1
|
Fairer JJM, Playfor S, Sutherland AB, Tume LN. Is a UK multicentre trial of intravenous maintenance fluid volumes in critically ill children feasible? Intensive Crit Care Nurs 2024; 82:103624. [PMID: 38245495 DOI: 10.1016/j.iccn.2024.103624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Affiliation(s)
- Jane J M Fairer
- Staff Nurse in Paediatric Critical Care, Royal Manchester Children's Hospital, Manchester UK.
| | - Stephen Playfor
- Consultant Paediatric Intensivist, Royal Manchester Children's Hospital, Manchester UK.
| | - Adam B Sutherland
- Healthcare Quality & Safety, School of Pharmacy, Healthcare Quality & Safety, School of Life Sciences, University of Bradford.
| | | |
Collapse
|
2
|
McManus M, White P, Beers N, Levey E, Coy N, Caulker J, Gaither T, Schmidt A, Ilango S. Value-Based Payment to Support Health Care Transition for Young Adults with Intellectual and Developmental Disabilities: A Feasibility Study. Matern Child Health J 2024; 28:789-797. [PMID: 37952212 DOI: 10.1007/s10995-023-03835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Only 20% of youth with intellectual and developmental disability (ID/DD) receive health care transition (HCT) preparation from their health care providers (HCPs). To address HCT system gaps, the first-of-its-kind HCT value-based payment (VBP) pilot was conducted for young adults (YA) with ID/DD. METHODS This feasibility study examined the acceptability, implementation, and potential for expansion of the pilot, which was conducted within a specialty Medicaid managed care organization (HSCSN) in Washington, DC. With local pediatric and adult HCPs, the HCT intervention included a final pediatric visit, medical summary, joint HCT visit, and initial adult visit. The VBP was a mix of fee-for-service and pay-for-performance incentives. Feasibility was assessed via YA feedback surveys and interviews with HSCSN, participating HCPs, and selected state Medicaid officials. RESULTS Regarding acceptability, HSCSN and HCPs found the HCT intervention represented a more organized approach and addressed an unmet need. YA with ID/DD and caregivers reported high satisfaction. Regarding implementation, nine YA with ID/DD participated. Benefits were reported in patient engagement, exchange of health information, and care management and financial support. Challenges included care management support needs, previous patient gaps in care, and scheduling difficulties. Regarding expansion, HSCSN and HCPs agreed that having streamlined care management support, medical summary preparation, and payment for HCT services are critical. DISCUSSION This study examined the benefits and challenges of a HCT VBP approach and considerations for future expansion, including payer/HCP collaboration, HCT care management support, and updated system technology and interoperability.
Collapse
Affiliation(s)
- Margaret McManus
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
| | - Patience White
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
| | - Nathaniel Beers
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Eric Levey
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Nadine Coy
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Jalima Caulker
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Takisha Gaither
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Annie Schmidt
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA.
| | - Samhita Ilango
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
| |
Collapse
|
3
|
Larkin L, McKenna S, Pyne T, Comerford P, Moses A, Folan A, Gallagher S, Glynn L, Fraser A, Esbensen BA, Kennedy N. Promoting physical activity in rheumatoid arthritis through a physiotherapist led behaviour change-based intervention (PIPPRA): a feasibility randomised trial. Rheumatol Int 2024; 44:779-793. [PMID: 38438576 PMCID: PMC10980645 DOI: 10.1007/s00296-024-05544-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/17/2024] [Indexed: 03/06/2024]
Abstract
Physical activity (PA) is recommended as a key component in the management of people with rheumatoid arthritis (RA). The objective of this study was to examine the feasibility of a physiotherapist led, behaviour change (BC) theory-informed, intervention to promote PA in people with RA who have low levels of current PA. A feasibility randomised trial (ClinicalTrials.gov NCT03644160) of people with RA over 18 years recruited from outpatient rheumatology clinics and classified as insufficiently physically active using the Godin-Shephard Leisure Time Physical Activity Questionnaire. Participants were randomised to intervention group (4 BC physiotherapy sessions in 8 weeks) delivered in person/virtually or control group (PA information leaflet only). Feasibility targets (eligibility, recruitment, and refusal), protocol adherence and acceptability were measured. Health care professionals (HCPs) involved in the study and patients in the intervention and control arms were interviewed to determine acceptability. Descriptive statistics were used to analyse the data with SPSS (v27) with interviews analysed using content analysis using NVivo (v14). Three hundred and twenty participants were identified as potentially eligible, with n = 183 (57%) eligible to participate, of which n = 58 (32%) consented to participate. The recruitment rate was 6.4 per month. Due to the impact of COVID-19 on the study, recruitment took place over two separate phases in 2020 and 2021. Of the 25 participants completing the full study, 23 were female (mean age 60 years (SD 11.5)), with n = 11 allocated to intervention group and n = 14 to control. Intervention group participants completed 100% of sessions 1 & 2, 88% of session 3 and 81% of session 4. The study design and intervention were acceptable overall to participants, with enhancements suggested. The PIPPRA study to improve promote physical activity in people with RA who have low PA levels was feasible, acceptable and safe. Despite the impact of COVID-19 on the recruitment and retention of patients, the study provides preliminary evidence that this physiotherapist led BC intervention is feasible and a full definitive intervention should be undertaken. Health care professionals involved in the study delivery and the patient participants described a number of positive aspects to the study with some suggestions to enhance the design. These findings hence inform the design of a future efficacy-focused clinical trial.
Collapse
Affiliation(s)
- Louise Larkin
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Seán McKenna
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Tadhg Pyne
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Paul Comerford
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Anusha Moses
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Ailish Folan
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Alexander Fraser
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Department of Rheumatology, University Limerick Hospitals Group, Limerick, Ireland
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Norelee Kennedy
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
| |
Collapse
|
4
|
von Preetzmann N, Zipplies D, Span R, Richter M. Utilization of a High-Pressure Vibrating Tube Densimeter for Liquids at Temperatures Down to 100 K. Int J Thermophys 2024; 45:72. [PMID: 38645609 PMCID: PMC11031472 DOI: 10.1007/s10765-024-03357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 04/23/2024]
Abstract
A high-pressure vibrating tube densimeter, specified by the manufacturer for temperatures from (263 to 473) K at pressures up to 140 MPa, was tested at temperatures down to 100 K and from vacuum to pressures up to 10 MPa. To verify the functionality and overall performance under these conditions, the densimeter was calibrated with measurements under vacuum as well as methane and propane as reference fluids. The calibration range is T = (120 to 200) K at pressures from (2.0 to 10.0) MPa. To evaluate the recorded data, two established calibration models were used to describe the dependence of the densimeter's oscillation period on the investigated reference fluids' temperature, pressure, and density. The experiments showed that the vibrating tube densimeter is operational even at temperatures down to 100 K, but exhibits a shift of its vacuum resonance when subjected to thermal cycling at temperatures below 180 K. Accordingly, the calibration models were modified with respect to how the vacuum resonance is considered. Then, the determined calibration parameters reproduce the densities of the reference fluids within ± 0.10 kg·m-3 for the calibration model that performed better for the present study. Measurements on pure ethane and argon validate the calibration of the densimeter. Here, the densities are within (- 0.47 to 0.16) kg·m-3 of values calculated with the respective reference equation of state. The estimated combined expanded uncertainty (k = 2) in density for the validation measurements ranges from (0.52 to 1.13) kg·m-3 or is less than 0.1 % for liquid densities. Supplementary Information The online version of this article (10.1007/s10765-024-03357-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Daniel Zipplies
- Applied Thermodynamics, Chemnitz University of Technology, 09107 Chemnitz, Germany
| | - Roland Span
- Thermodynamics, Ruhr University Bochum, 44780 Bochum, Germany
| | - Markus Richter
- Applied Thermodynamics, Chemnitz University of Technology, 09107 Chemnitz, Germany
| |
Collapse
|
5
|
Abbassi K, Janghorban M, Javanmardi F, Mobasseri S. Feasibility study of femur bone with continuum model. J Med Eng Technol 2024:1-12. [PMID: 38625882 DOI: 10.1080/03091902.2024.2336512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/23/2024] [Indexed: 04/18/2024]
Abstract
It is known that the geometric structures of bones are very complex. This has made researchers unable to model them with the continuum approach and suffice to model them with simulation or experimental tests. Undoubtedly, provide a simple and accurate continuum model for studying bones is always desirable. In this article, as the first serious endeavour, a suggested beam model is investigated to see whether it is suitable for modelling femur bones or not. If this model gives an acceptable answer, it can be a link to the continuum theories for beams. In other words, the approximated beam model can be formulated with continuum approach to study femur bone. For feasibility study of the approximated model for femur bones, both static and dynamic analysis of them are investigated and compared. It is found that in most cases for vibration analysis, the suggested model has acceptable results but in static analysis, the mean difference between the results is about 16%. This research is hoped to be the first serious step in this category.
Collapse
Affiliation(s)
- Kianoosh Abbassi
- Department of Mechanical Engineering, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| | - Maziar Janghorban
- Department of Mechanical Engineering, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| | | | - Saleh Mobasseri
- Department of Mechanical Engineering, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| |
Collapse
|
6
|
Paradongan HT, Hakam DF, Wiryono SK, Prahastono I, Aditya IA, Banjarnahor KM, Sinisuka NI, Asekomeh A. Techno-economic feasibility study of solar photovoltaic power plant using RETScreen to achieve Indonesia energy transition. Heliyon 2024; 10:e27680. [PMID: 38586405 PMCID: PMC10998000 DOI: 10.1016/j.heliyon.2024.e27680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 04/09/2024] Open
Abstract
Indonesia, a key player in the global energy transition, faces surging electricity demand and ambitious renewable energy goals. In response, the government introduced a new regulation about renewable energy tariffs, including tariffs for photovoltaic (PV). However, there remains a gap in the academic literature regarding PV power plant feasibility studies under these tariffs. To address this gap, this study investigates the feasibility of a utility-scale solar photovoltaic (PV) power plant in Indonesia, focusing on the newly implemented renewable energy tariffs based on Independent Power Producers (IPPs) and Indonesia's state-owned electricity company (PLN) perspectives. Five scenarios were developed based on the proposed 26 MW solar power plant on Nias Island utilizing RETScreen software. The results showed that based on the IPP perspective, the newly implemented renewable energy tariff was inadequate to make the project feasible, however, an introduction of a 10 USD/t CO2 emission incentive would make the project financially viable for IPPs. Therefore, it is recommended to introduce emission incentives as a strategic approach to attract investors and stimulate investment in Indonesia's PV power plants market, to accelerate Indonesia's energy transition. Conversely, the results also showed that the project is very profitable for PLN due to the significant cost-savings from the de-dieselization, leading to a reduction in the average generation cost for Nias.
Collapse
Affiliation(s)
| | - Dzikri Firmansyah Hakam
- School of Business and Management, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Sudarso Kaderi Wiryono
- School of Business and Management, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Iswan Prahastono
- PLN Research Institute, PT PLN Persero, Jakarta, 12760, Indonesia
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Indra A. Aditya
- PLN Research Institute, PT PLN Persero, Jakarta, 12760, Indonesia
| | - Kevin M. Banjarnahor
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Ngapuli Irmea Sinisuka
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Ayodele Asekomeh
- Aberdeen Business School, Robert Gordon University, Aberdeen, AB10 1FR, Scotland, UK
| |
Collapse
|
7
|
Zhang X, Lewis S, Chen X, Zhou J, Wang X, Bucci S. Acceptability and experience of a smartphone symptom monitoring app for people with psychosis in China (YouXin): a qualitative study. BMC Psychiatry 2024; 24:268. [PMID: 38594713 PMCID: PMC11003104 DOI: 10.1186/s12888-024-05687-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Access to high-quality mental healthcare remains challenging for people with psychosis globally, including China. Smartphone-based symptom monitoring has the potential to support scalable mental healthcare. However, no such tool, until now, has been developed and evaluated for people with psychosis in China. This study investigated the acceptability and the experience of using a symptom self-monitoring smartphone app (YouXin) specifically developed for people with psychosis in China. METHODS Semi-structured interviews were conducted with 10 participants with psychosis to explore the acceptability of YouXin. Participants were recruited from the non-randomised feasibility study that tested the validity, feasibility, acceptability and safety of the YouXin app. Data analysis was guided by the theoretical framework of acceptability. RESULTS Most participants felt the app was acceptable and easy to use, and no unbearable burdens or opportunity costs were reported. Participants found completing the self-monitoring app rewarding and experienced a sense of achievement. Privacy and data security were not major concerns for participants, largely due to trust in their treating hospital around data protection. Participants found the app easy to use and attributed this to the training provided at the beginning of the study. A few participants said they had built some form of relationship with the app and would miss the app when the study finished. CONCLUSIONS The YouXin app is acceptable for symptom self-monitoring in people with experience of psychosis in China. Participants gained greater insights about their symptoms by using the YouXin app. As we only collected retrospective acceptability in this study, future studies are warranted to assess hypothetical acceptability before the commencement of study to provide a more comprehensive understanding of implementation.
Collapse
Affiliation(s)
- Xiaolong Zhang
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Shôn Lewis
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jiaojiao Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xingyu Wang
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
| |
Collapse
|
8
|
Lane J, Manceau LM, de Chantal PL, Chagnon A, Cardinal M, Lauzier-Jobin F, Lanoue S. Implementing a mental health app library in primary care: A feasibility study. Eval Program Plann 2024; 103:102413. [PMID: 38471327 DOI: 10.1016/j.evalprogplan.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Confronted with a wide range of digital health tools (DHT), professionals and patients need guidance to use these tools correctly and optimize health management. In the fall of 2020, a DHT library developed by Quebec-based company TherAppX was implemented in 22 institutions. The library was designed to enable healthcare professionals to use DHT in clinical care. The purpose of the current study was to assess the feasibility of implementing the library, including user experience, changes in DHT recommendation habits, and factors that helped or hindered the implementation process. A multi-methods design focusing on secondary use of quantitative data collected by TherAppX and semi-structured interviews with users was employed. While the quantitative analyses indicated infrequent use of the library, qualitative analyses highlighted several factors that hindered its implementation, including certain library and user characteristics and the unprecedented context of the COVID-19 pandemic. Nevertheless, the quantitative analyses confirmed interest in DHT and their usefulness during follow-ups. The results revealed a marginally significant pre-post changes in the frequency with which DHT were recommended. This study helped identify areas for improvements and indicates that further evaluation is needed. Future implementations would benefit from ensuring optimal conditions for a successful implementation.
