Beta Testing Research Articles

Behavioral Cloning Strategies in Steering Angle Prediction: Applications in Mobile Robotics and Autonomous Driving

Artificial neural networks (ANNs) are artificial intelligence techniques that have made autonomous driving more efficient and accurate; however, autonomous driving faces ongoing challenges in the accuracy of decision making based on the analysis of the vehicle environment. A critical task of ANNs is steering angle prediction, which is essential for safe and effective navigation of mobile robots and autonomous vehicles. In this study, to optimize steering angle prediction, NVIDIA’s architecture was adapted and modified along with the implementation of the Swish activation function to train convolutional neural networks (CNNs) by behavioral cloning. The CNN used human driving data obtained from the UDACITY beta simulator and tests in real scenarios, achieving a significant improvement in the loss function during training, indicating a higher efficiency in replicating human driving behavior. The proposed neural network was validated through implementation on a differential drive mobile robot prototype, by means of a comparative analysis of trajectories in autonomous and manual driving modes. This work not only advances the accuracy of steering angle predictions but also provides valuable information for future research and applications in mobile robotics and autonomous driving. The performance results of the model trained with the proposed CNN show improved accuracy in various operational contexts.

Development of an Educational Website for Patients With Cancer and Preexisting Autoimmune Diseases Considering Immune Checkpoint Blockers: Usability and Acceptability Study.

Patients with cancer and an underlying autoimmune disease who are considering immune checkpoint blockers (ICBs) need to know about the benefits and risks of severe immune-related adverse events and flares of the autoimmune condition. This study aims to develop and alpha test an educational website for patients with cancer. Learning topics, images, and website architecture (including flow and requirements) were developed and iteratively reviewed by members of a community scientist program, a patient advisory group, and content experts. Alpha testing was performed, measuring the site's usability using the Suitability Assessment of Materials and its acceptability using the Ottawa Acceptability Measure. The website included a home page; general information about ICBs; comprehensive modules on the benefits and risks of ICBs for patients with cancer and preexisting autoimmune diseases; general wellness information; and features such as a quiz, additional resources, and a glossary. For the alpha testing, 9 users assessed the newly developed website. Patient reviewers (n=5) had rheumatoid arthritis, Crohn disease, Sjogren syndrome, or vasculitis. Health care provider reviewers (n=4) were medical oncologists or rheumatologists. The median Suitability Assessment of Materials rating was 75 (IQR 70-79; range 0-100) for patients versus 66 (IQR 57-72; range 0-100) for providers (scores ≥70 indicate no substantial changes needed). Recommendations for improvement, mostly involving navigation and accessibility, were addressed. All participants expressed that the website was acceptable and balanced in terms of discussion of benefits and harms. Because half (2/4, 50%) of the providers suggested we increase the amount of information, we extended the content on the impact of having an autoimmune disease when considering ICB treatment, the probability of flares, and the management of flares in this context. The feedback led to minor revisions to enhance readability, navigation, and accessibility, ensuring the website's suitability as a decision-making aid. The newly developed website could become a supporting tool to facilitate patient-physician discussion regarding ICBs.

Serratus Anterior Plane Block Remote Learning Curriculum.

Regional anesthesia aids in management of acute pain in the emergency department, but many emergency physicians remain inadequately trained. Further complicating medical education, our academic center continues to use remote learning as the primary setting for residency didactics. This project aims to create a remote conference session on ultrasound-guided serratus anterior plane blocks (USG-SAPB). We used the ADDIE (analyze, design, develop, implement, evaluate) model for curricular design, with emergency medicine residents as our intended learners. For the analyze element, we examined clinical need and resident program evaluation feedback. For design, we utilized best practices for remote learning, principles of mental rehearsal, and multimodal instructional theory. For develop, we completed recruitment of faculty leads, materials, and beta testing of each component. We implemented our 50-minute session on the videoconferencing platform Zoom. For evaluate, we created a program evaluation survey based on Kirkpatrick's evaluation model. Seventeen learners completed the evaluation. For Kirkpatrick level 1, 94% reported being very or extremely satisfied. For Kirkpatrick level 2, 91% ranked their presession confidence level in performing USG-SAPB as not at all or slightly confident, compared to the postsession, where 88% ranked themselves as moderately, very, or extremely confident. For Kirkpatrick level 3, 94% reported that they would incorporate at least a moderate amount of content into clinical practice. This remote learning session on USG-SAPB demonstrated high levels of learner satisfaction, improvement in learner confidence, and potential to impact learners' clinical practice. Future studies can elucidate patient outcomes related to educational sessions.

