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Background: Mental health disorders are one of the leading causes of illness globally. The importance of psychosocial skills acquired in early childhood, such as executive functions, inhibitory control, emotional regulation, and social problem-solving, in preventing mental disorders has been reported. Furthermore, mental health care delivery is evolving, and mobile technology is becoming the medium for assessment and intervention. We have developed Japi 2.0, the second iteration of a gaming platform, to stimulate cognitive and non-cognitive skills in early childhood, supported by early years educators using a web-based dashboard integrated into one system. This study aims to assess the acceptability and feasibility of this gaming platform and web-based dashboards. Methods: This is a pilot randomized controlled trial, parallel-group type, where the school-based implementation of "Japi 2.0" training is compared to standard school curricula in control schools. A total of six schools with low socio-economic status located in the city of Santiago, Chile, are expected to be recruited and randomized with 1:1 allocation. Japi 2.0 has 24 sessions, and 2 sessions of 15 min per week are delivered for 12 weeks. Measures will be conducted using different instruments with children, parents, and early years educators to gain insight into their acceptance of the intervention and the development of cognitive and non-cognitive skills. Discussion: This is a randomized control trial to assess the acceptability and feasibility of a gaming platform called "Japi 2.0" among preschoolers in Chile. This platform stimulates cognitive and non-cognitive skills with the final objective of reducing emotional and behavioral problems in early childhood. Evaluating the acceptability and feasibility of this technological solution for children is expected to produce relevant information about these novel designs. It may help guide future studies, such as a randomized controlled trial on a larger scale. Trial registration: Clinical Trials NCT06420544, May 20, 2024 [https://www.clinicaltrials.gov/study/NCT06420544]. [ABSTRACT FROM AUTHOR]

Background: Outcomes following surgery to operatively manage extremity fractures are variable, and up to two-thirds of patients report chronic post-surgical pain. Preliminary evidence suggests that psychotherapy directed at improving coping skills and reducing somatic vigilance may improve outcomes among fracture patients. The objective of this pilot study was to test the feasibility and acceptability of a randomized controlled trial comparing an online cognitive behavioural therapy (CBT) program versus usual care in patients with an operatively managed open or closed extremity fracture. Methods: We conducted a single-centre internal pilot study over a 10-month period in patients with at least one operatively managed open or closed fracture of the appendicular skeleton. Participants were randomized to an online CBT program or usual care and followed for 12 months. The goals of our pilot study were to determine an acceptable rate of recruitment, the degree to which participants randomized to CBT were compliant with treatment, the site investigator's ability to adhere to study protocol and data collection procedures, and our ability to achieve high follow-up rates. Feasibility criteria were evaluated using a graded "traffic light" approach, in which "green light" indicates moving forward with the definitive trial, "yellow light" indicates proceeding with modifications to the protocol and trial procedures, and "red light" indicates a definitive trial is not feasible without significant protocol and trial procedure modifications. Results: We enrolled 94 participants over 10 months, which resulted in a "yellow light" for recruitment. Participant compliance with completion of the online CBT program received a "yellow light", with 60% of participants who were randomized to CBT completing all seven modules. However, 40% of participants in the CBT-arm withdrew from the program, resulting in a "red light". Adherence with the study protocol activities at baseline was relatively high (88%) which resulted in a "yellow light". Follow-up was 85% (80 of 94) at 12 months, resulting in a "yellow light". Conclusions: These results suggest feasibility of a definitive, multi-centre trial to compare CBT versus usual care in the management of persistent post-operative pain in fracture patients despite the pilot phase identifying some challenges with enrollment timelines, compliance with the CBT program, and participant follow-up. For the definitive trial, we will expand participant recruitment to additional centres and implement strategies to optimize participant engagement and compliance with the CBT program and follow-up. Trial registration: ClincialTrials.gov (NCT04274530). Registered February 18, 2020, https://classic.clinicaltrials.gov/ct2/show/NCT04274530. [ABSTRACT FROM AUTHOR]

Background and methods: E-health solutions are a promising tool to assist patients in self-managing symptoms for various diseases. This study aimed to assess the feasibility, reliability, usability, and satisfaction of a digital medical device (ZEMY) for patients' self-monitoring of symptoms commonly experienced during breast cancer treatment and to enhance interaction with healthcare professionals. In this open-label, interventional, multicentre, single-arm clinical trial (NCT03558490), patients at all stages of breast cancer initiating oral and/or parenteral treatment were recruited at initiation of therapy and followed for 3 months. During treatment, the patients reported 9 symptoms (diarrhoea, nausea/vomiting, fever/febrile neutropenia, fatigue, pain, cutaneous and mucosal toxicities, hypertension, anxiety/depression) through the ZEMY application, which provided self-management recommendations and sent message alerts to healthcare professionals. To reach the primary feasibility endpoint, more than 50% of patients with one-sided 95% confidence interval (exact CI computed using Clopper-Pearson method) had to complete at least 3 symptoms entries, of which more than 60% complete until receiving a recommendation. Results: Out of the 56 screened patients, 54 were included in the analysis between June 12th 2018 and January 11th 2019, and 52 completed the study. Over half of patients (31/54 [57.4%]) were feasibility responders, but this percentage was not significantly higher than the predefined minimum feasibility cut-off of 50%, as the lower limit of the one-sided 95% exact CI was 45.3%. Nonetheless, 87.0% of patients reported at least 3 symptoms with ZEMY and 66.0% had an entry completion rate ≥ 60%. Six of the 9 symptoms were reported at least once by more than 30% of the patients. The recommendations were considered relevant at least once for more than 80% of cases for each symptom. Patients were more satisfied (mean 10-point visual analogue scale score: 6.3 ± 2.9) with ZEMY than healthcare professionals (4.4 ± 1.5). The global patients' quality of life remained stable during the study. Conclusions: ZEMY provided satisfactory recommendations for the self-management of selected symptoms occurring during anti-cancer treatment and demonstrated good usability, but its feasibility was indemonstrable. Trail registration: The trial was registered on June 14th 2018 at ClinicalTrails.gov (Trial Registration Number: NCT03558490). [ABSTRACT FROM AUTHOR]

Background: Dignity therapy is a brief, structured psychotherapeutic intervention originally designed to help last-stage cancer patients maintain their dignity. It consists of a semi-structured interview encouraging patients to talk about their lives. The recorded session are transcribed and edited, after which the patient has the opportunity to make further changes to the final document. It can be shared with whom the patient likes. We cross-culturally translated dignity therapy into Dutch and explored its feasibility of applying it to Dutch cognitively capable nursing home residents. Method: Beaton's Guidelines for Good Clinical Practice were used to cross-culturally translate dignity therapy. Next, a pilot study was conducted with 12 nursing home residents in which the original English-language questionnaire was transculturally translated according to the method of Beaton. After the interviews were completed, feasibility was examined by open-ended questions and a five-point Likert scale questionnaire. Results: We translated the questionnaire. The translated questions were well understood and resulted in an appropriate Dutch version of the English-language dignity therapy questions. However, the words 'dignity' and 'therapy' caused confusion. The mean number of words in the legacy document was 1078 words, which appeared shorter than in a community-based hospice setting or patients with metastatic cancer or terminally ill people. The reading aloud was much appreciated and was an emotional experience for some. Conclusion: We successfully translated the DTQP into the Dutch language and tested it in 12 nursing home residents. The questions posed by this therapy appeared suitable and acceptable. Furthermore, participants all accepted the therapy and gave no suggestions to adapt the procedure. Follow-up research in the form of an impact study is needed to show whether and how this therapy can strengthen the sense of dignity of Dutch nursing home residents. [ABSTRACT FROM AUTHOR]

(1) Background: This pilot study evaluates the feasibility and preliminary effects of acupuncture for cancer-related cognitive dysfunction (CRCD) in cancer survivors. (2) Methods: A randomized trial comparing real acupuncture (RA) to sham acupuncture (SA) and waitlist control (WLC) among cancer survivors reporting cognitive difficulties. Interventions were delivered weekly over 10 weeks. Feasibility was evaluated by recruitment, treatment adherence, and assessment completion. Subjective CRCD was assessed by the Functional Assessment of Cancer Therapy-Cognitive Function—Perceived Cognitive Impairment subscale (FACT-Cog PCI) and objective CRCD was assessed by the Hopkins Verbal Learning Test—Revised (HVLT-R). (3) Results: 32 participants (57.1% of eligible patients) were enrolled. All participants in acupuncture groups completed ≥8 of 10 treatments. Assessment completion rate was 100% for all participants. From baseline to week 10, the RA group (n = 19) reported a clinically meaningful 17.3-point increase in FACT-Cog PCI (95% confidence interval [CI] 12.5 to 22.1), compared to 9.7 points (95% CI 2.8 to 16.7) in the SA group (n = 9), and 6.8 points (95% CI −3.7 to 17.2) in the WLC group (n = 4). In the subgroup analysis among patients with a below-average baseline HVLT-R (T-score < 50), the RA group (n = 8) increased FACT-Cog PCI scores by 20.4 (95% CI 13.6 to 27.3), compared to 11.1 points (95% CI 0.6 to 21.5) in the SA group (n = 5). The improvements from RA persisted through week 16 in both the total sample and the sub-group. Eleven mild adverse events were reported, with pain and bleeding at the needling sites being the most common. (4) Conclusions: The findings support the feasibility and safety of conducting a randomized, placebo-controlled trial to evaluate acupuncture for cognitive dysfunction in cancer survivors. [ABSTRACT FROM AUTHOR]

