Evaluation Process Research Articles

Nursing students' perspectives on peer assessment in basic nursing procedures: A qualitative study

BackgroundTraditionally, the assessment of student nursing skills relies heavily on lecturer evaluations. However, lecturers, as the primary evaluators, may be influenced by their individual subjective preferences, experience, and knowledge background. This limitation needs thorough consideration to improve students' assessment skills and ensure that assessment tasks are more objective and accurate. Peer assessment appears to take it into account. Currently, improving the quality of peer assessment in Basic Nursing skills remains a challenge for educators. AimTo assess the effectiveness of peer assessment as applied to the basic nursing skills examination process and suggestions for improvement, to understand nursing students' perceptions of it, and to explore the feasibility of peer assessment as an alternative to single faculty assessment as perceived by nursing students. DesignQualitative research. SettingsConducted in a clinical skills simulation laboratory at a university in Wuxi, Jiangsu Province, China. Participants23 Second-year nursing students applying peer assessment to Basic Nursing course exams. MethodsUsed face-to-face, semi-structured interviews, and thematic analysis to analyze data. ResultsThree major themes and nine subthemes were identified: (1) Positive sentiments towards peer evaluation (e.g., enhancing the learning capacity, increasing emotional intelligence, and improving the objectivity and fairness of nursing skills assessment); (2) Challenges encountered in the peer evaluation process (e.g., inconsistent scoring criteria, exacerbate anxiety, and triggering team conflict); (3) Suggestions for improving peer evaluation (e.g., applying the design of peer assessment exam content, incorporation of lecturer evaluation, and refinement and materialization of marking criteria). ConclusionsIn this study, while the positive impact is evident, the challenges faced by nursing students and future recommendations for peer assessment application are critical. This study provides valuable insights into the potential of peer assessment to enhance nursing education and provides recommendations for optimizing peer assessment strategies for meaningful integration into Nursing Education practice.

A PLC-Embedded Implementation of a Modified Takagi–Sugeno–Kang-Based MPC to Control a Pressure Swing Adsorption Process

The paper presents a case study that applies a model predictive control (MPC) approach in a Micro850 programmable logic controller (PLC) to a laboratory pressure swing adsorption (PSA) process used for separating gas mixtures of CO2 and CH4. PLC is an industrial hardware characterized by its robustness to hazardous environments and limited computational capacities, which poses computational challenges for MPC implementation. This paper’s main contribution is the application of the modified Takagi–Sugeno–Kang-based MPC (MTSK-MPC) algorithm to this PSA unit, which provides features to investigate and implement feasible MPC designs in PLCs. The investigation consists of a sensitivity analysis of how some design parameters influence the PLC memory and the MPC implementation and a comparative evaluation of the computational processing from different MPC algorithms and simulations. The comparison comprises software-in-the-loop simulations with three algorithms in the PC: an implicit MPC, an explicit MPC, and the MTSK-MPC. Additionally, it includes a hardware-in-the-loop simulation with the implemented MTSK-MPC in Micro850. The results show that the MPC algorithms achieve close performance, tracking setpoint changes and rejecting output disturbances, with the MTSK-MPC presenting the lower processing time among the MPCs in the PC. The study concludes that the implementation of MTSK-MPC in the Micro850 is feasible.

Development and Content Validation of the Communication, Organization, and Intrafamilial Beliefs in Neonatology Scale for Family Resilience in the Neonatal Intensive Care Unit.

Background and Purpose: Family resilience in the neonatal intensive care unit (NICU) is a promising avenue for promoting parental mental health, yet no tool is available to assess it. This study aimed to develop a new scale to measure family resilience in French-speaking parents during the NICU hospitalization and evaluate content validation. Methods: This methodological study was conducted in Quebec and included two phases: (a) item development process and (b) content validity evaluation process using successive quantitative and qualitative methods. A total sample of 14 experts evaluated item clarity, relevance, and representativeness on 1-4 rating scales and provided qualitative feedback on scale characteristics. Results: An initial scale of 55 items was developed. Excellent content validity (Scale Content Validity Index > .90) and consensus regarding item selection and scale presentation were achieved. Conclusions: This content-validated 55-item Communication, Organization, and Intrafamilial Beliefs in Neonatology (COCINL) scale should be psychometrically tested in the Quebec NICU parent population.