Determining the Fitness Level of People with Down Syndrome Living in Kosovo Based on the ALPHA Protocol

Purpose: This study aimed to establish national norm values for body composition and fitness levels among individuals with Down syndrome. It also aimed to investigate gender differences in body composition features and fitness parameters, analyze the impact of the region where individuals with Down syndrome reside, and compare their fitness levels with international peers. Methods: The sample included 81 participants, 40 females (height: 146.6±4.88 cm, weight: 63.6±16.4 kg) and 41 males (height: 157.4±6.21 cm, weight: 66.8±14.8 kg). To assess the physical fitness levels of the participants with Down syndrome, a modified version of the ALPHA testing protocol was used. Findings: The results demonstrated significant gender differences (p<0.05) in body composition and fitness parameters, with males generally exhibiting better outcomes compared to females. Moreover, significant disparities (p<0.05) in body composition and fitness parameters were observed among individuals with Down syndrome residing in different regions of Kosovo. Noteworthy gender disparities exist in terms of body composition and physical fitness metrics, with male participants achieving superior results compared to their female counterparts. Furthermore, noticeable variations were observed among the regional Down syndrome centers, with participants from older centers displaying improved fitness metrics and body composition features compared to those from newly established facilities. Conclusion: Gender differences in body composition and fitness were evident, with males outperforming females, except in muscle mass. Future studies should explore fitness and health barriers in Kosovo's DS population, with a focus on improving physical activity through tailored strategies.

An mHealth App to Support Caregivers in the Medical Management of Their Child With Cancer: Beta Stage Usability Study.

Previous research demonstrated that caregivers of children with cancer desired a mobile health (mHealth) tool to aid them in the medical management of their child. Prototyping and alpha testing of the Cope 360 app (Commissioning Agents, Inc) resulted in improvements in the ability to track symptoms, manage medications, and prepare for urgent medical needs. This study aims to engage caregivers of children with cancer in beta testing of a smartphone app for the medical management of children with cancer, assess acceptance, identify caregivers' perceptions and areas for improvement, and validate the app's design concepts and use cases. In this pilot, study caregivers of children with cancer used the Cope 360 mHealth app for 1 week, with the goal of daily logging. Demographics and a technology acceptance survey were obtained from each participant. Recorded semistructured interviews were transcribed and analyzed iteratively using NVivo (version 12, QSR International) and analyzed for information on usage, perceptions, and suggestions for improvement. A total of 10 caregivers participated in beta testing, primarily women (n=8, 80%), married, with some college education, and non-Hispanic White (n=10, 100%). The majority of participants (n=7, 70%) had children with acute lymphocytic leukemia who were being treated with chemotherapy only (n=8, 80%). Overall, participants had a favorable opinion of Cope 360. Almost all participants (n=9, 90%) believed that using the app would improve their ability to manage their child's medical needs at home. All participants reported that Cope 360 was easy to use, and most would use the app if given the opportunity (n=8, 80%). These values indicate that the app had a high perceived ease of use with well-perceived usefulness and behavioral intention to use. Key topics for improvement were identified including items that were within the scope of change and others that were added to a future wish list. Changes that were made based on caregiver feedback included tracking or editing all oral and subcutaneous medications and the ability to change the time of a symptom tracked or medication administered if unable to do so immediately. Wish list items included adding a notes section, monitoring skin changes, weight and nutrition tracking, and mental health tracking. The Cope 360 app was well received by caregivers of children with cancer. Our validation testing suggests that the Cope 360 app is ready for testing in a randomized controlled trial to assess outcome improvements.

