Feasibility Of Programs Research Articles

Summary of the best evidence for risk stratification of exercise rehabilitation in patients with a cardiac implantable electronic device.

Hierarchical management of sports risk is highly critical to ensure the safety of sports rehabilitation. Early identification, timely prevention and control of sports-related risk factors, and enhanced supervision and guidance can provide a basis for the formulation of sports programmes and the setting of sports monitoring levels. This study aimed to retrieve, evaluate, and integrate evidence for the stratified management of motor risk in patients with a cardiac implantable electronic device (CIED). We searched for evidence according to the "6S" model of evidence-based resources. CNKI, VIP, Wanfang Data, CBM, PubMed, Cochrane Iibrary, CINAHL, EMbase, Web of Science, BMJ Best Practice, Up To Date, and International Guidelines Collaboration Network were searched from inception to February 2024. To search for evidence on stratified management of motor risk in patients with CIEDs, this research includes guidelines, systematic reviews, meta-analyses, expert consensus, clinical decision-making, and randomized controlled trials. After methodological quality evaluation, the evidence was extracted and summarized accordingly. According to the inclusion and exclusion criteria, 16 pieces of evidence were screened, including 5 guidelines, 1 clinical decision-making, 5 systematic reviews, 4 expert consensus, and 1 randomized controlled trial. After reading, extracting, and categorizing, 34 pieces of evidence in 4 areas were identified, namely, screening and assessment of exercise risk in CIEDs, exercise monitoring, implementation of exercise prescriptions, and prevention and management of exercise-related risks. This study provides the best evidence for the prevention and management of exercise risk in patients with CIEDs, clarifies the role of nurses in evaluating, monitoring, and educating patients undergoing motor rehabilitation, and provides a basis for the formulation of clinically feasible rehabilitation programs. PROSPERO, identifier (CRD2024509622).

Multidisciplinaire aanpak van obesitas bij kinderen in de eerste lijn: hoe doe je dat en waar kan het mislopen?

Multidisciplinary approach to childhood obesity in primary care: how do you do it and where can it go wrong? The prevalence of childhood obesity and the recently launched care pathway for children living with obesity in Belgium should prompt reflection on the role of the general practitioner (GP) in tackling childhood obesity. There is a need for research on the perspective of parents and multidisciplinary care providers in primary care concerning the facilitating and hindering factors of a constructively feasible multidisciplinary counselling program to treat obesity in children aged 2 to 17 years within primary care. Data collection involved semi-structured interviews conducted through 5 separate focus groups (FGs). These included 2 FGs consisting of 8 parents, 2 FGs with 17 primary care providers from 1 GP region and 1 FG with 8 secondary care providers from 1 pediatric multidisciplinary obesity center (PMOC). The data were thematically analyzed following the COREQ method (consolidated criteria for reporting qualitative studies). Caregivers and parents identified barriers and facilitating factors, and provided possible solutions on several themes. Not only organizational factors were cited, but also factors intrinsic or specific to the child and its environment. The importance of practical and communicative connections between care providers on the one hand and children and their environment on the other hand were emphasized. Finally, influencing social factors were also highlighted. By addressing the identified facilitating and impeding factors, a multidisciplinary approach for children with obesity in primary care could be threshold-reducing and more efficient, both for GPs as well as for professional and supportive primary care providers and parents.

An interdisciplinary approach to rehabilitation in Parkinson's disease: case series.

Interdisciplinary care is increasingly promoted to enhance satisfaction and outcomes for individuals with complex medical conditions, such as Parkinson's disease (PD). However, there is little research on the feasibility or efficacy of interdisciplinary care in clinical settings. And, while the use of an integrated team of allied health professionals has the potential to provide significant health benefits to individuals with PD, there are educational and logistical barriers to the use of interdisciplinary care in clinical settings. An interdisciplinary care model was described that aimed to facilitate these benefits and alleviate some of these known clinical feasibility challenges. Three cases are also provided to exemplify how this approach to collaborative care was used to address individual needs and to highlight some of the successes and challenges associated with the implementation of an interdisciplinary and person-centered care model via telehealth. These cases may help clinicians adopt techniques to facilitate greater collaboration across disciplines or aid in the development of a feasible interdisciplinary program in their own clinics. Further research is needed to further enhance individual outcomes and integrate other disciplines into the care team.

