12 years. Fathers may express initial hesitation, yet engaging them in treatment is important. Parents reported improved confidence and perspective taking after taking part in the BEST-Foundations intervention. [ABSTRACT FROM AUTHOR]

Although evidence-based parenting programs are widely available, they remain inaccessible to many families of children with social, emotional and behavioural problems, particularly in remote settings. In partnership with Aboriginal communities in the remote Fitzroy Valley, Western Australia, we introduced and evaluated the Indigenous Triple P – Positive Parenting Program, with additional Stepping Stones Triple P strategies (for children with complex needs). Implementation followed community consultation and program adaptation to acknowledge local culture, social complexities and language. The initiative was named Jandu Yani U, meaning "for all families" in the local Bunuba language. Local practitioners (parent coaches) were trained to deliver Triple P. Parents and carers (henceforth carers) of children up to 15 years of age were invited to participate. Families attending the program reported on child behaviour, parenting practices, self-efficacy, wellbeing and empowerment pre- and post-intervention and at 8-month follow-up using standardised assessment tools delivered by local community navigators. Of 30 participating families, 100% completed Triple P and reported the program was culturally appropriate. Of the index children, 93% were Aboriginal, 63% boys, median age 6.83 years. Following the program, carers reported high levels of empowerment and reaching goals for behaviour change (p <.001) and less use of unhelpful parenting strategies (over-reactivity and hostility; p <.05), and this maintained at 8-month follow-up (p <.001). At follow-up, improvement in carer self-efficacy (p <.001) and reduced anxiety (p <.001) were documented. Significant improvements in prosocial behaviour, reductions in challenging behaviour and decreased intensity and frequency of behavioural problems (all p <.05) were reported in children at follow-up. The average level of goal attainment was 65% at post, which was maintained at follow-up. This study demonstrates the feasibility of delivering Indigenous Triple P to Aboriginal families in remote settings, and the importance of partnership with communities. Program tailoring, flexible delivery, use of Aboriginal parent coaches and provision of practical support to families resulted in a culturally acceptable parent support program. With local Aboriginal co-design, this initiative should be generalisable to similar remote communities elsewhere. What is already known about the topic: Aboriginal and Torres Strait Islander families are more often exposed to stressful life events than non-Indigenous families, with children overrepresented in hospitalisation rates, poor health outcomes, early school dropout, out-of-home care, involvement with the justice system and youth suicide. There is a significant evidence base that parenting programs, such as Triple P, built on the principles of social learning and self-regulation, can be effective in addressing emotional and behavioural problems in children in the short and longer term. Despite the availability of evidence-based parenting programs, a minority of parents of children with behavioural and emotional problems access such programs, and access by Aboriginal and Torres Strait Islander families is lower. What this topic adds: This study determined the feasibility of delivering a community tailored, evidence-based parenting program to families in a very remote Western Australian Aboriginal community. Families reported significant reductions in unhelpful parenting strategies, carer anxiety and challenging child behaviours and significant increases in parenting confidence and empowerment and prosocial child behaviour following the program. Co-design methods, community-led modifications to resources, two-way learning with Aboriginal and non-Indigenous trainers, training local parent coaches, flexible program delivery and long-term practical support were essential for delivering a culturally acceptable parenting program implementation strategy that could be adapted for remote communities elsewhere. [ABSTRACT FROM AUTHOR]

To develop a consumer nutrition environment assessment tool to assess policy, systems, and environmental initiatives that are implemented in food pantries, which incorporates recent national guidance, and evaluate its validity and reliability. Illinois, US. This study had 4 phases: (1) tool revision, (2) pilot testing, (3) content validity assessment, and (4) interrater and test-retest reliability assessment. The original Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was revised to incorporate evidence from updated guidelines and evidence. The NEFPAT+ was pilot-tested by 9 professionals at 5 food pantries. After revisions, 18 experts rated the content validity. Interrater and test-retest reliability was based on 2–4 professionals completing independent evaluations at 21 food pantries twice, 1 month apart. Content validity indices and intraclass correlation (ICC) coefficients for reliability estimates were compared with established thresholds. The NEFPAT+ was rated content valid by 94% of experts. The ICC for NEFPAT+ scores indicated excellent interrater reliability (ICC, 0.96; 99% confidence interval, 0.75–0.97) and good test-retest reliability (ICC: 0.80; 99% confidence interval, 0.60–0.92). Evidence supports the content validity, interrater reliability, and test-retest reliability of the NEFPAT+. Future studies can assess how NEFPAT+ scores relate to intervention outcomes and dietary behaviors. [ABSTRACT FROM AUTHOR]

Early interventions may promote reductions in mothers' anxiety-depression (AD) symptoms and improvements in their offspring. This longitudinal randomized research was conducted to assess the effects of interdisciplinary online therapeutic groups (GIO) in at-risk mothers and babies during the COVID-19 pandemic in a disadvantaged neighborhood in Barcelona (Spain). A total of 135 babies were born from March 2020 to June 2021 in a primary healthcare center of Barcelona (Spain). Pregnant woman and new mothers were screened for AD symptomatology through EPDS and STAI questionnaires. Seventy-two of them met high-risk criteria for AD and were included in the study. They were randomly assigned into the two groups of the study: 40 participants were assigned to GIO, the therapeutic group (TG), while 32 of them were assigned to the control group (CG) and received treatment as usual. The course of the mothers' symptomatology was assessed, as well as the baby's development at 6 months old in a blind pediatric follow-up. No differences were found in AD between both groups before the intervention. However, we obtained a significant decrease in AD symptomatology (EPDS p <.001; STAI state p =.015 and STAI trait p <.001at 6 months of life) after the intervention in the TG compared to the CG. Pediatric follow-up at 6 months demonstrated significant differences between groups in babies' development assessment (manipulation p =.003; language p <.001; sociability p <.001). The GIO helped to ensure healthy development of the baby and reduction of the mothers' depressive-anxiety symptomatology. [ABSTRACT FROM AUTHOR]