Decision Support Tool to Improve Decision-Making for HIV Pre-Exposure Prophylaxis (PrEP): Development Process and Alpha Testing.

African, Caribbean, and Black (Black) communities in Canada are disproportionately affected by the HIV epidemic. Pre-exposure prophylaxis (PrEP) is a highly effective option for the prevention of HIV. However, the use of PrEP for HIV prevention among eligible Black clients in Canada remains far below the thresholds necessary to achieve the goal of zero new HIV infections. In a recent study in Toronto, PrEP-eligible Black clients were found to have decisional conflict and unmet decisional needs, which affected the quality of their decision-making process regarding the initiation and adherence to PrEP. There is evidence that decision support tools (DSTs) can improve the quality of a decision, the quality of the decision-making process, the implementation or continuation of the chosen option, and the appropriate use of health services. Despite these benefits, there is currently no DST for PrEP-eligible Black clients being asked to consider PrEP for HIV prevention. Our study aimed to develop a DST to improve PrEP decision-making for Black clients and to evaluate the tool's acceptability and usability. We developed and evaluated the PrEP DST for Black patients using the 7-step process outlined in the Ottawa Decision Support Group Guideline for the development and evaluation of DST. To facilitate the implementation of the Ottawa Decision Support Group guideline, we assembled a multidisciplinary team of primary health care providers, researchers, community members with lived experiences, and digital content designers to serve as the steering committee. First, we assessed patients' and primary health care providers' views on decisional support needs, after which we determined the content, design, and distribution plan for the DST. Subsequently, we conducted evidence synthesis, reviews, and appraisal before developing the PrEP DST prototype. The final tool was reviewed by steering committee members for completeness before acceptability and usability testing with potential Black clients and PrEP providers. The web-based DST yielded 27 pages divided into 6 distinct sections. The six sections include (1) an introduction of the DST, (2) clarify your decision, (3) knowledge, (4) a value clarification exercise, (5) support system, and (6) next steps. Both Black clients and PrEP providers reported ease of task performance, general satisfaction, and usefulness of the tool to support decision-making for Black clients. Feedback on usability centered on the need to add a user guide to increase usability. All feedback was incorporated into the final tool. A PrEP DST for Black clients developed using a systematic process and a multidisciplinary steering committee was acceptable and usable by both Black clients and PrEP providers. Further study (eg, randomized controlled trials) may be needed to evaluate the efficacy of the PrEP DST.

Experimental and numerical analysis of instrumented caissons in tropical soil

This paper presents an experimental and numerical study on the behavior of three (3) instrumented caissons in a tropical laterite soil in the Planalto Central, DF, Brazil. The concrete caissons have a shaft diameter of 0.6 m, a bell diameter of 1.2 m and 1.3 m and lengths of 8.9 to 14.4 m. Static load tests were conducted out to investigate the behavior of the caissons. The results of load vs displacement and their interactions with the tropical soil were measured and evaluated using the methodology of Camapum de Carvalho et al. (2008, 2010) and numerical modeling with back-calculation of static load tests in the Plaxis 3D software. The paper presents the analysis of the load transfer lines and the comparison with the proposed methods. The results pointed to a constant load transfer along the shaft, with a significant contribution from the skin friction, developed for a fraction of the displacement necessary for its mobilization. The accuracy of using the Camapum de Carvalho et al. methodology stands out (2008, 2010), identifying the region dominated by skin friction, tip and plasticization of the foundation, confirming the authors’ predictions for a tropical soil in the Distrito Federal/DF, Brazil. The numerical method using the Plaxis 3D software, proves that for the limit test load there was a significant contribution from skin friction, which must be consider in the analysis of the behaviour of caissons.