Abstract 4125957: Feasibility and Acceptability of Behavioral Weight Loss Programs for Men in Trade and Labor Occupations

Objective: Men who work in trade and labor occupations experience high rates of obesity and related cardiovascular disease due to high rates of sedentary leisure time and poor diet. Despite this, they are underrepresented in weight control programs. This pilot randomized trial evaluated the feasibility and acceptability of a 6-month program tailored to this occupational group versus a non-tailored standard-of-care behavioral weight loss program. Methods: Men with overweight or obesity working in trade and labor occupations were randomly assigned to either a tailored program or the DPP Group Lifestyle Balance program delivered via 16 one-hour virtual group sessions. In-person assessments were conducted at baseline, 3, and 6 months. Semi-structured interviews and self-report were used to assess the acceptability of the interventions. Feasibility was assessed using recruitment metrics and proportion group sessions and study assessments completed. Results: Participants (N = 28; median 44.0 years, interquartile range (IQR): 38.5-54.5), median 31.8 BMI, IQR 31.1-39.6) were recruited into the study over 7 months, and 71% and 79% were retained for assessments at 3 and 6 months, respectively. Overall, participants attended a median of 7 of the 16 group sessions (IQR 2.5-11.5). The tailored group completed a median of 11 of 16 weekly online progress reports (IQR 5-15). All participants reported that they would recommend the programs to other men and felt confident that they would continue using the strategies learned in the programs. Though the trial focused on feasibility rather than efficacy, median weight losses at 6 months were -3.0% in the tailored group (95% CI -9.3, -0.6) and -1.9% in the standard group (95% CI -7.4, 2.0). Conclusions: Results suggest that both the tailored and standard weight loss interventions were well received by this group, but engagement was low. Future research should focus on understanding how to increase engagement rather than exclusively tailoring the program to this occupational group to enhance this group's involvement with cardiovascular disease prevention programs.

Effectiveness and Feasibility of Digital Pulmonary Rehabilitation in Patients Undergoing Lung Cancer Surgery: Systematic Review and Meta-Analysis.

Pulmonary rehabilitation (PR) has been shown to effectively support postsurgical recovery in patients with lung cancer (LC) at various stages. While digital PR programs offer a potential solution to traditional challenges, such as time and space constraints, their efficacy and feasibility for patients undergoing LC surgery remain unclear. This systematic review aims to assess the feasibility and effectiveness of digital PR programs for individuals undergoing LC surgery. A systematic review was conducted, retrieving data from 6 English and 4 Chinese databases from their inception to January 1, 2024. References in related studies were also manually reviewed. The primary outcomes assessed were physical capacity, lung function, and the incidence of postoperative pulmonary complications (PPCs). The secondary outcomes were compliance, hospital stay, chest tube duration, anxiety, depression, and quality of life. Where applicable, recruitment and withdrawal rates were also evaluated. Meta-analysis and descriptive analysis were used to assess the outcomes. A total of 5 randomized controlled trials and 6 quasi-experimental studies (n=1063) were included, with 4 studies being included in the meta-analyses. Our meta-analyses revealed that digital PR reduced the decline in 6-minute walk distance (6-MWD) by an average of 15 m compared with routine PR programs from admission to discharge, demonstrating a clinically significant improvement in physical capacity (mean difference -15.00, 95% CI -25.65 to -4.34, P=.006). Additionally, digital PR was associated with a reduction (26/58, 45%) in the likelihood of PPCs (risk ratio 0.45, 95% CI 0.30-0.66, P<.001) and a reduction of 1.53 days in chest tube duration (mean difference -1.53, 95% CI -2.95 to -0.12, P=.03), without a statistically significant effect on postoperative hospital stay (mean difference -1.42, 95% CI -3.45 to 0.62, P=.17). Descriptive analyses suggested that digital PR has the potential to improve knowledge, lung function, quality of life, and self-efficacy, while reducing depression and anxiety. Notably, digital PR was found to be a safe, feasible, and acceptable supplementary intervention. Despite challenges with low recruitment, digital PR enhanced exercise compliance, increased patient satisfaction, and lowered dropout rates. This systematic review is the first comprehensive analysis to suggest that digital PR is a safe, feasible, acceptable, and effective intervention for promoting recovery in patients with LC after surgery. Digital PR has the potential to be a valuable supplement, expanding access to traditional PR programs. Future research should prioritize the development of interactive and inclusive digital solutions tailored to diverse age groups and educational backgrounds. Rigorous studies, including large-scale, high-quality randomized controlled trials with detailed protocols and robust methodologies, are needed to assess the short-, medium-, and long-term efficacy of digital PR, ensuring reproducibility in future research. PROSPERO CRD42023430271; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=430271.