Collapse
Affiliation(s)
- Julie Lane
- Centre RBC d'expertise universitaire en santé mentale, Faculty of Education, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada.
| | - Luiza Maria Manceau
- Centre RBC d'expertise universitaire en santé mentale, Faculty of Education, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
| | - Pier-Luc de Chantal
- Department of Psychology, Faculty of human sciences, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montréal, QC H3C 3P8, Canada
| | - Alexandre Chagnon
- TherAppX, 160 Rue Cowie #203, Granby, QC J2G 3V3, Canada; Faculty of Pharmacy, Université Laval, 2325, rue de l'Université, Québec, QC G1V 0A6, Canada
| | - Michael Cardinal
- TherAppX, 160 Rue Cowie #203, Granby, QC J2G 3V3, Canada; Public Health School, Université de Montréal, 2900, Bd Édouard-Montpetit, Montréal, QC H3T 1J4, Canada
| | - François Lauzier-Jobin
- Centre RBC d'expertise universitaire en santé mentale, Faculty of Education, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
| | - Sèverine Lanoue
- Centre RBC d'expertise universitaire en santé mentale, Faculty of Education, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
| |
Collapse
|
9
|
Tang JY, Teng PHJ, Chen CY, Tan KT, Ang W, Lau S, Ang AGC, Kyaw KK, Tay XY, Lim WMS, Espeleta WDV, Lin H, Ding YY, Lun P. Appropriate Prescribing for older adults with Multimorbidity (Pro-M): protocol for a feasibility study. Arch Public Health 2024; 82:37. [PMID: 38500190 PMCID: PMC10949664 DOI: 10.1186/s13690-024-01264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Potentially inappropriate prescribing is common among older adults with multimorbidity due to various reasons, from concurrent application of multiple single-disease clinical guidelines to fragmentation of care. Interventions such as medication review have been implemented worldwide to reduce inappropriate prescribing for older adults. However, the implementability of such interventions are underexplored in the outpatient clinics in Singapore's public hospitals. Hence, the Pro-M study aims to assess the feasibility of implementing a physician-pharmacist collaborative care intervention in geriatric medicine outpatient clinics to facilitate appropriate prescribing for older adults in Singapore. METHODS This is a single-arm, non-randomised feasibility study using a pre-post evaluation design. This study consists of two parts: (1) implementation phase of the intervention (6 months) and an (2) evaluation phase (3 months). Eligible patients will be recruited from geriatric medicine outpatient clinics at two public hospitals in Singapore through convenience sampling. The main components of the Pro-M intervention are: (1) pharmacist-facilitated medication reviews with feedback on any medication issues and potential recommendations to physicians, and (2) physicians communicating changes to other relevant prescribers. The evaluation phase will involve surveying and interviewing physicians and pharmacists involved in the implementation of the intervention. A mixed-method approach will be employed for data collection and analysis. The quantitative and qualitative findings will be triangulated and reported using Proctor's implementation outcomes: appropriateness, penetration, acceptability, fidelity, feasibility, and sustainability. A basic cost analysis will be conducted alongside the study. DISCUSSION This is a phase 2 study to test the feasibility of implementing an intervention that was co-created with stakeholders during phase 1 development of an intervention to optimise prescribing for older adults with multimorbidity. The implementation will be assessed using Proctor's implementation outcomes to provide insights on the process and the feasibility of implementing medication reviews for older adults with multimorbidity as a routine practice in outpatient clinics. Data collected from this study will inform a subsequent scale-up study. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05756478. Registered on 06 March 2023.
Collapse
Affiliation(s)
- Jia Ying Tang
- Geriatric Education & Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore.
| | - Poh Hoon June Teng
- Geriatric Education & Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore
| | | | - Keng Teng Tan
- Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore
| | - Wendy Ang
- Pharmacy, Changi General Hospital, Singapore, Singapore
| | - Sabrina Lau
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Kay Khine Kyaw
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Xin Yong Tay
- Pharmacy, Changi General Hospital, Singapore, Singapore
| | | | | | - Huimin Lin
- Pharmacy, Changi General Hospital, Singapore, Singapore
| | - Yew Yoong Ding
- Geriatric Education & Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Penny Lun
- Geriatric Education & Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore
| |
Collapse
|
10
|
Drees C, Afra P, Verner R, Kaye L, Keith A, Jiang M, Szaflarski JP, Nichol K. Feasibility study of microburst VNS therapy in drug-resistant focal and generalized epilepsy. Brain Stimul 2024; 17:382-391. [PMID: 38499287 DOI: 10.1016/j.brs.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Vagus nerve stimulation (VNS) at low frequencies (≤30 Hz) has been an established treatment for drug-resistant epilepsy (DRE) for over 25 years. OBJECTIVE To examine the initial safety and efficacy performance of an investigational, high-frequency (≥250 Hz) VNS paradigm herein called "Microburst VNS" (μVNS). μVNS consists of short, high-frequency bursts of electrical pulses believed to preferentially modulate certain brain regions. METHODS Thirty-three (33) participants were enrolled into an exploratory feasibility study, 21 with focal-onset seizures and 12 with generalized-onset seizures. Participants were titrated to a personalized target dose of μVNS using an investigational fMRI protocol. Participants were then followed for up to 12 months, with visits every 3 months, and monitored for side-effects at all time points. This study was registered as NCT03446664 on February 27th, 2018. RESULTS The device was well-tolerated. Reported adverse events were consistent with typical low frequency VNS outcomes and tended to diminish in severity over time, including dysphonia, cough, dyspnea, and implant site pain. After 12 months of μVNS, the mean seizure frequency reduction for all seizures was 61.3% (median reduction: 70.4%; 90% CI of median: 48.9%-83.3%). The 12-month responder rate (≥50% reduction) was 63.3% (90% CI: 46.7%-77.9%) and the super-responder rate (≥80% reduction) was 40% (90% CI: 25.0%-56.6%). Participants with focal-onset seizures appeared to benefit similarly to participants with generalized-onset seizures (mean reduction in seizures at 12 months: 62.6% focal [n = 19], versus 59.0% generalized [n = 11]). CONCLUSION Overall, μVNS appears to be safe and potentially a promising therapeutic alternative to traditional VNS. It merits further investigation in randomized controlled trials which will help determine the impact of investigational variables and which patients are most suitable for this novel therapy.
Collapse
Affiliation(s)
- Cornelia Drees
- Mayo Clinic Arizona, Department of Neurology, Phoenix, AZ, USA; University of Colorado School of Medicine, Department of Neurology, Aurora, CO, USA
| | - Pegah Afra
- University of Utah School of Medicine, Department of Neurology, Salt Lake City, UT, USA; Weill-Cornell Medicine, Department of Neurology, New York, NY, USA; University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Ryan Verner
- LivaNova PLC (or a Subsidiary), Department of Clinical and Medical Affairs, London, UK
| | - Lesley Kaye
- University of Colorado School of Medicine, Department of Neurology, Aurora, CO, USA
| | - Amy Keith
- LivaNova PLC (or a Subsidiary), Department of Clinical and Medical Affairs, London, UK
| | - Mei Jiang
- LivaNova PLC (or a Subsidiary), Department Statistics and Data Science, London, UK
| | - Jerzy P Szaflarski
- University of Alabama at Birmingham School of Medicine, Department of Neurology, Birmingham, AL, USA
| | - Kathryn Nichol
- LivaNova PLC (or a Subsidiary), Department of Clinical and Medical Affairs, London, UK.
| |
Collapse
|
11
|
de Moura JQ, Saratt MM, da Silva SCS, Silva VC, Murta SG, Habigzang LF. Adaptation and feasibility assessment of a dating violence prevention program for girls in foster care. Psicol Reflex Crit 2024; 37:9. [PMID: 38483652 PMCID: PMC10940555 DOI: 10.1186/s41155-024-00292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Dating violence in adolescence is a serious public health issue due to its significant impact on mental health and its significant predictive value for intimate partner violence in adulthood. Universal and selective programs can contribute to the prevention of this issue. Nonetheless, there are few selective programs with evidence of feasibility in contexts of social vulnerability. OBJECTIVE The present study examined evidence of the feasibility of a dating violence selective prevention program for girls in foster care by monitoring process indicators during the implementation phase of a pilot study. METHODS The program, originally designed for adolescents in the general population, was adapted to the context of girls at risk. The pilot study was conducted in the southern region of Brazil and involved the participation of six girls aged between 15 and 17. Both quantitative and qualitative measures were used, and the data were explored through frequency analysis, the Jacobson and Truax test, and content analysis. RESULTS The study identified favorable evidence regarding demand, acceptability, and adaptation of the intervention. On the other hand, contextual and institutional barriers hindered recruitment and restricted the reach of the intervention. CONCLUSION Although there are changes to be made to improve the program's applicability in its specific context, it should be emphasized that this study provides evidence to maintain the methods and content of the intervention.
Collapse
Affiliation(s)
- Julliane Quevedo de Moura
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil.
| | - Manoela Mosena Saratt
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
| | | | - Victória Caroline Silva
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
| | - Sheila Giardini Murta
- Departamento de Psicologia Clínica, Universidade de Brasília, SQN 606, Campus Universitário Darcy Ribeiro, ICC Sul, IP-PCL Asa Norte, Brasília, DF, 70910900, Brazil
| | - Luísa Fernanda Habigzang
- Pontifícia Universidade Católica do Rio Grande do Sul, Prédio 11, 9º Floor, Room 924, Partenon, Porto Alegre, RS, 90619900, Brazil
| |
Collapse
|
12
|
Blankenburg N, Henkelmann R, Theopold J, Löffler S, Hepp P. Comparison of needle and conventional arthroscopy for visualisation of predefined anatomical structures of the knee joint: a feasibility study in human cadavers and patients. BMC Musculoskelet Disord 2024; 25:212. [PMID: 38475756 DOI: 10.1186/s12891-024-07346-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/08/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In terms of the optics used for Knee arthroscopy, a large number of different endoscopes are currently available. However, the use of the 30° optics in knee arthroscopy has been established as the standard procedure for many years. As early as the 1990s, needle arthroscopy was occasionally used as a diagnostic tool. In addition to the development of conventional optics technology in terms of camera and resolution, needle arthroscopes are now available with chip-on-tip image sensor technology. To date, no study has compared the performance of this kind of needle arthroscopy versus standard arthroscopy in the clinical setting in terms of the visibility of anatomical landmarks. In this monocentric prospective feasibility study, our aim was to evaluate predefined anatomical landmarks of the knee joint using needle arthroscopy (0° optics) and conventional knee arthroscopy (30° optics) and compare their performance during knee surgery. METHODS Examinations were performed on eight cadavers and seven patients who required elective knee arthroscopy. Two surgeons independently performed the examinations on these 15 knee joints, so that we were able to compare a total of 30 examinations. The focus was on the anatomical landmarks that could be visualized during a conventional diagnostic knee arthroscopy procedure. The quality of visibility was evaluated using a questionnaire. RESULTS In summary, the average visibility for all the anatomic landmarks was rated 4.98/ 5 for the arthroscopy using 30° optics. For needle arthroscopy, an average score of 4.89/ 5 was obtained. Comparatively, the needle arthroscope showed slightly limited visibility of the retropatellar gliding surface in eight (4.5/ 5 vs. 5/ 5), medial rim of the patella in four (4.85/ 5 vs. 5/ 5), and suprapatellar recess in four (4.83/ 5 vs. 5/ 5) cases. Needle arthroscopy was slightly better at visualizing the posterior horn of the medial meniscus in four knee joints (4.9/ 5 vs. 4.85/ 5). CONCLUSION Needle arthroscopy is a promising technology with advantages in terms of minimally invasive access and good visibility of anatomical landmarks. However, it also highlights some limitations, particularly in cases with challenging anatomy or the need for a wide field of view.
Collapse
Affiliation(s)
- Notker Blankenburg
- Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, Leipzig, 04103, Germany.
| | - Ralf Henkelmann
- Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, Leipzig, 04103, Germany
| | - Jan Theopold
- Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, Leipzig, 04103, Germany
| | - Sabine Löffler
- Institute of Anatomy, University of Leipzig, Liebigstraße 13, Leipzig, 04103, Germany
| | - Pierre Hepp
- Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, Leipzig, 04103, Germany
| |
Collapse
|
13
|
van der Linde ML, Baas DC, van der Goot TH, Vervest AMJS, Latour C. Biopsychosocial complexity in patients scheduled for elective TKA surgery: A feasibility pilot study with the INTERMED self-assessment questionnaire. Int J Orthop Trauma Nurs 2024; 53:101094. [PMID: 38508099 DOI: 10.1016/j.ijotn.2024.101094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Primary aim; to determine the feasibility of implementation of the INTERMED Self-Assessment (IM-SA) in adult patients scheduled for total knee arthroplasty (TKA). Secondary aim; to measure biopsychosocial complexity, referral to psychiatry or psychology in cases of complexity and to gain insight into the relation between biopsychosocial complexity and length of stay (LOS), method of discharge (MOD) and polypharmacy. METHODS A feasibility study was conducted with 76 participants in a general hospital in the Netherlands. Feasibility was determined by the number of completed questionnaires, time spent completing the questionnaire and the attitude of staff and patients towards the IM-SA. A cut off point ≥19 on the IM-SA was used to determine the prevalence of biopsychosocial complexity. A case file study was performed to check if referral to psychiatry or psychology had taken place. The Spearman's Rank Correlation Coefficient or Phi was used to determine if there was a relation between biopsychosocial complexity and LOS, MOD and polypharmacy. RESULTS All participants completed the IM-SA. The average time spent completing the questionnaire was 11.46 min (SD 5.74). The attitude towards the IM-SA was positive. The prevalence of biopsychosocial complexity was 11.84%. Referral to psychiatry or psychology did not take place. There was no relation between complexity and LOS (Spearman's rho (r) = 0.079, p = 0.499, MOD (Phi = 0.169, p = 0.173) and polypharmacy (Phi = 0.007, p = 0.953). CONCLUSION Biopsychosocial complexity can be identified in TKA patients during the pre-operative phase by using the IM-SA. Implementation of the IM-SA in a Dutch general hospital is feasible.
Collapse
Affiliation(s)
| | - D C Baas
- Department of Orthopaedic Surgery, Tergooi MC, Hilversum, the Netherlands
| | - T H van der Goot
- Department of Orthopaedic Surgery, Tergooi MC, Hilversum, the Netherlands
| | - A M J S Vervest
- Department of Orthopaedic Surgery, Tergooi MC, Hilversum, the Netherlands
| | - C Latour
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, the Netherlands
| |
Collapse
|
14
|
Lostelius PV, Gustavsson C, Adolfsson ET, Söderlund A, Revenäs Å, Zakrisson AB, Mattebo M. Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System. BMC Med Inform Decis Mak 2024; 24:64. [PMID: 38443898 PMCID: PMC10913260 DOI: 10.1186/s12911-024-02465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. METHODS This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16-23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants' quantitative Youth Health Report System data were analyzed for descriptive statistics. RESULTS Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. CONCLUSIONS The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.