Evaluation of Uncertainty in Linear Cylindrical Diameter Measurement based on Coordinate Measuring Machines

According to the measurement method of linear cylindrical diameter based on coordinate measuring machine (CMM), establish a black box evaluation model for the uncertainty of CMM linear cylindrical diameter measurement, and analyze the sources of each uncertainty. Combining measurement examples, this paper elaborates on the uncertainty evaluation process of linear cylindrical diameter measurement based on CMM, calculates the extended uncertainty of linear cylindrical diameter measurement based on CMM, and provides a reference for the uncertainty evaluation of linear cylindrical diameter measurement based on CMM.

The work behind an interdisciplinary team: Creating a postpartum hemorrhage virtual reality training platform

BackgroundThis article examines an interdisciplinary team's collaboration experience in the development of a virtual reality (VR) training platform for postpartum hemorrhage management. The project started during the COVID-19 pandemic to support remote training in nursing. Methods & ProcessesComprised of multidisciplinary specialists, the team collaborated through virtual meetings and digital tools such as an online whiteboard. The project went through three processes: (a) initial process, in which the team established the mutual goal, determined the targeted training, understood the subject matter, and created the framework; (b) VR development process, in which members contributed their expertise to map the task flow, create 3D objects, and develop the VR prototype; and (c) evaluation process, in which tests were performed among team members, subject matter experts, and undergraduate nursing students, to gain insights and fix problems. ConclusionLessons learned from this interdisciplinary collaboration include the accommodation of different objectives, workload expectations and distribution, changes of team members, and evaluation implementation.

Research on an Evaluation Method of Snowdrift Hazard for Railway Subgrades

The objective of this study is to investigate the potential risks posed by snowdrifts, a prevalent cause of natural disasters in northern China, on railway subgrades, and to assess their risk level. As a wind-driven process of snow migration and redeposition, snowdrifts pose a significant threat to the safety of transportation infrastructures. This study focuses on the Afu Railway in Xinjiang, situated on the northern slopes of the Eastern Tianshan Mountains, where it experiences periodic snowdrifts. We employed a combination of the Analytic Hierarchy Process (AHP) and fuzzy comprehensive evaluation (FCE) to construct an integrated evaluation system for assessing the risk of snowdrift to railway subgrades. The results indicate that subgrade design parameters and regional snowfield conditions are two key metrics affecting the extent of snowdrift disasters, with topography, vegetation coverage, and wind speed also exerting certain impacts. The evaluation method of this study aligns with the results of on-site observations, verifying its accuracy and practicality, thereby providing a solid risk assessment framework for snowdrifts along the railway. The scientific and systematic hazard assessment method of railway subgrades developed in this research provides basic data and theoretical support for future research, and provides a scientific basis for relevant departments to formulate countermeasures, so as to improve the safety and reliability of railway operations.

The SME tool supporting employers of small- and medium-sized enterprises during the return to work of employees on long-term sick leave: study protocol for a randomized controlled trial and for a process evaluation

BackgroundReturning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer’s intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer’s autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool.MethodsA randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool.DiscussionThe SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers’ intention and ability to support.Trial registrationClinicalTrials.gov, NCT06330415. Registered on February 14, 2024.

Comparative analysis of delivered and planned doses in target volumes for lung stereotactic ablative radiotherapy