Introduction: Stroke poses challenges to the physiological, psychosocial and spiritual well‐being of affected individuals. As the impacts of stroke might not be reversible, a shift in focus to providing care is desirable. Visual art interventions using visual and symbolic art can help participants to express their feelings, give them a sense of choice and the feeling that they are retaining a sense of control, promote insights, restructure their sense of cognition and instil hope. There have been few studies on visual art interventions involving older people with stroke and none in residential care homes (RCHs). Theoretical support and rigorous research designs on the subject are lacking. Thus, this study seeks to address this research gap by examining the feasibility of a visual art intervention for older people in RCHs and exploring the impacts on their holistic well‐being. Methods: This was a single‐blinded, two‐arm, randomised controlled feasibility study grounded on Watson's Caring Theory. The Holistic Well‐Being Scale and Caring Factor Survey were used in the study, with three assessment time‐points: before the intervention (T1), at the mid‐point of the intervention (T2) and immediately after the intervention (T3). Results: Sixty‐one older people with stroke were recruited from 14 RCHs and randomised into the intervention and control groups. The recruitment rate was 44.53%, and the retention rate for the intervention group was 93.55%. Implementing the programme was affordable (at approximately US$126/head), the duration was acceptable (721 min) and the feedback from participants and staff of the RCHs was positive. Conclusions: The visual art intervention programme proved to be clinically feasible. This study adds new insights to the development of visual art interventions and to the caring sciences. The efficacy of the programme on holistic well‐being has yet to be confirmed. [ABSTRACT FROM AUTHOR]

To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2019 and received standard level of physiotherapy. The intervention group were recruited between May and December 2019 and received extended physiotherapy, corresponding to 50% additional physiotherapist, working 4 hours per weekday. The intervention participants received an individual rehabilitation plan developed in collaboration with a ward-based physiotherapist, and an extended number of sessions provided by the extra resource included practicing individualized exercises, for example walking and stair climbing. Physical function was measured with the Chelsea Critical Care Physical Assessment tool (CPAx) at ICU discharge, during hospital stay and discharge. Group differences were analyzed using the Mann–Whitney U-test and Chi2 test. Out of 46 eligible patients, 39 (85%) fulfilled the study (comparison n = 12, intervention n = 27) and were included in the final analyses. No adverse events occurred, and the attendance rate was high (98.5%). There were no statistically significant differences between the groups regarding physical function, hospital stay, and readmissions, but there were tendencies to better outcomes in all these parameters in favor of the intervention group. Additionally, patients in the intervention group had statistically significantly higher scores in the CPAx items "transferring from bed to chair" (median 5 vs 4, p =.039) and "stepping" (median 5 vs 4, p =.005) at hospital discharge. This pilot study indicates that extended physiotherapy after ICU discharge is feasible and does not entail patient safety risks. However, determining the potential beneficial effects for the patients remains to be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

The six-minute walk test (6MWT) is considered reliable and valid for assessing walking capacity in people with neurologic conditions. However, the consistency in the test length and configuration used is unclear. To determine how the 6MWT was configured by licensed physical therapists working with patients with neurologic conditions in clinical practice, identify their knowledge of the American Thoracic Society (ATS) and Academy of Neurologic Physical Therapy (ANPT) guidelines for the 6MWT and assess relationships between therapist demographic characteristics and knowledge of the 6MWT guidelines. One hundred forty-six therapists completed a survey related to the configuration they used for the 6MWT. Configuration of the 6MWT varied widely. Space limitation was the most frequently selected reason for reported configurations. Over half had available the standardized 100-feet straight walkway but fewer than one-third used this configuration of the ATS guidelines. Fewer than half knew of the ATS guidelines and nearly three-fourths knew of the ANPT guidelines. American Physical Therapy Association membership and having a higher percentage of neurologic patients were associated with knowledge of both guidelines. The 6MWT must be completed within the constraints of the working environment, and this requirement is clinically relevant when comparing patient results to normative values and measurements across clinics. Our results suggest a need for updated norms that are more congruent with space constraints in current practice settings. [ABSTRACT FROM AUTHOR]

Individuals with advanced cancer can benefit from physical activity (PA), but face barriers to PA participation. Physiotherapists can be well-positioned to support this patient population. Our objective was to describe the perspectives, practices, knowledge, and skills of oncology physiotherapists related to PA in people with advanced cancer. In this mixed-methods study, we recruited Canadian physiotherapists with current or recent clinical experience with advanced cancer. Phase I consisted of an online survey about views toward PA in advanced cancer and activity-related recommendations and concerns for two case scenarios. Phase II involved individual, semi-structured interviews about perspectives related to working with advanced cancer. Sixty-two physiotherapists participated in the survey, of which 13 participated in interviews. Most respondents (> 85%) agreed or strongly agreed PA is important and safe for individuals with advanced cancer. Case responses highlighted cancer-related considerations (e.g. bone metastases) tailored activity recommendations, and patient-centered, interprofessional care. Interview themes included: 1) situating PA within individually meaningful goals; 2) tailored strategies to promote PA; 3) overarching roles in functional optimization and symptom management; and 4) generalized lack of awareness regarding physiotherapy. Our findings indicate Canadian oncology physiotherapists describe knowledge of the safety and importance of PA, as well as key considerations in advanced cancer. Moreover, they highlight the importance of a patient-centered approach to support this population, particularly in facilitating safe and meaningful PA, as well as optimizing function and alleviating symptom burden. Further efforts are needed to investigate the development and integration of physiotherapy within cancer care. [ABSTRACT FROM AUTHOR]

