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T-cell responses to minor histocompatibility antigens (mHAs) mediate graft-versus-leukemia (GVL) effects and graft-versus-host disease (GVHD) in allogeneic hematopoietic cell transplantation. Therapies that boost T-cell responses improve allogeneic hematopoietic cell transplant (alloHCT) efficacy but are limited by concurrent increases in the incidence and severity of GVHD. mHAs with expression restricted to hematopoietic tissue (GVL mHAs) are attractive targets for driving GVL without causing GVHD. Prior work to identify mHAs has focused on a small set of mHAs or population-level single-nucleotide polymorphism–association studies. We report the discovery of a large set of novel GVL mHAs based on predicted immunogenicity, tissue expression, and degree of sharing among donor-recipient pairs (DRPs) in the DISCOVeRY-BMT data set of 3231 alloHCT DRPs. The total number of predicted mHAs varied by HLA allele, and the total number and number of each class of mHA significantly differed by recipient genomic ancestry group. From the pool of predicted mHAs, we identified the smallest sets of GVL mHAs needed to cover 100% of DRPs with a given HLA allele. We used mass spectrometry to search for high-population frequency mHAs for 3 common HLA alleles. We validated 24 predicted novel GVL mHAs that are found cumulatively within 98.8%, 60.7%, and 78.9% of DRPs within DISCOVeRY-BMT that express HLA-A∗02:01, HLA-B∗35:01, and HLA-C∗07:02, respectively. We confirmed the immunogenicity of an example novel mHA via T-cell coculture with peptide-pulsed dendritic cells. This work demonstrates that the identification of shared mHAs is a feasible and promising technique for expanding mHA-targeting immunotherapeutics.

T cell responses to minor histocompatibility antigens (mHAs) mediate graft versus leukemia (GvL) effects and graft versus host disease (GvHD) in allogeneic hematopoietic cell transplant (alloHCT). Therapies that boost T cell responses improve the efficacy of alloHCT; however, these have been limited by concurrent increases in the incidence and severity of GvHD. mHAs with expression restricted to hematopoietic tissue (GvL mHAs) are attractive targets for driving GvL without causing GvHD. Prior work to identify mHAs has focused on a small set of mHAs or population-level SNP association studies. We report here the discovery of a large set of novel GvL mHAs based on predicted peptide immunogenicity, restriction of expression to hematopoietic tissue or GvHD target organs, and degree of sharing among donor-recipient pairs (DRPs) in the DISCOVeRY-BMT dataset of 3231 alloHCT DRPs. The total number of predicted mHAs and count within each class of predicted mHAs significantly differed by recipient genomic ancestry group, with European American>Hispanic>African American for each. The number of mHAs also differed markedly by HLA allele, even among alleles of the same gene. From the pool of predicted mHAs, we identified the smallest sets of GvL mHAs needed to cover 100% of DRPs with a given HLA allele. We then used mass spectrometry to search for high population frequency mHAs for three common HLA alleles. We validated a total of 24 novel predicted GvL mHAs that cumulatively are found within 98.8%, 60.7%, and 78.9% of DRPs within DISCOVeRY-BMT that express HLA-A*02:01, HLA-B*35:01, and HLA-C*07:02 respectively. We also confirmed in vivo immunogenicity of one example novel mHA via coculture of healthy human CD8 T cells with mHA-pulsed dendritic cells. This work demonstrates that identification of shared mHAs is a feasible and promising technique for expanding mHA-targeting immunotherapeutics to larger numbers of patients.