Variable viscosity and activation energy aspects in convection heat transfer over gravity driven solar collector plate for thermal energy storage

Variable viscosity, activation energy and microgravity effects on Darcy nanofluid for the thermal performance improvement in thermal energy storage systems through stretching flat plate solar collector is the focus of this research. Thermal energy storage (TES) can be improved though solar collectors, phase change materials and photovoltaic cells using nanofluid in the base liquid. To increase the reaction rate in nanoparticles, the activation energy and solar radiations are used for the efficiency of TES. The viscosity of nanofluid improves the heat and mass transmission. Due to solar radiations, nanofluid plays prominent role in TES applications such as heat exchangers, electronic cooling devices and solar power generation through solar plate collector. Solar energy based mathematical model is developed to execute the frequency of oscillating heat transfer in TES numerically. Primitive and Stokes coefficients are used for feasible programming. Finite difference analysis is performed to display oscillatory thermal energy using Gaussian-elimination matrix scheme. Steady velocity, surface temperature and concentrations are plotted and utilized in oscillatory formula to perform oscillatory skin friction, oscillatory heat transfer and oscillatory mass transfer along π⁄4 angle. Fluid velocity enhances but temperature and concentration variation decreases as viscosity decreases. High amplitude in velocity, temperature and concentration is sketched as activation energy and microgravity increases. Steady heat and mass transmission enhances as thermophoretic and Brownian motion enhances. Amplitude and frequency of oscillations in heat transport, skin friction and mass transport enhances as Prandtl and Schmidt component enhances. In validation of results, the 0.00064% percentage error for heat transport and 0.00102% percentage error for mass transmission are deduced.

Effectiveness, efficacy, acceptability, and feasibility of trauma-informed depression, anxiety, and substance use prevention programs for young people aged 12-25 years: A mixed-methods systematic review.

Mental ill-health and substance use bear significant public health burden on young people. Prevention is key. Trauma-informed approaches to prevention of mental ill-health and substance use demonstrate significant promise, yet it is unclear how well existing approaches work for young people targeting mental ill-health and substance use. This review aimed to assess the effectiveness, feasibility, and acceptability of trauma-informed mental ill-health and/or substance use prevention programs for young people. We searched the PsycINFO, CINAHL, Embase, MEDLINE, and Cochrane Library reference databases for peer-reviewed studies of trauma-informed mental ill-health and/or substance use prevention programs for young people published between 2013 and 2022. Studies in any language were included and reference lists of included articles were scanned for additional studies of relevance. In total, 30 studies were included in this review, comprising five randomized controlled trials (RCTs), seven non-RCTs, 10 quasi-experimental designs, and eight qualitative studies. Among the 30 studies, 27 unique trauma-informed prevention interventions were detailed. Eighteen studies reported statistically significant decreases in mental ill-health, and two studies reported significant decreases in substance use outcomes among participants, up to 6 months following the interventions. Most preventative interventions with statistically significant effects were selective (rather than universal or indicated) in their approach (n = 10, 55%). Broad acceptability and feasibility of trauma-informed prevention programs was observed among studies reporting this information though most quantitative studies were at high risk of bias and/or did not include a control group, whilst qualitative studies tended to report research conducted without a priori research aims. This review synthesizes for the first-time evidence on the effectiveness (or efficacy), feasibility, and acceptability of trauma-informed mental ill-health and/or substance use programs for young people, especially for those exposed to traumatic or adverse experiences. While there are promising efficacy outcomes, further research conducting rigorous, well-powered RCTs is required for large-scale evaluation and scaling of the potential preventative benefits of such programs.