Background: Conventional thalassemia screening takes a stepwise approach and has limitations in comprehensively identifying all spectrums of mutations. This study aimed to investigate the performance of third-generation sequencing (TGS) compared to conventional molecular testing. Methods: TGS was applied to validate all known variants detected by conventional testing and to detect missing variants in undiagnosed cases. The study was conducted at Maharaj Nakorn Chiang Mai Hospital between December 2021 and April 2022. Results: In total, 19 cases were included in this study, among which 52.6% (10/19) had known thalassemia variants, while 47.7% (9/19) cases were undiagnosed by conventional methods. All 16 variants previously detected were validated by TGS, and TGS additionally detected 43.8% (7/16) thalassemia variants for 36.8% (7/19) cases. Conclusion: TGS could provide additional genetic diagnoses compared with conventional methods. Further cost-effectiveness studies with a larger sample size are needed to explore the role of TGS in clinical practices. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of a vocabulary-based teacher intervention to increase preschool teachers' production of complement clauses (e.g. I wonder if we can put the monkey in the tree) in teacher–children play interactions. Using a multiple baseline across participants design we measured the impact of an intervention that promoted preschool teachers' production of four complement clause verbs (CCVs)— figure out, notice, remember, wonder. Based on visual analysis we established a functional relation between the teacher intervention and the teachers' production of the target CCVs produced with a complement clause. Asking teachers to increase their use of CCVs in verbal interactions with children is a promising approach to increase teacher complex syntax input in the preschool classroom. [ABSTRACT FROM AUTHOR]

Multilingual children living in areas with low socioeconomic status (SES) are at an increased risk of having speech, language and communication needs (SLCN). Many multilingual children with SLCN in Sweden have insufficient basic vocabulary knowledge in the majority language, preventing them from achieving the school's learning goals. However, there is a lack of studies of interventions that could improve vocabulary development in this group, and that can be delivered in an everyday educational setting. This pilot study evaluates the effect of a school-based vocabulary group intervention, which combines elements from shared book reading and the Lexicon Pirate method, on vocabulary skills. A non-randomised pretest–posttest control group design was used. Eighteen six- to seven-year-old multilingual children attending preschool class in low SES areas either received intervention (n = 9) or were included in a control group (n = 9). The intervention group participated in 12 intervention sessions over six weeks. Word knowledge, semantic fluency, and comprehension of semantic relations were assessed pre- and post-intervention. Results revealed that children in the intervention group demonstrated significant gains in knowledge of both trained and untrained words, compared to the control group. No effects were found on semantic fluency or comprehension of semantic relations. [ABSTRACT FROM AUTHOR]

Background: Patients who are malnourished and have emergency general surgery, such as a laparotomy, have worse outcomes than those who are not malnourished. It is paramount to identify these patients and minimise this risk. This study aimed to describe current practices in identifying malnutrition in patients undergoing a laparotomy, specifically focusing on screening, assessment, nutrition pathways and barriers encountered by clinicians. Methods: Following piloting and validity assessment, anaesthetic and surgical National Emergency Laparotomy Audit (NELA) Leads at hospitals across England and Wales were emailed an invitation to a survey. Responses were gathered using Qualtrics. Descriptive analysis and correlation with laparotomy volume and professional role were performed in SPSSv26. University of Sheffield ethical approval was obtained (UREC 046205). The results from the survey are reported according to the CHERRIES guidelines. Results: The survey was completed by 166/289 NELA Leads from 117/167 hospitals (57.4% and 70.1% response rates, respectively). Participants reported low rates of nutritional screening (42/166; 25.3%) and assessment (26/166; 15.7%) for malnutrition preoperatively. More than one third of respondents (40.1%) had no awareness of local screening tools; indeed, the Malnutrition Universal Screening Tool (MUST) was used by approximately half of respondents (56.6%). Contrary to guidelines, NELA Leads report albumin levels continue to be used to determine malnutrition risk (73.5%; 122/166). Postoperative nutrition pathways were common (71.7%; 119/166). Reported barriers to nutritional screening and assessment included a lack of time, training and education, organisational support and ownership. Participants indicated nutrition risk is inadequately identified and is an important missing data item from NELA. There was no significant correlation with hospital laparotomy volume in relation to screening or assessment for malnutrition, the use of nutritional support pathways or organisational barriers. There was interprofessional agreement across a number of domains, although some differences did exist. Conclusions: Wide variation exists in the current practice of identifying malnutrition risk in NELA patients. Barriers include a lack of time, knowledge and ownership. Nutrition pathways that encompass the preoperative phase and incorporation of nutrition data in NELA may support improvements in care. Highlights: Emergency general surgical patients, in particular those who undergo a laparotomy and are malnourished, are at high risk of worse outcomes than those who are not malnourished.There is wide variation in current practices in relation to screening and assessment of malnutrition in laparotomy (NELA‐eligible) patients.A number of barriers to identifying malnutrition in laparotomy patients exist, including a lack of time, training and education, access and ownership of the problem. [ABSTRACT FROM AUTHOR]