We aimed to assess the effectiveness of a single dose of the Ad26.COV2.S vaccine (JohnsonJohnson) in health-care workers in South Africa during two waves of the South African COVID-19 epidemic.In the single-arm, open-label, phase 3B implementation Sisonke study, health-care workers aged 18 years and older were invited for vaccination at one of 122 vaccination sites nationally. Participants received a single dose of 5 × 10Between Feb 17 and May 17, 2021, 477 102 health-care workers were enrolled and vaccinated, of whom 357 401 (74·9%) were female and 119 701 (25·1%) were male, with a median age of 42·0 years (33·0-51·0). 215 813 vaccinated individuals were matched with 215 813 unvaccinated individuals. As of data cutoff (July 17, 2021), vaccine effectiveness derived from the total matched cohort was 83% (95% CI 75-89) to prevent COVID-19-related deaths, 75% (69-82) to prevent COVID-19-related hospital admissions requiring critical or intensive care, and 67% (62-71) to prevent COVID-19-related hospitalisations. The vaccine effectiveness for all three outcomes were consistent across scheme A and scheme B. The vaccine effectiveness was maintained in older health-care workers and those with comorbidities including HIV infection. During the course of the study, the beta (B.1.351) and then the delta (B.1.617.2) SARS-CoV-2 variants of concerns were dominant, and vaccine effectiveness remained consistent (for scheme A plus B vaccine effectiveness against COVID-19-related hospital admission during beta wave was 62% [95% CI 42-76] and during delta wave was 67% [62-71], and vaccine effectiveness against COVID-19-related death during beta wave was 86% [57-100] and during delta wave was 82% [74-89]).The single-dose Ad26.COV2.S vaccine shows effectiveness against severe COVID-19 disease and COVID-19-related death after vaccination, and against both beta and delta variants, providing real-world evidence for its use globally.National Treasury of South Africa, the National Department of Health, Solidarity Response Fund NPC, The MichaelSusan Dell Foundation, The Elma Vaccines and Immunization Foundation, and the BillMelinda Gates Foundation.

Summary: Background and Aims: Oesophagectomy is the primary curative treatment for oesophageal cancer but is associated with considerable postoperative morbidity and mortality. To better understand the aetiology of impaired health-related quality of life (HRQL) in oesophageal cancer survivors (OCS), this study sought to determine the longitudinal changes in nutritional status, nutrition-impact symptoms (NIS), and HRQL in this cohort, and to determine which variables have the greatest impact on postoperative HRQL decline. Methods: Data, derived from St. James' Hospital, Dublin, included patients who underwent oesophagectomy from October 2017 to May 2019 and attended clinic preoperatively and 6 months postoperatively. A subset attended a further 12-month appointment. HRQL and symptom data were collected using validated questionnaires and anthropometric measures were completed by clinicians. Data were analysed using SPSS. Results: A total of 66 patients were studied preoperatively and 6 months postoperatively, of whom 37 were studied at 12 months postoperatively. Malnutrition remained prevalent at each time-point, although rates did not significantly change longitudinally. Conversely, the prevalence of malabsorption (7.6%–14.3%, P

Purpose: Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS) are heritable connective tissue disorders associated with joint instability and pain, but with scant guidance for supporting patients. The aim was to determine recommendations for an HSD/hEDS self-management intervention. Materials and methods: Barriers to self-management were mapped onto the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation-Behaviour (COM-B) model in a behavioural analysis. A modified Nominal Group Technique was used to prioritise behaviour change technique (BCT) interventions (n = 9 women). Results: Possible BCTs incorporated: Education: Incorporating self-help strategies, education to improve their knowledge of HSD/hEDS, and how to judge information about HSD/hEDS. Training: In activity pacing, assertiveness and communication skills, plus what to expect during pregnancy, when symptoms can worsen. Environmental restructuring and enablement: Support from occupational therapists to maintain independence at work and home. Modelled behaviour: That illustrates how other people with HSD/hEDS have coped with the psychosocial impact. Conclusions: This study is the first to apply theoretically-informed approaches to the management of HSD/hEDS. Participants indicated poor access to psychological support, occupational therapy and a lack of knowledge about HSD/hEDS. Future research should evaluate which intervention options would be most acceptable and feasible.Implications for rehabilitation Patients with Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome can be active partners in the co-design of behaviour change interventions. Behaviour change interventions should target psychological support and patient education, particularly patient information. Additional behaviour change interventions included environmental restructuring and enablement; adaptations to participants’ environment with input from occupational therapy. Participants were keen to suggest opportunities for behavioural modelling; positive fist-person modelling narratives, written by those with HSD/hEDS, which addressed how they coped with the psychosocial impact of their condition.

Launched in 1999, at a time of radical change for the publishing industry, Persephone Books has become a successful independent publisher of neglected female authors mainly from the 20th-century inter-war period. Publishing being an industry primarily shaped by the differential distribution of symbolic and economic capital (Bourdieu, ‘The Market for Symbolic Goods’, in The Rules of Art, Polity Press, 1996, p. 9), competing principles of cultural legitimacy within an increasingly commercial climate clarify the position of modern publishing at the intersection of culture and commerce (Bourdieu, The Field of Cultural Production, Columbia University Press, 1993, p. 27). This article explores how Persephone Books’ understated assertion of publishing’s ‘middle ground’ and commitment to the historically reviled ‘middlebrow’ genre have reconciled the perennial tension between culture and commerce to create a thriving yet unintentional publishing brand.