Collapse
Affiliation(s)
- Petra V Lostelius
- Centre for Innovation, Research and Education, Region Västmanland, Västmanland Hospital Västerås, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden.
| | - Catharina Gustavsson
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
- Orthopedic Clinic, Västerås Hospital Region Västmanland, Västerås, Sweden
| | - Ann-Britt Zakrisson
- University Health Care Research Center, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| |
Collapse
|
15
|
Spratling R, Ali SZ, Faulkner MS, Feinberg I, Hayat MJ. Enhancing caregivers self-management for their children who require medical technology: A feasibility study for the COPE-STAR intervention. J Pediatr Nurs 2024; 75:23-30. [PMID: 38096760 DOI: 10.1016/j.pedn.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE To test feasibility of the Creating Opportunities for Personal Empowerment: Symptom and Technology Management Resources intervention for caregivers of children who require medical technologies of tracheostomies and feeding tubes. DESIGN AND METHODS Quasi-experimental one group design with measures at baseline and at 4 weeks. Intervention feasibility was tested from August 2019-June 2021, including recruitment, retention, and adherence, and caregiver satisfaction. Caregiver and child characteristics and outcomes were assessed. RESULTS Caregivers were enrolled (n = 22) and completed (n = 16) the study. Caregivers were primarily female (n = 21), were predominately Caucasian (n = 14, 64%) followed by African-American (n = 8, 36%), and Non-Hispanic/Latino (n = 18, 82%). Feasibility indicators of recruitment (92%), retention (73%), and adherence (100%) were satisfactory. Outcome measures of management of child's chronic condition, caregiver beliefs about managing their child's symptoms and medical technology, anxiety, and depressive symptoms remained stable. Caregivers agreed that the intervention was useful, easy to use, and acceptable, and had positive feedback. CONCLUSIONS This is a feasible and acceptable intervention. With further development and efficacy testing, the intervention has potential for use and expansion to a larger population of caregivers of children who require medical technology. PRACTICE IMPLICATIONS Children who require medical technology have multiple complex chronic conditions and complex care needs at home. This intensive and focused care is provided by informal caregivers who need education and resources for their child's care. This intervention addressed caregiver management of common symptoms and medical technologies of children in the home setting.
Collapse
Affiliation(s)
- Regena Spratling
- Professor, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Room 950, Atlanta, GA 30303, USA.
| | - Syeda Zahra Ali
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Melissa Spezia Faulkner
- Adjunct Professor, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, USA.
| | - Iris Feinberg
- Associate Director, Adult Literacy Research Center, College of Education and Human Development, Georgia State University, USA.
| | - Matthew J Hayat
- Chair & Professor of Biostatistics, Department of Population Health Sciences, School of Public Health, Byrdine F. Lewis College of Nursing & Health Professions (Joint), Georgia State University, USA.
| |
Collapse
|
16
|
Martsinchyk K, Martsinchyk A, Łazor M, Shuhayeu P, Kupecki J, Niemczyk A, Błesznowski M, Milewski J. Feasibility study and techno-economic assessment of power-to-gas (P2G) technology based on solid oxide electrolysis (SOE). J Environ Manage 2024; 354:120425. [PMID: 38412734 DOI: 10.1016/j.jenvman.2024.120425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
Power-to-Gas (P2G) is considered as a promising energy storage technology in a long-time horizon. The rapid growth in the share of intermittent renewables in the energy mix is driving forward research and development in large-scale energy storage. This paper presents a feasibility analysis of a power-to-gas system in terms of various operating points and capacities. The analysis was performed using a system model, which features a solid oxide electrolyzer (SOE), a CO2 separation unit, and a methanation reactor as the key components. For the purposes of the techno-economic assessment (TEA) of the system, the CAPEX/OPEX estimation was performed and the cost structure defined. The model proposed in the study enables system-level optimization, including technical and economic criteria, considering two nominal scales: 10 kW and 40 GW, which corresponds to the nominal capacity of SOE in each case. According to the study, in an SOE-based P2G system, the cost of synthetic natural gas (SNG) production will fall by 15-21% by 2030 and 29-37% by 2050. SNG production would cost 3.15-3.75 EUR2023/kgSNG in 2030 and 2.6-3.0 EUR2023/kgSNG in 2050 for systems with SOE power >10 MW. Generally, product cost reductions occur as a result of material development and large-scale production, which influences the system's CAPEX. According to the research, the technology will break even by 2050. The large-scale power-to-gas system with a total of 40 GW installed capacity delivers a product price of 2.4 EUR2023/kgSNG with the average conversion efficiency of 68%.
Collapse
Affiliation(s)
- Katsiaryna Martsinchyk
- Institute of Heat Engineering, Warsaw University of Technology, Nowowiejska 21/25, 00-665 Warsaw, Poland
| | - Aliaksandr Martsinchyk
- Institute of Heat Engineering, Warsaw University of Technology, Nowowiejska 21/25, 00-665 Warsaw, Poland
| | - Monika Łazor
- Institute of Power Engineering - National Research Institute, Mory 8, 01-330, Warsaw, Poland; Center for Hydrogen Technologies (CTH(2)), Institute of Power Engineering - National Research Institute, Augustówka 36, 02-981 Warsaw, Poland; Faculty of Chemistry, Warsaw University of Technology, Noakowskiego 3, 00-664 Warsaw, Poland.
| | - Pavel Shuhayeu
- Institute of Heat Engineering, Warsaw University of Technology, Nowowiejska 21/25, 00-665 Warsaw, Poland
| | - Jakub Kupecki
- Institute of Power Engineering - National Research Institute, Mory 8, 01-330, Warsaw, Poland; Center for Hydrogen Technologies (CTH(2)), Institute of Power Engineering - National Research Institute, Augustówka 36, 02-981 Warsaw, Poland; National Fuel Cell Research Center (NFCRC), Engineering Laboratory Facility, University of California, Irvine, CA, 92697-3550, United States
| | - Anna Niemczyk
- Institute of Power Engineering - National Research Institute, Mory 8, 01-330, Warsaw, Poland; Center for Hydrogen Technologies (CTH(2)), Institute of Power Engineering - National Research Institute, Augustówka 36, 02-981 Warsaw, Poland
| | - Marcin Błesznowski
- Institute of Power Engineering - National Research Institute, Mory 8, 01-330, Warsaw, Poland; Center for Hydrogen Technologies (CTH(2)), Institute of Power Engineering - National Research Institute, Augustówka 36, 02-981 Warsaw, Poland
| | - Jarosław Milewski
- Institute of Heat Engineering, Warsaw University of Technology, Nowowiejska 21/25, 00-665 Warsaw, Poland
| |
Collapse
|
17
|
Di Nota PM, Scott SC, Huhta JM, Gustafsberg H, Andersen JP. Physiological Responses to Organizational Stressors Among Police Managers. Appl Psychophysiol Biofeedback 2024; 49:85-102. [PMID: 38244109 PMCID: PMC10869394 DOI: 10.1007/s10484-023-09613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 01/22/2024]
Abstract
Police officers demonstrate increased risk of physical and mental health conditions due to repeated and prolonged exposure to stressful occupational conditions. Occupational stress is broken into two types: operational stress, related to the content of field duties (e.g., physical demands); and organizational stress, related to cultural and structural contexts (e.g., interpersonal relationships). Applied police research focuses on physiological activation in operational tasks as a mechanism explaining health risk and non-optimal performance outcomes. However, recent survey-based studies indicate numerous organizational stressors associated with self-reported mental health symptoms. The question of whether organizational stressors elicit significant physiological activity remains unknown. The current proof-of-concept field study tests the hypothesis that police managers will display significant physiological reactivity before, during, and after engaging in reality-based scenarios representative of stressful police management tasks developed from evidence-based pedagogical approaches. A sample of 25 training police managers (7 female, M = 16 +/- 5.3 years of experience) completed 5 reality-based scenarios, including resolving a heated conflict between colleagues, delivering negative feedback to a subordinate, and critical incident command. Significant increases in heart rate relative to rest were observed during all tasks, and in anticipation of several tasks. Greater increases in reactive heart rate were associated with longer recovery times. Sex differences and relationships between objective biological and subjective psychological measures of stress are discussed. The current findings demonstrate significant physiological responses to organizational stressors similar to levels observed during operational tasks, despite the absence of physical or aerobic exertion. Implications for police health and training are discussed.
Collapse
Affiliation(s)
- Paula M Di Nota
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Sarah C Scott
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Juha-Matti Huhta
- Police University College of Finland, Tampere, Finland
- Faculty of Culture & Education, Tampere University, Tampere, Finland
| | | | - Judith P Andersen
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada.
| |
Collapse
|
18
|
Lenskjold A, Brejnebøl MW, Nybing JU, Rose MH, Gudbergsen H, Troelsen A, Moller A, Raaschou H, Boesen M. Constructing a clinical radiographic knee osteoarthritis database using artificial intelligence tools with limited human labor: A proof of principle. Osteoarthritis Cartilage 2024; 32:310-318. [PMID: 38043857 DOI: 10.1016/j.joca.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To create a scalable and feasible retrospective consecutive knee osteoarthritis (OA) radiographic database with limited human labor using commercial and custom-built artificial intelligence (AI) tools. METHODS We applied four AI tools, two commercially available and two custom-built tools, to analyze 6 years of clinical consecutive knee radiographs from patients aged 35-79 at the University of Copenhagen Hospital, Bispebjerg-Frederiksberg Hospital, Denmark. The tools provided Kellgren-Lawrence (KL) grades, joint space widths, patella osteophyte detection, radiographic view detection, knee joint implant detection, and radiographic marker detection. RESULTS In total, 25,778 knee radiographs from 8575 patients were included in the database after excluding inapplicable radiographs, and 92.5% of the knees had a complete OA dataset. Using the four AI tools, we saved about 800 hours of radiologist reading time and only manually reviewed 16.0% of the images in the database. CONCLUSIONS This study shows that clinical knee OA databases can be built using AI with limited human reading time for uniform grading and measurements. The concept is scalable temporally and across geographic regions and could help diversify further OA research by efficiently including radiographic knee OA data from different populations globally. We can prevent data dredging and overfitting OA theories on existing trite cohorts by including various gene pools and continuous expansion of new clinical cohorts. Furthermore, the suggested tools and applied approaches provide an ability to retest previous hypotheses and test new hypotheses on real-life clinical data with current disease prevalence and trends.
Collapse
Affiliation(s)
- Anders Lenskjold
- Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark; Radiological Artificial Intelligence Testcenter, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Mathias W Brejnebøl
- Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark; Radiological Artificial Intelligence Testcenter, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Janus U Nybing
- Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark; Radiological Artificial Intelligence Testcenter, Copenhagen, Denmark.
| | - Martin H Rose
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
| | - Henrik Gudbergsen
- The Parker Institute, University of Copenhagen, Copenhagen, Denmark; Center for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Anders Troelsen
- Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre & CAG ROAD - Research OsteoArthritis, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Anne Moller
- Center for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Henriette Raaschou
- Radiological Artificial Intelligence Testcenter, Copenhagen, Denmark; Department of Radiology, Copenhagen University Hospital Herlev-Gentofte, Copenhagen, Denmark.
| | - Mikael Boesen
- Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark; Radiological Artificial Intelligence Testcenter, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
19
|
Pocock H, Deakin CD, Lall R, Michelet F, Sun C, Smith D, Hill C, Rai J, Starr K, Brown M, Rodriguez-Bachiller I, Perkins GD. Prehospital optimal shock energy for defibrillation (POSED): A cluster randomised controlled feasibility trial. Resusc Plus 2024; 17:100569. [PMID: 38370312 PMCID: PMC10869912 DOI: 10.1016/j.resplu.2024.100569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
Background We explored the feasibility of a large-scale UK ambulance services trial of optimal defibrillation shock energy for out-of-hospital cardiac arrest. The primary objective of this feasibility study was to establish the number of eligible patients and the number recruited. Secondary outcomes were adherence to allocated treatment and data completeness. Methods We conducted a three-arm parallel group cluster randomised controlled feasibility study in a single ambulance service in southern England. Adult patients in out-of-hospital cardiac arrest treated for a shockable rhythm were included. Zoll X series defibrillators (clusters) were randomised to deliver 120-150-200 J, 150-200-200 J, or 200-200-200 J shock strategies. Results Between March 2022 and February 2023, we randomised 38 eligible patients (120-150-200 J (n = 12), 150-200-200 J (n = 10), 200-200-200 J (n = 16)) to the study. The recruitment rate per cluster was 0.07 per month. The median patient age was 71 years (IQR 59-81 years); 79% were male. Twenty-eight cardiac arrests (74%) occurred in a private residence, 29 (76%) were witnessed and 32 (84%) patients received bystander CPR. Treatment adherence was 93% and completeness of clinical and electrical outcomes was 86%. At 30 days, 3/36 (8.3%) patients survived; we were unable to collect survival outcomes for two patients. Defibrillation data collection became difficult when defibrillators became separated from their allocated vehicles. Conclusion We have demonstrated the feasibility of a cluster randomised controlled trial of optimal shock energy for defibrillation in a UK ambulance service. We have identified possible solutions to issues relating to trial design.
Collapse
Affiliation(s)
- Helen Pocock
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Charles D Deakin
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
- University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Felix Michelet
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Chu Sun
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Deb Smith
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Catherine Hill
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Jeskaran Rai
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Kath Starr
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
| | - Martina Brown
- South Central Ambulance NHS Foundation Trust, Talisman Way, Bicester, Oxfordshire OX26 6HR, UK
| | | | - Gavin D. Perkins
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, Warwickshire, UK
- University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2GW, Warwickshire, UK
| |
Collapse
|
20
|
Richmond JP, Kelly MG, Johnston A, Murphy PJ, O'Connor L, Gillespie P, Hobbins A, Alvarez-Iglesias A, Murphy AW. A community-based advanced nurse practitioner-led integrated oncology care model for adults receiving oral anticancer medication: a pilot study. Pilot Feasibility Stud 2024; 10:46. [PMID: 38424625 PMCID: PMC10902979 DOI: 10.1186/s40814-024-01461-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Oral anti-cancer medications (OAMs) are being used increasingly within cancer care. OAMs offer the potential to improve patient convenience and increase hospital capacity. The clinical assessment for each cycle of OAMs requires specialist patient review often performed in hospital-based oncology units. Consequently, any potential improvement in patient expediency or increased hospital capacity that OAMs can offer is not realised. This study aimed to develop and pilot the specialist assessment of patients receiving OAMs by an Advanced Nurse Practitioner (ANP) in a community-based location.The primary aim of this pilot study was to assess the feasibility of a community-based ANP-led integrated oncology care model for adults receiving OAMs in Ireland who met the pre-specified eligibility criteria. The objectives were to determine the feasibility of a definitive trial of this intervention by measuring patient safety, acceptability to patients and staff and cost of the new model of care.This single-centre pilot study provided patient care (n = 37) to those receiving OAM therapies within a community setting for a 4-month period. Consent rate was high with no attrition other than for clinical reasons. There were 151 contacts with the sample during that time.Results demonstrated that the ANP-led intervention and new model for OAM care was safe, highly acceptable to patients and staff and that related healthcare costs could be captured. Based on the success of this pilot study, the authors conclude that a community-based ANP-led integrated oncology care model for adults receiving OAMs is feasible, and a definitive trial is warranted.Trial registration ISRCTN, ISRCTN10401455 . Registered 30 November 2020.