Objective To pilot measurement of hair cortisol concentration (HCC) in pregnant women with opioid use disorder and their infants over time and study the potential utility of hair cortisol as a biomarker of chronic stress in this population. Study Design In this pilot prospective cohort study of mother–infant dyads with and without prenatal opioid exposure, we obtained mother–infant HCCs at delivery and again within 1 to 3 months' postpartum. HCCs were compared between the opioid and control groups and between the two time points. Results There were no significant differences between opioid and control group maternal or infant HCCs at either time point. However, within the opioid-exposed group, there was a significant increase in infant HCCs across the two time points. Conclusion This pilot study describes our experience with the measurement of HCCs in opioid-exposed mother–infant dyads. Key Points Maternal stress impacts fetal and child health. Many stressors in pregnant women with opioid use disorder. Hair cortisol may be a useful stress biomarker. [ABSTRACT FROM AUTHOR]

Objective: Creation of a novel 3D-printed physical cochlear model that demonstrated the feasibility of creating the model, and impact of a Graphical User Interface (GUI) system on training insertion metrics. Study Design: Feasibility study with a pilot prospective data collection. Setting: Tertiary academic center. Methods: The study was IRB exempt. Five resident trainees (PGY1-PGY5) practiced electrode insertions in cadaveric temporal bones before using the simulator. Nine students were educated on how to hold the electrodes and position them, and then allowed to use the simulator. All trainees were instructed that slower insertions were favorable. One cochlear implant (CI) surgeon used the simulator. The GUI captured the real video feed, but also provided distance, trajectory, and velocity measurements. The program is designed to plot the real-time depth of insertion and speed of insertion of the electrode; the user is also provided real-time occurrence of any kinks and back-outs. Results: A total of 14 trainees and 1 CI surgeon inserted the electrode at least 5 times without the use of the GUI (before) and then at least 5 times with the use of the GUI (after). Average Speed before and after (100.84 and 53.23 mm/s); Average minimum speed before and after (59.34 and 9.65 mm/s); and Average maximum speed before and after (416 and 285.81 mm/s). Statistically significant improvements were noted in all the measured speeds of insertion (P <.001). The other variables improved but not to a statistical significance. Conclusions: Real-time training using the 3D-printed model and GUI for cochlear implantation can help improve surgical resident training and comfort levels with electrode insertion for surgical trainees. The advantage of this model is that surgeons/trainees can use it as many times as they like, as the whole set-up is easy, economical, and reusable. The real time graphical user interface enhances training and retention of the practiced skills. [ABSTRACT FROM AUTHOR]

Background: Cellulite represents a common multi‐factorial condition that affects nearly all women and is now recognized as a clinical condition associated with systemic factors and negative psychological effects. Several noninvasive and minimally invasive treatments were developed during the last few years, but limited evidence supports many of them due to lack of evidence, insufficient participants, and potential adverse effects. Methods: This study aimed to evaluate the efficacy of a seaweed mud application in improving both the structure and function of tissues affected by cellulite. Sixty women with cellulite underwent 4‐week applications of seaweed mud on the buttocks and thighs. The following assessments were performed at baseline and after the last treatment: photographic, clinical, and anthropometric evaluation; tests for elasticity and hydration; ultrasonography of cellulite nodules; and cellulite biopsies in the trochanteric region. Patient satisfaction was assessed using a 5‐point Likert‐scale questionnaire. Results: The treatment resulted in a significant improvement in the severity of cellulite severity between the initial assessment and the 4‐week follow‐up, with enhanced structure, elasticity, and hydration of the affected tissues. Microscopic analysis of the cellulite biopsies revealed a significant restoration of dermal organization with induced collagen synthesis and reduced inflammation, edema, and lipid deposition following the 4‐week seaweed mud applications. Additionally, the treatment led to a remarkable improvement in comfort and satisfaction as well as a reduction in body circumferences. Conclusions: The cosmetic application of seaweed mud has proven to be a safe, non‐invasive treatment for improving the tissue alterations characteristic of cellulite. [ABSTRACT FROM AUTHOR]

Few studies have reported outcomes from the delivery of naturalistic developmental behavioral interventions (NDBI) in group-based community care. Further, while the importance of inclusion for autistic individuals is well established, there is little research on the feasibility of community-based inclusion programs for preschool-aged autistic children. Positive outcomes have been reported from a few model inclusion programs. However, most involved extensive training from researchers, with limited available data on self-sustaining community-based programs. This quasi-experimental study tracked outcomes for 31 autistic preschool-aged children with verbal and play skills close to age level, who were enrolled in a community inclusion preschool program utilizing NDBI. Children, aged 2.5 to 5 years of age at entry, attended the program for 8 to 36 months. Paired sample t -tests indicated statistically significant improvements from time 1 to time 2 on standardized measures of adaptive behavior, social skills, and autism characteristics. Implications for the feasibility of using NDBI for autistic children in inclusive preschool settings and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Few studies examine the effectiveness of community-based early interventions in unselected samples of autistic children, especially those from minoritized backgrounds. These types of studies require attention to strategies for recruitment, retention, data collection, and support for community providers beyond those used in university-based trials. We conducted a pilot trial of Project ImPACT, a promising caregiver-mediated naturalistic developmental behavioral intervention, in partnership with the early intervention system in a poor, large city. We assessed recruitment and retention strategies, training protocol, and measurement battery. We recruited representative provider and family samples, and had good measure completion among retained participants. Retention varied by study arm, providers had relatively poor fidelity to the intervention despite substantial support, and our measures did not appear sensitive to change. Lessons learned include the need for (a) a ramp-up training period prior to starting the study, (b) intensive implementation supports, and (c) additional strategies for family retention. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of food insecurity (FI) among patients in a regional New Zealand ED, factors associated with FI and feasibility of an ED‐based FI screening programme with voluntary social work (SW) follow up. Methods: Cross‐sectional study of patients presenting to the Whangarei Hospital ED, using the validated two‐item Hunger Vital Sign screening tool to assess for FI. Participants were offered SW follow up to discuss community food resources. Results: Of the 300 participants who completed the questionnaire, 111 (37.0%, 95% confidence interval [CI] 32.0–43.0) were food insecure. Factors associated with FI include Māori ethnicity (odds ratio [OR] 2.12 [95% CI 1.19–3.80], P = 0.011), household crowding (OR 1.19 [95% CI 1.02–1.39], P = 0.024) and lower socioeconomic status (OR 1.13 [95% CI 1.00–1.27], P = 0.048). There was no statistically significant association between FI and number of comorbidities or the primary reason for ED attendance. Of participants who were food insecure, only half reported being aware of (n = 56/111, 50.5%) or had used (n = 60/111, 54.1%) food resources. Participants who were food insecure were more likely to have utilised resources, either currently or in the past (OR 8.50 [95% CI 4.46–16.18], P < 0.001). Forty (13.3%) participants requested SW follow up and of those, most (n = 31/40, 77.5%) were successfully contacted. FI was associated with interest in SW follow up (OR 16.95 [95% CI 5.81–49.42], P < 0.001). At follow up, the majority (n = 24/31, 77.4%) of participants requested further information regarding food resources. Conclusion: FI was prevalent among patients in a regional NZ ED. An ED‐based FI screening programme with voluntary SW follow up was feasible and acceptable to ED patients. [ABSTRACT FROM AUTHOR]