To explore the decision-making processes and experiences of acute and rehabilitation clinicians, regarding referral and acceptance of patients to rehabilitation after stroke.Multi-site rapid ethnography, involving observation of multidisciplinary case conferences, interviews with acute stroke and rehabilitation clinicians, and review of key documents within five (5) acute stroke units (ASUs) in Queensland, Australia. A cyclical, inductive content analysis was performed.Seven key themes were identified, revealing the complex nature of post-stroke rehabilitation referral and acceptance decision making. Although the majority of clinicians felt that all patients could benefit from rehabilitation, they acknowledged this could not always be the case. Rehabilitation potential and goals were considered by clinicians, but decision making was impacted by ASU context and team processes, rehabilitation service availability and access procedures, and the relationships between the acute and rehabilitation clinicians. Patients and families were not actively involved in the decision-making processes.Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients.IMPLICATIONS FOR REHABILITATIONReferral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs.Clear and straightforward access procedures and positive relationships between acute and rehabilitation clinicians have a positive impact on referral decision making.Stroke services should review their processes to ensure shared decision making is facilitated when patients require access to rehabilitation.

ObjectivesTo explore patients’ agreement and reasons for agreement or disagreement with the EULAR recommendations for patient education (PE) for people with inflammatory arthritis (IA).MethodsThis mixed-method survey collected data using snowball sampling. The survey had been translated into 20 languages by local healthcare professionals, researchers and patient research partners. It explored the degree to which patients with IA agreed with each recommendation for PE (0=do not agree at all and 10=agree completely) and their rationale for their agreement level in free text questions. Descriptive statistics summarised participants’ demographics and agreement levels. Qualitative content analysis was used to analyse the free text data. Sixteen subcategories were developed, describing the reasons for agreement or disagreement with the recommendations, which constituted the categories.ResultsThe sample comprised 2779 participants (79% female), with a mean (SD) age 55.1 (13.1) years and disease duration 17.1 (13.3) years. Participants strongly agreed with most recommendations (median 10 (IQR: 9–10) for most recommendations). Reasons for agreement with the recommendations included the benefit of using PE to facilitate collaborative care and shared decision making, the value of flexible and tailored PE, and the value of gaining support from other patients. Reasons for disagreement included lack of resources for PE, not wanting information to be tailored by healthcare professionals and a reluctance to use telephone-based PE.ConclusionThe EULAR recommendations for PE have been disseminated among patients with IA. Overall, agreement levels were very high, suggesting that they reflect patients’ preferences for engaging in collaborative clinical care and using PE to facilitate and supplement their own understanding of IA. Reasons for not completely agreeing with the recommendations can inform implementation strategies and education of healthcare professionals.

Objectives:The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia.Methods:This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes.Results:Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered.Discussion:While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.

Research Question How can an Australian police agency best test its role in a truancy prevention programme that can help to prevent crime? Data Operational and analytic planning for testing the Ability School Engagement Partnership (ASEP) programme in Queensland that aims to increase school attendance and reduce anti-social behaviour, including offending. Methods Fulfilling the requirements for registering a randomised trial protocol with the Clinicaltrials.gov Registry (NCT04281966; date registered 24 February 2020). Findings A protocol deploying a cluster randomised trial offers sufficient statistical power to detect a moderately large effect size as statistically significant with 80% probability. Conclusion Implementation of this protocol as planned would provide an internally valid test of the effectiveness of the ASEP programme in real-world conditions.

Research indicates truancy and being bullied (otherwise called bully victimization) are independently linked to violent offending. We examine the associations between truancy, bully victimization, and violent offending in a sample of young people who participated in the Ability School Engagement Program (ASEP) truancy reduction experiment. Pre-intervention, half of the sample reported missing school because they were being bullied. Experiment and control participants both exhibited significant reductions in bully victimization and missing school because of bully victimization. Neither groups exhibited significant reductions in violent offending. Contrasting expectations, participants in the control group had significantly larger reductions in missing school because of bully victimization. Post-intervention measures of bully victimization were significantly related to higher odds of violent offending. Bully victimization is a critical factor in understanding the nexus between truancy and violent offending which, if neglected in an intervention (like ASEP) can lead to backfire effects for young people.