Collapse
Affiliation(s)
| | | | | | - Patrick J Murphy
- Discipline of General Practice, HRB Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Laura O'Connor
- Discipline of General Practice, HRB Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Paddy Gillespie
- Centre for Research in Medical Devices (CÚRAM, RC/2073_P2) and Health Economics and Policy Analysis Centre, University of Galway, SFI 13, Galway, Ireland
| | - Anna Hobbins
- Centre for Research in Medical Devices (CÚRAM, RC/2073_P2) and Health Economics and Policy Analysis Centre, University of Galway, SFI 13, Galway, Ireland
| | | | - Andrew W Murphy
- Discipline of General Practice, HRB Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| |
Collapse
|
21
|
Zemlin C, Nourkami-Tutdibi N, Schwarz P, Wagenpfeil G, Goedicke-Fritz S. Teaching breaking bad news in a gyneco-oncological setting: a feasibility study implementing the SPIKES framework for undergraduate medical students. BMC Med Educ 2024; 24:134. [PMID: 38347593 PMCID: PMC10863240 DOI: 10.1186/s12909-024-05096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND It is a crucial task for physicians to deliver life threatening information to patients (breaking bad news; BBN). Many aspects influence these conversations on both sides, patients, and doctors. BBN affects the patient-physician relationship, patients' outcome, and physicians' health. Many physicians are still untrained for this multi-facetted task and feel unprepared and overburdened when facing situations of BBN. Therefore, any faculties should aim to integrate communication skills into their medical curricula as early as possible. The SPIKES protocol is an effective framework to deliver BBN. Aim of this study is to evaluate the feasibility and obstacles of a BBN seminar and its acceptance and learning curve among undergraduate medical students. METHODS 158 2nd year undergraduate medical students attended a compulsory BBN seminar. The task was to deliver a cancer diagnosis to the patient within a patient - physician role-play in a gyneco-oncological setting before and after a presentation of the SPIKES protocol by the lecturer. The students evaluated important communication skills during these role-plays respectively. Self-assessment questionnaires were obtained at the beginning and end of the seminar. RESULTS Most students indicated that their confidence in BBN improved after the seminar (p < 0.001). They like the topic BBN to be part of lectures (76%) and electives (90%). Communication skills improved. Lecturer and seminar were positively evaluated (4.57/5). CONCLUSION The seminar significantly increased confidence and self-awareness in delivering life-threatening news to patients among undergraduate medical students. Important learning aspects of BBN and communication skills could be delivered successfully to the participants within a short time at low costs. The integration of communication skills should be implemented longitudinally into medical curricula starting before clinical education to increase the awareness of the importance of communication skills, to decrease anxiety, stress, and workload for future doctors and- most importantly- to the benefit of our patients.
Collapse
Affiliation(s)
- Cosima Zemlin
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Pascal Schwarz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Sybelle Goedicke-Fritz
- Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany.
| |
Collapse
|
22
|
Rougereau G, Marty-Diloy T, Vigan M, Donadieu K, Vialle R, Langlais T, Hardy A. Biomechanical evaluation of the anterior talo-fibular and calcaneo-fibular ligaments using shear wave elastography in young healthy adults. Orthop Traumatol Surg Res 2024; 110:103647. [PMID: 37356798 DOI: 10.1016/j.otsr.2023.103647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the stiffness of the anterior talo-fibular ligament (ATFL) and calcaneo-fibular ligament (CFL) using shear wave elastography (SWE) with the ankle in the neutral position and in varus, in young healthy adult volunteers. We also evaluated the reliability and reproducibility of the SWE measurements. HYPOTHESIS The stiffness of both ligaments increases with increasing ankle varus. SWE may be a reliable tool for evaluating the lateral collateral ligament complex of the ankle. MATERIAL AND METHODS We used SWE to evaluate both ankles of each of 20 healthy volunteers (10 females and 10 males). For each test, the foot was placed on a hinged plate and tested in the neutral position and in 15° and 30° of varus. Stiffness was evaluated based on shear wave velocity (SWV). RESULTS Stiffness of both the ATFL and CFL was minimal in the neutral position (2.06m/s and 3.43m/s, respectively). Stiffness increased significantly for both ligaments in 15° of varus (2.48m/s and 4.11m/s, respectively; p<0.0001) and was greatest in 30° of varus (3.15m/s and 4.57m/s, respectively; p<0.0001). ATFL stiffness was greater in males than in females in 15° (p=0.04) and 30° (p=0.02) of varus. For the CFL, in contrast, stiffness was not different between males and females. Stiffness of the ATFL and CFL was not associated with age, dominant side, height, or foot morphology. No correlations were found between stiffness of the two ligaments in any of the positions. Repeating each measurement three times produced excellent concordance for both ligaments in all three positions. CONCLUSION The ATFL and CFL are the main lateral stabilisers of the ankle, and each exerts a specific function. Their stiffness increases with the degree of varus. This study describes a protocol for evaluating ATFL and CFL density by SWE, which is a reliable and reproducible technique that provides a normal range. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Grégoire Rougereau
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département de chirurgie orthopédique adulte, hôpital de la Pitié-Salpêtrière, université de la Sorbonne, AP-HP, 75571 Paris, France.
| | - Thibault Marty-Diloy
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Marie Vigan
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Unité de recherche clinique, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France
| | - Kalinka Donadieu
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France
| | - Raphaël Vialle
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département hospitalo-universitaire MAMUTH pour les thérapies innovantes dans les maladies musculosquelettiques, université de la Sorbonne, Paris, France
| | - Tristan Langlais
- Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département de chirurgie orthopédique pédiatrique, hôpital des enfants, université de Toulouse, Purpan, Toulouse, France
| | - Alexandre Hardy
- Département de chirurgie orthopédique, clinique du sport, 75005 Paris, France
| |
Collapse
|
23
|
Szilassy E, Coope C, Emsley E, Williamson E, Barbosa EC, Johnson M, Dowrick A, Feder G. Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care. BMC Prim Care 2024; 25:38. [PMID: 38273231 PMCID: PMC10811857 DOI: 10.1186/s12875-023-02249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019-21. METHODS We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention. RESULTS The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence. CONCLUSIONS Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS + . Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions.
Collapse
Affiliation(s)
- Eszter Szilassy
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Caroline Coope
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Elizabeth Emsley
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Estela Capelas Barbosa
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Anna Dowrick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
24
|
Farmer AJ, Allen J, Bartlett YK, Bower P, Chi Y, French DP, Gudgin B, Holmes E, Horne R, Hughes DA, Jones L, Kenning C, Locock L, McSharry J, Miles L, Newhouse N, Rea R, Robinson S, Tarassenko L, Velardo C, Williams N, Yu LM. Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D pilot): results of a feasibility randomised trial. Pilot Feasibility Stud 2024; 10:15. [PMID: 38273420 PMCID: PMC10809651 DOI: 10.1186/s40814-023-01429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The purpose of this 6-month intervention pilot feasibility randomised trial was to test sending brief messages using mobile phones to promote self-management through taking medication as prescribed to people with type 2 diabetes. This was to inform the design and conduct of a future large-scale United Kingdom-based clinical trial and establish the feasibility of recruitment, the technology used, follow-up, and data collection. METHODS A multicentre individually randomised, controlled parallel group trial in primary care, recruiting adults (≥ 35 years) with type 2 diabetes in England. Consenting participants were randomly allocated to receive short message system text messages up to four times a week, or usual care, for a period of 6 months; messages contained behavioural change techniques targeting medication use. The primary outcome was the rate of recruitment to randomisation of participants to the trial with a planned rate of 22 participants randomised per month. The study also aimed to establish the feasibility of follow-up at 6 months, with an aim of retaining more than 80% of participants. Data, including patient-reported measures, were collected at baseline and the end of the 6-month follow-up period, and a notes review was completed at 24 months. RESULTS The trial took place between 26 November 2018 and 30 September 2019. In total 209 participants were randomly allocated to intervention (n = 103) or usual care (n = 106). The maximum rate of monthly recruitment to the trial was 60-80 participants per month. In total, 12,734 messages were sent to participants. Of these messages, 47 were identified as having failed to be sent by the service provider. Participants sent 2,864 messages to the automated messaging system. Baseline data from medical records were available for > 90% of participants with the exception of cholesterol (78.9%). At 6 months, a further HbA1c measurement was reported for 67% of participants. In total medical record data were available at 6 months for 207 (99.0%) of participants and completed self-report data were available for 177 (84.7%) of participants. CONCLUSION The feasibility of a large-scale randomised evaluation of brief message intervention for people with type 2 diabetes appears to be high using this efficient design. Failure rate of sending messages is low, rapid recruitment was achieved among people with type 2 diabetes, clinical data is available on participants from routine medical records and self-report of economic measures was acceptable. TRIAL REGISTRATION ISCTRN ISRCTN13404264. Registered on 10 October 2018.
Collapse
Affiliation(s)
- Andrew J Farmer
- University of Oxford, Oxford, UK.
- Nuffield Department of Primary Care Health Sciences, Woodstock Road, Oxford, OX2 6GG, UK.
| | | | | | | | - Yuan Chi
- University of Oxford, Oxford, UK
| | | | | | | | | | | | | | | | | | | | - Lisa Miles
- University of Manchester, Manchester, UK
| | | | - Rustam Rea
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | | | | | | |
Collapse
|
25
|
Mirshahi A, Bakitas M, Khoshavi M, Khanipour-Kencha A, Riahi SM, Wells R, Odom JN, Ghiyasvandian S, Zakerimoghadam M. The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study. BMC Palliat Care 2024; 23:22. [PMID: 38254058 PMCID: PMC10804593 DOI: 10.1186/s12904-024-01348-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran. METHODS This single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits. RESULTS We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference. CONCLUSION This nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran. TRIAL REGISTRATION The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform. IRCT registration number: IRCT20100725004443N29.
Collapse
Affiliation(s)
- Arvin Mirshahi
- Students' Scientific Research Center, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marie Bakitas
- School of Nursing, and Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Meysam Khoshavi
- Department of Cardiology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khanipour-Kencha
- Students' Scientific Research Center, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Riahi
- Department of Community Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Rachel Wells
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham (UAB) and UAB Center for Palliative and Supportive Care, Birmingham, AL, USA
| | - Shahrzad Ghiyasvandian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq, Tehran, Post Code: 14197-33171, Iran
| | - Masoumeh Zakerimoghadam
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq, Tehran, Post Code: 14197-33171, Iran.
| |
Collapse
|
26
|
Ritchie LA, Penson PE, Akpan A, Lip GYH, Lane DA. Pharmacist-led intervention for older people with atrial fibrillation in long-term care (PIVOTALL study): a randomised pilot and feasibility study. BMC Geriatr 2024; 24:64. [PMID: 38229013 DOI: 10.1186/s12877-023-04527-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Older care home residents are a vulnerable group of people with atrial fibrillation (AF) at high risk of adverse health events. The Atrial Fibrillation Better Care (ABC: Avoid stroke; Better symptom management; Cardiovascular and other comorbidity management) pathway is the gold-standard approach toward integrated AF care, and pharmacists are a potential resource with regards to its' implementation. The aim of this study was to determine the feasibility of pharmacist-led medicines optimisation in care home residents, based on the ABC pathway compared to usual care. METHODS Individually randomised, prospective pilot and feasibility study of older (aged ≥ 65 years) care home residents with AF (ISRCTN14747952); residents randomised to ABC pathway optimised care versus usual care. The primary outcome was a description of study feasibility (resident and care home recruitment and retention). Secondary outcomes included the number and type of pharmacist medication recommendations and general practitioner (GP) implementation. RESULTS Twenty-one residents were recruited and 11 (mean age [standard deviation] 85.0 [6.5] years, 63.6% female) were randomised to receive pharmacist-led medicines optimisation. Only 3/11 residents were adherent to all three components of the ABC pathway. Adherence was higher to 'A' (9/11 residents) and 'B' (9/11 residents) components compared to 'C' (3/11 residents). Four ABC-specific medicines recommendations were made for three residents, and two were implemented by residents' GPs. Overall ABC adherence rates did not change after pharmacist medication review, but adherence to 'A' increased (from 9/11 to 10/11 residents). Other ABC recommendations were inappropriate given residents' co-morbidities and risk of medication-related adverse effects. CONCLUSIONS The ABC pathway as a framework was feasible to implement for pharmacist medication review, but most residents' medications were already optimised. Low rates of adherence to guideline-recommended therapy were a result of active decisions not to treat after assessment of the net risk-benefit.
Collapse
Affiliation(s)
- Leona A Ritchie
- Liverpool Centre for Cardiovascular Science, William Henry Duncan Building, University of Liverpool, Liverpool, L7 8TX, UK.
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.
- Clinical Pharmacy and Therapeutics Research Group, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
| | - Peter E Penson
- Liverpool Centre for Cardiovascular Science, William Henry Duncan Building, University of Liverpool, Liverpool, L7 8TX, UK
- Clinical Pharmacy and Therapeutics Research Group, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Asangaedem Akpan
- Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, William Henry Duncan Building, University of Liverpool, Liverpool, L7 8TX, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
27
|
Song Y, Xia L, Ju X, Wang W, Ge X, Hong J. Development of a supportive care needs eHealth application for patients with cervical cancer undergoing surgery: a feasibility study. BMC Health Serv Res 2024; 24:3. [PMID: 38166854 PMCID: PMC10763441 DOI: 10.1186/s12913-023-10437-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE To inform the development of an eHealth application for patients with cervical cancer for monitoring supportive care needs, perceived care supply and quality of life. METHODS A mixed-method design was used. The 19-month process involved five phases: (1) a literature review to screen the components of applications, (2) a cross-sectional needs assessment for patients with cervical cancer to define the needs and application program frame, (3) expert consultation to refine the draft, (4) software development, and (5) pilot testing and user comment collection. Patients in the intervention group received a 7-day application intervention combined with usual care. Supportive care needs, perceived care supply, quality of life and user's additional comments were collected. RESULTS The literature review results in phase 1 revealed the importance of full preparation, especially a supportive care needs assessment, before application development. Subsequent supportive care needs investigation in phase 2 revealed that the most urgent needs were informational needs and privacy protection. In phase 3, 43 expert recommendations for application improvement were refined. The new application contained the patient and the health care professional portal in phase 4. Then, on Day 7, there existed score changes of the outcome measures in both intervention and control group. Users had a positive experience with the application. CONCLUSIONS This study demonstrates the feasibility of applications targeting access to supportive care, which may be effective for improving the outcome measures but needed to be evaluated in future studies.