Objective: Moderate risk patients with chest pain and no previously diagnosed coronary artery disease (CAD) who present to ED require further risk stratification. We hypothesise that management of these patients by ED physicians can decrease length of stay (LOS), without increasing patient harm. Methods: A prospective pilot study with comparison to a pre‐intervention control group was performed on patients presenting with chest pain to an ED in Perth, Australia between May and October 2021, following the introduction of a streamlined guideline consisting of ED led decision making and early follow up. Patients had no documented CAD and were at moderate risk of major adverse cardiac events (MACE). Electronic data was used for comparison. Primary outcomes were total LOS and LOS following troponin. Results: One hundred eighty‐six patients were included. Median total LOS was reduced by 62 min, but this change was not statistically significant (482 [360–795] vs 420 [360–525] min, P = 0.06). However, a significant 60 min decrease in LOS was found following the final troponin (240 (120–571) vs 180 (135–270) min, P = 0.02). There was no difference in the rate of MACE (0% vs 2%, P = 0.50), with no myocardial infarction or death. Conclusions: Our study suggests that patients with no pre‐existing CAD can be safely managed by emergency physicians streamlining their ED management and decreasing LOS. This pathway could be used in other centres following confirmation of the results by a larger study. [ABSTRACT FROM AUTHOR]

Objective: To describe the relationships between different methods of measuring functional fibrinogen levels in severely injured, bleeding trauma patients across multiple timepoints during hospitalisation. Methods: In 100 adult trauma patients enrolled in the FEISTY pilot randomised clinical trial at four tertiary trauma centres in Australia, blood samples were collected prospectively. Consistency of agreement was calculated, comparing functional fibrinogen levels measured by four methods – ROTEM® Delta and Sigma FIBTEM A5, TEG® 6s CFF MA, and gold‐standard Clauss Fibrinogen. Results: Comparing the ROTEM® Delta and new‐generation ROTEM® Sigma machine, consistency of agreement for FIBTEM A5, measured by calculating intraclass correlation coefficients (ICCs), was ≥0.73 across all analysed timepoints, with mean differences (Sigma minus Delta) of 0.10–3.57 mm. Corresponding values comparing the ROTEM® Sigma FIBTEM A5 and TEG® 6s CFF MA were ICC = 0.55–0.82 and ICC = 4.69–7.97 (CFF MA minus A5). Comparing ROTEM® Sigma FIBTEM A5 and Clauss Fibrinogen Analysis (CFA), among statistically significant simple linear regression models, R2 was 0.25–0.67, and comparing TEG® 6s CFF MA and CFA (CFA) 0.65–0.82, although not all differences were significant with the latter comparison. Relationships across all timepoints combined were Clauss Fibrinogen (CF) (g/L) = 0.21푥 + 0.004 (where 푥 = ROTEM® Sigma FIBTEM A5 in mm) and (g/L) = 0.16푥 − 0.06 (where 푥 = TEG® 6s CFF MA in mm). Conclusions: The present study revealed acceptable agreement between four different assays measuring functional fibrinogen, with current‐ and previous‐generation ROTEM® machines (Sigma, Delta) performing similarly measuring functional fibrinogen via FIBTEM assay. This suggests that haemostatic resuscitation algorithms designed for the ROTEM® Delta can be applied to the ROTEM® Sigma to guide fibrinogen replacement. [ABSTRACT FROM AUTHOR]

Wuhan was the first large city where the initial breakout of COVID-19 took numerous lives. A group of social workers and mental health specialists coordinated the "Be Together Program" (BTP), a psychosocial grief intervention program to help a group of Wuhan COVID-19 bereaved people. Under the Dual-process model framework, BTP used the internet and social media as the main tools, combined with group and individual intervention. Additionally, it employed a "Supermarket Mode" with abundant intervention themes and approaches for BTP participants to choose according to their special needs. Additionally, Chinese cultural elements are integrated into the program. At the end of the program, the grief scores of participants in the qualified sample reduced significantly, and the prevalence of the potential Prolonged Grief Disorder diagnosis reduced from 75% to 12%. The study also found that the BTP was especially effective for those who had high levels of grief reaction. [ABSTRACT FROM AUTHOR]