Introduction: There is a high prevalence of cognitive difficulties in MS, but despite this, there are few programmes targeting cognition that focus on the ability to function well in everyday life. The Cognitive Occupation-Based programme for people with Multiple Sclerosis (COB-MS), an occupation-focused cognitive intervention, was developed to address this. It addresses both the functional difficulties and the wide-ranging symptoms that present in MS. Objective: Here we report on the results of a cluster-randomised controlled feasibility trial (ISRCTN11462710; registered 4th September 2019) evaluating the COB-MS in terms of feasibility and initial efficacy as a cognitive intervention for people with MS. Method: The eight-session COB-MS intervention was delivered remotely by occupational therapists to participants with MS in the intervention group. Following the end of the trial the COB-MS was delivered to the wait-list control group. Data was collected from people with MS experiencing cognitive difficulties at baseline, post-intervention, 12-weeks, and 6-month follow-up. The primary outcome measure was the Goal Attainment Scaling at 12 weeks. Data was also collected in the domains of cognition, quality of life, and mood. Results: One hundred and eighteen people with MS and cognitive difficulties were randomised to either usual care (n = 60) or COB-MS intervention (n = 58). Ninety-four participants were retained at 6-month follow-up. The COB-MS was found to be feasible, including trial procedures and protocol. Data indicates that the COB-MS is accepted by participants and had positive impacts on daily life. Those allocated to the COB-MS group had a significant improvement in the primary outcome compared to the control condition. Progression criteria set for the feasibility trial have been met therefore further testing of the COB-MS at a definitive trial is supported by the results. Conclusion: The results provide a strong basis for a pathway to a future definitive trial of COB-MS, with respect to both feasibility and preliminary, clinical efficacy. Trial Registration: ISRCTN11462710 Date of registration: 4th September 2019. [ABSTRACT FROM AUTHOR]

Suicide prevention programs delivered in school settings have been shown to reduce suicide attempts and ideation among adolescents. School-based digital interventions targeting at-risk youth are a promising avenue for suicide prevention, and some evidence has shown that blending digital and face-to-face components may improve the effectiveness. However, further evidence on its acceptability, feasibility, and effectiveness is needed, especially in Latin America, where mental health support is limited. Reframe-IT is an internet-based Cognitive Behavioral Therapy (CBT) program to reduce youth suicidal ideation in school settings. We created four complementary face-to-face CBT sessions and, through a pilot study, tested the acceptability, feasibility, and effectiveness of a blended intervention (Reframe-IT +) in adolescents (N = 52) from 6 public schools in Chile, randomized into two groups: Reframe-IT + (N = 33) and Control (N = 19). We found that the intervention was acceptable and feasible, with high degrees of satisfaction and adherence. We also observed a significant reduction in suicidal ideation and depressive symptoms in the intervention group compared to the control group at post-intervention. Our results suggest that the Reframe-IT + could be delivered as a suitable, acceptable, and effective intervention to reduce suicide ideation in adolescents in school settings. Further research is needed to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

Background/Objectives: The early detection of individuals at risk of cognitive impairment is a clinical imperative. With the recent advancement of digital devices, smartphone application-based cognitive assessment is considered a promising tool for cognitive screening and monitoring inside and outside the clinic. This study examined whether a smartphone-based cognitive assessment, Brain OK, was valid for evaluating cognitive performance and identifying people at risk of cognitive impairment. Methods: We recruited 88 study participants aged over 60. They completed two cognitive tests with the Montreal Cognitive Assessment (MoCA), a validated paper-and-pencil cognitive screening tool, and Brain OK, a smartphone-based cognitive testing application. To examine convergent validity, we conducted analyses of Spearman correlations between MoCA and BrainOK, a Bland–Atman plot with regression analysis, and the area under the curve (AUC). Results: There was a significant positive association between Brain OK and the MoCA total score, with a coefficient of 0.9044 (SE = 0.057, t = 15.750, p < 0.001). The Bland–Altman plot represented a reasonable level of agreement between the two tests. We conducted the AUC analysis of Brain OK to compare the cognitively normal and impaired groups. The AUC value for the Brain OK score of 13.5 was the highest at 0.941. The sensitivity and specificity were 0.958 and 0.925, respectively. Conclusions: The smartphone app-based Brain OK test was feasible for assessing cognitive function and acceptable for identifying subjects with cognitive impairment. The results suggest Brain OK complements traditional in-person cognitive assessments and may help enhance cognitive health dialogue between doctors and patients. [ABSTRACT FROM AUTHOR]

Disturbed sleep is prevalent after corona virus disease (COVID-19). However, little is known of post infectious prevalence, course, predictors and treatment of chronic insomnia. To estimate the prevalence of chronic insomnia three and twelve months after hospitalisation for COVID-19, to identify predictors of chronic insomnia, and to evaluate the feasibility of a nurse-administered digital cognitive behavioural therapy for insomnia (dCBTi) protocol. Patients hospitalised at Akershus University Hospital (Norway) for COVID-19 between February–June 2020 were eligible. The 94 patients that consented to participate were contacted by phone and interviewed with a modified DUKE structured interview three- and twelve months after discharge. Participants with chronic insomnia after twelve months were offered a nurse-administered dCBTi treatment protocol. Outcome measurements were sleep efficiency (SE) calculated by standard formulas (0-100 %) and the Bergen Insomnia Scale (BIS) (0-42). At three-month follow-up, 22 persons (23 %) fulfilled the diagnostic criteria for chronic insomnia. At twelve-month follow-up, 23 fulfilled the diagnostic criteria. The odds ratios for chronic insomnia after twelve months were 0.857 (0.742–0.989) for body mass index (BMI), and 0.239 (0.069–0.821) for male sex. Ten participated in the dCBTi feasibility study. Five completed the treatment protocol. SE improved, but not significantly. The BIS score improved significantly from 24 to 12 (p-value = 0.036). Chronic insomnia remained stable three- and twelve months post COVID-19 hospitalisation. Female sex and low BMI were independent predictors of chronic insomnia twelve months post infection, but only 50 % of participants completed the protocol. Completers significantly reduced insomnia symptoms. • Insomnia is a commonly reported symptom after corona virus disease (COVID-19). • Post COVID-19 chronic insomnia remained stable over a twelve-month period. • Body mass index and sex predicted chronic insomnia twelve months post discharge. • Digital cognitive behavioural therapy may be an effective treatment for insomnia. [ABSTRACT FROM AUTHOR]

In this paper we study the nonconvex constrained composition optimization, in which the objective contains a composition of two expected-value functions whose accurate information is normally expensive to calculate. We propose a STochastic nEsted Primal-dual (STEP) method for such problems. In each iteration, with an auxiliary variable introduced to track the inner layer function values we compute stochastic gradients of the nested function using a subsampling strategy. To alleviate difficulties caused by possibly nonconvex constraints, we construct a stochastic approximation to the linearized augmented Lagrangian function to update the primal variable, which further motivates to update the dual variable in a weighted-average way. Moreover, to better understand the asymptotic dynamics of the update schemes we consider a deterministic continuous-time system from the perspective of ordinary differential equation (ODE). We analyze the Karush-Kuhn-Tucker measure at the output by the STEP method with constant parameters and establish its iteration and sample complexities to find an \epsilon-stationary point, ensuring that expected stationarity, feasibility as well as complementary slackness are below accuracy \epsilon. To leverage the benefit of the (near) initial feasibility in the STEP method, we propose a two-stage framework incorporating a feasibility-seeking phase, aiming to locate a nearly feasible initial point. Moreover, to enhance the adaptivity of the STEP algorithm, we propose an adaptive variant by adaptively adjusting its parameters, along with a complexity analysis. Numerical results on a risk-averse portfolio optimization problem and an orthogonal nonnegative matrix decomposition reveal the effectiveness of the proposed algorithms. [ABSTRACT FROM AUTHOR]

Following the global commitment on net zero emissions during the Paris Agreement in 2016, Indonesia is fulfilling its commitment by focusing their strategy on electric vehicles batteries investment and decreasing the coal-based power generation. One of the company groups in Indonesia that mainly operating on coal starts to look at green minerals that would increase in demand as a diversification strategy. This study aims to investigate which green mineral options that would be the most feasible strategy for the company through decision-making method. Based on the literature review on business strategy and decision-making method decision tree analysis, a questionnaire was distributed across the internal team of the target company that works on the diversification attempt. The respondents were asked on their confidence on the proposed green mineral options. Analysis on the responses shows that there is a strong, if not perfect, relationship between the confidence scores and all the calculated expected monetary values (EMV) of the proposed green minerals. The analysis also shows that the highest EMV compared to other green mineral option, is gold. On this basis, it is recommended for the company to choose gold as their diversification strategy on green minerals. Further research is needed to investigate other factors that has not been covered in this dissertation, or to investigate through other decision-making method. [ABSTRACT FROM AUTHOR]

Background: A significant number of individuals diagnosed with SARS-CoV-2 continue to suffer from persistent symptoms, a condition commonly referred to as Post-COVID syndrome (PCS). The most common manifestations are fatigue, post-exertional malaise, respiratory problems and cognitive deficits due to the lack of a causal treatment, therapeutic options remain symptom oriented. The aim of this study was to develop a low-threshold group therapy concept for patients with PCS and to test its feasibility in face-to-face and online format. Method: An interprofessionally oriented group therapy concept for patients with PCS was developed and a treatment manual was established. The concept comprises eight weekly sessions of 90 minutes each, during which the management of fatigue, stress intolerance and other symptoms are addressed and coping strategies are discussed and developed. The group therapy was conducted alternating in face-to-face and online format and evaluated via questionnaires. Results: A total of 57 patients, most of them with severe limitations due to PCS, took part in the groups (n=36 online; n=21 face-to-face). The group offer was requested and accepted in both the face-to-face and online formats, and was predominantly evaluated as beneficial. Of particularly value was the opportunity to engage with peers who share similar experiences. Conclusion: The interprofessional, integrative psychotherapeutic/psychoeducational group therapy is safe, accepted and is predominantly rated as helpful by participants. It should be carried out in online formats for patients with PCS who are limited in mobility. Controlled studies are necessary to further evaluate the proposed concept and its integration into the care landscape. [ABSTRACT FROM AUTHOR]