BackgroundAdaptive therapy has been enormously improved based on the art of generating adaptive computed tomography (ACT) from planning CT (PCT) and the on-board image used for the patient setup. Exploiting the ACT, this study evaluated the dose delivered to patients with non-small-cell lung cancer (NSCLC) patients treated with stereotactic ablative radiotherapy (SABR) and derived relationship between the delivered dose and the parameters obtained through the evaluation procedure.MethodsSABR treatment records of 72 patients with NSCLC who were prescribed a dose of 60 Gy (Dprescribed) to the 95% volume of the planning target volume (PTV) in four fractions were analysed in this retrospective study; 288 ACTs were generated by rigid and deformable registration of a PCT to a cone-beam computed tomography (CBCT) per fraction. Each ACT was sent to the treatment planning system (TPS) and treated as an individual PCT to calculate the dose. Delivered dose to a patient was estimated by averaging four doses calculated from four ACTs per treatment. Through the process, each ACT provided the geometric parameters, such as mean displacement of the deformed PTV voxels (Warpmean) and Dice similarity coefficient (DSC) from deformation vector field, and dosimetric parameters, e.g. difference of homogeneity index (ΔHI, HI defined as (D2%-D98%)/Dprescribed*100) and mean delivered dose to the PTV (Dmean), obtained from the dose statistics in the TPS. Those parameters were analyzed using multiple linear regression and one-way-ANOVA of SPSS® (version 27).ResultsThe prescribed dose was confirmed to be fully delivered to internal target volume (ITV) within maximum difference of 1%, and the difference between the planned and delivered doses to the PTV was agreed within 6% for more than 95% of the ACT cases. Volume changes of the ITV during the treatment course were observed to be minor in comparison of their standard deviations. Multiple linear regression analysis between the obtained parameters and the dose delivered to 95% volume of the PTV (D95%) revealed four PTV parameters [Warpmean, DSC, ΔHI between the PCT and ACT, Dmean] and the PTV D95% to be significantly related with P-values < 0.05. The ACT cases of high ΔHI were caused by higher values of the Warpmean and DSC from the deformable image registration, resulting in lower PTV D95% delivered. The mean values of PTV D95% and Warpmean showed significant differences depending on the lung lobe where the tumour was located.ConclusionsEvaluation of the dose delivered to patients with NSCLC treated with SABR using ACTs confirmed that the prescribed dose was accurately delivered to the ITV. However, for the PTV, certain ACT cases characterised by high HI deviations from the original plan demonstrated variations in the delivered dose. These variations may potentially arise from factors such as patient setup during treatment, as suggested by the statistical analyses of the parameters obtained from the dose evaluation process.

Image processing and machine learning approach for yolk color evaluation

Image processing and machine learning approach for yolk color evaluation

Utilizing technology for diet and exercise change in complex chronic conditions across diverse environments (U-DECIDE): feasibility randomised controlled trial

BackgroundDiet and exercise are important components of treatment for complex chronic conditions, however access to allied health support is limited. When available, support is often siloed and fragmented. Digital health incorporating patient choice may help to align health care services with preferences and goals. This study evaluated the implementation of a ubiquitously accessible patient-centred digital health diet and exercise service.MethodsU-DECIDE was a single-centre, 26-week randomised controlled trial set in kidney and liver disease clinics in a tertiary hospital in Brisbane, Australia. Participants were adults with a complex chronic condition referred for dietetic consultation with at least one feature of the metabolic syndrome. All participants received a dietary consultation, an activity monitor and usual care. Intervention participants were offered one text message per week and access to additional digital health options (increased text message frequency, nutrition app, exercise app, group-based diet and/or exercise video consultations). The primary outcome of feasibility was determined by safety (study-related serious adverse events: SRSAEs), recruitment (≥ 50% eligible patients), retention (≥ 70%), exposure uptake (≥ 75% of intervention group had greater access to health professional contact than comparator) and video consultation adherence (≥ 80% attendance). Secondary outcomes included process evaluation metrics and clinical outcomes.ResultsOf 67 participants (intervention n = 33, comparator n = 34), 37 (55%) were men, median (IQR) age was 51 (41–58) years. The most chosen digital health options were the nutrition app (n = 29, 88%) and exercise video consultations (n = 26, 79%). Only one participant chose no additional digital health options. The intervention group had no SRSAEs. The study exceeded targets for recruitment (52%), retention (81%) and exposure uptake (94%). Video consultation adherence was 42%. Engagement across digital health options was inconsistent.ConclusionsDigital health options incorporating patient choice were feasible and can be offered to people with complex chronic disease as a service model option.Trial registrationAustralia and New Zealand Trials Register: Trial Registration Number: ACTRN12620001282976. Registered 27th November 2020.