Investigating the Status of Mothers and Newborns' Access to Safe and Quality Care from the Perspective of Midwifery Personnel Working in Government Hospitals: A Cross-Sectional Study

Aim The present study was conducted to determine the status of mothers’ and newborns' access to safe and quality care from the perspective of midwifery personnel. Background Safe and quality care is recognized as a principle in providing healthcare to mothers and newborns. Methods This was a cross-sectional study conducted through random sampling on 270 midwifery personnel working in government hospitals of Mashhad University of Medical Sciences in 2023. The data were collected using a questionnaire created by a researcher and analyzed using descriptive and inferential statistical tests in SPSS-22 statistical software at a significance level of less than 0.05. Results The average age of the participants was 34.41 ± 7.93 years. The results showed the status of mothers' and newborns' access to safe and quality care to be in the average range of 38.30 ± 6.67. The midwifery personnel have demonstrated adherence to scientific and specialized protocols regarding the way for childbirth and how to care for mothers and newborns to be the most frequent (51.5%), while the provision of emotional and psychological support to women who have given birth with newborn problems to be the least frequent (8.5%). Conclusion Midwifery personnel believe that the safe and quality care provided to mothers and newborns is adequate. Midwifery personnel are committed to following evidence-based practices, but need additional training and resources to support women in need emotionally and psychologically. This is particularly concerning given the potential impact of maternal mental health on both the mother and the newborn.

A-298 A Novel DNA Array Technology to Detect and Discriminate Complex Panels of Microbial Pathogens

Abstract Background UTI (Urinary Tract Infection) is a prototype for the field of polymicrobial testing. Current testing standards suggest that UTI testing may require the Detection and Discrimination of a panel of at least (@24) bacteria and fungi (@2) along with a panel of antibiotic resistance gene (ARG) markers (>12). Today, such analysis of UTI’s at the DNA level can be obtained with predicates such as large-panel qPCR reactions, e.g. the Thermo OpenArray qPCR assembly, or by NGS based microbiomics. The necessary complexity of such polymicrobial testing pushes the content limits of qPCR and, although NGS has substantial capacity to resolve complex mixtures, NGS remains relatively low throughput and requires a level of data processing that exceeds what is practical in some laboratories. Methods We have developed a new technology for UTI testing, “D3 ArrayTM-UTI”, which obviates most of the present limitations of DNA based polymicrobial testing. The process begins with urine being isolated and purified using standard automated magnetic bead DNA sample prep, already in place in most molecular laboratories, at up to 96 samples in parallel. This is followed by a single multiplex, endpoint PCR reaction on each sample, also at up to 96 samples in parallel, then automated room temperature hybridization of the PCR product in a standard 96 well format, onto a single 21x21 D3 Array at the bottom of each well. Dedicated autonomous software analyzes the hybridization data yielding the complete list of microbial pathogens and ARG’s detected in a urine specimen. The first deployment of the D3 Array-UTI test is now available to support analysis of 96 urine samples in 6hrs. The results of such preliminary testing are presented here. Results aLOD analysis has been performed with purified DNA and found to be in the 0.1-10cp/RXN range among the full set of 24 bacterial species and 12 ARG targets. Concordance analysis for bacterial Species Detection and Discrimination has been performed on 235 clinical isolates obtained from collaborators at Mako Medical laboratories (Thermo Openarray as the comparator) which averaged = 97 +/- 5% for all but two species: A urinae (88%) and M morganii (94%). Concordance analysis for Antibiotic Resistance Gene Detection and Discrimination has been performed on 384 clinical isolates also obtained from Mako Medical laboratories (Thermo Openarray as the comparator) which averaged = 98 +/-5% and was found to be >98% for all but one ARG target: gyrA point mutation (88%). Conclusions The data provided here demonstrates that the D3 Array-UTI platform can perform complex polymicrobial/ARG testing as a high throughput 96 well plate based assay, with Sensitivity and Specificity that matches or exceeds that of qPCR, using standard automation that can be deployed in any molecular laboratory. The resulting performance is unique in that Species and ARG Discrimination are readily scalable to 3-4 dozen Species per test, performed in triplicate in a single well with completely autonomous, cloud enabled data analysis, at a sample-to-answer throughput >96 samples per shift. Beta testing has been initiated among laboratory partners.