Forest landscape restoration (FLR) is purported to achieve socio‐ecological outcomes in addressing the interlinked crises of deforestation and land degradation, biodiversity loss, and climate change. While several instruments exist to substantiate progress toward such outcomes and the effectiveness of FLR interventions, various challenges hinder monitoring. This study uses a proposed analytical framework that articulates elements of restoration monitoring feasibility to examine the realistic application and convenience of proposed restoration monitoring instruments, focusing on Africa, where continental‐level flagships are scaling up restoration actions. We applied a critical content analysis guided by our analytical lens to secondary data collected from top‐down and bottom‐up monitoring instruments. A survey was also used to explore the level of knowledge and identify the tools and guiding frameworks used by restoration practitioners, which we analyze using descriptive statistics. Our analysis reveals 34 restoration monitoring indicators spanning biophysical, socio‐economic, and institutional realms, along with 196 related metrics. The strong emphasis on biophysical metrics relative to socio‐economic and institutional ones reflects unbalanced attention to sustainability dimensions. Our analysis of the identified 39 monitoring tools and guiding frameworks indicates that most require essential (super)infrastructural capacities, appropriate knowledge, and tailored skills for their effective use. Confirming this, the survey reveals low awareness and use of these monitoring instruments, with the three most cited limiting reasons being inadequate funding, infrastructure deficits, and inadequate technical expertise. Overall, the results reaffirm the need for pragmatic, low‐cost, and accessible instruments to advance FLR monitoring in Africa, and we offer actionable suggestions for some limiting challenges. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONPurpose: Frame Running is an adapted community-based exercise option for people with moderate-to-severe walking impairments. This mixed-methods study aimed to examine the feasibility of 1) community-based Frame Running by young people with moderate-to-severe walking impairments and 2) conducting future studies on the impact of Frame Running on functional mobility and cardiometabolic disease risk factors.Materials and Methods: Weekly training sessions and data collection occurred in two sites. Quantitative data were collected at baseline, and after 12 (both sites) and 24 (one site) weeks of training, followed by interviews or focus groups. Consent and retention rates, attendance and outcome measure completion rates were calculated. Qualitative data were analysed abductively using concurrent inductive and deductive thematic content analysis. Data for the assessments at baseline, 12 and 24 weeks were available for 23, 15 and 5 participants respectively.Results: Participants were aged 5-25 with most diagnosed with cerebral palsy (GMFCS II-IV). Consent, intervention drop-out and adherence rates were 55%, 17% and 83% respectively with no serious adverse events. Outcome measure completion rates ranged between 60% and 98%. Themes related to facilitators to participating in Frame Running were mostly identified in the personal and social domains with barriers more common in the environmental and policy domains.Conclusions: The study results support the existing evidence that Frame Running is a safe and acceptable community-based exercise option for those with moderate-to-severe walking impairments. Themes identified in personal, social, environmental and policy domains can guide the implementation of community-based Frame Running participation. Our feasibility data can inform the design of future definitive studies.Frame Running is a safe and acceptable community-based exercise option for young people with moderate-to-severe walking impairments.The identified key themes related to personal, social, environmental and policy domains will aid clinicians, sports officials and policy makers with the implementation of Frame Running in community settings.Participants observed improvements in their activities of daily living related performance after participating in Frame Running for 12 weeks or more.Frame Running is a safe and acceptable community-based exercise option for young people with moderate-to-severe walking impairments.The identified key themes related to personal, social, environmental and policy domains will aid clinicians, sports officials and policy makers with the implementation of Frame Running in community settings.Participants observed improvements in their activities of daily living related performance after participating in Frame Running for 12 weeks or more. [ABSTRACT FROM AUTHOR]

AbstractDepression is the most prevalent mental disorder in the population worldwide. A systematic review of meaning-based psychotherapies (MBPs) for depression has shown their efficacy in improving depression. However, to date, all the studies on the efficacy of MBP have been carried out in English-speaking countries. The construction of meaning in life depends on cultural, social, and religious factors, and so it is necessary to adapt MBPs and verify their effectiveness in samples that speak languages other than English, such as Spanish. The aim of the study reported was to analyze the feasibility of MBPs in Spanish participants with depression. The sample was composed of 30 participants who met the DSM5 criteria for depressive disorders, 20 of whom completed MBP. Qualitative and quantitative outcomes were measured. The participants indicated that MBP was useful, that they were very satisfied with the intervention, and that they would highly recommend it to other people with depression. At the end of the treatment, there was a reduction in depression and anxiety and an increase of meaning in life. The change in depression was highly associated with the change in meaning in life. MBP is a feasible intervention for Spanish participants with depression. [ABSTRACT FROM AUTHOR]

Background: Low back pain is a common musculoskeletal condition which causes substantial disability globally. The biopsychosocial model of management has been recommended in national and international guidelines for the management of patients with chronic low back pain (CLBP). However, biopsychosocial approaches are predominantly delivered in high income countries (HICs), although the prevalence of LBP is substantially higher in low- and middle-income countries (LMICs) especially in Africa (39%; 95% CI 30–47). Understanding the effectiveness of BPS interventions in LMICs especially in Africa is underexplored, with substantial inequity between research from HICs and LMICs. Ghana is a LMIC where the effectiveness of biopsychosocial interventions has been underexplored. Therefore, the aim of this study was to explore the feasibility of delivering a physiotherapist-led BPS programme for the management of patients with CLBP in Ghana. Methods: This was a mixed-methods, sequential, pretest-posttest feasibility study. Participants involved thirty patients with CLBP. The biopsychosocial intervention involved an exercise and patient education programme based on principles of cognitive behavioural strategies with emphasis on self-management. The biopsychosocial intervention was delivered for six weeks for each participant. Feasibility outcomes regarding management and processes were captured pre-intervention, post-intervention, and three-months post intervention. Semi-structured interviews were conducted post-intervention to explore participants' experiences with the biopsychosocial intervention. Patients' demographics were collected at baseline. Patient reported outcome measures such as intensity of pain, disability, pain catastrophising, kinesiophobia, self-efficacy, and general quality of life, were collected pre-intervention, post-intervention and at three-months follow-up. Qualitative analysis explored participants' experiences regarding the acceptability of the biopsychosocial intervention. Results: The results of this feasibility study demonstrated that the training programme was acceptable to physiotherapists. Recruitment rate (5 patient participants per week − 100% recruitment met), retention rate post-intervention (90%), data completion rate post-intervention (99.8%) and intervention fidelity (83.1%), all met feasibility thresholds. There were no adverse events. Qualitative data also demonstrated that the biopsychosocial intervention was acceptable to participants. Conclusion: This study has established the potential to deliver a biopsychosocial intervention programme in a Ghanaian hospital setting. This biopsychosocial intervention therefore shows promise, and the result of the study provides a platform to develop future clinical studies. [ABSTRACT FROM AUTHOR]

Background: Chronic physical illnesses are often associated with significant psychological distress and chronic mental illnesses are often co-morbid with physical illnesses. Efforts to integrate mental health into primary health care in Uganda are underway. However, there are enormous logistical challenges. Effective resource-oriented and evidence-based interventions such as DIALOG + have the potential to improve treatment outcomes for patients with chronic conditions. We aimed to assess the acceptability of DIALOG + among patients with chronic physical illnesses in Uganda. Methods: This was a qualitative aspect of a mixed methods exploratory non-controlled study conducted in chronic physical illness out-patient clinics at two hospitals in Uganda. We conducted fifteen in-depth interviews with patients, ten key informant interviews with clinicians, and four focus group discussions with patients. Thematic data analysis was done through an iterative process. Results: The results support the acceptability of the intervention as evidenced by willingness to participate, better relationships between patients and clinicians, and improved control of both physical illnesses and psychological distress. Participants also talked about ways in which the implementation of DIALOG + could be improved. Conclusion: DIALOG + is acceptable among patients with chronic physical illness in primary health care settings in Uganda. [ABSTRACT FROM AUTHOR]

Introduction: Leveraging every interaction between patients and healthcare professionals constitutes an opportunity to foster behavior change. We developed a mobile Screening and Brief Intervention (mSBI) designed to screen for and intervene with multiple health behaviors, based on a personalized feedback. The objectives of the present study were to assess its feasibility during consultations for chronic conditions, collect users' opinions, and to investigate patients' behaviors and intention to change. Methods: Research counselors provided the mSBI to patients from 2 departments at University Hospital. Socio-demographic, behavioral, and acceptability data were collected from patients together with feasibility data from counselors' reporting. Results: A total of 259 participants were analyzed, aged 51 ± 17 years, with a majority of women (53%). The m-SBI averaged 20 min and most patients (92%) could complete the screening with minimal assistance. Medical doctors' involvement facilitated referral to and uptake of the m-SBI, and limited adverse events. On average, patients adhered to 11 of the 18 guidelines screened. A majority of patients rated the personalized feedback as comprehensible and useful. Nearly half of them intended to change behavior. Conclusions: The m-SBI seems well-accepted and useful, but doctor referral, adapting the screening tool to patients with low health literacy, and app's ability to send the feedback to patients/doctors are essential for feasibility. [ABSTRACT FROM AUTHOR]

Background: Following the publication of international cardio-oncology (CO) imaging guidelines, standard echocardiographic monitoring parameters of left ventricular systolic function have been endorsed. Recommendations highlight that either two-dimensional (2D) or three-dimensional (3D) left ventricular ejection fraction (LVEF), alongside global longitudinal strain (GLS) should be routinely performed for surveillance of patients at risk of cancer therapy-related cardiac dysfunction (CTRCD). We studied the feasibility of 3D-LVEF, 2D-GLS and 2D-LVEF in a dedicated CO service. Methods: This was a single-centre prospective analysis of consecutive all-comer patients (n = 105) referred to an NHS CO clinic. Using a dedicated Philips EPIQ CVx v7.0, with X5-1 3D-transducer and 3DQA software, we sought to acquire and analyse 2D- and 3D-LVEF and 2D-GLS, adhering to the British Society of Echocardiography (BSE) and British Cardio-Oncology Society (BCOS) transthoracic echocardiography protocol. Results: A total of 105 patients were enrolled in the study; 5 were excluded due to carcinoid heart disease (n = 5). Calculation of 3D-LVEF was achieved in 40% (n = 40), 2D-GLS in 73% (n = 73), and 2D-LVEF in 81% (n = 81). LV quantification was not possible in 19% (n = 19) due to poor myocardial border definition. Strong correlation existed between 2D-LVEF and 3D-LVEF (r = 0.94, p < 0.0001). Bland–Altman plot demonstrated no statistical differences in that the mean deviation between 2D-LVEF and 3D-LVEF were consistent throughout a range of LVEF values. The most persistent obstacle to 3D-LVEF acquisition was insufficient myocardial border tracking (n = 30, 50%). Conclusion: This study demonstrates the high feasibility of 2D-GLS and 2D-LVEF, even in those with challenging echocardiographic windows. The lower feasibility of 3D-LVEF limits its real-world clinical application, even though only a small difference in agreement with 2D-LVEF calculation was found when successfully performed. [ABSTRACT FROM AUTHOR]