Employing child-focused evaluation methods across West and Central Africa – A UNICEF Experience

Background: This article explores the strategies that the UNICEF West and Central Africa Regional Office (WCARO) has implemented in order to fulfil children’s rights through evaluations.Objectives: It intends to support evaluation managers and practitioners by discussing challenges and proposed corrective actions encountered when adapting adult-centric evaluation processes into child-friendly ones, both in development and humanitarian settings.Method: The UNICEF WCARO leveraged on insights shared by evaluation practitioners, academics, and children’s organisation representatives during the 2019 Symposium on Child-Centred Evaluations held in Senegal. Three years later, it led to a series of reflective sessions between UNICEF evaluation managers and external consultants to capture lessons learned and insights to improve evaluation practice.Results: The UNICEF WCARO’s evaluation practice has shifted from a rather marginal integration of child-focused methods in its evaluations to a more substantial mainstreaming of such methods. This article highlights how important it is to engage children during all key phases, while keeping ethical considerations into account.Conclusion: Implementing child-focused evaluations enhances the inclusivity of evaluation processes under the prism of 2030 Sustainable Development Goals. Moreover, this article underscores the significance of integrating children’s perspectives to strengthen equity-based approaches in contemporary evaluation and enhance the validity of evaluation results.Contribution: This article contributes practical insights and tips on adapting data collection tools for children, fostering active participation, and navigating ethical considerations. UNICEF WCARO’s experience serves as a valuable reference for organisations seeking to amplify the voices of the most vulnerable in their evaluation processes.

Multi-modal data clustering using deep learning: A systematic review

Multi-modal clustering represents a formidable challenge in the domain of unsupervised learning. The objective of multi-modal clustering is to categorize data collected from diverse modalities, such as audio, visual, and textual sources, into distinct clusters. These clustering techniques operate by extracting shared features across modalities in an unsupervised manner, where the identified common features exhibit high correlations within real-world objects. Recognizing the importance of perceiving the correlated nature of these features is vital for enhancing clustering accuracy in multi-modal settings. This survey explores Deep Learning (DL) techniques applied to multi-modal clustering, encompassing methodologies such as Convolutional Neural Networks (CNN), Autoencoders (AE), Recurrent Neural Networks (RNN), and Graph Convolutional Networks (GCN). Notably, this survey represents the first attempt to investigate DL techniques specifically for multi-modal clustering. The survey presents a novel taxonomy for DL-based multi-modal clustering, conducts a comparative analysis of various multi-modal clustering approaches, and deliberates on the datasets employed in the evaluation process. Additionally, the survey identifies research gaps within the realm of multi-modal clustering, offering insights into potential future avenues for research.

Occupational Therapy Doctoral Capstone Research Agenda: A Scoping Review.

As identified in the American Occupational Therapy Association's (AOTA's; 2023) statement about the purpose and value of the occupational therapy doctoral capstone, there is a lack of evidence about the purpose and value of the doctoral capstone. As an essential element of occupational therapy doctoral degree curricula, the capstone is unique to each program, supports the program's scholarship agenda, and serves the needs of students and the communities served by the profession. To develop a doctoral capstone research agenda in an attempt to prioritize and guide research that can supplement the current paucity of evidence related to capstone efficacy or effectiveness. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were used to conduct a scoping review. Peer-reviewed articles published between 1999 and June 2023 were searched using the CINAHL, PsycINFO, PubMed, and Embase databases. The doctoral capstone research agenda was developed and organized into five categories to drive research activities inclusive of the didactic and experiential learning associated with the planning, implementation, and evaluation of the capstone process: (1) teaching and learning; (2) learner characteristics and competencies; (3) shaping professional identity; (4) faculty/mentor development and resources; and (5) promotion of diversity, equity, and inclusion. A doctoral capstone research agenda was developed in accordance with AOTA's (2018) Occupational Therapy Education Research Agenda. It identifies an array of areas in which research is needed to inform the distinct value and purpose of the doctoral capstone to students, sites, programs, and the profession. Plain-Language Summary: The occupational therapy doctoral capstone is unique to each program, supports the program's scholarship agenda, and supports the needs of students and the communities served by the profession. The American Occupational Therapy Association's official document on the "Occupational Therapy Doctoral Capstone: Purpose and Value" states that there is a lack of evidence about how to identify the distinct purpose and value of the doctoral capstone. This scoping review explored the development of a doctoral capstone research agenda. A research agenda is provided to guide and prioritize research to articulate best practices and the distinct purpose and value of the doctoral capstone in occupational therapy education and for the profession.