Genetic monitoring is an important, but frequently lacking, component of management actions to support long-term persistence in reintroduced populations. Populations that remain small, due to demographic processes and genetic diversity, are more likely to experience a second extinction event. The natterjack toad (Epidelea calamita) is legally protected in Britain and was the subject of a reintroduction programme in the 1990s. However, subsequent genetic assessment has been mostly lacking. The aim of this study was to assess the genetic diversity of two reintroduced populations of natterjack toads in order to inform conservation management. Adults were sampled and nine microsatellites amplified to assess neutral genetic variation within each site and for comparison with the source population. Inbreeding was observed at the reintroduction sites, as evidenced by high FIS values (0.43 and 0.72), low observed compared to expected heterozygosities, and significant deviation from Hardy-Weinberg equilibrium. Observed heterozygosity is currently lower in the reintroduction sites than it was in the source population at the time of the reintroductions (Red Rocks: 0.15±0.20; Talacre: 0.12±0.20; Ainsdale (source): 0.29). Evidence for a bottleneck was not found, although this is likely a result of sampling overlapping generations. No withinsite population structuring was observed. Such low genetic diversity has not previously been recorded in any natterjack population. Genetic rescue, combined with pool creation, is the most viable option for safeguarding the species at these sites into the future. Our work highlights the importance of ongoing genetic monitoring, in collaboration with conservation organisations, to support conservation management.

The intergenerational cycle of crime is well‐documented and there exists strong evidence that children of offenders are more likely to be involved in the Criminal Justice System (CJS) than children...

Purpose This paper aims to understand the association of dietary patterns with perceived fatigue and identify predictors for presence of fatigue in women who are obese and trying to lose weight. Design/methodology/approach An online survey, hosted by slimming world (SW), comprised of a questionnaire regarding weight, level of fatigue and food frequency questionnaire before joining the weight management programme (T0) and current data (T1) was conducted. In total, 543 non-pregnant women with obesity of child-bearing age (19-49 years) completed the survey (T0-T1). The principal components analysis was used to determine dietary patterns and multinomial logistic regression was used to analyse predictors for presence of fatigue. Findings The participants who have a “simple carbohydrate and high fat” dietary pattern were more likely to have fatigue at T0 (p ≤ 0.001) and those who followed a “vegetables” dietary pattern were less likely to have fatigue at T1 (p ≤ 0.05). The study findings indicate that while “simple carbohydrate and high fat” dietary pattern was associated with increased risk of fatigue, “vegetables” dietary pattern was associated with reduced risk of fatigue and a higher percentage of weight loss. Originality/value The present study appears to be the first study to examine associations between dietary patterns and fatigue. The strengths of the study included the in-depth analysis of this association in both before joining a weight management programme (SW) and currently as a member of SW with an adequate sample size.

To explore older inpatients' experiences and perceptions of delirium and non-pharmacological delirium prevention strategies (NDPS). Delirium is a distressing and serious complication in hospitalised older adults. NDPS (supporting nutrition, mobility and cognitive participation) have strong supporting evidence. Few studies have explored older inpatients' perspectives of these strategies. This information may assist staff to better support patient participation in NDPS. Qualitative study using an interpretive descriptive (ID) methodological approach to explore older patient's experience of delirium and NDPS. Structured interviews of inpatients aged over 65 years across 6 medical and surgical wards explored patients' experiences and perceptions of delirium and prevention activities related to nutrition, mobility and cognition; and barriers and enablers to participation. Reporting used COREQ. Twenty-three participants were included (12 male, 11 reported delirium experience). Participants reported a range of physiological, emotional and psychological responses to delirium, hearing about delirium was different to experiencing it. Most participants were aware of the benefits of maintaining nutrition and hydration, physical activity and cognitive engagement in hospital. Barriers included poor symptom control, inflexible routines and inconsistent communication, while enablers included access to equipment, family involvement, staff encouragement and individual goals. These were organised into themes: outlook, feeling well enough, hospital environment, feeling informed and listened to, and support networks. A more patient centred approach to delirium prevention requires consideration of older people's values, needs, preferences and fit within the hospital environment and routines. Feeling informed, listened to and receiving support from staff and family carers can improve older inpatients' engagement in NPDS to prevent delirium in hospital. Nurses are ideally placed to improve patient participation in NDPS through holistic assessment and care, addressing symptoms, providing clear information about delirium and delirium prevention, and facilitating family carer support and patient interactions.