Background: Though evidence-based research about system constellations (SCs) appears marginal, it is applied in many psychiatric, psychological, and psychotherapeutic institutions as well as in different contexts of organizational counseling. To date, only one randomized controlled trial (RCT) has been conducted to assess the short- to long-term efficacy of SCs, which entail clients meeting at the same location in person. This study is to investigate the feasibility of a RCT investigating SCs in virtual reality (VR), and to calculate the number of clients needed for a confirmatory RCT. Design: We will perform a prospective, monocentric, parallel-group, feasibility RCT with subsequent intervention. A total of 128 clients of 3-day group-based SC-VR seminars will be randomized to either the intervention group (IG; n = 64) or wait-list group (WLG; n = 64), which receives SCs in VR after 4 months. Feasibility and acceptability of the (1) research methodology and (2) intervention as well as the (3) estimation of effect sizes will be assessed using qualitative and quantitative data. Based on the model of a general mental health, the proposed primary outcome includes the SC-VR adherence, and the proposed secondary outcomes refer to psychological functioning (OQ-45.2), social system functioning (EXIS), psychological distress (FEP-2), motivational incongruence (INK-SF), and goal attainment (GAS). We plan to investigate the short-term efficacy at 2-week and 4-month follow-up within the RCT design (n = 128), and mid-term efficacy at 8- and 12-month follow-up for the intervention group (n = 64). Discussion: The study is expected to be the first study on the feasibility of SC-VR. We will reflect on successfully implemented study procedures, and we will provide recommendations for changes considering the design, rationale, analyses, and interpretation of the study results where they became necessary. The discussion will conclude with an evaluation whether a confirmatory RCT on SC-VR is worth the investment of future resources, including the calculated number of clients needed based on the efficacy trends derived from this feasibility study. Trial registration: ClinicalTrials.gov: ID = N CT05557890; date of registration: September 23, 2022; https://clinicaltrials.gov/ct2/show/NCT05557890. [ABSTRACT FROM AUTHOR]

Background: Cognitive restructuring (CR) is an evidence-based psychological technique for depression. However, face-to-face CR is not easily accessible. Digital CR interventions often overlook the difficulties individuals experiencing depression encounter in identifying their negative automatic thoughts (NAT), leading to suboptimal outcomes. Virtual Reality (VR) has potential advantages in assisting the identification of NAT in CR intervention. Objective: The aim of this preliminary feasibility study is to assess the efficacy, acceptability and safety of a VR-based self-guided training on the identification of negative automatic thoughts (VR-STINAT) for depression, as well as to evaluate the user experience. Methods: In a mixed methods study, 20 healthy participants underwent VR-STINAT and completed a semi-structured interview, followed by post-training homework. The VR-STINAT includes three modules: psychological education, NAT identification training in VR scenarios, and practice in personally experienced scenarios. Effectiveness was measured via Thought Record Skills Assessment (TRSA) of homework and Cognitive Therapy Awareness Scale (CTAS). Acceptability was measured using an adapted Technology Acceptance Model and duration of training. Safety was measured via Simulator Sickness Questionnaire and self-reported negative emotions. Qualitative material was analyzed using thematic analysis. Results: The VR-STINAT was acceptable, with an average rating of 80.68%. The accuracy of NAT identification in TRSA reached 84.55%, and CTAS correctness reached 76.67%. The majority of participants experienced minimal or no side effects, although a few (10%, 2/20) reported relatively severe fatigue and craniofacial pain. Thematic analysis reviewed four themes: effectiveness, acceptability, advantages of VR, difficulties in use and suggestions for improvement. Most participants indicated that they've learned how to identify their NAT through VR-STINAT (85%, 17/20), which was engaging (90%, 18/20) and easy to use (60%, 12/20). Conclusion: This study provides preliminary evidence that self-guided training for the identification of negative automatic thoughts related to depression using VR is feasible. Future studies are needed to compare the efficacy of VR with other intervention modalities in people with depression. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions We aimed to determine acceptability and feasibility of innovative wearable alcohol biosensor monitors (ABM) for patients with alcohol‐related liver disease (ALD) and their clinicians.Patients and clinicians at a tertiary care centre participated in qualitative interviews on usability, acceptability, feasibility, efficiency/effectiveness, impact of device on behaviour/clinical practice and preferences/barriers. Interviews were audiotaped, transcribed and coded using a constant comparison method for category themes.Patients (n = 23) were 56% female, mean 44 years old, 87% White, with moderate–severe liver disease. Some felt the ABMs appearance was unappealing; others felt it provided an opportunity for openness and education of others. While some found it feasible to wear, others felt it was unrealistic to wear 24/7. Importantly, there were many positive themes on effectiveness/efficiency—participants felt the ABM could better record their alcohol use and patterns of use than they could remember. Patients felt wearing the ABM motivated abstinence, gave accountability and was a source of security.Clinicians (n = 13) were mostly hepatologists (77%), seeing on average 38 ALD patients/month. Clinicians felt seeing patterns and amounts of alcohol use could inform clinical decision making and treatments but expressed concern over the volume and complexity of data.Perspectives on ABMs for managing ALD were mixed among patients and providers. Future device designs may overcome acceptability barriers due to device appearance. However, for clinicians, the logistics of data gathering plus the complexity and volume of data produced by the ABM device requires considerable thought to make this an efficient tool for clinical use. Clinicaltrials.gov identifier NCT03533660: Alcohol biosensor monitoring for alcohol liver disease. [ABSTRACT FROM AUTHOR]

Background and aims: Injectable opioid agonist treatment (iOAT) is a valuable, patient-centred, evidence based intervention. However, limited information exists on contextual factors that may support or hinder iOAT implementation and sustainability. This study aims to examine existing research on iOAT using diacetylmorphine and hydromorphone, focusing on identifying the key barriers and facilitators to its successful implementation. Methods: A systematic search was conducted in the MEDLINE and PsycInfo databases (via Ovid) from inception to February 2024, supplemented by a comprehensive grey literature search. No restrictions were applied regarding publication type, year, or geographic location. Articles were independently screened by two reviewers. Eligible articles described the feasibility, implementation, and/or evaluation of iOAT in one or more countries, presenting perspectives on receiving, administering, or governing iOAT. Results: Forty-four publications were selected for inclusion. Barriers identified through thematic analysis included public acceptance concerns such as medication diversion, increased crime, and the Honey-Pot effect. Legal and ethical challenges identified involved enacting changes in law to make certain substances available as a medically controlled options for treatment, and addressing patient consent issues. Negative media coverage and public controversies were found to undermine acceptance, and high start-up costs especially for security, facility access, and economic feasibility were seen as additional obstacles. Regulatory barriers and stringent protocols were the most frequently cited limiting factors by patients and providers. Facilitators included the integration of trial prescriptions into comprehensive drug policy strategies and publishing data for evidence-based debates, together with ethics committees ensuring compliance with ethical standards. Developing information strategies and addressing opponents' claims improved public perception. Cost-effectiveness evidence was found to support long-term implementation, while flexible treatment protocols, inclusive spaces, and affirming therapeutic relationships were seen as important facilitators to enhance patient engagement and treatment effectiveness. Conclusions: Successful implementation of iOAT requires balancing political and social acceptability with scientific integrity, alongside strategic communication and public outreach. Further research is needed to enhance the transferability of findings across diverse socio-political contexts and address key influencing factors associated with iOAT programs. [ABSTRACT FROM AUTHOR]

Background: The prevalence of patients with prostate cancer is increasing, and the first year after treatment is a vulnerable period for patients as they experience symptoms and unmet needs. Although electronic patient-reported outcomes that focus on patient self-management have demonstrated benefits, evidence is sparse regarding patients with prostate cancer in primary care settings and the role of nurses as a supportive resource. The significant role of primary care in future cancer care is on the agenda. This study aims to test the feasibility of a complex intervention that includes electronic patient-reported outcomes and self-management advice in an app, combined with nurse-led support, in primary care settings during the first year after curative intended prostate cancer treatment. Methods: The intervention lasted four weeks and was a single-arm study. Feasibility was assessed by examining the recruitment process, retention rate, adherence to the reporting of symptoms in the app, and acceptability of the intervention. Data was collected through (1) logged data from the app that included patient-reported outcomes and self-management advice, (2) field notes by the nurse, and (3) semi-structured interviews with patients. Descriptive statistics were applied to logged data. The interviews and the field notes were analysed using qualitative content analysis. Results: The recruitment rate was 55%, yielding 11 patients with high retention as all completed the intervention. Adherence to reporting was 100%, and all functions in the app were used. Individual variation in how patients used the app was found, which was attributed to patients' current needs. In total, 36 health dialogues with the nurse (virtual, face-to-face, telephone) were performed; all first dialogues lasted longer, while follow-ups were shorter. Patients described that the health dialogues covered relevant subjects and that the combination of using the app and health dialogues was tailored and provided supplementary support. No adverse events occurred; however, a few technical difficulties interfered with the intervention, and the patients gave valuable suggestions for improvement. Furthermore, patients suggested that the intervention should start immediately after treatment. Conclusion: As the patients adhered to and accepted the intervention, it was considered feasible. Findings suggest intervention should start directly after treatment ends. [ABSTRACT FROM AUTHOR]