Cephalosporin Allergy: Updates on Diagnostic Testing.

Cephalosporins are one of the most prescribed antibiotics worldwide and are implicated in a wide range of hypersensitivity reactions (HSR). This review summarizes recent updates in cephalosporin hypersensitivity with a focus on diagnostic testing. Reported testing strategies to evaluate different immediate and delayed cephalosporin HSR have included skin testing, in vitro testing, and diagnostic drug challenges. However, the diagnostic performance of in vivo and in vitro tests remains unclear across different hypersensitivity endotypes; adequately powered studies investigating the true positive and negative predictive value of these diagnostic modalities are needed using the reference standard of drug challenges to define cephalosporin hypersensitivity. Refinement of diagnostic testing should be guided by growth in our understanding of cephalosporin antigenic determinants. This growth will be crucial in driving further clarification of cross-reactivity between cephalosporins, and potentially delineating streamlined evaluation processes resulting in reduced unnecessary antibiotic avoidance.

Equity and Inclusion for LGBTQ+ Residents: Lessons Learned from the Initial Long-Term Care Equality Index (LEI)

ObjectivesMost older adults with lesbian, gay, bisexual, queer, questioning, transgender, and related identities (LGBTQ+) are concerned about receiving lower-quality care and/or being mistreated in nursing homes. Older LGBTQ+ veterans may have additional reservations about care in Department of Veterans Affairs (VA) nursing homes (Community Living Centers [CLCs]) because of experience with past discriminatory military policies (eg, bans on participating in military service, Don't Ask Don't Tell). This article describes one of the first VA CLCs to participate in the Human Rights Campaign–developed Long-Term Care Equality Index (LEI). DesignA single-site formative evaluation was completed to support quality improvement and identify opportunities for growth using the LEI. The LEI is a facility benchmarking tool to support more inclusive environments for LGBTQ+ residents and employees. The LEI offers 4 evaluation criteria: (1) Non-Discrimination and Staff Training; (2) LGBTQ+ Resident Services and Support; (3) Employee Benefits and Policies; and (4) Resident and Community Engagement. Facilities receive ratings based on the number of requirements achieved in each category. Participants and Methods: Older LGBTQ+ veterans, current CLC residents, interdisciplinary CLC providers and leadership, and national Geriatrics and Extended Care program managers collaborated to pilot the LEI and develop tools and materials to support other VA facilities' participation in the LEI. ResultsQualitative interviews with veterans and CLC residents supported inclusion of gender identity and sexual orientation in resident handbooks, discussions about person-centered care, and opportunities for additional staff training and community engagement (eg, observing Pride Month in June). Resources to support VA long-term care facilities' participation in the LEI were developed. Conclusions and ImplicationsThe LEI offers a structured approach to identifying areas for improvement in providing high-quality and equitable care in long-term care settings. Practical suggestions for CLCs and other nursing home settings considering the LEI for the first time are discussed.

Approach in inputs & outputs selection of Data Envelopment Analysis (DEA) efficiency measurement in hospitals: A systematic review.

The efficiency and productivity evaluation process commonly employs Data Envelopment Analysis (DEA) as a performance tool in numerous fields, such as the healthcare industry (hospitals). Therefore, this review examined various hospital-based DEA articles involving input and output variable selection approaches and the recent DEA developments. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was utilised to extract 89 English articles containing empirical data between 2014 and 2022 from various databases (Web of Science, Scopus, PubMed, ScienceDirect, Springer Link, and Google Scholar). Furthermore, the DEA model parameters were determined using information from previous studies, while the approaches were identified narratively. This review grouped the approaches into four sections: literature review, data availability, systematic method, and expert judgement. An independent single strategy or a combination with other methods was then applied to these approaches. Consequently, the focus of this review on various methodologies employed in hospitals could limit its findings. Alternative approaches or techniques could be utilised to determine the input and output variables for a DEA analysis in a distinct area or based on different perspectives. The DEA application trend was also significantly similar to that of previous studies. Meanwhile, insufficient data was observed to support the usability of any DEA model in terms of fitting all model parameters. Therefore, several recommendations and methodological principles for DEA were proposed after analysing the existing literature.