Community-based distribution program's response to increased contraceptive demand in the Democratic Republic of Congo during COVID-19.

In the Democratic Republic of Congo (DRC), the United States Agency for International Development (USAID) Integrated Health Program supports the Ministry of Health to strengthen family planning (FP) services through a Community-Based Distribution (CBD) program. As a part of this project, we investigated whether the CBD program responded to the increased need for contraceptives in nine provinces of the DRC during COVID-19 pandemic. Analysis compared distribution rates of contraception methods, uptake by new users, and renewal rates among women before and during the pandemic. Data sourced from women of childbearing age using modern contraceptives through CBD across 179 health zones were analyzed using chi-square tests in MedCalc software to examine proportion differences pre-COVID-19 versus during COVID-19. The CBD program distributed about 348,958 contraceptives during the pandemic, with 18.3% being new users, significantly higher than pre-pandemic levels (14.5%; P < 0.0001). Renewal rates were higher pre-pandemic overall (26.3% vs. 24.6%; P < 0.0001), but urban areas saw increased renewals during COVID-19 compared to before (34.8% vs. 24.1%; P < 0.0001). Despite pandemic-induced healthcare challenges, the CBD program effectively met escalated contraceptive demands. These findings underscore CBD's efficacy in crisis response, offering insights for governments on optimizing CBD services during health emergencies

An innovative mobile app for educating teens and young adults about reproductive health and wellness including sexually transmitted infections, pregnancy and contraception

Objective: The authors studied the use of a new mobile app technology platform to offer easy access to accurate, evidence-based comprehensive reproductive health information with links to resources for teens and young adults to enhance wellness and reduce the risks of HIV, other STIs, pregnancy, and complications such as infertility and pelvic inflammatory disease.Methods: The Healthy Teens Mobile App was designed, developed, tested, and implemented to deliver up-to-date sexual and reproductive health education based on science and written by experts. Initial testing was done for useability, readability and ease of navigation of the app.Results: Beta testing among teens, young adults, parents, health educators, and nurse clinicians (n = 32) revealed the app was valuable, engaging, and could be revised to improve flow and functionality. 60% strongly agreed and 40% agreed the app was valuable, with important information and resources on sexual health and wellbeing. 55% strongly agreed and 45% agreed the images improved the experience of using the app and the text size was adequate for readability. Other comments were utilized to enhance the app, add more images, and decrease the amount of white space on certain sections of the app. The app was released in June 2024 in both the Apple & Google App Stores.Conclusions: Utilizing a mobile app to delivery evidence-based sexual and reproductive health information for teens and young adults is practical and well accepted by teens, young adults, parents, health educators, and nurse clinicians. Plans are underway to disseminate the app widely. Future plans include translating the app into Spanish, French and other languages to promote global sexual and reproductive health and wellness and reduce the risks of HIV, other STIs, pregnancy, and complications such as infertility and pelvic inflammatory disease.