Background: Previous upper abdominal surgery was considered a contraindication to laparoscopic cholecystectomy; Patients who have had surgery in the upper abdomen were advised against having laparoscopy due to the creation of adhesions and the challenge of seeing the gallbladder. This raises the risk of harm to the bowel or blood vessels caused by the first trocar. This study aims to evaluate the possibility and results of laparoscopic cholecystectomy in patients who had previously had surgery in the upper abdomen. Subjects and Methods: This prospective study was conducted at the General Surgery Department of Zagazig University Hospital. Thirty patients with gallstone disease (13 males and 17 females), aged 30-62 years with a mean age of 47.03±7.61 years, all of whom had a previous upper abdominal incision and were subjected to laparoscopic cholecystectomy. Results: In our study, laparoscopic cholecystectomy was feasible and completed safely in 27 patients, while in 3 patients, it was converted to open cholecystectomy due to intra-abdominal adhesions; we failed to create pneumoperitoneum in one of the converted cases; in another patient, there were dense adhesions in the periportal area, and the last patient to be converted was due to small intestine injury, which was managed by direct repair of the injury. Conclusion: Patients with previous upper abdominal surgeries reported difficulties during their procedure of laparoscopic cholecystectomy, but only those who had prior major abdominal surgery and incisions near the cholecystectomy laparoscopic area reported longer operating times, higher rates of conversion, high-grade adhesions, and longer hospital stays. [ABSTRACT FROM AUTHOR]

Aim: There is no validated symptom scale for Swedish children with gastrointestinal disorders. Our aim was to validate the Swedish version of the Paediatric Quality of Life Inventory (PedsQL) gastrointestinal symptoms scale and symptoms module. Methods: Families were recruited from two hospitals in Gothenburg, Sweden, from 1 March 2021 to 31 October 2022. The instruments were completed by 115 children with functional, congenital or organic acquired gastrointestinal disorders and 149 of their parents. These were the gastrointestinal symptoms scales, symptoms module and the 4.0 Generic core scale. Data were analysed for feasibility, construct validity and reliability, including internal consistency, re‐test reliability and child–parent agreement. Results: Feasibility was good, with a failure to respond of ≤5%. Construct validity showed strong correlation in the PedsQL gastrointestinal symptoms module. The known‐group validity agreed with the expectations associated with the disease characteristics (p < 0.05). Cronbach's alpha was 0.96, which indicated excellent internal reliability. The intraclass correlation coefficient for the child self‐report and parent‐proxy report was 0.74, which indicated good agreement. Conclusion: The Swedish PedsQL Gastrointestinal Symptoms Scales, the symptoms module provided acceptable measurement properties and can be used to evaluate symptoms of gastrointestinal disorders and quality of life during clinical work or research projects. [ABSTRACT FROM AUTHOR]

Purpose: Hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS) are multisystem conditions marked by dysfunctional connective tissue. This feasibility study evaluated a 9-week integrative medicine program in this population. Methods: Using a single-arm study design, adults with HSD or EDS were given recommendations for an anti-inflammatory Mediterranean diet and self-management with additional behavioral and psychosocial support. Preliminary data on feasibility based on recruitment and retention, adherence to the diet, mobile app tracking, changes to perceived well-being via health outcomes, and satisfaction with care were obtained. Results: Thirteen participants were enrolled within a 4-month timeframe. Eight participants completed the study. Three participants met dietary tracking requirement in at least 4 of 8 intervention weeks and met the macronutrient requirements in at least half of the weeks tracked. No decreases in VAS pain scores after 5 and 9 weeks were noted; however, 62.5% (n = 5) of participants had decreased pain at 9 weeks, compared to baseline. There were significant improvements (p<.05) in six of twelve measurements of satisfaction with care at the end of the intervention. Conclusion: This study provides a foundation for future research on patient experience and introduces a novel treatment paradigm focused on nutrition and self-management. Trial Registration: National Institutes of Health clinicaltrials.gov; identifier: NCT04734041. IMPLICATIONS FOR REHABILITATION: Lifestyle and dietary interventions are relatively safe and well tolerated in the hypermobility spectrum disorder (HSD) and Ehlers-Danlos disorder (EDS) population. Participants in our 9-week integrative medicine program actively engaged in self-management of their condition and showed promising adherence to dietary and tracking requirements. Effective treatment of the intricacies and dynamics of these highly variable and clinically heterogeneous disorders may require a network of healthcare providers, integrative healthcare, as well as behavioral and psychosocial support. Dietary tracking through mobile apps might help promote self-efficacy and adherence to dietary changes. Symptom tracking might be an effective way for patients to track changes to their health and could provide valuable information for health professionals engaged in managing the disorders. [ABSTRACT FROM AUTHOR]

Purpose: Assessing feasibility and initial impact of the Home-Graded Repetitive Arm Supplementary Program combined with in-home accelerometer-based feedback (AH-GRASP) on perceived and actual daily-life upper limb (UL) activity in stroke survivors during the chronic phase with good UL motor function but low perceived daily-life activity. Material and methods: A 4-week intervention program (4 contact hours, 48 h self-practice) encompassing task-oriented training, behavioral techniques, phone-based support, monitoring, and weekly feedback sessions using wrist-worn accelerometery was implemented using a pre-post double baseline repeated measures design. Feasibility, clinical assessments, patient-reported outcomes, and accelerometer data were investigated. Results: Of the 34 individuals approached, nineteen were included (recruitment rate 56%). Two dropped out, one due to increased UL pain (retention rate 89%). Seven (41%) achieved the prescribed exercise target (120 min/day, six days/week). Positive patient experiences and improvements in UL capacity, self-efficacy, and contribution of the affected UL to overall activity (p < 0.05, small to large effect sizes) were observed. Additionally, seven participants (41%) surpassed the minimal clinically important difference in perceived UL activity. Conclusions: A home-based UL exercise program with accelerometer-based feedback holds promise for enhancing perceived and actual daily-life UL activity for our subgroup of chronic stroke survivors. IMPLICATIONS FOR REHABILITATION: Implementing a home-based exercise program with accelerometer-based feedback and telephone supervision may effectively improve upper limb activity after stroke. This program is most suitable for individuals with mild upper limb impairment and should be tailored to their abilities, preferences, and limitations to enhance engagement. The AH-GRASP program shows promising recruitment and retention rates, safety, and positive patient experiences. To improve adherence, consider dividing exercises into shorter sessions that accommodate patient's schedules, attention and endurance levels. [ABSTRACT FROM AUTHOR]

Purpose: Evidence-based interventions (EBIs) are essential to improve the well-being and neurocognitive outcomes of pediatric cancer patients; however, considerable barriers hamper the implementation of these tools. The present study assessed health care professionals’ (HCP) perceived barriers and facilitators to the implementation of a specific EBI for pediatric oncology in a standardized manner to define effective solutions and practical recommendations. Methods: An adapted version of the Consolidated Framework for Implementation Research (CFIR) questionnaire was applied to inquire n = 31 HCPs in pediatric oncology about the five domains of implementation. Results: While most ‘intervention characteristics’ were considered beneficial for implementation, various aspects of the ‘inner’ and ‘outer setting’ were considered problematic. The most prevalent barriers included a shortage in resources, poor integration of EBIs into policies and lacking incentives such as user benefits. Concrete proposed and realized steps to facilitate effective implementation include a patient-focused design and continuous evaluation and adaption of the tool, a detailed EBI user manual and application workshops, as well as regular interdisciplinary meetings to improve communication. Regarding the internal and external settings, involving policy makers, establishing psychosocial care in the insurance system and increasing awareness by sharing evidence are essential steps for improved implementation. Conclusion: Based on standardized implementation evaluation, various targeted actions could be defined and implemented to facilitate successful implementation of EBIs in pediatric oncology. The results emphasize that psychosocial care must become an integral part of treatment standards and public health policies to ensure that effective psychosocial interventions for improved wellbeing and neurocognitive skills successfully reach pediatric cancer patients. Trial registration number: ClinicalTrials.gov Identifier: NCT04474678 (July 17th 2020). [ABSTRACT FROM AUTHOR]

Background: The occupational therapy intervention programme ABLE 1.0 was designed to enhance the ability to perform activities of daily living in persons living with chronic conditions. There is a need to determine if content and delivery of the ABLE 1.0 are acceptable among occupational therapists (OTs) and clients after having delivered or received the programme, respectively. Objectives: The paper reports on evaluation of content and delivery of the ABLE 1.0 among OTs and clients. This, in terms of acceptability of intervention in principle, and perceived value, benefits, harms, or unintended consequences of the intervention. Material and methods: Qualitative semi-structured interviews were conducted with OTs having delivered and clients having received ABLE 1.0 in a Danish municipality. Content analysis was performed. Findings: Two OTs and three clients participated. Analyses revealed six categories related to content and delivery; 'Overall perception of the programme'; 'Potential for implementation'; 'Evaluation, goal setting and clarification of reasons for ADL task performance problems'; 'Intervention: compensatory solutions'; 'Format and duration' and 'Preconditions for delivery'. Conclusions and significance: The findings provided valuable information used for further development of the ABLE programme. [ABSTRACT FROM AUTHOR]

The now well-known impossibility results of algorithmic fairness demonstrate that an error-prone predictive model cannot simultaneously satisfy two plausible conditions for group fairness apart from exceptional circumstances where groups exhibit equal base rates. The results sparked, and continue to shape, lively debates surrounding algorithmic fairness conditions and the very possibility of building fair predictive models. This article, first, highlights three underlying points of disagreement in these debates, which have led to diverging assessments of the feasibility of fairness in prediction-based decision-making. Second, the article explores whether and in what sense fairness as defined by the conjunction of the implicated fairness conditions is (un)attainable. Drawing on philosophical literature on the concept of feasibility and the role of feasibility in normative theory, I outline a cautiously optimistic argument for the diachronic feasibility of fairness. In line with recent works on the topic, I argue that fairness can be made possible through collective efforts to eliminate inequalities that feed into local decision-making procedures. [ABSTRACT FROM AUTHOR]