Collapse
Affiliation(s)
- Yongxia Song
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, Hefei City, Anhui Province, China
- The First Affiliated Hospital of Anhui Medical University, No, 218 Ji Xi Road, Shu Shan District, Hefei City, Anhui Province, China
| | - Lili Xia
- The First Affiliated Hospital of Anhui Medical University, No, 218 Ji Xi Road, Shu Shan District, Hefei City, Anhui Province, China
| | - Xiaodi Ju
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, Hefei City, Anhui Province, China
| | - Wenjing Wang
- The First Affiliated Hospital of University of Science and Technology of China, No. 17 Lu Jiang Road, Lu Yang District, Hefei City, Anhui Province, China
| | - Xiaoling Ge
- The First Affiliated Hospital of Anhui Medical University, No, 218 Ji Xi Road, Shu Shan District, Hefei City, Anhui Province, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, Hefei City, Anhui Province, China.
- Nursing International Collaboration Research Center of Anhui Province, Hefei, China.
| |
Collapse
|
28
|
Poh JXY, Chan KH, Tan SSL, Xu T. Occupational therapists' perceptions of the feasibility of using tele-assessment for remote prescription of assistive devices in Singapore: A qualitative study. Work 2024; 77:1153-1163. [PMID: 38007633 DOI: 10.3233/wor-230168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Occupational therapists (OT) assess and prescribe assistive devices to older adults with limitations in performing daily living activities. Timely prescription of assistive devices to accommodate the rising demand has been affected by the COVID-19 pandemic. Tele-assessment allows for continuity of care, but its success depends on therapists' acceptance. OBJECTIVE This study examined OTs' perceptions of the feasibility of conducting tele-assessment and developing a clinical practice guideline for remote prescription of assistive devices for older adults in Singapore. METHODS Eligible OTs were recruited from purposive sampling. Semi-structured interviews were conducted via a virtual platform (Zoom). Audio recordings were transcribed verbatim. Inductive thematic analysis using a line-by-line coding method was used to identify common trends. RESULTS Interviews with 10 participants revealed three main themes: (1) therapists' perceptions of the feasibility of tele-assessment, (2) criteria for safe and appropriate prescription of assistive devices via tele-assessment, and (3) practical considerations for the implementation of tele-assessment. Participants felt that tele-assessment increases efficiency with more older adults being more receptive towards technology. They also raised suggestions to address OTs' concerns regarding the safety and accuracy prescription of assistive devices following tele-assessment. This included establishing the client's suitability for assistive device prescription, characteristics of assistive devices, resources required, and considering the preferences of stakeholders involved. CONCLUSION Tele-assessment for assistive device prescription by OTs appears feasible in Singapore. OTs should consider collaborating with other stakeholders to develop a tele-assessment clinical practice guideline for assistive device prescription. Further studies testing its clinical effectiveness during and/or post-pandemic are warranted.
Collapse
Affiliation(s)
- Jess Xiu Yi Poh
- Rehabilitation Department, National University Hospital, Singapore
| | - Kuang Hong Chan
- Department of Occupational Therapy, Institute of Mental Health, Singapore
| | - Samantha Si Li Tan
- Department of Occupational Therapy, Singapore General Hospital, Singapore
| | - Tianma Xu
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| |
Collapse
|
29
|
Robinson-Oghogho JN, Gittelsohn J, Bowie J, Dankwa L, Thorpe RJ. Ours to eat and own: assessing the feasibility of a cooperative meal-kit service to improve food access. Public Health Nutr 2023; 27:e17. [PMID: 38126279 PMCID: PMC10830382 DOI: 10.1017/s1368980023002884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Although typically serving higher income and younger demographic groups, meal-kit subscription services have the potential to improve food availability and dietary quality in communities experiencing low food access due to systemic discrimination. This study describes the development and characteristics of a pilot community-led meal-kit service (SouthEats) and evaluates key implementation outcomes of adoption, acceptability, and feasibility among households experiencing less income. DESIGN We utilised a mixed methods study design, including data from administrative records, customer surveys and worker interviews. Thematic qualitative analyses and descriptive quantitative analyses were conducted to illuminate the characteristics and extent the pilot meal-kit service was adopted, acceptable, and financially feasible among the target populations. SETTING The study took place in Washington DC, USA. PARTICIPANTS Study participants included SouthEats consumers (n 35) and workers (n 3). RESULTS During the pilot period, sixty-seven community members signed up for the meal-kit service, with 52 % making recurring purchases. Our results suggest that the meal-kit service is acceptable among people living in low food access areas. Our feasibility analysis indicates that, although not without challenges, the SouthEats model could be financially feasible. CONCLUSION These preliminary insights can inform the scalability and potential replication of this service and provide foundational evidence for an approach that may be used to improve food access.
Collapse
Affiliation(s)
- Joelle N Robinson-Oghogho
- Johns Hopkins Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, MD21205, USA
| | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | - Janice Bowie
- Johns Hopkins Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, MD21205, USA
| | - Lois Dankwa
- Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, MD21205, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
30
|
Kato A, Yoshiuchi K, Hashimoto H, Suzuki R, Yamauchi T, Kadowaki T. Feasibility, acceptability, and effects of a self-stigma reduction pilot program for Japanese individuals with type 2 diabetes. PEC Innov 2023; 2:100112. [PMID: 37214517 PMCID: PMC10194166 DOI: 10.1016/j.pecinn.2022.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/02/2022] [Accepted: 11/27/2022] [Indexed: 05/24/2023]
Abstract
Objective To examine the feasibility, acceptability, and effects of a self-stigma reduction program for patients with type 2 diabetes mellitus (T2DM). Methods We adopted a within-subjects pre-post study design, measuring self-stigma among T2DM patients who received treatment at a tertiary-level hospital. Results Of the 17 participants, 11 participants completed the program (mean age: 54.36 ± 8.58 years; women: 63.6%; mean T2DM duration: 12.09 ± 10.41 years). Participants experienced reduced levels of self-stigma between the pre- and post-study time points (mean pre-study score: 35.82 ± 16.26; mean post-study score: 25.55 ± 16.91). The difference in self-stigma was not significant (effect size: d = 0.8, χ2 = 3.6, p = 0.057). Overall, participants who completed the program were satisfied except for the duration of each session. Conclusion The self-stigma reduction program was relatively feasible and acceptable. Although due to the small sample size our results were not statistically significant, a large reduction of self-stigma was found in those who completed the program, which is promising. Future studies with larger sample sizes are needed to measure the program's long-term effects on the reduction of self-stigma. Innovation This program is innovative as the researchers and healthcare professionals collaborated with patients who contributed their narratives.
Collapse
Affiliation(s)
- Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Ryo Suzuki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Toranomon Hospital, Tokyo, Japan
| |
Collapse
|
31
|
Short E, Thompson D, Taren D, Bryant H, Gonzalez R, Sheava J, Hingle M. Feasibility of a food-based diabetes self-management education intervention for food insecure patients with type 2 diabetes: a convergent mixed methods study. Public Health Nutr 2023; 26:3100-3111. [PMID: 37759394 PMCID: PMC10755446 DOI: 10.1017/s1368980023002082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE To assess the feasibility of a food-based diabetes self-management education and support (DSMES) intervention delivered to persons with type 2 diabetes (T2DM) and food insecurity. DESIGN This single arm pre-/post convergent mixed methods study tested the feasibility of a 3-month intervention using food boxes, recipes, DSMES and dietitian visits. Feasibility benchmarks assessed were acceptability (> 50 % participants satisfied), demand (> 50 % used program components) and implementation (75 % adherence, 80 % retention). Assessments included: self-reported food security, health-related quality of life, diabetes self-efficacy, socio-demographic and dietary intake, height, weight, and HbA1c and one in-depth interview with participants and key staff. Enrollment, recruitment and retention rates were summarised; qualitative data were analysed using structured thematic analysis (participant interviews) and key point summaries (staff interviews). Quantitative/qualitative data integration was conducted using a joint display. SETTING Food bank and Federally Qualified Health Center in the Southwestern U.S. PARTICIPANTS English- or Spanish-speaking adults with T2DM and food insecurity. RESULTS In total, 247 patients with T2DM and food insecurity were recruited, seventy-one expressed interest and twenty-five consented. Twenty-one participants completed study measurements. 71 % (n 15) received six home food deliveries and ≥ 1 dietitian visit. A priori benchmarks were approached or met within each feasibility criterion - most participants found the intervention to be acceptable, used most or all intervention components, and reported some challenges within intervention implementation (e.g. timing of food deliveries). Data integration provided deeper understanding of reported intervention implementation challenges, yet high adherence to the intervention. CONCLUSIONS The intervention was feasible. Next steps include a clinical trial to establish intervention efficacy.
Collapse
Affiliation(s)
- Eliza Short
- University of Arizona School of Nutritional Sciences and Wellness, 1177 E 4th St, Tucson, AZ85721, USA
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates St, Houston, TX77030, USA
| | - Douglas Taren
- University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop F561, Aurora, CO80045, USA
| | - Holly Bryant
- El Rio Community Health Center, 450 W Paseo Redondo, Tucson, AZ, 85701, USA
| | - Rhonda Gonzalez
- Community Food Bank of Southern Arizona, 3003 S Country Club Rd, Tucson, AZ85713, USA
| | - Jessi Sheava
- Community Food Bank of Southern Arizona, 3003 S Country Club Rd, Tucson, AZ85713, USA
| | - Melanie Hingle
- University of Arizona School of Nutritional Sciences and Wellness, 1177 E 4th St, Tucson, AZ85721, USA
| |
Collapse
|
32
|
Rougereau G, Marty-Diloy T, Vigan M, Donadieu K, Vialle R, Langlais T, Hardy A. Biomechanical evaluation of the spring ligament and the posterior tibial tendon by shear-waves elastography: validation of a reliable and reproducible measurement protocol. J Exp Orthop 2023; 10:121. [PMID: 38006458 PMCID: PMC10676337 DOI: 10.1186/s40634-023-00678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/19/2023] [Indexed: 11/27/2023] Open
Abstract
PURPOSE The anatomy of the spring ligament complex, as well as its pathology, is not well known in daily clinical practice. The purpose of this study was to evaluate the shear-wave elastography properties of the spring ligament and the posterior tibial tendon in healthy adults, and to assess the reliability and reproducibility of these measurements. METHODS Shear-wave elastography was used to evaluate both ankles in 20 healthy patients (10 females/10 males) resting on a hinge support with their ankles in neutral, valgus 20° and varus 30° positions. The stiffness of the spring ligament and posterior tibial tendon was assessed by measuring the speed of shear wave propagation through each structure. RESULTS Posterior tibial tendon and spring ligament reach a maximum estimated stiffness in valgus 20° position (7.43 m/s vs 5.73 m/s, respectively). Flat feet were associated with greater spring ligament stiffness in the 20° valgus position (p = 0.01), but not for the posterior tibial tendon (p = 0.71). The physiologic weightbearing hindfoot attitude had no impact on the stiffness of the posterior tibial tendon or the spring ligament, regardless of the analysis position. Intra- and inter-observer agreements were all excellent for spring ligament stiffness, regardless of ankle position, and were good or excellent for posterior tibial tendon. CONCLUSIONS This study describes a protocol to assess the stiffness of tibialis posterior and the spring ligament by shear-wave elastography, which is reliable, reproducible, and defines a corridor of normality. Further studies should be conducted to define the role of elastography for diagnosis/ evaluation of pathology, follow-up, or surgical strategies.
Collapse
Affiliation(s)
- Grégoire Rougereau
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France.
- Department of Adult Orthopedic Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, APHP, 75571, Paris, France.
| | - Thibault Marty-Diloy
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
| | - Marie Vigan
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Unité de Recherche Clinique Hôpitaux Universitaires Paris Ile-de-France Ouest, APHP, 92100, Boulogne-Billancourt, France
| | - Kalinka Donadieu
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
| | - Raphaël Vialle
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Department for Innovative Therapies, Musculoskeletal Disease Sorbonne University, The MAMUTH Hospital University, Paris, France
| | - Tristan Langlais
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Department of Pediatric Orthopedic Surgery, Toulouse University, Children's Hospital, Purpan, Toulouse, France
| | - Alexandre Hardy
- Department of Orthopedic Surgery, Clinique du Sport, 75005, Paris, France
| |
Collapse
|
33
|
Solbakken AM, Sellevold S, Spasojevic M, Julsrud L, Emblemsvåg HL, Reims HM, Sørensen O, Thorgersen EB, Fauske L, Ågren JSM, Brennhovd B, Ryder T, Larsen SG, Flatmark K. Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer. Ann Surg Oncol 2023; 30:7602-7611. [PMID: 37481493 PMCID: PMC10562504 DOI: 10.1245/s10434-023-13964-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/03/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND In some surgical disciplines, navigation-assisted surgery has become standard of care, but in rectal cancer, indications for navigation and the utility of different technologies remain undetermined. METHODS The NAVI-LARRC prospective study (NCT04512937; IDEAL Stage 2a) evaluated feasibility of navigation in patients with locally advanced primary (LARC) and recurrent rectal cancer (LRRC). Included patients had advanced tumours with high risk of incomplete (R1/R2) resection, and navigation was considered likely to improve the probability of complete resection (R0). Tumours were classified according to pelvic compartmental involvement, as suggested by the Royal Marsden group. The BrainlabTM navigation platform was used for preoperative segmentation of tumour and pelvic anatomy, and for intraoperative navigation with optical tracking. R0 resection rates, surgeons' experiences, and adherence to the preoperative resection plan were assessed. RESULTS Seventeen patients with tumours involving the posterior/lateral compartments underwent navigation-assisted procedures. Fifteen patients required abdominosacral resection, and 3 had resection of the sciatic nerve. R0 resection was obtained in 6/8 (75%) LARC and 6/9 (69%) LRRC cases. Preoperative segmentation was time-consuming (median 3.5 h), but intraoperative navigation was accurate. Surgeons reported navigation to be feasible, and adherence to the resection plan was satisfactory. CONCLUSIONS Navigation-assisted surgery using optical tracking was feasible. The preoperative planning was time-consuming, but intraoperative navigation was accurate and resulted in acceptable R0 resection rates. Selected patients are likely to benefit from navigation-assisted surgery.