Aim: Patients with chronic kidney disease (CKD) are more susceptible to endothelial dysfunction and cardiovascular disease (CV). Remote ischemic preconditioning (rIPC) has been proven efficient in improving endothelial function and lowering the risk of CV. However, the safety and effect of rIPC on endothelial function in patients with CKD have not been effectively assessed. Methods: 45 patients with CKD (average estimated glomerular filtration rate: 48.4 mL/min/1.73 m2) were randomly allocated to either 7‐day daily upper‐arm rIPC (4 × 5 min 200 mmHg, interspaced by 5‐min reperfusion) or control (4 × 5 min 60 mmHg, interspaced by 5‐min reperfusion). Vascular endothelial function was assessed by natural log–transformed reactive hyperemia index (LnRHI) before and after a 7‐day intervention. Arterial elasticity was assessed by augmentation index (AI). Results: The results showed that LnRHI could be improved by rIPC treatment (Pre = 0.57 ± 0.04 vs. Post = 0.67 ± 0.04, p =.001) with no changes relative to control (Pre = 0.68 ± 0.06 vs. Post = 0.64 ± 0.05, p =.470). Compared with the control group, the improvement of LnRHI was greater after rIPC treatment (rIPC vs. Control: 0.10 ± 0.03 vs. −0.04 ± 0.06, between‐group mean difference, −0.15 [95% CI, −0.27 to −0.02], p =.027), while there was no significant difference in the change of AI@75 bpm (p =.312) between the two groups. Conclusion: RIPC is safe and well tolerated in patients with CKD. This pilot study suggests that rIPC seems to have the potential therapeutic effect to improve endothelial function. Of note, further larger trials are still warranted to confirm the efficacy of rIPC in improving endothelial function in CKD patients. [ABSTRACT FROM AUTHOR]

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: To explore patients' willingness to have medication adherence measured using different methods and evaluate the feasibility and validity of their combination (i.e., pill counts, a medication diary and a questionnaire assessing adherence two months post-discharge). Methods: (1) A cross-sectional evaluation of the willingness of patients with polypharmacy to have their medication adherence measured post-discharge. (2) Medication adherence was monitored during two months using pill counts based on preserved medication packages and a diary in which patients registered their adherence-related problems. During a home visit, the Probabilistic Medication Adherence Scale (ProMAS) and a questionnaire on feasibility were administered. Results: A total of 144 participants completed the questionnaire at discharge. The majority was willing to communicate truthfully about their adherence (97%) and to share adherence-related information with healthcare providers (99%). More participants were willing to preserve medication packages (76%) than to complete a medication diary (67%) during two months. Most participants reported that preserving medication packages (91%), completing the diary (99%) and the ProMAS (99%) were no effort to them. According to the majority of participants (60%), pill counts most accurately reflected medication adherence, followed by the diary (39%) and ProMAS (1%). Medication adherence measured by pill counts correlated significantly with ProMAS scores, but not with the number of diary-reported problems. However, adherence measured by the medication diary and ProMAS correlated significantly. Conclusion: Combining tools for measuring adherence seems feasible and can provide insight into the accordance of patients' actual medication use with their prescribed regimen, but also into problems contributing to non-adherence. [ABSTRACT FROM AUTHOR]

Background: Volume overload (VO) is common in the intensive care unit (ICU) and associated with negative outcomes. Approaches have been investigated to curtail VO; however, none specifically focused on medication diluent volume optimization. Objective: Investigate the impact of a pharmacist-driven medication diluent volume optimization protocol on fluid balance in critically ill patients. Methods: A prospective, pilot study was conducted in a medical ICU during October 2021 to December 2021 (pre) and February 2022 to April 2022 (post). A pharmacist-driven medication diluent volume optimization protocol focusing on vasopressor and antimicrobial diluent volumes was implemented. Demographics and clinical data were collected during ICU admission up to 7 days. The primary outcome was net fluid balance on day 3. Secondary outcomes were medication volumes administered, net fluid balance, ICU length of stay, and mortality. Results: Supply chain shortages caused the study to stop at the end of February 2022. Overall, 152 patients were included (123 pre group, 29 post group). The most common admission diagnosis was acute respiratory failure (35%). Vasopressors and antimicrobials were utilized in 47% and 66% of patients, respectively. Net fluid balance on day 3 was greater but not significant in the post group (227.1 mL [−1840.3 to 3483.7] vs 2012.3 mL [−2686.0 to 4846.0]; P =.584). Antimicrobial diluent volumes were significantly less in the post group. No differences were seen in other secondary outcomes. Protocol group assignment was not associated with net fluid balance on day 3. Conclusion: Despite decreasing antimicrobial volume contributions, optimizing diluent volumes alone did not significantly impact overall volume status. Future studies should focus on comprehensive approaches to medication diluent optimization and fluid stewardship. [ABSTRACT FROM AUTHOR]