Development of a Leg And Walking Self-exercise (LAWS) program for older adults during cancer treatment.

We developed a self-directed Leg And Walking Self-exercise (LAWS) program informed by the Exercise is Medicine initiative and evaluated the feasibility and acceptability of this program in older adults with cancer. Over a 1-year period, we prospectively enrolled 40 older adults who received a comprehensive geriatric assessment (CGA) at a geriatric oncology service and initiated a new line of systemic therapy for advanced cancer as inpatients. LAWS is a tailored, self-directed exercise program consisting of leg resistance training and walking. Exercise adherence was recorded using an exercise diary to assess feasibility. Patient perspectives on this program were evaluated using the Feasibility of Intervention Measure (FIM) and Acceptability of Intervention Measure (AIM), with a score range of 1-5, higher being better. Overall, 28% of patients were fit, 53% pre-frail, and 20% frail based on the CGA. During hospitalization (average 12days), 63% of the patients adhered to exercises at lowest intensity during more than 50% of their inpatient stay: on average, 2.8 leg exercises, 23 repetitions a day, 5.6days/week, and 19min of walking a day, 4.9days/week. Patients rated their perceived exertion at 3.0 for leg exercise and 3.0 for walking on a 1-10 Likert scale. During the period between discharge and their first outpatient appointment (average 11days), 71% of patients adhered to the LAWS program. Mean scores of FIM and AIM were 4.2 (SD = 0.5) and 4.2 (SD = 0.7), respectively. For older adults undergoing cancer treatment, LAWS is a feasible and acceptable self-directed exercise program.

Effects of semiochemical pre-feeding, physiological state, and weather on the response of Bactrocera dorsalis to methyl eugenol baited traps

Plant-derived phenylpropanoids are semiochemicals that are often highly attractive to Bactrocera (Diptera: Tephritidae) males. One of these semiochemicals, methyl eugenol (ME), is used in the male annihilation technique (MAT) for the management of B. dorsalis (Hendel), a destructive horticultural pest. It is not normally viable to simultaneously implement MAT with the sterile insect technique (SIT), as released sterile males are attracted to MAT devices. However, prior semiochemical exposure can reduce the later response of Bactrocera males to the same or another semiochemical, which may allow the synchronous application of MAT and SIT. We determined how the interaction between semiochemical pre-feeding, weather, and fly physiology impacted the response of male B. dorsalis to ME baited traps. Response by a known number of males in field cages was determined in relation to temperature, relative humidity, semiochemical pre-feeding (ME, eugenol, or none), diet (protein supplemented and protein deprived) and age (4, 10 and 20 days old). Semiochemical pre-feeding of both ME and eugenol equally decreased the response of males that were 10 days old, or older, to ME baited traps. Adult diet had no effect on the response of males to ME baited traps. Response improved as temperature and relative humidity increased. These results highlight the feasibility of synchronous MAT-SIT programmes targeting B. dorsalis and the viability of continued protein supplementation of sterile males. We show that eugenol is an alternative to ME for suppression of male B. dorsalis response to MAT devices and that weather conditions significantly affect the variability and reliability of abundance estimates from trap captures.