Collapse
Affiliation(s)
- Arne M Solbakken
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Simen Sellevold
- Department of Orthopaedic Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Milan Spasojevic
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Lars Julsrud
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Hanne-Line Emblemsvåg
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Henrik M Reims
- Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Olaf Sørensen
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ebbe B Thorgersen
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Lena Fauske
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Bjørn Brennhovd
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Truls Ryder
- Department of Oncologic Plastic Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Stein G Larsen
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Kjersti Flatmark
- Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Tumour Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
34
|
Wilson DH, German D, Ricker A, Gourneau H, Hanson GC, Mayhew J, Brockie TN, Sarche M. Feasibility, acceptability and effectiveness of a culturally informed intervention to decrease stress and promote well-being in reservation-based Native American Head Start teachers. BMC Public Health 2023; 23:2088. [PMID: 37880677 PMCID: PMC10599064 DOI: 10.1186/s12889-023-16913-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND While benefiting from strong cultural ties to family, land and culture Native Americans residing on reservations experience psychological distress at rates 2.5 times that of the general population. Treatment utilization for psychological health in reservation-based communities is low with access to culturally appropriate care lacking. Evidence suggests that for mental health treatment, Native Americans prefer culturally informed care that respects Native perspectives on health and well-being. METHODS To decrease stress and promote well-being in tribal Head Start teachers we adapted and implemented a culturally focused intervention within a community-based participatory research framework using mixed methods. Feasibility and acceptability of the adapted 5-session curriculum was tested in a single arm intervention study with a sample of 18 teachers on the Fort Peck Reservation. Participants completed surveys at baseline and upon completion of the intervention. Within session observations and two post-intervention focus groups (n = 8, n = 10) were conducted to elaborate and explain the quantitative results eliciting participant experience of intervention effectiveness and feasibility, acceptably and appropriateness. Implementation outcomes were assessed quantitatively using the Acceptability of Intervention, Intervention Appropriateness, and Feasibility of Intervention measures. RESULTS Quantitively, attendance rate overall was 93% with no dropouts. Pretest/posttest surveys were analyzed using t-tests and Hedges g to measure effect size. Contrary to our hypothesis, self-perceived stress showed a small positive effect size, indicating that participants were more stressed post intervention. However, depression decreased, with tribal identity and resilience showing positive effect sizes. Content analysis for the qualitative data collected within session observations and post intervention focus groups revealed how lifetime traumas were affecting participants, providing some explanation for the increase in stress. Teachers reported that the sessions helped their psychological health and well-being, supporting feasibility of future interventions. Acceptability scored highest with a mean (SD) of 4.25 (.84) out of 5, appropriateness 4.18 (.86) and feasibility 4.06 (.96) supporting intervention to be acceptable, appropriate, and feasible. CONCLUSION Utilizing a culturally based intervention to buffer stress and support the well-being of reservation-based teachers showed promise in helping them recognize their cultural strengths, stress, and need for ongoing support. Implementation outcomes show that intervention scale-out is feasible.
Collapse
Affiliation(s)
- Deborah H Wilson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA.
- Auckland University of Technology School of Clinical Sciences, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
| | - Danielle German
- Department of Health Behavior and Society, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Adrian Ricker
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Hilary Gourneau
- Fort Peck Tribes Head Start, 409 G St, W Poplar, MT, 59255, USA
| | - Ginger C Hanson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Justin Mayhew
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD, 21231, USA
| | - Teresa N Brockie
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Michelle Sarche
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Mail Stop, 13001 E 17th Pl B119, Aurora, CO, 80045, USA
| |
Collapse
|
35
|
Canfield SM, Canada KE, Rolbiecki AJ, Petroski GF. Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial. BMC Pregnancy Childbirth 2023; 23:739. [PMID: 37853333 PMCID: PMC10585730 DOI: 10.1186/s12884-023-06031-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Untreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples. METHODS We conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13-30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview. RESULTS There were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people's anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB. CONCLUSION Online dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous. TRIAL REGISTRATION ClinicalTrials.gov NCT05867680, 19/05/2023.
Collapse
Affiliation(s)
- Shannon M Canfield
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA.
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, MO, USA
| | - Abigail J Rolbiecki
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Family Medicine and Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory F Petroski
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, School of Medicine - University of Missouri, Columbia, MO, USA
| |
Collapse
|
36
|
Warbrick LA, Dunn BD, Moran PA, Campbell J, Kessler D, Marchant K, Farr M, Ryan M, Parkin M, Sharpe R, Turner K, Sylianou M, Sumner G, Wood E. Non-randomised feasibility study of training workshops for Talking Therapies service high-intensity therapists to optimise depression and anxiety outcomes for individuals with co-morbid personality difficulties: a study protocol. Pilot Feasibility Stud 2023; 9:170. [PMID: 37798752 PMCID: PMC10552316 DOI: 10.1186/s40814-023-01394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The NHS Talking Therapies for Anxiety and Depression programme ('TTad'; formerly Improving Access to Psychological Therapies 'IAPT') delivers high-intensity cognitive behavioural therapy (CBT) to over 200,000 individuals each year for common mental health problems like depression and anxiety. More than half of these individuals experience comorbid personality difficulties, who show poorer treatment outcomes. TTad therapists report feeling unskilled to work with clients with personality difficulties, and enhancing the training of TTad therapists may lead to improved treatment outcomes for individuals presenting with secondary personality difficulties alongside depression and anxiety. METHODS This is a pre-post non-randomised mixed-method feasibility study, exploring the feasibility and acceptability of a 1-day training workshop for high-intensity (HI) CBT therapists. The workshop is focused on understanding and assessing personality difficulties and adapting HICBT treatments for anxiety and depression to accommodate client needs. The feasibility and acceptability of the workshop and the evaluation procedures will be investigated. It will be examined to what extent the workshop provision leads to improvements in therapist skills and confidence and explored to what extent the training has the potential to enhance clinical outcomes for this client group. DISCUSSION This feasibility study will provide data on the acceptability and feasibility of delivering brief therapist training to adapt usual HICBT to optimise care for individuals with secondary personality difficulties seeking treatment in TTad services for a primary problem of depression and/or anxiety. The study will also evaluate proof of concept that such an approach has the potential to improve clinical outcomes for those with secondary personality difficulties and report any possible harms identified. The study will inform the design of a future randomised controlled trial designed to test the effectiveness and cost-effectiveness of the training. TRIAL REGISTRATION ISRCTN81104604 . Submitted on 6th June 2022. Registration date: 3rd January 2023.
Collapse
Affiliation(s)
- Laura A Warbrick
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QQ, UK.
- College of Medicine and Health, University of Exeter, Exeter, UK.
| | - Barnaby D Dunn
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QQ, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Paul A Moran
- Bristol Medical School, University of Bristol, Bristol, UK
| | - John Campbell
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - David Kessler
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Marchant
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QQ, UK
| | - Michelle Farr
- Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Mary Ryan
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QQ, UK
| | - Megan Parkin
- Royal Devon University Healthcare NHS Foundation Trust, Tiverton, UK
| | | | - Katrina Turner
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Gemma Sumner
- Everyturn Mental Health, Newcastle Upon Tyne, UK
| | - Emma Wood
- Everyturn Mental Health, Newcastle Upon Tyne, UK
| |
Collapse
|
37
|
Salim H, Cheong AT, Sharif-Ghazali S, Lee PY, Lim PY, Khoo EM, Hussein N, Harrun NH, Ho BK, Pinnock H. A self-management app to improve asthma control in adults with limited health literacy: a mixed-method feasibility study. BMC Med Inform Decis Mak 2023; 23:194. [PMID: 37759184 PMCID: PMC10523795 DOI: 10.1186/s12911-023-02300-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Digital technology tailored for those with limited health literacy has the potential to reduce health inequalities. Although mobile apps can support self-management in chronic diseases, there is little evidence that this approach applies to people with limited health literacy. We aimed to determine the acceptability of a self-management app in adults living with asthma and have limited health literacy and the feasibility of delivering the intervention and assessing outcomes. METHODS We recruited eligible adults from the Klang Asthma Cohort registry in primary care for a 3-month mixed-method study plus a 2-month extended observation. We collected baseline data on socio-demography, health literacy and asthma control level. The outcomes of the intervention were assessed at 1- and 3-month: i) adoption (app download and usage), ii) adherence (app usage), iii) retention (app usage in the observation period), iv) health outcomes (e.g., severe asthma attacks) and v) process outcomes (e.g., ownership and use of action plans). At 1-month, participants were purposively sampled for in-depth interviews, which were audio-recorded, transcribed verbatim, and analysed deductively. RESULTS We recruited 48 participants; 35 participants (23 Female; median age = 43 years; median HLS score = 28) completed the 3 months study. Of these, 14 participants (10 Female; median age = 48 years; median HLS score = 28) provided interviews. Thirty-seven (77%) participants adopted the app (downloaded and used it in the first month of the study). The main factor reported as influencing adoption was the ease of using the app. A total of 950 app usage were captured during the 3-month feasibility study. App usage increased gradually, peaking at month 2 (355 total log-ins) accounting for 78% of users. In month 5, 51.4% of the participants used the app at least once. The main factors influencing continued use included adherence features (e.g., prompts and reminders), familiarity with app function and support from family members. CONCLUSIONS An asthma self-management app intervention was acceptable for adults with limited health literacy and it was feasible to collect the desired outcomes at different time points during the study. A future trial is warranted to estimate the clinical and cost-effectiveness of the intervention and to explore implementation strategies.
Collapse
Affiliation(s)
- Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sazlina Sharif-Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Malaysian Research Institute On Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Petaling Jaya, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Noor Harzana Harrun
- Klinik Kesihatan Pandamaran, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit On Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
38
|
Allan L, O'Connell A, Raghuraman S, Bingham A, Laverick A, Chandler K, Connors J, Jones B, Um J, Morgan-Trimmer S, Harwood R, Goodwin VA, Ukoumunne OC, Hawton A, Anderson R, Jackson T, MacLullich AMJ, Richardson S, Davis D, Collier L, Strain WD, Litherland R, Glasby J, Clare L. A rehabilitation intervention to improve recovery after an episode of delirium in adults over 65 years (RecoverED): study protocol for a multi-centre, single-arm feasibility study. Pilot Feasibility Stud 2023; 9:162. [PMID: 37715277 PMCID: PMC10503099 DOI: 10.1186/s40814-023-01387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/24/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Delirium affects over 20% of all hospitalised older adults. Delirium is associated with a number of adverse outcomes following hospital admission including cognitive decline, anxiety and depression, increased mortality and care needs. Previous research has addressed prevention of delirium in hospitals and care homes, and there are guidelines on short-term treatment of delirium during admission. However, no studies have addressed the problem of longer-term recovery after delirium and it is currently unknown whether interventions to improve recovery after delirium are effective and cost-effective. The primary objective of this feasibility study is to test a new, theory-informed rehabilitation intervention (RecoverED) in older adults delivered following a hospital admission complicated by delirium to determine whether (a) the intervention is acceptable to individuals with delirium and (b) a definitive trial and parallel economic evaluation of the intervention are feasible. METHODS The study is a multi-centre, single-arm feasibility study of a rehabilitation intervention with an embedded process evaluation. Sixty participants with delirium (aged > 65 years old) and carer pairs will be recruited from six NHS acute hospitals across the UK. All pairs will be offered the intervention, with follow-up assessments conducted at 3 months and 6 months post-discharge home. The intervention will be delivered in participants' own homes by therapists and rehabilitation support workers for up to 10 intervention sessions over 12 weeks. The intervention will be tailored to individual needs, and the chosen intervention plan and goals will be discussed and agreed with participants and carers. Quantitative data on reach, retention, fidelity and dose will be collected and summarised using descriptive statistics. The feasibility outcomes that will be used to determine whether the study meets the criteria for progression to a definitive randomised controlled trial (RCT) include recruitment, delivery of the intervention, retention, data collection and acceptability of outcome measures. Acceptability of the intervention will be assessed using in-depth, semi-structured qualitative interviews with participants and healthcare professionals. DISCUSSION Findings will inform the design of a pragmatic multi-centre RCT of the effectiveness and cost-effectiveness of the RecoverED intervention for helping the longer-term recovery of people with delirium compared to usual care. TRIAL REGISTRATION The feasibility study was registered: ISRCTN15676570.
Collapse
Affiliation(s)
- Louise Allan
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Abby O'Connell
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Shruti Raghuraman
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Alison Bingham
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Abigail Laverick
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Kirstie Chandler
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - James Connors
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Benjamin Jones
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Jinpil Um
- University of Exeter Medical School, University of Exeter, Exeter, UK.
| | | | - Rowan Harwood
- School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Victoria A Goodwin
- Department of Ageing and Rehabilitation, University of Exeter, Exeter, UK
| | - Obioha C Ukoumunne
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), University of Exeter, Exeter, EX1 2LU, UK
| | - Annie Hawton
- Health Economics Group, University of Exeter Medical School, Exeter, UK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Thomas Jackson
- Institute of Inflammation and Ageing, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2WD, UK
| | - Alasdair M J MacLullich
- Scottish Hip Fracture Audit (SHFA), NHS National Services Scotland, Edinburgh, UK
- Ageing and Health Group, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah Richardson
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 7HB, UK
| | - Lesley Collier
- Faculty of Health and Well-Being, University of Winchester, Winchester, SO22 4NR, UK
| | - William David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, EX2 5AX, UK
| | | | - Jon Glasby
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Linda Clare
- University of Exeter Medical School, University of Exeter, Exeter, UK
| |
Collapse
|
39
|
Mahlknecht A, Engl A, Piccoliori G, Wiedermann CJ. Supporting primary care through symptom checking artificial intelligence: a study of patient and physician attitudes in Italian general practice. BMC Prim Care 2023; 24:174. [PMID: 37661285 PMCID: PMC10476397 DOI: 10.1186/s12875-023-02143-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Rapid advancements in artificial intelligence (AI) have led to the adoption of AI-driven symptom checkers in primary care. This study aimed to evaluate both patients' and physicians' attitudes towards these tools in Italian general practice settings, focusing on their perceived utility, user satisfaction, and potential challenges. METHODS This feasibility study involved ten general practitioners (GPs) and patients visiting GP offices. The patients used a chatbot-based symptom checker before their medical visit and conducted anamnestic screening for COVID-19 and a medical history algorithm concerning the current medical problem. The entered data were forwarded to the GP as medical history aid. After the medical visit, both physicians and patients evaluated their respective symptoms. Additionally, physicians performed a final overall evaluation of the symptom checker after the conclusion of the practice phase. RESULTS Most patients did not use symptom checkers. Overall, 49% of patients and 27% of physicians reported being rather or very satisfied with the symptom checker. The most frequent patient-reported reasons for satisfaction were ease of use, precise and comprehensive questions, perceived time-saving potential, and encouragement of self-reflection. Every other patient would consider at-home use of the symptom checker for the first appraisal of health problems to save time, reduce unnecessary visits, and/or as an aid for the physician. Patients' attitudes towards the symptom checker were not significantly associated with age, sex, or level of education. Most patients (75%) and physicians (84%) indicated that the symptom checker had no effect on the duration of the medical visit. Only a few participants found the use of the symptom checker to be disruptive to the medical visit or its quality. CONCLUSIONS The findings suggest a positive reception of the symptom checker, albeit with differing focus between patients and physicians. With the potential to be integrated further into primary care, these tools require meticulous clinical guidance to maximize their benefits. TRIAL REGISTRATION The study was not registered, as it did not include direct medical intervention on human participants.
Collapse
Affiliation(s)
- Angelika Mahlknecht
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Christian Josef Wiedermann
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy.