Web Application for Recommendation of Ayurvedic Drugs and Medicine using ML

This project aims to develop a comprehensive Ayurvedic drug recommendation website that seamlessly integrates traditional Ayurvedic principles with modern technology. The platform will cater to both students seeking educational resources and practitioners offering personalized healthcare guidance. The website's key features include drug prediction algorithms, herbal drug recommendations based on individualized assessments on symptoms, and a user-friendly interface. The initial phase involves meticulous planning, scoping, and research to define project objectives, target audiences, and select an appropriate technology stack. Subsequent weeks focus on design and prototyping, incorporating user feedback to ensure an intuitive and engaging interface. The front-end development phase emphasizes responsiveness and usability, while the back-end development integrates sophisticated algorithms for drug prediction and drug recommendation. User authentication and authorization mechanisms will be implemented to cater to both students and practitioners, ensuring a secure and personalized experience. The website's robustness and reliability will be validated through comprehensive testing, addressing any identified issues to guarantee a seamless user experience. The refinement and optimization phase involve continuous feedback collection, iterative improvements, and performance optimization. Beta testing will be conducted to gather user insights, refining the platform further. The deployment and launch process will involve hosting the website on a reliable platform, setting up monitoring tools, and officially releasing the Ayurvedic drug prediction and drug recommendation website to the public. This project combines the rich heritage of Ayurveda with cutting-edge technology, offering a valuable resource for education and healthcare in the Ayurvedic domain. The website aims to empower both students and practitioners with accurate drug predictions and personalized drug recommendations based on symptoms, fostering a holistic approach to healthcare that aligns with traditional Ayurvedic principle.

Development of Augmented Reality Learning Media to Introduce Musical Instruments for Deaf Elementary School Student

This research aims to develop Augmented Reality learning media for deaf children at the elementary school level in recognizing musical instruments and measuring their effectiveness on learning outcomes. The research method used is research and development (R&D) and uses the Multimedia Development Life Cycle development method. The effectiveness of the media was tested using pretest-posttest. Data analysis techniques use the parametric statistical test. The results of testing by media and content experts concluded that the application was declared suitable for use as a learning medium. From the beta test, it was discovered by 33 deaf students that Augmented Reality learning media was well received. The t-test comparison test shows that there is a difference, which means that the use of Augmented Reality learning media as a medium for introducing musical instruments to deaf students has a positive impact on learning outcomes.

The development of 'Petanque match statistics': an android-based application for petanque matches analysis

The accelerated pace of technological advancement necessitates that many disciplines align themselves with these developments, whether directly engaged in the process or not. The field of sports provides an illustrative example of the profound impact of modern technology on various disciplines. This research aimed to develop an Android-based statistical application, designated "Petanque Match Statistic," which was designed to analyze Petanque matches. The research and development (R&D) methodology was employed to undertake six project stages. The application, constructed on the Kodular platform, offers real-time data capture, sophisticated statistical analysis, interactive visualization, and comprehensive performance reporting. The application was subjected to rigorous alpha and beta testing to ensure its accuracy, reliability, and usability. Following its deployment, user training and a support system were established. Continuous evaluation and user feedback facilitated ongoing improvements. The application significantly enhances match analysis, benefiting players, coaches, analysts, and fans by providing accurate, real-time data and comprehensive insights, thereby promoting the growth and development of the sport of petanque. Keywords: Android Application, Match Statistics, Statistical Analysis, Real-Time Data, Sports Technology

A new method of intraoperative assessment of the dynamics of cortical blood flow using imaging photoplethysmography

Background. Intraoperative assessment of changes in cerebral blood flow is an important component of objective quality control of surgical treatment of cerebral artery aneurysms. Various techniques have been tried to solve this task, but they all have their drawbacks, which forces us to look for new ways of blood flow monitoring. We propose to use the technology of imaging photoplethysmography (IPPG) – a technically simple, contactless, safe and cheap optical method for assessing the perfusion of biological tissues.Aim. To demonstrate the possibility of using IPPG to assess the dynamics of cerebral blood flow parameters during aneurysm clipping surgery, as well as to identify early changes in blood supply to the cerebral cortex.Materials and methods. The study was carried out during six surgeries of clipping aneurysms of the anterior part of the Willis’s circle, both in the acute stage of rupture (n = 1) and in a planned manner (n = 5). The IPPG system, which is an LED illuminator in a single unit with a digital video camera, was located on a tripod 25 cm from the intervention zone. During each operation, two one-minute recordings of the illuminated surface of the cerebral cortex were performed: after dissection of the dura mater and before its suturing at the end of the main stage of the intervention. To improve the measurement accuracy, video frames of the studied area were recorded synchronously with the registration of an electrocardiogram. After recording, two IPPG parameters were calculated and compared: the amplitude of the pulsatile component and the pulse wave transit time. Thereafter, the obtained data were compared with the results of computed tomography. Statistical analysis was performed using pairwise comparison tests in the GraphPad Prism software package.Results. Clipping of cerebral vessel aneurysms are accompanied by significant changes in the parameters of cerebral blood flow. Analysis of the data for all patients revealed significant differences in IPPG parameters before and after surgery, namely, statistically significant increase in amplitude of the pulsatile component (n = 3) and decrease in pulse wave transit time (n = 5). The absence of significant changes in both parameters was found only in one patient who had mechanical damage in the cortex in the region of video recording.Conclusion. The IPPG system is capable to quantify changes in blood supply to the cortex during surgical treatment of cerebral artery aneurysms and to identify areas with either increased or decreased blood supply. In-depth studies are required to obtain additional markers of the postoperative state of cerebral blood flow.