Effectiveness of a community-based exercise program for ambulatory individuals with spinal cord injury: a randomized controlled trial

ObjectiveTo evaluate the effectiveness of a community-based structured exercise program, compared to usual care, in enhancing physical, functional, and psychological outcomes for ambulatory individuals with spinal cord injury (SCI). DesignRandomized controlled trial comparing exercise group with usual care group. SettingOne university-affiliated rehabilitation hospital. ParticipantsFifty-seven participants with chronic SCI who could walk more than 10 meters. InterventionsA supervised 20-session program focusing on flexibility, aerobic, and strengthening exercises was provided over 8 weeks for the exercise group, while the usual care group maintained their regular daily exercise routines. Main outcome measuresPrimary outcome included 6-minute walk test, while secondary outcomes assessed EuroQol-5 Dimensions 5-Level, Spinal Cord Independence Measure III, Berg Balance Scale (BBS), timed up and go, grip strength, 30-second sit to stand (30-STS) test, sit and reach test (SRT), Beck Anxiety Inventory, Beck Depression Inventory, and bioelectrical impedance analysis. ResultsThe 51 participants were allocated to intervention (n=36) and usual care (n=15) groups, consisting of 34 males and 17 females (average age 59.78±13.19 years). The participants included 24 with cervical, 17 with thoracic, 8 with lumbar, and 2 with sacral lesions, with all participants having motor incomplete injuries. The exercise group showed significant improvement compared to the usual care group in the 6-Minute Walk Test by 49.80 meters (95% CI: 13.04, 86.55), BBS scores by 3.50 (95% CI: 0.96, 6.03), 30-STS by 2.38 (95% CI: 0.29, 4.47), and SRT by 3.89 centimeters (95% CI: 0.96, 6.82). The adherence rate was remarkably high at 89.6%, suggesting the feasibility of community exercise programs for this population. However, no significant changes were observed in psychological and quality of life measures. ConclusionCommunity-based structured exercise programs have been shown to be both feasible and effective in improving walking capacity, balance, lower extremity strength, and flexibility in ambulatory individuals with SCI.

Research Priorities in Pulmonary Rehabilitation: The Urgent Need to Increase the Portfolio of Rehabilitation Options for Chronic Lung Disease.

Pulmonary rehabilitation (PR) plays a crucial role in improving outcomes for individuals with chronic respiratory diseases. The most outstanding challenge in PR is the low referral, uptake, and adherence that is dramatically low in the post-hospitalization period in rural, minority, and low-income populations. Research efforts to increase the portfolio of PR through the testing and implementation of new and effective options for home-based and community-based programs are potential research targets. Other potential foci of research efforts are the pursuit of behavior-change techniques to achieve a lifestyle change during PR and the referral process to increase uptake and adherence rates. Creating new rehabilitation options for chronic lung disease that can reach more people may require expanding the definition of PR for chronic lung disease to one more flexible and perhaps concordant with the World Health Organization's definition of rehabilitation as "a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment." While efforts to augment access to conventional PR are warranted, it is time to devote research efforts to reach many more individuals with chronic lung disease, particularly minorities, rural, and low-income individuals that currently have no access to any rehabilitation, a social injustice that requires action. This manuscript outlines suggested future directions in rehabilitation research with the pursuit of evidence to support feasible and effective programs that may increase the rehabilitation portfolio to accommodate most individuals with chronic lung disease.

Exploring the Feasibility of Social Skills Programs for Autistic Youth Through Virtual Reality.

Many autistic individuals may desire support and services primarily in the areas of adaptive functioning and social well-being throughout their lifetime. There is a need for community-informed and person-centered social programs targeted for autistic adolescents and adults. New technology, such as virtual reality (VR), is being researched to assess the feasibility of providing therapeutic services to autistic individuals. This qualitative study aims to better understand and explore the perceptions of parents and autistic adolescents regarding social development and thoughts around social skills interventions delivered through technologies such as VR. Eight autistic adolescents between the ages of 12 to 17, and five parents participated across five focus groups. The focus group interviews were semi-structured, and qualitative data analysis was conducted through an open thematic approach and inductive coding process. Seven primary themes with sub-themes were identified throughout the focus group interview discussions: Social Skills of the participating autistic adolescents as reported by their parents and by self-report, Family Dynamics affecting social relationships within the family, Social Skills Goals both groups hoped to develop and improve, the existence and quality of In-Person vs. Online Friendships, Experience/Comfort With Technology, Openness to Virtual Environments, and Concerns for Virtual Environments. Researchers identified these themes across both parent and adolescent focus groups. This study provides guidance to the research community on investigating different innovative approaches for offering a social program that is supported by autistic individuals.