Purpose: Medication history is the method many organizations use to adhere to The Joint Commission's (TJC) National Patient Safety Goal (NPSG) to communicate accurate patient medication information. Literature is sparse comparing the number of medication histories completed in-person versus virtually. Methods: This is a single system, multi-site, retrospective observational study. Patients included were admitted through the Emergency Department during October 2022. The primary aim of this study compared the percent capture rates of medication history between 2 hybrid sites to an in-person site within a health-system. Our secondary objective compared the differences in the 'medication history acuity score' (MHAS), defined as the total number of edits, additions, and deletions made during a medication history. Results : The medication history capture rate at the in-person site was 74% and at the hybrid sites were 91% and 80%. There were no differences in total medications on each medication history between in-person and hybrid (11 [5-16] vs 11 [6-16]; P =.252). There were no differences in changes made on medication histories between in-person and hybrid (4 [1-7] vs 3 [1-7]; P =.595). Conclusions: Our study demonstrates that medication history capture rates and MHAS are comparable in both in-person and hybrid environments. This similarity suggests the feasibility of implementing hybrid models for medication history services in diverse healthcare settings, potentially enhancing the capacity of health systems to meet TJC NPSG. These findings indicate that hybrid models could be an effective strategy for healthcare systems to optimize their medication history services, especially in settings with varied patient volumes and site specialties. [ABSTRACT FROM AUTHOR]

Mexican Americans are among the highest risk groups for obesity and its associated health consequences, including diabetes, heart disease, and cancer. 154 overweight/obese Mexican Americans recruited from the Mexican Consulate in New York City were enrolled in COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), a 12-week Spanish-language lifestyle intervention that included a dietary counseling session, weight-loss resources, and thrice-weekly text messages. Participants' weight (primary outcome); dietary intake, physical activity, and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Of the 109 who completed follow-up, 28% lost ≥ 5% of their baseline body weight. Post-intervention, participants consumed more fruit and less soda, sweet pastries, fried foods and red meat; increased physical activity; and evidenced greater nutrition knowledge. A community-based lifestyle intervention with automated components such as text messaging may be a scalable, cost-effective approach to address overweight/obesity among underserved populations. [ABSTRACT FROM AUTHOR]

Based on previous work, we developed the comic "A healthy liver will always deliver!" to raise awareness about Non-Alcoholic Fatty Liver Disease (NAFLD) and promote healthy lifestyles. An online pre-post questionnaire design demonstrated an increase in health-threat beliefs regarding NAFLD among the general public, as well as response efficacy and self-efficacy beliefs, normative and control beliefs regarding the maintenance of preventive strategies involving healthy diets and active lifestyles, after interaction with the comic's narrative. This effect was more evident in women. Furthermore, although we could not perform all the ideal controls during the COVID-19 pandemic, and the online strategy attracted mostly university education-level subjects, the comic seemed relatable and engaging. However, more work will have to be performed to ensure its usefulness in terms of acquired knowledge and behavior changes, especially in at-risk segments of the population. [ABSTRACT FROM AUTHOR]

Objective: Advanced laryngeal cancers are clinically complex; there is a paucity of modern decision-making models to guide tumour-specific management. This pilot study aims to identify computed tomography-based radiomic features that may predict survival and enhance prognostication. Methods: Pre-biopsy, contrast-enhanced computed tomography scans were assembled from a retrospective cohort (n = 72) with advanced laryngeal cancers (T3 and T4). The LIFEx software was used for radiomic feature extraction. Two features: shape compacity (irregularity of tumour volume) and grey-level zone length matrix – grey-level non-uniformity (tumour heterogeneity) were selected via least absolute shrinkage and selection operator-based Cox regression and explored for prognostic potential. Results: A greater shape compacity (hazard ratio 2.89) and grey-level zone length matrix – grey-level non-uniformity (hazard ratio 1.64) were significantly associated with worse 5-year disease-specific survival (p < 0.05). Cox regression models yielded a superior C-index when incorporating radiomic features (0.759) versus clinicopathological variables alone (0.655). Conclusions: Two radiomic features were identified as independent prognostic biomarkers. A multi-centre prospective study is necessary for further exploration. Integrated radiomic models may refine the treatment of advanced laryngeal cancers. [ABSTRACT FROM AUTHOR]

This article highlights the significance of pilot studies in research and offers guidance on how to design, conduct, and report them. Pilot studies serve as preliminary investigations that help identify potential issues in future trials. However, it is important to note that many studies labeled as pilot studies are actually different types of studies. Pilot studies can evaluate various aspects of a future study, such as recruitment rates, data optimization, and treatment safety. They also provide an opportunity to refine study methods before conducting larger trials. Nonetheless, it is important to acknowledge the limitations of pilot studies and interpret their findings cautiously. The article also provides reporting guidelines specifically for non-randomized pilot studies. These guidelines cover different aspects of pilot studies, including randomization methods, analytical methods, participant flow, recruitment, baseline data, outcomes, and interpretation. The document also emphasizes the importance of assessing the quality of pilot studies and planning for the conversion of a pilot study into a full hypothesis-testing trial. The authors stress the need for rigorous methodology and clear progression criteria in pilot studies to ensure informative and publishable results. [Extracted from the article]

Aims: To explore the feasibility and potential benefits of a peer support programme for adults with insulin‐treated type 2 diabetes (T2D) starting continuous glucose monitoring (CGM). Methods: This part of the Steno2tech study is an exploratory, single‐centre, open‐labelled, prospective, randomised controlled trial (RCT). A total of 60 participants were randomised 2:1 to 12 months of CGM with or without peer support. All participants received a 3‐h diabetes self‐management education course including a CGM part on how to use the CGM and interpret the CGM‐derived data. Peer support consisted of three 3‐h peer support meetings over the first 6 months of the study period with groups of three to six people. The exploratory outcomes included the acceptability and feasibility of the peer support intervention, and the between‐group difference in change in several glycaemic, metabolic and participant‐reported outcomes measured at baseline, 6 and 12 months. Results: The peer support intervention was found acceptable and feasible. Participants shared their experiences of using and interpreting CGM data and its association with health behaviour. While both groups had improvements in glycaemic, metabolic and participant‐reported outcomes, there were no significant between‐group differences. Conclusions: Although feasible, we found no measured additional benefits when adding a peer support programme after starting CGM in this exploratory RCT including adults with insulin‐treated T2D. Understanding the perceived effect of and preferences for a peer support intervention from the participants' points of view, including why individuals declined to participate, would be of value for future research. [ABSTRACT FROM AUTHOR]