- Department of Public Health, Medical Decision Making and HTA, University of Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer Place 1, 6060, Hall, Austria.
| |
Collapse
|
40
|
Veldheer S, Whitehead-Zimmers M, Bordner C, Weinstein O, Choi H, Spreenberg-Bronsoms K, Davis J, Conroy DE, Schmitz KH, Sciamanna C. Growing Healthy Hearts: a single-arm feasibility study of a digitally delivered gardening, cooking, and nutrition intervention for adults with risk factors for cardiovascular disease. Pilot Feasibility Stud 2023; 9:152. [PMID: 37653532 PMCID: PMC10470136 DOI: 10.1186/s40814-023-01380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Food gardening may positively influence cardiovascular disease (CVD) risk-related behaviors. However, the vast majority of existing gardening interventions have used an in-person delivery model which has limitations for scalability. It is not known whether a digitally delivered gardening intervention would be feasible or acceptable to participants. The purpose of this pilot study was to assess the feasibility of a digitally delivered gardening intervention in three domains: participant acceptability, demand, and practicality. METHODS A single-arm, pre-post-study design was used. Participants (n = 30) were aged 20 + with no plans to garden in the coming season and had at least 1 CVD risk factor. The intervention included ten 1-h video-conferencing sessions, written materials, and access to a study website. Content focused on gardening skills, cooking skills, and the Dietary Approaches to Stop Hypertension (DASH) diet. Feasibility outcomes included acceptability (post-program ratings), demand (session attendance rate), and practicality (ability to start a garden and grow F&V). The study was considered feasible if the following criteria were met: ≥ 70% rated the intervention as good or excellent, overall session attendance rate was ≥ 70%, and > 70% were able to start a garden and grow F&V. We also assessed pre-post-program changes in behavioral mediators (gardening confidence, gardening enjoyment, cooking confidence, and nutrition knowledge). Descriptive statistics were calculated. Pre-post differences were evaluated with means and 95% confidence intervals (95% CI). Effect sizes were calculated (Cohen's d). RESULTS All feasibility criteria were met. A total of 93.3% of participants rated the intervention as good or excellent, 96% started a garden and grew F&V, and the overall session attendance rate was 81%. The largest mean pre-post changes were in gardening confidence (pre 7.1 [95% CI: 6.4, 7.9], post 9.0 [95% CI: 8.6, 9.5], Cohen's d = 1.15), gardening enjoyment (pre: 6.3 [95% CI: 5.9, 6.7], post: 7.5 [95% CI: 7.1, 7.9], Cohen's d = 1.69), and cooking self-efficacy (pre: 4.7 [95% CI: 4.3, 5.1], post: 7.7 [95% CI: 7.3, 8.0], Cohen's d = 3.0). CONCLUSION A digitally delivered gardening intervention was feasible, acceptable to participants, and they had meaningful changes in behavioral mediators. The next step is to evaluate the impact of the intervention in a future randomized controlled trial.
Collapse
Affiliation(s)
- Susan Veldheer
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | | | - Candace Bordner
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Hena Choi
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA
| | | | - Jason Davis
- Department of Early, Middle, and Exceptional Education, Millersville University, Millersville, PA, USA
| | - David E Conroy
- Department of Kinesiology, Penn State University, State College, PA, USA
| | | | - Christopher Sciamanna
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
41
|
Cuvelier C, Hars M, Zamorani-Bianchi MP, Herrmann FR, Wieczorkiewicz CD, Zekry D, Gold G, Trombetti A. Hypnosis to reduce fear of falling in hospitalized older adults: a feasibility randomized controlled trial. Pilot Feasibility Stud 2023; 9:139. [PMID: 37559112 PMCID: PMC10410891 DOI: 10.1186/s40814-023-01366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fear of falling is associated with numerous negative health outcomes in older adults and can limit the rehabilitation process. Hypnosis is now recognized as an effective treatment for a variety of conditions, especially anxiety and pain, which can be integrated safely with conventional medicine. The objective of this study was to assess the feasibility and acceptability of a hypnosis intervention in hospitalized older adults to reduce fear of falling. METHODS In this feasibility randomized controlled trial, 32 older patients, hospitalized in geriatric rehabilitation wards, were randomly allocated (1:1 ratio) to either an intervention group (hypnosis, 2 sessions, one per week, plus usual rehabilitation program) or a control group (usual rehabilitation program only). Clinical assessors and statistician were blinded to group allocation. Primary outcomes were recruitment rate, retention rate, and adherence to the intervention. Exploratory outcomes, analyzed according to the intention-to-treat principle, included impact of hypnosis on fear of falling (assessed by a new scale perform-FES), functional status, in-hospital falls, and length of hospital stay. RESULTS Recruitment rate was 1.3 patients per week. The recruitment of the population sample was achieved in 5.5 months. The retention rate did not differ significantly between groups and a good adherence to the hypnosis intervention was achieved (77% of patients received the full intervention). No adverse event related to the hypnosis intervention was observed. Regarding exploratory clinical outcomes, no differences were found between groups on any outcome. CONCLUSION Hypnosis is feasible and well accepted in a geriatric hospitalized population undergoing rehabilitation. Further pilot work should be conducted, with an increased number of hypnosis sessions, before conducting a full-scale trial to conclude whether, or not, hypnosis is effective to reduce fear of falling. TRIAL REGISTRATION NCT04726774.
Collapse
Affiliation(s)
- Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Pia Zamorani-Bianchi
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| |
Collapse
|
42
|
Sneed RS, El-Alamin L, Thrower M, Nadrowski J, Habermehl K. Harnessing education and lifestyle change to support transitional health for returning citizens: a feasibility study protocol. Pilot Feasibility Stud 2023; 9:141. [PMID: 37559101 PMCID: PMC10410923 DOI: 10.1186/s40814-023-01369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Exercise and healthy eating are known to reduce chronic disease risk; however, formerly incarcerated individuals (i.e., returning citizens) face significant social barriers when attempting to engage with existing community-based physical activity and nutrition programs. Given the high disease burden and unique educational needs of returning citizens, this proposed work fills an important gap in the support services currently offered to this population. METHODS This article describes a process for evaluating the feasibility and acceptability of a physical activity and nutrition intervention tailored to the needs of returning citizens via a partnership between an academic research organization and a community-based reentry program for returning citizens. Staff from the community-based reentry program will train four returning citizens as group fitness instructors and work with a nutritionist to design a 16-week nutrition education curriculum. Reentry program staff will enroll up to 15 formerly incarcerated adults (aged 18 +) in the exercise and nutrition program. Participants will take part in weekly nutrition classes led by the nutritionist and weekly group exercise classes led by a peer instructor. Research staff will evaluate program success in four domains: reach, preliminary effectiveness, implementation, and maintenance. RESULTS This feasibility study will allow us to design and test a program that can eventually be evaluated in a large, randomized trial. It also addresses the multitude of social determinants that impact the health of returning citizens and builds a framework for program sustainability. Individuals recruited as fitness trainers will acquire skills and certifications that may be used to sustain physical fitness activities within the reentry program. CONCLUSIONS This feasibility study will test our ability to address social determinants that impact the health of returning citizens through a peer-led physical activity and nutrition programming. In the long term, study results may inform development and implementation of reentry programming and policy on a wider scale.
Collapse
Affiliation(s)
- Rodlescia S Sneed
- Charles Stewart Mott Department of Public Health, Michigan State University, 200 East 1st Street, MI, 48502, Flint, USA.
| | - Leon El-Alamin
- MADE Institute, 503 East Garland St, Flint, MI, 48502, USA
| | - Marsha Thrower
- MADE Institute, 503 East Garland St, Flint, MI, 48502, USA
| | - Jessica Nadrowski
- Charles Stewart Mott Department of Public Health, Michigan State University, 200 East 1st Street, MI, 48502, Flint, USA
- MADE Institute, 503 East Garland St, Flint, MI, 48502, USA
| | - Kayla Habermehl
- Charles Stewart Mott Department of Public Health, Michigan State University, 200 East 1st Street, MI, 48502, Flint, USA
| |
Collapse
|
43
|
Khalid T, Ben-Shlomo Y, Bertram W, Culliford L, England C, Henderson E, Jameson C, Jepson M, Palmer S, Whitehouse MR, Wylde V. Prehabilitation for frail patients undergoing total hip or knee replacement: protocol for the Joint PREP feasibility randomised controlled trial. Pilot Feasibility Stud 2023; 9:138. [PMID: 37550774 PMCID: PMC10405490 DOI: 10.1186/s40814-023-01363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/15/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Approximately, 8% of community-based adults aged ≥ 50 years in England are frail. Frailty has been found to be associated with poorer outcomes after joint replacement. Targeting frailty preoperatively via exercise and protein supplementation has the potential to improve outcomes for people undergoing joint replacement. Prior to proceeding with a randomised controlled trial (RCT), a feasibility study is necessary to address key uncertainties and explore how to optimise trial design and delivery. METHODS The Joint PRehabilitation with Exercise and Protein (Joint PREP) study is a feasibility study for a multicentre, two-arm, parallel group, pragmatic, RCT to evaluate the clinical and cost-effectiveness of prehabilitation for frail patients undergoing total hip or knee replacement. Sixty people who are ≥ 65 years of age, frail according to the self-reported Groningen Frailty Indicator, and scheduled to undergo total hip or knee replacement at 2-3 hospitals in England and Wales will be recruited and randomly allocated on a 1:1 ratio to the intervention or usual care group. The usual care group will receive the standard care at their hospital. The intervention group will be given a daily protein supplement and will be asked to follow a home-based, tailored daily exercise programme for 12 weeks before their operation, in addition to usual care. Participants will be supported through six follow-up calls from a physiotherapist during the 12-week intervention period. Study questionnaires will be administered at baseline and 12 weeks after randomisation. Embedded qualitative research with patients will explore their experiences of participating, reasons for nonparticipation, and/or reasons for withdrawal or treatment discontinuation. Primary feasibility outcomes will be eligibility and recruitment rates, adherence to the intervention, and acceptability of the trial and the intervention. DISCUSSION This study will generate important data regarding the feasibility of a RCT to evaluate a prehabilitation intervention for frail patients undergoing total hip and knee replacement. A future phase-3 RCT will determine if preoperative exercise and protein supplementation improve the recovery of frail patients after primary joint replacement. TRIAL REGISTRATION ISRCTN11121506, registered 29 September 2022.
Collapse
Affiliation(s)
| | - Yoav Ben-Shlomo
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Wendy Bertram
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Lucy Culliford
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Clare England
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Catherine Jameson
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Marcus Jepson
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Shea Palmer
- Centre for Care Excellence, Coventry University and University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Michael R Whitehouse
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Vikki Wylde
- Bristol Medical School, University of Bristol, Bristol, UK.
- National Institute for Health and Care Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| |
Collapse
|
44
|
Sakamoto M, Minaki Y, Nakano T, Tsuge I, Yamanaka H, Sowa Y, Shimizu Y, Inoie M, Saito S, Morimoto N. A novel approach for wound treatment using dried cultured epidermal allograft: A phase I/II, single-center, open-label clinical trial. Burns 2023; 49:1079-1086. [PMID: 36372600 DOI: 10.1016/j.burns.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/16/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Autologous cultured epidermis (CE) is successfully used in burn care, but it requires a manufacturing time of three weeks and is very expensive owing to its custom-made nature of treatment. To compensate this disadvantage, dried allogeneic CE promises a novel therapeutic approach; and previous reports have demonstrated its efficacy in promoting wound healing using a murine skin defect model. Herein, a prospective clinical study was conducted to confirm the safety and efficacy of dried allogeneic CE for wound treatment. METHODS Dried CE was manufactured using donor keratinocytes obtained from excess surgical skin and applied to skin defects that were at least 3 cm in length and less than 10 % of the body surface area of the patients. The patients were observed for 14 days after CE application. The primary endpoint was the incidence of adverse events and the secondary endpoint was the percentage of wound healed since baseline, on days 7 and 14. Furthermore, as a stratified analysis, the percentage of wound healed, specified as deep dermal burns, was calculated. RESULTS Six patients (five burns and one skin ulcer after necrotizing fasciitis) enrolled in the study. As a serious adverse event, a local infection was observed in one patient, which resolved by debridement and conventional skin grafting. Other adverse events that were potentially related to this treatment included two cases of skin erosion, and one case of systemic fever. No unresolved adverse events remained at the end of the study period. The percentage of wound healed was 73.4 ± 19.2 % on Day 7, and 92.2 ± 11.8 % on Day 14. When the targeted disease was restricted to deep dermal burns, the percentage of wound healed was 69.9 ± 28.9 % on Day 7 and 90.5 ± 13.2 % on Day 14. CONCLUSION Treatment with dried CE was safely performed without any unresolved severe adverse effects. Dried CE is a new and promising modality for skin defect treatment, such as burns and ulcers, and is expected to compensate for the disadvantages of autologous CE. However, large-scale clinical trials are required to confirm their efficacy.
Collapse
Affiliation(s)
- Michiharu Sakamoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Yasuko Minaki
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Nakano
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Itaru Tsuge
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamanaka
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Sowa
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | - Susumu Saito
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoki Morimoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
45
|
Dantuma M, Gasteau D, Manohar S. Photoacoustic spectrum analysis for spherical target size and optical property determination: A feasibility study. Photoacoustics 2023; 32:100534. [PMID: 37545488 PMCID: PMC10400969 DOI: 10.1016/j.pacs.2023.100534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
The photoacoustic signal generated by an optically absorbing target is determined by the spatial profile of absorbed optical energy within the target. The analysis of the time profile and frequency content of the signal enables the recovery of the geometry of the object, as well as information about the optical properties. The photoacoustic response of spheres with a homogeneous absorbed optical energy profile is well described, and it is known that the width of the photoacoustic pulse is determined by the diameter of the sphere and its sound speed. In practice, the optical attenuation coefficients within the sphere will result in an inwardly decaying fluence profile leading to a similarly decaying absorbed optical energy profile. Further, the optical attenuation coefficients may be inhomogeneously distributed in the sphere. The implication for both cases is that the existing model for spheres does not fully apply. In this work, we developed analytical expressions for the photoacoustic time traces and amplitude spectra generated by a sphere with absorbed optical energy only in a spherical shell, and by a sphere with an inwardly decaying optical energy profile. Numerical simulations and experiments were conducted on these two imperfect sphere types. Fitting our model to the simulated or measured spectra allowed us to test our model's ability to extract the sphere size and optical properties. We found that the radii can be recovered with high accuracy, even when the frequency response of the detector recording the photoacoustic pulse is not precisely known. The model was found to be less sensitive in recovering the optical attenuation coefficient, but it is feasible when the detector's frequency response is well known.