Background and Aim: Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD) have high symptom burden, serious health-related suffering, and mortality that necessitate palliative care (PC) integration. There is an information gap on PC needs, symptom burden, anxiety and depression in COPD and ILD, and the feasibility of PC integration from low-middle-income countries (LMICs). The PCIntegCOPD-ILD study aims to identify PC needs, symptom burden, and psychological distress in severe COPD/ ILD and assess the feasibility of PC integration within standard care. It will also explore experiences and unmet needs relating to disease and PC services for patients and informal carers. Methods and Design: This mixed-methods study will assess PC needs, symptom burden, and psychological distress in patients with severe COPD (stages C, D) and ILD (stages II, III). Assessment will be done at recruitment (T0) and third (T3) month (face-to-face) and first (T1) and second (T2) month (phone call). After initial recruitment, patients will be provided PC interventions as required. At T3, patients' and informal carers' experiences and unmet needs of disease and PC services will be explored through semi-structured interviews. Impact and feasibility of integration of PC within standard care will also be assessed. Discussion: The PCIntegCOPD-ILD study will provide robust data on PC needs, symptom burden, psychological distress and understanding of patient and caregiver perspecitves in severe COPD and ILD. An objective information on feasibility of PC integration will inform development and evaluation of similar models in the management of other progressive chronic diseases in LMICs. [ABSTRACT FROM AUTHOR]

This 6‐week pilot study aimed to investigate the feasibility, perceived efficacy, and participation perspectives of a university campus stair climbing‐based exercise snack (ES) intervention and to compare it to moderate‐intensity continuous training (MICT). Healthy, young, inactive adults (age: 21.6 ± 2.3 years, BMI: 22.5 ± 3.6 kg/m2) were randomly assigned to three groups (ES, MICT, and Control [CON]). ES (n = 14, 6 females) and MICT (n = 13, 9 females) groups performed three sessions per week over 6 weeks, while the control group (n = 15, 9 females) maintained their habitual lifestyle. ES involved 3 × ~30 s 'all‐out' stair‐climbing (6 flights, total 126 steps and 18.9 m elevation) bouts separated by > 1 h rest, and MICT involved 40 min stationary cycling at 60%–70% HRmax. Mixed linear effect models were used to explore within and between‐group differences, and the change in magnitude was determined using mean difference (MD), 95% confidence interval (CI), and Cohen's d effect size. Fourteen participants also completed post‐intervention semi‐structured interviews. Retention rates of 93% (ES, 14/15), 93% (MICT, 13/14), and 100% (CON, 15/15) were achieved from baseline to post‐assessments, with compliance (participants' attendance to scheduled ES sessions) of 97% (733/756 sessions) and 93% (217/234 sessions) in ES and MICT, respectively. No significant differences were found between ES and MICT for future intentions (4.8 ± 1.4 and 5.0 ± 0.9), enjoyment (PACES, 89.0 ± 16.4 and 94.5 ± 11.9), and satisfaction. A significant group × time interaction was found in the quality of life and perceived stress. ES and MICT significantly increased the quality of life by 8% (MD = 5.5 [95% CI = 0.3, 10.7], Cohen's d = 0.64) and 6% (MD = 4.6 [95% CI = 0.9, 8.2], Cohen's d = 0.88) compared to baseline, whereas CON experienced a significant decrease (MD = −7.9 [95% CI = −14.4, −1.6], Cohen's d = 0.56). ES significantly decreased perceived stress by 7% (MD = −4.6 [95% CI = −8.9, −0.3], Cohen's d = 0.58), while MICT (MD = 2.0 [95% CI = −0.1, 4.1], Cohen's d = 0.28) and CON (MD = −2.4 [95% CI = −6.1, 1.3], Cohen's d = 0.22) had no significant effects. The majority (12/14) of participants generally demonstrated positive attitudes toward participation in ES and found it easier than expected while highlighting enablers, barriers, and future recommendations. Stair climbing‐based ES could be integrated into the campus setting, appeared feasible, and was similar to MICT regarding future intentions, enjoyment, and satisfaction. Both ES and MICT might induce relevant positive effects on the quality of life, and ES demonstrated greater benefits compared to MICT or CON for reducing perceived stress. Interviews provided positive insights into fostering adherence to ES among university students. [ABSTRACT FROM AUTHOR]

Recent advancements in methodologies such as ecological momentary assessment (EMA) and ambulatory physiology devices have enhanced our ability to measure emotions experienced in daily life. Despite the feasibility of EMA for assessing children's and youth's emotional self‐reports, the feasibility of combining it with physiological measurements in a real‐life context has yet to be established. Our scoping review evaluates the feasibility and usability of implementing emotional and physiological EMA in children and youth. Due to the complexities of physiological EMA data, this review also synthesized existing methodological and statistical practices of existing studies. Following the PRISMA‐ScR guidelines, we searched and screened PsycINFO, PubMed, and Web of Science electronic databases for studies that assessed children's and youth's subjective emotions and cardiac or electrodermal physiological responses outside the laboratory. Our initial search resulted in 4174 studies, 13 of which were included in our review. Findings showed significant variability in the feasibility of physiological EMA, with physiology device wear‐time averaging 58.77% of study periods and data loss due to quality issues ranging from 0.2% to 77% across signals. Compliance for emotional EMA was approximately 60% of study periods when combined with physiological EMA. The review points to a lack of standardized procedures in physiological EMA and suggests a need for guidelines in designing, processing, and analyzing such data collected in real‐life contexts. We offer recommendations to enhance participant engagement and develop standard practices for employing physiological EMA with children and youth for emotion, developmental, and psychophysiology researchers. This is the first review to examine the feasibility and synthesize methodological aspects of studies employing emotional and physiological ecological momentary assessment (EMA) with children and youth. We provide insights into the compliance and usability of such data. We also offer recommendations for improving participant engagement and refining study protocols for designing, processing, and analyzing physiological EMA studies, which will enable researchers to better capture and understand children's emotional experiences in real‐life contexts. [ABSTRACT FROM AUTHOR]

The lower risk gambling guidelines (LRGG) represent an evidence-based collaborative effort to provide clear advice to people on the limits of safe gambling consumption. The guidelines are as follows: 1) Gamble no more than 1% of household income per month; and 2) Gamble no more than 4 days per month; and 3) Avoid regularly gambling at more than 2 types of games. In an online survey study (N = 778), we evaluated the feasibility and acceptability of the LRGG among different subpopulations in Finland. We found that the guidelines were generally evaluated positively as understandable, sensible, clear, and "just right" in terms of their content. There were some notable differences between subpopulations: Individuals who were at risk of gambling problems evaluated the LRGG more negatively than others, while professionals working in the field of gambling prevention were the most optimistic about the guidelines. Thus, increased level of potentially harmful gambling engagement was linked with a somewhat more pessimistic attitude towards the guidelines. On the other hand, those who had not gambled in the past year viewed the guidelines as too permissive compared with those who had gambled, or those working in gambling prevention. Overall, our results show clear differences of opinion between the various subpopulations, which appear to be associated with the individuals' level and nature of gambling experience. We conclude that the LRGG can likely be adopted into wider use in Finland. [ABSTRACT FROM AUTHOR]

Objectives: Some young individuals participating in sports activities may encounter lower leg muscle pain and tightness, potentially indicating chronic exertional compartment syndrome (CECS). While muscle pressure measurement is typically recommended for diagnosis, it is invasive and associated with low sensitivity and specificity. Thus, there is a need for novel diagnostic approaches. Methods: This feasibility study aims to assess whether an ultrasound-guided technique can effectively measure the compressibility of the anterior tibial muscle compartment, focusing on optimal leg positioning and identifying reliable external and internal anatomical landmarks. The compressibility of the anterior tibial muscle compartment was evaluated using ultrasound images obtained at 10 mmHg and 80 mmHg external pressure, with the drop in compartment thickness used to calculate the compressibility ratio. Measurements were conducted in various leg positions and utilizing different external and internal landmarks. Results: Studies in healthy volunteers showed that knee and heel support positioning, measuring at the leg's widest circumference, and using the interosseous membrane as an internal landmark yielded the lowest measurement variability with an intra class correlation of.977 (.764–1.000; 95%-confidence interval). Conclusion: These findings suggest that ultrasound-guided techniques can feasibly determine the compressibility ratio of the anterior tibial muscle compartment, providing valuable insights for standardized protocols in future studies on suspected cases of chronic exertional compartment syndrome. [ABSTRACT FROM AUTHOR]

Background/Objectives: Extensive research has emphasised the persistent challenges and failures in providing hospitalised patients with fundamental evidence-based nursing care, often resulting in grave consequences for patient safety. Recommendations from implementation research indicate that a tailored theory- and research-based implementation strategy targeting contextual determinants can optimise the implementation of evidence-based clinical practice for the benefit of patients. This study evaluated the feasibility of an implementation strategy designed to improve the quality of nursing care by targeting behavioural and environmental barriers in a hospital setting. Methods: Proctor's conceptual model for implementation was applied to evaluate the strategy based on eight outcomes: adoption, acceptability, appropriateness, fidelity, feasibility, penetration, sustainability, and costs. Data collection methods included field observations, informal and focus group interviews, registrations, and audits of electronic patient records. Results: The strategy was adoptive, acceptable, appropriate, and feasible in targeting complex environmental and behavioural determinants (at the individual, team, and management level), enabling successful implementation of fundamental evidence-based nursing care. However, fidelity, feasibility, and sustainability were challenged by competing organisational demands and time constraints. Conclusions: The tailored, multifaceted strategy proved effective in addressing complex environmental and behavioural determinants across multiple levels, facilitating the implementation of fundamental evidence-based nursing care in a clinical practice. Further testing and larger-scale studies is needed to assess the strategy's transferability and its impact on nursing-sensitive patient outcomes in different clinical settings. [ABSTRACT FROM AUTHOR]