Background The author works as an antenatal and newborn (ANNB) screening coordinator in a hospital designated as an area of low prevalence for sickle cell and thalassaemia (SCT). As such, the opportunity for an ANNB coordinator to gain competency in prenatal counselling of individuals with SCT is limited. Method Two case studies are used to demonstrate social, cultural and ethical issues arising from counselling individuals with SCT. Findings Information regarding genetic risk and haemoglobinopathy status can be threatening for individuals and families, as well as transforming, depending on the context in which information is provided.

Mechanisms for listening and responding to students need to offer space for diverse voices and meaningful dialogue for greater student–staff partnership. This study explores the beneficial impacts ...

Background Deep brain stimulation is a surgical treatment for Parkinson’s disease. Its impacts on motor symptoms are widely reported; however, little is known about the broader impact of deep brain stimulation on the community lives of people with Parkinson’s disease. Lifespace is a measure of lived community mobility, providing an indication of community access and participation. Aims This pilot study explored the feasibility of remotely monitoring the qualitative and quantitative community outcomes related to deep brain stimulation. Methods A longitudinal mixed methods study with a convergent design was undertaken exploring the lifespace, quality of life, life satisfaction and lived experiences of people with Parkinson’s disease before and after deep brain stimulation. Data were collected through questionnaires, semi-structured interviews and a smartphone-based application which collected geolocation data. Results Quantitative and qualitative data from eight participants living with Parkinson’s disease were analysed and integrated. At baseline, participants had a median age of 68 years and a median Hoehn and Yahr score of 2. Measuring a range of community-based outcomes indicated different change trajectories for individuals across outcomes. Key content areas were developed from the qualitative data: participation in occupations and travel and home. This study indicates the potential value of including geolocation data-based lifespace collection in metropolitan and regional areas. Conclusions Monitoring lifespace in conjunction with subjective measures provides insights into the complex and individually varied experiences. Further research could explore the impacts of deep brain stimulation on occupations and community participation to gain a deeper understanding of the related needs and support clinical approaches.

The legitimacy of authorities is paramount to their ability to exercise their powers. We examine truanting students’ and their parents’ perceptions of the legitimacy of authorities in the context of the adapted family group conference component of the Ability School Engagement Program (ASEP), a police–school partnership aimed at reducing antisocial behavior. To evaluate the program, 102 truanting students were randomly allocated to a control or the ASEP condition. Students’ and their parents’ perceptions of authorities were collected to explore how this intervention component, specifically designed to encourage legitimacy views through procedural justice, impacted perceptions of police and school staff. Results indicated that parents participating in ASEP conferences showed significant changes in their perceptions of legitimacy of authorities. ASEP parents’ perceptions of police increased following the conference, but parental perceptions of school legitimacy appeared to be affected by perceptions of the procedural justness (or unjustness) of specific authority figures in the conference. Parental views of school authorities were driven by the few school representatives who failed to engage families in procedurally just ways. Students themselves showed little change in their views following the ASEP conference, suggesting the conference alone was not sufficient for bringing about changes in student perceptions of authority legitimacy.

Objective: To examine whether cognitive and physical fatigue are differentially associated with problems in self-care, mobility, relationships, participation, psychological well-being, and quality of life in people with multiple sclerosis.Methods: A cross-sectional study involving seventy-four community-dwelling people with MS was undertaken. Between-groups analysis was used to compare ratings on the Perceived Impact of Problem Profile (PIPP) in a range of functional domains and the SF-36 quality of life measure, across median-split groups based on level of both physical and cognitive fatigue using the Modified Fatigue Impact Scale.Results: The impact of poor psychological well-being (p = .005), and associated distress (p = .008) on PIPP was greater in the 'high-level' cognitive fatigue group than the low-level' cognitive fatigue group. By contrast, the 'high-level' and low-level' physical fatigue groups differed significantly in their self-reported impact of problems in the areas of mobility (p = .002), relationships (p = .014), participation (p = .001), and psychological wellbeing (p = .004). Overall mental quality of life was significantly lower (p < .001) in those high in cognitive fatigue comparative to the low-level group, and overall physical quality of life was significantly lower (p = .002) in people with multiple sclerosis high in physical fatigue as opposed to low.Conclusion: Cognitive and physical fatigue were associated with distinct problems in daily functioning, which impact differentially on role fulfilment and quality of life in multiple sclerosis. Therefore, these two types of fatigue should be considered distinct domains of the fatigue experience in MS.