Head and Neck Cancer (HNC) Prehabilitation: Advantages and Limitations.

Cancer prehabilitation is the process between the time of cancer diagnosis and the beginning of the active acute treatment; prehabilitation consists of various need-based interventions, e.g., physical activity, a nutritional program, and psychological support. It can be delivered as unimodal or multimodal interventions. Physical activity, including resistant exercise and aerobic activities, has to be tailored according to the patient's characteristics; nutritional support is aimed at preventing malnutrition and sarcopenia; while psychological intervention intercepts the patient's distress and supports specific intervention to address it. In addition, multimodal prehabilitation could have a potential impact on the immune system, globally reducing the inflammatory processes and, as a consequence, influencing cancer progression. However, many challenges are still to be addressed, foremost among them the feasibility of prehabilitation programs, the lack of adequate facilities for these programs' implementation, and the fact that not all prehabilitation interventions are reimbursed by the national health system.

A single-arm pilot study of a brief cognitive-behavioral therapy for insomnia intervention among Japanese occupational therapy and physical therapy university students with sleep disturbances

ObjectiveTo evaluate the feasibility of the Sleep Health through University Student Habits (SHUSH) program, a brief sleep improvement intervention based upon principles of cognitive-behavioral therapy for insomnia (CBT-I) developed for Japanese university students.MethodsPretest-posttest, single-arm pilot study design with 3-month follow up was used to evaluate the feasibility of SHUSH. We developed then offered a 90-min sleep education class based upon the two-process model of sleep regulation, sleep restriction, stimulus control, and sleep hygiene. We recommended individualized sleep prescriptions (e.g., prescribed time to bed and prescribed time out of bed) from 11 days of daily sleep diary data. We then offered 15 min of individualized follow-up meetings each week for three consecutive weeks in person or online in which we supported adherence to sleep prescriptions. Fifteen university students with self-reported sleep disturbance (Insomnia Severity Index; ISI score ≥ 9) completed the SHUSH program. Participants were on average age 19.7 years old; nine were women, and they were students in occupational therapy and physical therapy. We assessed validated Japanese versions of sleep-related (e.g., ISI, Sleep hygiene practice scale; SHPS), mental health-related (e.g., Generalized Anxiety Disorder Screener) patient-reported outcomes (PROs) and daily sleep diary variables (e.g., sleep onset latency and sleep efficiency).ResultsComparing baseline and posttest data, a statistically significant difference was observed in insomnia symptom severity, daytime sleepiness, sleep hygiene practices, eveningness to morningness, anxiety, depression, sleep diary improvements (e.g., sleep onset latency, total time in bed, and sleep efficiency). Comparing posttest and 3-mo follow up data (n = 10), a statistically significant difference wasn't observed for most PRO effects. However, there was a statistically significant difference in ineffective sleep behaviors (i.e., SHPS-J). We did observe a rebound effect for some SHPS-J items.ConclusionSHUSH was developed as a brief cognitive-behavioral intervention for insomnia. SHUSH participants showed improvements on sleep-related and mental health-related PROs after 4 weeks of intervention. At 3 months follow-up sleep quality and mental health gains were maintained. SHUSH was a feasible program. Randomized controlled trials are needed to test treatment efficacy on sleep related and mental health related PROs in the future.