Collapse
|
46
|
Holloway EE, Gray S, Halliday J, Harrap B, Hines C, Skinner TC, Speight J, Hendrieckx C. Feasibility and acceptability of 'low-intensity mental health support via a telehealth-enabled network' for adults with type 1 and type 2 diabetes: the LISTEN pilot study. Pilot Feasibility Stud 2023; 9:133. [PMID: 37501203 PMCID: PMC10373371 DOI: 10.1186/s40814-023-01367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND This study examined the feasibility and acceptability of the low-intensity mental health support via telehealth-enabled network (LISTEN) intervention, for adults with diabetes, facilitated by diabetes health professionals (HPs). METHODS LISTEN training. Three HPs participated in three half-day online workshops and applied their learnings during training cases (maximum four). Competency was assessed with a validated tool and achieved 'satisfactory' ratings for three consecutive sessions. LISTEN pilot. A single-group, pre-post study (up to four LISTEN sessions) with online assessments at baseline, post-intervention, and 4-week follow-up. Eligible participants were adults with type 1 or type 2 diabetes, with diabetes distress, but excluded if they had moderate/severe depressive and/or anxiety symptoms. Feasibility was assessed via recruitment and session completion rates. Acceptability was assessed with post-intervention self-report data. Changes in diabetes distress and general emotional well-being from baseline (T1) were explored at post-intervention (T2) and at 4-week follow-up (T3). RESULTS Two HPs achieved competency (median training case sessions required: 7) and progressed to deliver LISTEN in the pilot study. In the pilot, N = 16 adults (Med [IQR] age: 60 [37-73] years; 13 women) with diabetes participated (median sessions per participant: 2). Twelve participants (75%) completed the post-intervention assessment (T2): 92% endorsed the number of sessions offered as 'just right', 75% felt comfortable talking with the HP, and 67% were satisfied with LISTEN. Perceived limitations were the structured format and narrow scope of problems addressed. Diabetes distress scores were lower post-intervention. CONCLUSIONS This pilot demonstrates the feasibility of training HPs to deliver LISTEN, and the acceptability and potential benefits of LISTEN for adults with diabetes. The findings highlight adaptations that may enhance the delivery of, and satisfaction with, LISTEN that will be tested in a hybrid type 1 effectiveness-implementation trial.
Collapse
Affiliation(s)
- Edith E Holloway
- School of Psychology, Deakin University, Geelong, VIC, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia.
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Shikha Gray
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
| | - Jennifer Halliday
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Benjamin Harrap
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, VIC, Australia
| | | | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, ACBRD, 570 Elizabeth Street, Melbourne, VIC, 3000, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
47
|
Sirevåg K, Stavestrand SH, Sjøbø T, Endal TB, Nordahl HM, Andersson E, Nordhus IH, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer JF, Hovland A. Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial. Biopsychosoc Med 2023; 17:25. [PMID: 37468978 PMCID: PMC10357630 DOI: 10.1186/s13030-023-00280-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/04/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Generalised anxiety disorder (GAD) is a frequent and severe disorder among older adults. For older adults with GAD the effect of the recommended treatment, cognitive behaviour therapy (CBT), is reduced. Physical exercise (PE) may enhance the effect of CBT by improving cognitive function and increasing levels of brain-derived neurotrophic factor (BDNF), a predictor of the effect of CBT in patients with anxiety. The aim of the study was to assess the feasibility of a randomized controlled trial (RCT) investigating treatment effect of the combination of CBT and PE for GAD in a sample of older adults, including procedures for assessment and treatment. METHODS Four participants aged 62-70 years (M = 65.5, SD = 3.2) with a primary diagnosis of GAD were included. Participants received 15 weeks of PE in combination with 10 weeks of CBT. Participants completed self-report measures, and clinical, biological, physiological and neuropsychological tests at pre-, interim- and post-treatment. RESULTS Procedures, protocols, and results are presented. One participant dropped out during treatment. For the three participants completing, the total adherence to PE and CBT was 80% and 100%, respectively. An independent assessor concluded that the completers no longer fulfilled the criteria for GAD after treatment. Changes in self-report measures suggest symptom reduction related to anxiety and worry. The sample is considered representative for the target population. CONCLUSIONS The results indicate that combining CBT and PE for older adults with GAD is feasible, and that the procedures and tests are suitable and manageable for the current sample. TRIAL REGISTRATION ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016, https://clinicaltrials.gov/ct2/show/NCT02690441 .
Collapse
Affiliation(s)
- Kristine Sirevåg
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
| | - S H Stavestrand
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
| | - T Sjøbø
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - T B Endal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - H M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, NO-7030, Norway
| | - E Andersson
- The Swedish School of Sport and Health Sciences, GIH, Stockholm, 5626 SE-114 86, box, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, 171 177, Sweden
| | - I H Nordhus
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
- Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern, Oslo, NO-0316, Norway
| | - Å Rekdal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - K Specht
- Faculty of humanities, social sciences and education, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
| | - Å Hammar
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - A Halmøy
- Department of Psychiatry, Haukeland University Hospital, Kronstad DPS, P.O. Box 1400, Bergen, NO- 5021, Norway
- Department of Clinical Medicine, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway
| | - J Mohlman
- Department of Psychology, William Paterson University, 300 Pomton Road, Wayne, NJ, 07470, USA
| | - H Hjelmervik
- School of Health Sciences, Kristiania University College, Kalfarveien 78c, Bergen, 5022, Norway
| | - J F Thayer
- Department of Psychological Science, The University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - A Hovland
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
| |
Collapse
|
48
|
Miller J, Doulas T, Bisson EJ, Abebe A, Chala M, McClintock C, Varette K, Vader K, Desmeules F, Perreault K, Donnelly C, Booth R, Tawiah AK, Duggan S. Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study. Pilot Feasibility Stud 2023; 9:125. [PMID: 37461072 PMCID: PMC10351139 DOI: 10.1186/s40814-023-01352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Chronic pain management is challenging for health systems worldwide. Clinical practice guidelines recommend interprofessional chronic pain management, but chronic pain clinics often have lengthy wait-lists. Advanced practice physiotherapists (APP) in orthopedic clinics and emergency departments have provided effective care and reduced wait times. The purpose of this study is to determine the feasibility of a clinical trial to evaluate the effects of integrating an APP into a chronic pain clinic setting. The primary objectives are as follows: (1) determine the feasibility of implementing trial methods by evaluating participant recruitment rates, retention, and assessment completion; (2) determine the feasibility of implementing the APP model of care by monitoring care provided and treatment fidelity; and (3) assess contextual factors that may influence implementation of the APP model of care by exploring the perspectives of patient participants and healthcare providers related to the model of care. METHODS This will be a single-arm feasibility study with embedded qualitative interviews to assess contextual factors influencing implementation by exploring participant and provider perspectives. Approximately 40 adults with chronic musculoskeletal pain referred for care at an interprofessional chronic pain clinic will be invited to participate in the feasibility study. Approximately 10-12 patient participants and 5-10 health professionals from the interprofessional team will be interviewed using an interpretive description approach. The APP model of care will involve participants seeing a physiotherapist as the first point of contact within the interprofessional team. The APP will complete an initial assessment and make care recommendations. Outcome measures planned for the full trial will be reported descriptively, including pain severity, pain interference, health-related quality of life, psychosocial risk factors for chronic pain, treatment satisfaction, perceived change, healthcare utilization, and healthcare costs over one year. DISCUSSION This study will inform plans to implement a full-scale study to evaluate the impact of an APP model of care in an interprofessional chronic pain management program. The results of the full study are intended to inform stakeholders considering this model to improve patient-centered and health system outcomes in interprofessional pain management program settings. TRIAL REGISTRATION ClinicalTrials.gov, NCT05336903 (Registered April 5, 2022).
Collapse
Affiliation(s)
- Jordan Miller
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
- Health Services and Policy Research Institute, Faculty of Health Sciences, Queen’s University, 18 Barrie Street, Kingston, ON K7L 3N6 Canada
| | - Tom Doulas
- Chronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital site, Jeanne Mance 3, 166 Brock Street, Kingston, ON K7L 5G2 Canada
| | - Etienne J. Bisson
- Chronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital site, Jeanne Mance 3, 166 Brock Street, Kingston, ON K7L 5G2 Canada
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Center, Queen’s University, Victory 2, 76 Stuart Street, Kingston, ON K7L 2V7 Canada
- Centre for Neuroscience Studies, Queen’s University, Botterell Hall, 18 Stuart Street, Kingston, ON K7L 3N6 Canada
| | - Abey Abebe
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - Mulugeta Chala
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - Chad McClintock
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - Kevin Varette
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - Kyle Vader
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - François Desmeules
- School of Rehabilitation, Université de Montréal, 7077 Park Avenue, Montréal, Québec H1T 2M4 Canada
| | - Kadija Perreault
- Centre Interdisciplinaire de Recherche en Réadaptation Et Intégration Sociale, Centre de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel, Québec City, Québec G1M 2S8 Canada
- Department of Rehabilitation, Université Laval, Pavillon Ferdinand-Vandry, Suite 4247, Québec City, Québec G1V 0A6 Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
- Health Services and Policy Research Institute, Faculty of Health Sciences, Queen’s University, 18 Barrie Street, Kingston, ON K7L 3N6 Canada
| | - Randy Booth
- School of Rehabilitation Therapy, Queen’s University, Louise D Acton Building, 31 George Street, Kingston, ON K7L 3N6 Canada
| | - Andrews K. Tawiah
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4 Canada
| | - Scott Duggan
- Chronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital site, Jeanne Mance 3, 166 Brock Street, Kingston, ON K7L 5G2 Canada
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Center, Queen’s University, Victory 2, 76 Stuart Street, Kingston, ON K7L 2V7 Canada
| |
Collapse
|
49
|
Davies A, Lenguerrand E, Scott E, Kandiyali R, Douek I, Norman J, Loose A, Sawyer L, Timlin L, Burden C. Protocol for a multi-site randomised controlled feasibility study investigating intermittently scanned blood continuous glucose monitoring use for gestational diabetes: the RECOGNISE study. Pilot Feasibility Stud 2023; 9:120. [PMID: 37434220 DOI: 10.1186/s40814-023-01341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/07/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Incidence of gestational diabetes mellitus (GDM) is increasing and is associated with adverse perinatal outcomes including macrosomia, pre-eclampsia, and pre-term delivery. Optimum glycaemic control can reduce these adverse perinatal outcomes. Continuous glucose monitoring (CGM) informs users about interstitial glucose levels allowing early detection of glycaemic excursions and pharmacological or behavioural intervention. Few adequately powered RCTs to evaluate the impact of using CGM in women with GDM on perinatal outcomes have been undertaken. We aim to establish the feasibility of a multi-site RCT to evaluate the clinical- and cost-effectiveness of an intermittently scanned continuous glucose monitor (isCGM) compared with self-monitored blood glucose (SMBG) in women with GDM for reducing fetal macrosomia and improving maternal and fetal outcomes. We will evaluate recruitment and retention rates, adherence to device requirements, adequacy of data capture and acceptability of trial design and isCGM devices. METHODS Open-label multicentre randomised controlled feasibility trial. INCLUSION CRITERIA pregnant women, singleton pregnancy, recent diagnosis of GDM (within 14 days of commencing medication, up to 34 weeks gestation) prescribed metformin and/or insulin. Women will be consecutively recruited and randomised to isCGM (FreestyleLibre2) or SMBG. At every antenatal visit, glucose measurements will be evaluated. The SMBG group will use blinded isCGM for 14 days at baseline (~ 12-32 weeks) and ~ 34-36 weeks. The primary outcome is the recruitment rate and absolute number of women participating. Clinical assessments of maternal and fetal/infant health will be undertaken at baseline, birth, up to ~ 13 weeks post-natal. Psychological, behavioural and health economic measures will be assessed at baseline and ~ 34-36 weeks gestation. Qualitative interviews will be undertaken with study decliners, participants, and professionals to explore trial acceptability, of using isCGM and SMBG. DISCUSSION GDM can be associated with adverse pregnancy outcomes. isCGM could offer a timely, easy-to-engage-with intervention, to improve glycaemic control, potentially reducing adverse pregnancy, birth and long-term health outcomes for mother and child. This study will determine the feasibility of conducting a large-scale multisite RCT of isCGM in women with GDM. TRIAL REGISTRATION This study has been registered with the ISRCTN (reference: ISRCTN42125256 , Date registered: 07/11/2022).
Collapse
Affiliation(s)
- Anna Davies
- Academic Women's Health Unit, Translational Health Sciences, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - Erik Lenguerrand
- Academic Women's Health Unit, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Eleanor Scott
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | | | | | - Jane Norman
- Academic Women's Health Unit, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Abi Loose
- North Bristol NHS Trust, Bristol, UK
| | | | | | - Christy Burden
- Academic Women's Health Unit, Translational Health Sciences, University of Bristol, Bristol, UK.
- North Bristol NHS Trust, Bristol, UK.
| |
Collapse
|
50
|
Surendran A, McSharry J, Meredith D, McNamara J, Bligh F, Meade O, O'Hora D. Assessing the feasibility, fidelity and acceptability of a behaviour change intervention to improve tractor safety on farms: protocol for the BeSafe tractor safety feasibility study. Pilot Feasibility Stud 2023; 9:114. [PMID: 37403177 DOI: 10.1186/s40814-023-01319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/02/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND In Ireland, the agriculture sector reports the highest number of fatalities even though farmers constitute only 6% of the working population. Tractor-related behaviours are implicated in 55% of all vehicle work-related fatalities and 25% of reported injuries, and many of these occur in farmyards. There is limited research on the feasibility and acceptability of behaviour change interventions to improve tractor safety. Target behaviours that promote safe operation in farmyards, determining and addressing blind spots of tractors, were identified, and an intervention was developed following the Behaviour Change Wheel Approach. The objective of the study is to examine the feasibility, fidelity and acceptability of a behaviour change intervention to enhance the safe operation of tractors in farmyards with a particular focus on tractor blind spots. METHOD A single group feasibility study will be undertaken. Approximately 16 farmers from four major farm types will be recruited for the study between August and September 2022. The intervention involves an in-person demo session, facilitated discussion and personalised safety training procedure with safety goals. The study will collect data from participants at three time points: baseline (3-10 days prior to the intervention), during the intervention and at the follow-up session (7-30 days post-intervention). Quantitative data will be collected through a pre-intervention interview and feedback surveys. A pre- and post-intervention qualitative interview will also be conducted with the participants and will be supplemented with qualitative data from recruitment logs, observational memos and logs and feedback from recruiters. Evaluation of the feasibility, acceptability and fidelity of the intervention will be guided by a pre-determined feasibility checklist, fidelity framework and theoretical framework of acceptability, respectively. Interviews will be analysed using the content analysis. DISCUSSION The current study can determine the feasibility and fidelity of delivering a systematic, theoretically driven, tailored behaviour change intervention. It will also assess whether the intervention, its ingredients and delivery are acceptable to the farming population. This study will also inform the development of a future larger trial to test the effectiveness of the intervention. TRIAL REGISTRATION ISRCTN Identifier: ISRCTN22219089. Date applied 29 July 2022.
Collapse
Affiliation(s)
- Aswathi Surendran
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland.
| | - Jenny McSharry
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| | | | | | | | - Oonagh Meade
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| | - Denis O'Hora
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| |
Collapse
|