Objective: Truancy in adolescence is related to detrimental developmental outcomes over the life-course, including a greater risk for delinquency during adolescence and offending in adulthood. This paper presents results from the Ability School Engagement Program (ASEP): a Third Party Policing partnership between schools and police that sought to disrupt the relationship between truancy and delinquency by communicating, in a procedurally fair dialogue, the legal responsibilities of parents to ensure their children attend school. This paper examines the impact of ASEP on antisocial behavior and the modifying effects of ASEP on the relationship between willingness to go to school and antisocial behavior. Methods: ASEP was evaluated under randomized field trial conditions, where 102 truanting young people from a highly disadvantaged urban area in Brisbane, Australia, were randomly assigned to either the ASEP intervention or the business-as-usual condition. Results: Utilizing four waves of survey data collected over a 2-year time period, we found evidence that ASEP was related to decreases in self-reported antisocial behavior throughout the 2 years study. We also find that ASEP lessened the negative relationship between willingness to go to school and self-reported antisocial behavior for those in the experimental condition up to 1 year post random allocation. Conclusions: Partnerships between schools and police that communicate, in a procedurally fair way, parental legal responsibilities for their children to attend school holds promise for increasing a truanting young person’s willingness to go to school and reducing their self-reported antisocial behaviour, at least in the short run.

Background/Aims Fatigue is a substantial, disabling symptom of inflammatory rheumatic diseases (IRDs). LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using remotely delivered cognitive-behavioral approach (CBA) and personalised exercise programme (PEP) interventions, compared to normal care alone, with the aim to lessen the impact of fatigue in patients with IRDs. Most sessions were delivered by telephone. This nested qualitative study explored patients’ experiences of taking part in the interventions. Methods A subgroup of patients who had completed follow-up after the LIFT trial took part in semi-structured telephone interviews to discuss their views and experiences of the interventions and subsequent impact on their lives. Results Participants were purposively sampled from six UK research sites to include variation in gender, age and IRDs. A total of 47 participants (33 women, 14 men) from the PEP (n = 22) and CBA (n = 25) arms took part. SB conducted an inductive thematic analysis of the data set. ED, CA, AW and KL reviewed a sub-set of the data. Five main themes were agreed after group discussion: There is no miracle cure, but LIFT is a way to manage fatigue: participants had disabling fatigue, with substantial impact on their work and social lives. Many were keen to understand the link between their IRD and fatigue. Participants reflected that LIFT could not offer a miracle cure, but most felt that they were better able to cope with their fatigue after taking part. Building a therapeutic relationship: participants reported feeling validated by LIFT therapists who understood the impact of IRD-fatigue. They valued the continuity of interacting with the same therapist throughout the intervention. The advantages of structure, self-monitoring and being accountable: many participants liked the structured format of the interventions and the inclusion of techniques such as goal setting because self-monitoring and being accountable to the therapist were helpful. Some felt guilty if they did not meet their goals but used this as an incentive to set more realistic objectives. A new toolbox: many participants described feeling more confident and empowered after the interventions, with a new ‘toolbox’ of coping mechanisms; more motivated to socialise, exercise and better able to pace activity. PEP participants who were physically active prior to LIFT saw less benefit. LIFT going forward - a tailored remotely delivered programme: participants’ ideas included follow-up sessions at six and twelve months; the option for video calling; and group-based sessions to boost engagement and receive social support from other patients with fatigue. Conclusion Many patients engaged with the LIFT interventions and reported benefits of taking part. This suggests an important role for the remote delivery of fatigue self-management as services respond and adapt to the current pandemic. Disclosure S.E. Bennett: None. E. Dures: None. C. Almeida: None. E. Bachmair: None. K. Lovell: None. L. Paul: None. A. Wearden: None. G.J. Macfarlane: None. N. Basu: None.