Field Work Practice Monitoring System to Support Practical Activities for Vocational High School Students

Internship (INTERNSHIP) is an important part of the vocational education curriculum in vocational high schools, including SMK Negeri 1 Gesi. However, its implementation often faces various obstacles, such as inefficient communication, delayed reporting, and difficulties in monitoring student progress. To address these issues, an Internship monitoring system has been developed with the aim of optimizing the learning process. Therefore, this research aims to develop a internship monitoring system that is suitable for use by vocational high school students to support their activities. The research method applied in this study is research and development adopting the Alessi & Trollip model. The research subjects include software/media experts, content experts, and teachers. Data collection is carried out using observation, interviews, and questionnaires. The data obtained from the research is then analyzed qualitatively descriptively and quantitatively in terms of percentage. The research results show that in the alpha testing phase, the internship monitoring system product received a High Validity qualification from experts. Based on these results, it can be concluded that the internship monitoring system product deserves the category of high feasibility to use as an application or system to support a series of internship activities, both for teachers and students.

Using Design-Based Research to Develop the Learning Outcomes of a Curriculum-Based Environmental Citizen Science Project

The Intertidal Monitoring Project (IMP) is a local, curriculum-based citizen science project intentionally designed to support the development of science competencies in elementary students. The focus of the IMP is the Research Days, where students follow an established scientific protocol to collect monitoring data on an introduced species of clam in British Columbia, Canada. The IMP represents a unique program to study because the school district funds transportation and programming costs so that all grade five students can engage in authentic place-based scientific research. A design-based research (DBR) approach was used to develop and refine the IMP activities between 2014 and 2023. This research is focused on a DBR Evaluation/Reflection phase that qualitatively assessed learning outcomes during the beta testing of a supplementary classroom activity. Student- and teacher-generated data were collected to understand the process of a class “coming to know” science and its community of practice during the IMP activities. This included student learning artefacts and a teacher interview. The findings show that participation in IMP activities: i) fostered the development of science competencies in a grade five learning community; ii) did not promote science identities; and indicated that iii) the Nature of Science (NOS) required more explicit instruction. Student-teacher-scientist partnerships (STSPs) emerged as a critical design element of curriculum-based citizen science.

Implementing a Metabolism-informed approach for smoking cessation in an Alaska Tribal health system: study protocol for a single-arm implementation pilot trial

BackgroundIndividualized treatment for commercial tobacco smoking cessation, such as through the utilization of the nicotine metabolite ratio (NMR), offers potential clinical benefit. NMR is a metabolism-informed biomarker that can be used to guide medication selection. NMR testing is particularly promising for tobacco cessation efforts in populations with high rates of smoking, such as some Alaska Native and American Indian (AN/AI) communities. To date, no prior study has evaluated the implementation of NMR-guided tobacco cessation with AN/AI populations.MethodsThe present “QUIT” protocol is a two-phase study that will occur at Southcentral Foundation (SCF), an Alaska Native-owned health system, serving 70,000 AN/AI people, based in Anchorage, Alaska. In Phase one, qualitative interviews with customer-owners (patients), providers and administrators (n = 36) and a 10-participant beta-test will be used to refine a strategy to implement NMR testing in the health system. Phase two will involve a single-arm pilot trial (n = 50) and qualitative interviews throughout data collection (n = 48) to evaluate the implementation strategy and explore the real-world acceptability and feasibility of NMR testing to guide tobacco cessation with AN/AI populations.DiscussionThis study utilizes a community-based participatory approach to refine and implement a nicotine metabolism-informed smoking cessation program in a Tribal healthcare setting. The process and findings from this study will reflect the importance of customer-owner choice and honor the lived experience involved in quitting commercial tobacco. Pilot study data will inform the effect and sample sizes required for a future pragmatic trial of NMR-guided smoking cessation.Trial registrationThis study will be registered with clinicaltrials.gov after the beta test is complete and the final IRB protocol is approved.