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The potential for sorghum to be the driver of economic development in Sub-Saharan economies, including South Africa, is enormous. However, there has been a notable decline in the production, use, and consumption of sorghum due to the changes in preferences and lifestyle of its consumers in Southern Africa. While existing and extant studies have studied the benefits and impacts of sorghum on the African economy, there is an inadequate understanding of the feasibility of sorghum farming in South Africa using Garrett's ranking technique. As a result, this study explores the feasibility of sorghum farming in the Nyoni area of KwaZulu Natal, South Africa. Hence, a survey was conducted with a sample size of 150 respondents that were purposively selected. An interview schedule was also used to collect primary data, and the data were analyzed using Garrett's ranking technique. The results of this study indicated that edaphic factors, climatic factors, volatile markets, information transfers, education, drought resistance variety, access to credit, and technological advancement were critical in making sorghum farming feasible in the Nyoni area of KwaZulu Natal. Therefore, this study recommends that there is an overarching need to explore the feasibility of sorghum farming, starting at a smaller scale until a more stable state of marketability and potential profitability has been established. [ABSTRACT FROM AUTHOR]

The enhancement of local safety management capabilities through digital technology represents a pivotal strategy for implementing Peaceful China Initiative. However, limited research exists on whether these capabilities can establish a coordinated development relationship with digital technologies and the factors influencing this relationship. This paper employs the concept of coordinated development to establish an analytical framework termed 'Feasibility-Suitability-Sustainability,' which is utilized to identify indicators for measuring the relationship between the two variables. Using panel data from China mainland, this study evaluates the relationship. The findings indicate that the overall level of coordinated development between digital technologies and local safety management capabilities in China mainland has been increasing during the period from 2018 to 2022. Nonetheless, certain provinces, particularly in the western regions, such as Tibet Autonomous Region, Qinghai province, and Xinjiang Uyghur Autonomous Region, encounter significant challenges in achieving high coordination between digital technologies and local safety management capabilities. Key factors contributing to these challenges include a lack of innovative potential in local safety management and insufficient trust in digital technologies among citizens. The research results contribute a novel explanatory framework to coordinated development theory and offer practical guidance for local government digitalization and public safety enhancement. [ABSTRACT FROM AUTHOR]

Air pollution contributes to global warming and climate change, leading to extreme weather events and rising sea levels. Promoting sustainable practices has become the focus of policy programs and awareness campaigns. In this study, we propose an effective and powerful way to promote eco-driving behaviors by drawing on data storytelling. Our study shows that animated narrative and narrative sequence can trigger varying emphases on the feasibility and desirability of eco-driving practices, affecting actual driving behaviors and attitudes toward efficient driving. Specifically, in two experiments, we find that a chronological narrative sequence with animation improves subsequent driving efficiency and efficient driving attitudes. Visualization designers may consider employing narrative sequence and animation to facilitate individuals' information comprehension and behavioral changes. Policymakers can also encourage ecological practices through effective designs of data storytelling. Visualized narratives have been broadly employed to help individuals understand complex environmental issues, increase green awareness, and encourage sustainable behaviors. However, sustainability awareness only sometimes translates to actual green practices. In this study, we develop and test a model that explains how eco-driving behaviors and attitudes toward efficient driving can be promoted with post-trip visualized narratives. Drawing on human-computer interaction research, we integrate the mental construal literature to reveal feasibility and desirability perceptions as underlying mechanisms. We test our hypotheses in two experiments involving eye-tracking and driving simulation. Results show that pairwise animated illustration and prospective narratives elevated eco-driving behaviors and attitudes toward efficient driving. In the meantime, static illustration and retrospective narratives influenced attitudes toward efficient driving. In addition, feasibility and desirability perceptions were significant mediators. Overall, this study contributes to information systems literature, human-computer interaction literature, and the construal level theory by unraveling the effects of post-trip visualized narratives on promoting ecological practices and attitudes. History: Yulin Fang, Senior Editor; Heshan Sun, Associate Editor. Funding: This work was supported by the Start-up Grant for New Faculty, City University of Hong Kong [Grant 7200773] and Social Science & Humanities Research (SSHR) 2025 Seed Grant, Nanyang Technological University [Grant 022536-00001]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/isre.2022.0332. [ABSTRACT FROM AUTHOR]

With the rise of digital health platforms, consumers increasingly rely on online reviews when choosing healthcare services. Understanding how these reviews shape consumer decisions is crucial for both platforms and healthcare providers. To explore this, we analyzed a comprehensive data set from a leading online cosmetic surgery platform to understand how process-oriented (focusing on the recovery experience) and outcome-oriented (focusing on the end results) reviews influence the demand for healthcare services. Our findings reveal a striking disparity in the effectiveness of these two types of reviews. Generally, outcome-oriented reviews exhibit greater efficacy in boosting sales. However, the influence of each review type varies with the complexity and popularity of the services. Process-oriented reviews are more compelling for complex healthcare services, while outcome-oriented reviews prove more impactful for simpler, popular services. These insights underscore the need for tailored strategies in incentivizing and managing consumer reviews, vital for healthcare providers and digital health platforms. Furthermore, for policy makers, the study highlights the importance of regulating and guiding online review designs to ensure they accurately reflect the service process and outcome, aiding consumers in making informed decisions. The consumption of services inherently requires a process to achieve the desired outcome. For nonexperiential services (e.g., healthcare and education) primarily valued for their end outcomes, their consumption typically involves lengthy processes that are not designed for enjoyment (e.g., wound care and lecture attendance). Consequently, there exists a prominent tension between the processes (means) and outcomes (ends) of these services, which is largely ignored in the prior literature on user-generated content (UGC) that predominantly focuses on products (e.g., books and electronics) or experiential services (e.g., dining and lodging). To bridge this gap, we investigate the distinct roles of process- and outcome-oriented reviews in influencing consumers' decisions to pursue healthcare services, leveraging a comprehensive data set collected from an online platform for cosmetic procedures. By separating process- and outcome-oriented reviews through visual content analysis, we show that the effect of outcome-oriented reviews in boosting the sales of healthcare services is almost twice stronger than that of process-oriented reviews on average. However, the relative effectiveness of these two types of reviews varies substantially across different types of healthcare services. Specifically, we find that process-oriented reviews are more influential in affecting consumers' purchases of services with higher complexity, in contrast to outcome-oriented reviews that are more impactful for services with lower complexity. Moreover, the impact of process-oriented reviews is stronger for less popular services, whereas the impact of outcome-oriented reviews is stronger for more popular services. These nuanced findings show that consumers resort to different types of UGC while considering different types of healthcare services. Our work has important implications both theoretically and practically. History: Xiaoquan (Michael) Zhang, Senior Editor; Khim Yong Goh, Associate Editor. Supplemental Material: The e-companion is available at https://doi.org/10.1287/isre.2019.0168. [ABSTRACT FROM AUTHOR]

Background/Objectives: In the UK, significant and rising numbers of children arrive in schools with marked deficits in key skills such as oral language. This rise has been further negatively impacted by the COVID-19 pandemic. Given this, the foundation phase of primary school education is a necessary environment for targeting language deficits. There is evidence to suggest that teaching assistant (TA)-led interventions can be effective when adequate training and support are provided. This study explored the feasibility of providing a brief, online dialogic book-sharing training to TAs, and whether this training would be effective in upskilling TAs and enable them to improve the language outcomes of children aged 3–7 years in a school context. Methods: North Wales primary schools were invited to nominate TAs for the two half-day training sessions. Five schools responded, and eleven TA–child dyads participated. Data were collected on recruitment, training acceptability and baseline, and post-training measures from TAs and children (2–3 weeks after the final training session) and 4–6 weeks after the first follow-up. Measures of TA competence and behavior were collected, along with measures of child language and behavior. Results: Schools and TAs were recruited; TAs reported positively to the training, and the results showed small to large effect size benefits on all TA skills and child expressive language with significant positive post-training effects on TAs' use of reflections and child language abilities. However, these effects were somewhat reduced at follow-up. Conclusions: Overall, the results of this feasibility study provide positive evidence for this training as an accessible way for schools to strengthen their prevention infrastructures by professionalizing a growing, but relatively untrained, group within the school workforce. [ABSTRACT FROM AUTHOR]

Collaborative-Cooperative Learning (CCL) model can help to increase character change. This study aims to produce a suitable CCL model to improve the character of theology students in the Self-Development course. The study used a feasibility test by model experts (design), material experts (content), an alpha Cronbach test, an orthogonal iteration test, and field trials using a validation sheet. The results of the study show: (1) The CCL learning model has been tested to improve student character. Based on the expert's review, it was found that the conclusion of the CCL syntax can be categorized as having novelty based on the rationality aspect of the model with a value of 3.29. (2) The CCL learning model can improve the character of theology students in the Self-Development course and can be used to improve the character of students in courses with the same characteristics. Thus, the CCL model has been tested for its feasibility as a model to improve the character of theology students. The researcher suggests that the CCL model can be applied to courses that have the same characteristics, continue research in the context of a wider course, and be integrated with various disciplines. [ABSTRACT FROM AUTHOR]

Abstract Background The Medical Informatics Initiative (MII) introduced a broad consent form (MII-BC) encompassing clinical, insurance, and biomaterial data, along with re-contacting options. In the emergency department (ED), outpatient and inpatient patients of all illnesses and severity could be reached early in their treatment course. The BC-ED (Broad Consent in the Emergency Department) project uniquely investigated the implementation of MII-BC in EDs, exploring feasibility, selection bias and patients’ perceptions of voluntariness, information recall, motivation, and satisfaction. Methods The BC-ED project involving four university hospital EDs in Germany, is part of CODEX+ (Collaborative Data Exchange and Usage), an initiative within the Network University Medicine (NUM). To minimize selection bias, a systematic sampling approach (every 5th/30th patient) was applied, with patient recruitment and consent processes adapted to local conditions and therefore varying among sites. Data collection included patient questionnaires, surveys completed by study nurses, and routine clinical data. Analysis was conducted descriptively using SPSS. Results Of 1,138 patients approached, 553 (48.6%) were capable of giving consent. Of 353 patients who could not consent, primary reasons included language barriers (35.4%) and inability to grasp study details (21.5%). Of all eligible patients, 3.3% could not be contacted. Of 535 (47.0%) patients able to consent and contacted, 313 consented to the MII-BC. Resulting in a consent rate of 27.5% corresponding to the baseline population and 58.5% of those contacted. Motivations for consenting were general support for research (85.3%) and the desire to help future patients (78.2%). Patients generally reported a high level of understanding and satisfaction with the consent process, reporting comprehensive understanding of scientific data use (89.8%) and associated risks (82.2%). However, discrepancies were noted between consented options and patient recall. Conclusions This study is the first to investigate the implementation of the MII-BC in the challenging ED environment. With a consent rate of 27.5% total baseline population and 58.5% of those contacted, it demonstrates that patients were able and willing to participate in research. Reasons for non-consent were barriers like language and medical conditions. Strategies to address these barriers are crucial for inclusivity. Although patients generally understood the consent process, discrepancies in recall highlight the need for improved comprehension strategies. Trial registration German Clinical Trials Register on 25 October 2022 (DRKS0003054).