General practitioners’ perspectives on lifestyle interventions for cognitive preservation in dementia prevention

BackgroundGeneral practitioners (GPs) play a crucial role in identifying cognitive impairment and dementia and providing post-diagnostic care. This study investigates (1) how promising GP consider lifestyle changes to maintain cognitive performance in general, (2) GP beliefs about the power of modifiable health and lifestyle factors to maintain cognitive performance, and (3) whether those beliefs vary by GP age.MethodsAs part of the AgeWell.de trial, GPs (n = 72) completed a process evaluation questionnaire assessing their perspectives on lifestyle changes to preserve cognitive performance in elderly patients. In greater detail, their perceived efficacy of established risk and protective factors was investigated using a 5-point Likert scale. Descriptive statistical analyses were performed for research question (1) and (2). Spearman´s rank correlations and ordinal logistic regressions were used to answer research question (3). All results were interpreted exploratively.ResultsGPs rated the overall chance of lifestyle changes maintaining cognitive performance quite neutral with a median score of 3.0 (IQR = 2.0). They rated the efficacy of all the modifiable health and lifestyle factors high, with increase in physical and social activity ((Mdn = 5.0, IQR = 1.0) receiving the highest ratings with the narrowest range. Spearman's rank correlation indicated a significant positive relationship between age and the belief in “Optimization of nutrition” for preventing cognitive decline and dementia (ρ = .255, p = .041). However, ordinal logistic regressions showed no significant relationships between age and GP ratings of lifestyle change efficacy.ConclusionThese findings highlight the positive perception of GPs on the efficacy of modifiable health and lifestyle factors for preventing cognitive decline and dementia.Trial registrationThe AgeWell.de trial is registered in the German Clinical Trials Register (DRKS; trial identifier: DRKS00013555, Registration Date 07 December 2017).

Group-based pelvic floor muscle training for pregnant women: A randomized controlled feasibility study.

This study aims to test the feasibility and acceptability of a group-based pelvic floor muscle training for pregnant women in China and facilitate women's adherence to the pelvic floor muscle training programme. Urinary incontinence is a prevalent health problem in women worldwide, especially in pregnant women. Supervised pelvic floor muscle training is recommended as the first-line conservative treatment for urinary incontinence. However, the implementation and effectiveness of pelvic floor muscle training are limited by insufficient human resources and low adherence. Group-based interventions may improve people's adherence to interventions by facilitating peer support. However, it has been investigated in a limited number of maternity studies. Feasibility testing randomized controlled trial, accompanied by a mixed methods process evaluation. This study was guided by the Medical Research Council framework for complex interventions and the Behaviour Change Wheel guide to developing interventions. A three-phase, mixed-methods design was used in this study. This study reported the feasibility of the group-based pelvic floor muscle training programme. Semi-structured reviews were conducted following the intervention to explore the acceptability of the programme. The study included 48 pregnant women with a recruitment rate of 52.17%. The adherence rate to the training programme was 66.67%. The intervention was positively valued, in particular the support promoting participants' adherence, but additional changes need to be made to the programme for a future trial. Group-based pelvic floor muscle training programme provides a possible way of delivering pelvic floor muscle training with limited health professionals in China. The study showed promising results concerning the acceptability and feasibility of the intervention, which were well perceived by both pregnant women and the midwife. Group-based pelvic floor muscle training may have the potential of reducing the prevalence of urinary incontinence in pregnant women with insufficient healthcare professionals. This study assessed the feasibility of delivering group-based pelvic floor muscle training in pregnant women in China. The group-based pelvic floor muscle training is acceptable to both pregnant women and the midwife, but integrating online and face-to-face sessions need to be considered. The findings of this study provided evidence for delivering group-based pelvic floor muscle training to pregnant women in China. The study has adhered to CONSORT guidelines (Table S1) and TIDier checklist (Table S2). The patient and public have been invited as stakeholders during the development of the intervention. They worked with healthcare professionals to co-design the group-based pelvic floor muscle training programme. The trial was registered on ClinicalTrials.gov (NCT05242809) under the title 'Development and Feasibility Testing of a Group-based PFMT Programme for Antenatal Women in Nanjing City in China'.