Background: Immersive virtual reality (IVR) is a new technology that could motivate learners, but also could contain distracting elements that increase cognitive demands on learners. In contrast, learning with conventional media, such as a narrated slideshow could be less motivating, but also less distracting. Objectives: This experiment investigates: (1) in what situations executive function and working memory capacity play a role in learning in IVR and a slideshow lesson and (2) whether people learn science content better with IVR or with a narrated slideshow lesson. Method: Participants watched a lesson on ocean acidification either using a head‐mounted display IVR device or a pre‐recorded narrated slideshow lesson. A week later, they took a test on this material and completed tasks to assess executive function and working memory capacity. Results and Conclusion: On a post‐test, there was no difference between IVR and slideshow lessons, but there were differences in the role of executive function in learning with these two media. For students learning in IVR, executive function correlated significantly with post‐test scores, such that learners with stronger executive function did better on the posttest than those with weaker executive function, while for students learning with a slideshow lesson, executive function and working memory capacity did not correlate significantly with posttest scores. This research indicates that it is important to understand how a learner's attentional controls impact their understanding when using IVR for learning. Lay Description: What is already know about this topic: Immersive virtual reality increases demands on cognition for learners.Immersive virtual reality for learning has inconsistent effects in prior research.Executive function and working memory capacity are important components in processing material while learning. What this paper adds: Research focused on the role individual differences play in learning with technology.Using common cognitive assessments to understand the process of learning better. Implications for practice and/or policy: Executive function predicted test score for an immersive virtual reality lesson.Use of immersive technology needs to take into account executive function to reduce potential inequity in learning. [ABSTRACT FROM AUTHOR]

Background: A practical test that measures the information and communication technology (ICT) skills students need for effectively using ICT in primary education has yet to be developed (Oh et al., 2021). This paper reports on the development, validation, and reliability of a test measuring primary school students' ICT skills required for effectively using ICT (the ECC‐ICT test). Objectives: Based on existing literature, three ICT use domains were identified for effectively using ICT: Effective, collaborative, and creativeuse of ICT. For these three domains, 24 corresponding teaching objectives were identified from a widely used digital literacy framework. Thirty‐four test items cover these teaching objectives in an online test. Methods: A mixed‐method approach was used for the ECC‐ICT test. Four pilot rounds (n=25) implemented qualitative interviews for cognitive validity and refining the test items, followed by a qualitative usability study(n=6). Confirmatory factor analysis and ANOVA provided quantitative insight into the large‐scale test administration(n=575). Results and Conclusions: Composite reliability of our conceptual 3‐factor confirmatory model showed that the test reliably measured primary school effective use of ICT (ω = 0.82), collaborative use of ICT (ω = 0.80) and creative use of ICT (ω = 0.64). Convergent validity (ranging from 0.41 to 0.46) was acceptable. Internal consistency (ranging from 0.84 to 0.91) and discriminant validity (HTMT values below 0.90) are good. ANOVA results show that mean test scores are higher for students in higher grade levels (p < 0.001). The post hoc Bonferroni results show that most grade‐by‐grade comparisons are significant (p < 0.001). Lay Description: What is already known about this topic: Information and communication technology (ICT) skills are finding their way into national curriculums as teachers implement more digital learning environments.Teachers currently do not have a measurement instrument for the ICT skills primary education students need to learn in a personalised way. What this paper adds: This paper gives teachers a test that reliably measures the effective, collaborative, and creative ICT skills required for primary school students to learn using ICT.To our knowledge, this test is the first of its kind.Al materials to reproduce the test are available digitally for teachers. The implications of study findings for practitioners: For policy, this test can be used to check if a student is ready to use ICT in a self‐regulated setting.With this test, teachers can assess and support students' growth on the effective, collaborative, and creative ICT skills required for primary school students using ICT. [ABSTRACT FROM AUTHOR]

Background: Mind-body interventions focused on intentional breathing and movement have been found to mitigate the negative effects of caregiving such as such as stress, psychosocial distress, and emotional distress associated for persons living with Alzheimer's disease and related dementias. Objective: The objective was to assess the feasibility and acceptability and preliminary impacts of our 12-week mind body intervention "Gentle Yoga and Yogic Breathing" for caregivers of persons living with dementia on health outcomes including mutuality, depression and anxiety, loneliness and social support, quality of life, and physical function. Methods: We conducted a single-group cohort study in which 20 caregivers were enrolled. Data were collected at baseline and at the 12-week post-intervention endpoint. Results: The intervention was acceptable; 75% (n = 15/20) completed the study; 16 completed post-study questionnaires. Very few experienced technical issues; 31% (n = 3) most commonly reported as poor internet connectivity, 75% (n = 12/16) perceived a health benefit, 88% (n = 14/16) perceived improved day-to-day mood, and 100% (n = 16/16) would recommend the intervention to other caregivers. Although there was minimal change from baseline to 12 weeks, for health outcomes, there were very small improvements noted in anxiety and overall health. There were no reported adverse events. Conclusion: The intervention was well received and is feasible and acceptable for future studies of stress and health management interventions for caregivers of persons living with dementia. Registered with https://www.ClinicalTrials.gov (NCT03853148). [ABSTRACT FROM AUTHOR]