Abstract Background There is limited high-quality research examining conservative treatments for back-related leg pain (BRLP). This feasibility study was done in preparation for a full-scale trial comparing a whole-person supported self-management intervention to medical care for chronic BRLP. Methods Participants were randomized to 12 weeks of individualized supported self-management delivered by physical therapists and chiropractors or medical care consisting of guideline-based pharmacologic care. Supported self-management was based on a behavioral model that used a whole person approach to enhance participants capabilities, opportunities, and motivations to engage in self-care. It combined BRLP education with psychosocial strategies (e.g., relaxed breathing, progressive muscle relaxation, guided imagery, communication skills) and physical modalities such as exercise and spinal manipulation therapy. Providers were trained to address participants’ individualized needs and use behavior change and motivational communication techniques to develop a therapeutic alliance to facilitate self-management. Feasibility was assessed using pre-specified targets for recruitment and enrollment, intervention delivery, and data collection over the six-month study period. In addition, areas for potential refinement and optimization of processes and protocols for the full-scale trial were assessed. Results We met or exceeded nearly all feasibility targets. Forty-two participants were enrolled over a six-month period in 2022 and very few individuals declined participation due to preferences for one treatment. All but one participant received treatment and 95% of participants attended the minimum number of visits (self-management = 6, medical care = 2). At 12 weeks, 95% of participants in the self-management group reported engaging in self-management practices learned in the program and 77% of medical care participants reported taking medications as prescribed. Satisfaction with the self-management intervention was high with 85% of participants reporting satisfaction with the program overall. Self-management intervention providers delivered all required activities at 72% of visits. Providers also noted some challenges navigating the shared decision-making process and deciding what self-management tools to prioritize. Over the six-month study period, completion rates were 91% for monthly surveys and 86% for weekly surveys. Conclusion We were able to demonstrate that a full-scale randomized trial comparing a whole-person supported self-management intervention to medical care for chronic BRLP is feasible and identified important areas for optimization.

Abstract Background While there is evidence on the validity and reliability of field-based physical fitness tests in children, adolescents and adults, there is limited evidence to provide feasibility and safety data on the application and performance of the existing field-based physical fitness tests. Objectives (i) To examine the feasibility and safety of existing field-based physical fitness tests used in people of all ages and (ii) to establish a comprehensive view of criterion-related validity, reliability, feasibility and safety based on scientific evidence for the existing field-based physical fitness tests in adults. Methods The search was conducted through the electronic databases MEDLINE (via PubMed) and Web of Science (all databases) for published studies from inception to 31 January 2023. This systematic review was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were classified as very low quality, low quality or high quality, based on the criteria of appropriate number of participants, appropriate description of the study population, and appropriate number of items reported to assess feasibility/safety. Three evidence levels were constructed (strong, moderate and limited or inconclusive evidence) according to the number of studies and the consistency of the findings. Results We identified a total of 19 (14 of high quality) and 13 (11 high quality) original studies examining the feasibility and safety of field-based physical fitness tests, respectively. Strong evidence indicated that (a) the 2-km walk and 20-m shuttle run tests were feasible in adults and, children and adolescents, respectively; (b) the handgrip strength test was feasible in children and adolescents; and (c) the standing long jump test was feasible in children and adolescents. Only the 2-km walk test has shown strong evidence on safety in adults. Finally, combining the levels of evidence of criterion-related validity, reliability, feasibility and safety in adults, all the field-based physical fitness tests show limited evidence. Conclusion There is a need for more studies and consensus to establish homogeneous methodological criteria to assess the feasibility and safety of field-based fitness tests. The combined evidence on criterion-related validity, reliability, feasibility and safety of field-based tests was found to be limited in adults. PROSPERO reference number CRD42022298276.

Abstract Background Burnout is a critical factor that can influence the quality of care that doctors provide to their patients. Previous research suggests a link between inadequate communication skills training and burnout, and various approaches to enhance communication skills have been explored as a means to address this issue. However, evidence of the effect of these approaches is lacking. The aim of this study is to assess the effect of the novel On-site Supportive Communication Training (On-site SCT) in enhancing communication skills among oncologists and thereby addressing burnout. Methods This randomized, controlled, multicenter study was conducted across three oncological departments in Denmark. Doctors were eligible if they worked in the outpatient clinic at least four days per month and provided informed consent. Doctors in the intervention group underwent a two-hour introduction followed by three full days of On-site SCT facilitated by in-house psychologists, while those in the control group continued standard practices. Pre- and post-intervention assessments on burnout (Copenhagen Burnout Inventory) were conducted, as were assessments of related constructs (job satisfaction and communication self-efficacy). Differences in pre- and post- assessments were analyzed using a paired t-test. Feasibility was assessed descriptively by comparing intervention days with planned schedule, and doctors’ satisfaction with the intervention was assessed systematically by questionnaire. Results Of 101 screened doctors, 89 (88%) consented and were randomized. 65% were female, and the mean age was 46 (range 27 to 75). Due to nine exclusions, data from 39 doctors in the intervention group and 41 doctors in the control group were available for analysis. At baseline, doctors exhibited lower levels of burnout than reported in international literature. No statistically significant improvements in burnout (p > 0.05) were demonstrated post-intervention. Despite non-significant changes, the doctors reported an improvement in communication self-efficacy. The program showed high feasibility and received positive feedback from participating doctors. Conclusions Our findings caution against assuming a causal relationship between short-term interventions and a complex phenomenon like burnout. On-site SCT demonstrated high feasibility, participation rate and acceptance. This underscores its potential value in clinical settings. Consequently, On-site SCT will be implemented at the Department of Oncology, Vejle University Hospital, to facilitate further refinement based on ongoing feedback and to explore long-term outcomes. Trial registration December 2022– The Region of Southern Denmark (22/57137). April 2023– ClinicalTrials.gov (NCT05842083). April 2023– The Research Ethics Committee at the University of Southern Denmark (23/19397).

Abstract Introduction Chronic pain is common among Veterans, some of whom use cannabis for pain. We conducted a feasibility pilot study of a novel coaching intervention to help Veterans optimize use of medical cannabis products for pain management (NCT06320470). Methods The intervention drew from scientific literature, consultation with cannabis experts, Veteran input via a Community Advisory Board, and tenets of motivational interviewing. Participants were Veterans with chronic pain who endorsed current use or interest in using cannabis for pain management. Participants received up to 4 individual coaching sessions via videoconference, spaced approximately 2 weeks apart. We assessed feasibility (adherence, satisfaction, acceptability) and preliminary effects on pain symptoms 14 weeks after baseline. The primary outcome was the Patient Global Impression of Change (PGIC), and exploratory outcomes included domains from the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Results Of 22 enrolled participants, 17 attended 4 coaching sessions, 2 attended 3 sessions, and 2 attended 2 sessions. Among those who completed end of intervention surveys (16/21), 87.5% were very or completely satisfied with the intervention and 81.3% rated coaching as very or extremely helpful. All participants reported improvement on the PGIC, with 63% reporting much or very much improvement. Participants reported statistically significant decreased pain intensity (7.1/10 vs. 5.7/10) and pain interference (T-score 66.3 vs. 61.8), and increased social satisfaction (T-score 41.4 vs. 44.3). Participants noted helpful intervention factors, including co-developing a personalized plan, discussing questions/concerns, and trying different approaches to cannabis-based treatment. Conclusions In this feasibility pilot study of coaching on cannabis use for chronic pain among Veterans, participants were satisfied with the intervention and reported clinically significant improvements in pain symptoms. Our results support evaluating this intervention in a larger, efficacy trial.

Abstract Background Number of drugs are increasing with older age and present a risk factor for various adverse health outcomes. A comprehensive medication therapy management (MTM) before admission for elective surgery may help reduce unnecessary and potentially inadequate medications (PIM) and thus improve patient health. Our goal was to evaluate the implementation of PHAROS, a perioperative MTM intervention study, from the perspective of health care providers. The PHAROS intervention aimed to improve medication appropriateness in older inpatients at the outpatient / inpatient interface. Methods We performed a qualitative interview study within a pilot intervention study comparing a comprehensive MTM with standard care in older inpatients (≥ 65 years) in Germany. Semi-structured interviews with health care professionals were performed from March to July 2021. The Consolidated Framework for Implementation Research (CFIR) was used to guide development of interview guide, data coding, analysis, and reporting of findings. Results Ten health care professionals involved in the implementation of PHAROS were interviewed. Based on CFIR-constructs, facilitators included need for and meaningfulness of the intervention as well as positive and supportive cooperation within the project team. Implementation of MTM at the interface of inpatient to outpatient care before elective surgery was hampered by personal and organizational barriers as well as barriers resulting from broader health care structures in Germany. In particular, lack of documentation standards, missing compatibility with clinical workflow, difficulties in stakeholder engagement, as well as communication barriers between outpatient and inpatient care interfaces hindered implementation of the intervention. Conclusions Further studies should consider focusing on facilitators to pharmaceutical implementations such as transparent and clear communication structures between stakeholders, standardization of medication documentation, and intervention structures that are adapted to hospital workflows. Trial registration https://drks.de Identifier: DRKS00014621, this study was part of the PHAROS study.