Insomnia prehabilitation in newly diagnosed breast cancer patients: Protocol for a pilot, multicentre, randomised controlled trial comparing nurse delivered sleep restriction therapy to sleep hygiene education (INVEST trial).

Insomnia is a prevalent sleep disorder that negatively impacts daytime functioning and quality of life. Breast cancer patients report higher rates of insomnia and more circadian disruption than other cancer groups. Approximately 50% of patients experience acute insomnia following breast cancer diagnosis, which often persists during cancer treatment and rehabilitation. Sleep Restriction Therapy (SRT) is a clinically effective and tolerable treatment for persistent insomnia in breast cancer survivors. However, SRT has never been tested on patients with early signs of sleep disturbance who are undergoing cancer treatment. The aim of this pilot randomised controlled trial is to explore the feasibility and preliminary effectiveness of nurse delivered SRT for newly diagnosed breast cancer patients with acute insomnia. The trial has been registered on ClinicalTrials.gov (identifier: NCT06294041). The INVEST (INvestigating the Value of Early Sleep Therapy) trial will recruit 50 newly diagnosed breast cancer patients who meet criteria for acute insomnia. Patients will be recruited from breast cancer results clinics within two Scottish health boards (NHS Grampian and NHS Greater Glasgow and Clyde) and will be block randomised (1:1) to receive nurse delivered SRT or Sleep Hygiene Education (SHE). SRT will be delivered over 4 weekly sessions comprising two face-to-face meetings (either in person or online) and two telephone calls, whereas SHE will be administered in booklet form. Outcomes will be collected at baseline, 6 weeks, and 12 weeks post-randomisation. Primary outcomes in this trial relate to the feasibility of SRT for newly diagnosed breast cancer patients with acute insomnia. Specifically, we will explore (i) rates of patient recruitment and retention, (ii) intervention fidelity, (iii) data collection procedures and outcome measure completion, (iv) intervention acceptability. Secondary outcomes will focus on preliminary evaluation of patient responses to SRT, including insomnia severity, rest-activity rhythms, and mental health. Our dissemination plan comprises publishing trial outcomes in high-impact, peer-reviewed journals and on breast cancer charity websites and other patient resources. The outcomes from this pilot trial will also inform the development of a full-scale, multicentre RCT of SRT for acute insomnia in newly diagnosed breast cancer patients. University of Strathclyde is the sponsor (reference: UEC23/52). Protocol version v1.2 4 October 2023. This trial is the first to explore the value of sleep prehabilitation for newly diagnosed breast cancer patients.This will be the first trial to assess the feasibility of delivering SRT during breast cancer treatment, providing valuable insight into its tolerability and preliminary effectiveness.An embedded process evaluation will assess the acceptability of SRT, providing insight into potential optimisation of the intervention and recommendations for enhancing its future scalability and translation within cancer care.Due to the nature of the SRT intervention, nurse therapists and patients cannot be blinded to treatment allocation, increasing the risk of bias.

Integrated regulations for medical and nursing care in long-term care: qualitative results of the process evaluation: Innovative form of care in long-term care

Integrated regulations for medical and nursing care in long-term care: qualitative results of the process evaluation: Innovative form of care in long-term care Abstract: Background: Long-term care patients, most of whom suffer from multimorbidity, are dependent on appropriate medical and nursing care. Inadequate interdisciplinary cooperation structures and processes pose a challenge for nursing care when residents' conditions deteriorate and can lead to hospital admissions that could potentially be avoided. Objective: Structures and processes of interdisciplinary cooperation were developed and implemented as part of the SaarPHIR innovation fund project "Saarländische PflegeHeim Versorgung Integriert Regelhaft". The aims of the qualitative part of the process evaluation were the subjective assessment of the structural and process level of the complex intervention across all project phases from the perspective of the participants as well as an analysis of the context factors. Method: Qualitative interviews were conducted with all participating facilities and the medical care communities formed as part of the project in order to record the subjective experiences gained in the implementation and impact of the complex intervention. The data analysis was carried out using qualitative content analysis. Results: Both professional groups perceive a structural organizational change that has a positive effect on interdisciplinary cooperation. The benefits in terms of care are rated as high. Conclusion: Various measures (e.g. pre-weekend ward rounds, extended on-call duty) at the structural and process level should be retained when transferring to standard care.