A shared decision-making intervention between health care professionals and individuals undergoing Pulmonary Rehabilitation: An iterative development process with qualitative methods.

Pulmonary Rehabilitation (PR) services typically offer programmes to support individuals living with COPD make rehabilitation choices that best meet their needs, however, uptake remains low. Shared Decision-Making (SDM; e.g., Patient Decision Aids (PtDA)) interventions increase informed and values-based decision-making between individuals and healthcare professionals (HCPs). We aimed to develop an intervention to facilitate PR SDM which was acceptable to individuals living with COPD and PR HCPs. An iterative development process involving qualitative methods was adopted. Broad overarching frameworks included: complex intervention development framework, the multiple stakeholder decision making support model, and the Ottawa Decision Support Framework. Development included: assembling a steering group, outlining the scope for the PtDA, collating data to inform the PtDA design, prototype development, alpha testing with individuals with COPD (n = 4) and PR HCPs (n = 8), PtDA finalisation, and design and development of supporting components. This took nine months. The PtDA was revised six times before providing an acceptable, comprehensible, and usable format for all stakeholders. Supporting components (decision coaching training and a consultation prompt) were necessary to upskill PR HCPs in SDM and implement the intervention into the PR pathway. We have developed a three-component SDM intervention (a PtDA, decision coaching training for PR healthcare professionals, and a consultation prompt) to support individuals living with COPD make informed and values-based decision about PR together with their PR healthcare professional. Clear implementation strategies are outlined which should support its integration into the PR pathway.

Enhancing Mission Wellness: Iterative Optimization and Stakeholder Engagement to Promote Sexual and Reproductive Health in the United States Military.

Sexual and reproductive health is critical for the readiness of the warfighter, as costs of sexually transmitted infections and unintended pregnancy result in added health care costs, lost mission time, and impact on morale. The Multiphase Optimization Strategy (MOST) is an engineering-inspired framework used to optimize biobehavioral interventions. The Military Active-Duty Reproductive and Sexual Health (MARSH) research team applied the MOST framework to develop "Mission Wellness"-an electronic health intervention to promote sexual and reproductive health within the U.S. Military. From 2017 to 2022, the MARSH team implemented the first and second phases of MOST to develop and optimize "Mission Wellness." All phases received institutional review board approval. The first phase consisted of expert and literature review, qualitative interviews, and beta testing to identify intervention components and the optimization objective and to inform study design. The second phase consisted of a factorial trial. Figures1-4 outline the research program approach, demographics of the sample, and format of the app. Service members who used the application found it to be acceptable and, overall, reported that it would be easier to talk to a sexual partner about risk behaviors and history at the post-intervention assessment compared to baseline. This iterative optimization approach using both local and strategic engagement enhanced program development and set the stage for dissemination and implementation efforts. In line with the iterative nature of MOST, the lessons learned during the optimization trial led the MARSH team to return "Mission Wellness" to the preparation phase. The utilization of mixed (i.e., qualitative and quantitative) research methods and engagement with stakeholders at multiple levels of the military enterprise provided the information necessary to further optimize "Mission Wellness." This programmatic approach also provides a blueprint for the development of research design and testing in military health care balancing rigor and agility.