Effectiveness of community-based Baduanjin exercise intervention for older adults with varying frailty status: a randomized controlled trial

BackgroundDue to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status.MethodsA two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up.ResultsOverall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p = .047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention.ConclusionsOur study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal.Trial registrationClinicalTrials.gov NCT04549103. Registered September 16, 2020.

Towards Analysing Cache-Related Preemption Delay in Non-Inclusive Cache Hierarchies

The impact of preemptions has to be considered when determining the schedulability of a task set in a preemptively scheduled system. In particular, the contents of caches can be disturbed by a preemption, thus creating context-switching costs. These context-switching costs occur when a preempted task needs to reload data from memory after a preemption. The additional delay created by this effect is termed cache-related preemption delay (CRPD). The analysis of CRPD has been extensively studied for single-level caches in the past. However, for two-level caches, the analysis of CRPD is still an emerging area of research. In contrast to a single-level cache, which is only affected by direct preemption effects, the second-level cache in a two-level hierarchy can be subject to indirect interference after a preemption. Accesses that could be served from the L1 cache in the absence of preemptions, may be forwarded to the L2 cache, as the relevant data was evicted by a preemption. These accesses create the indirect interference in the L2 cache and can cause further evictions. Recently, a CRPD analysis for two-level non-inclusive cache hierarchies was proposed. In this article, we show that this state-of-the-art analysis is unsafe as it potentially underestimates the CRPD. Furthermore, we show that the analysis is pessimistic and can overestimate the indirect preemption effects. To address these issues, we propose a novel analysis approach for the CRPD in a two-level non-inclusive cache hierarchy. We prove the correctness of the presented approach based on the set of feasible program execution traces. We implemented the presented approach in a worst-case execution time (WCET) analysis tool and compared the performance to existing analysis methods. Our evaluation shows that the presented analysis increases task set schedulability by up to 14 percentage points compared with the state-of-the-art analysis.

Eye-tracking training improves visuospatial working memory of children with attention-deficit/hyperactivity disorder and autism spectrum disorder.

Given the close connection between eye movement and frontal lobe functions and some evidence supporting the effect of eye-tracking training on enhancing cognitive performance mediated by the frontal lobe, this study aimed to explore if after-school eye-tracking training can improve the visuospatial working memory (VSWM) and cognitive flexibility performance in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study is a non-randomized cluster trial. Forty children from eight primary schools were selected, half receiving eye-tracking training for 20 sessions over 9 months, while the other half served as a waitlist control. They were matched on demographic characteristics and baseline cognitive performance. Their VSWM and cognitive flexibility were assessed at the beginning and end of the study. Results showed that children who received eye-tracking training, but not those on a waitlist, exhibited significant improvements in the total score and working memory span of the VSWM tests, and the correct responses in cognitive flexibility tests. Specifically, VSWM performance at higher span levels (5 or above) yielded a greater improvement. The findings suggest that eye-tracking training can be a feasible and effective after-school program for improving working memory and cognitive flexibility performance in children with ADHD and ASD. This study was prospectively registered at ClinicalTrials.gov (https://clinicaltrials.gov/, trial number: NCT05428657).

Perioperative interventions to enhance surgical outcomes for older adults with cancer: A systematic review.

219 Background: Older adults with cancer have unique needs, particularly in the perioperative setting, which likely influence surgical outcomes in the geriatric oncology population. Little work has sought to describe available literature investigating perioperative interventions to enhance surgical outcomes for these individuals. Our systematic review sought to describe the literature on perioperative interventions in older adults with cancer undergoing surgery. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases, searching for literature published from 1/2010-10/2023 (search terms used relevant terminology for geriatric oncology in the perioperative setting). We included randomized controlled trials (RCT) focusing on patient-centered interventions that enrolled adults &gt;60 years old with cancer, excluding studies with pharmacologic, procedural, and radiographic interventions. Results: We included 11 RCTs with 2,177 patients. Patients’ age ranged from 60-95, and median number of patients per study was 147 (range: 44-690). Most studies included patients with colorectal cancer (81.8% [9/11]), all involving non-emergent elective surgeries. Half the studies (54.5% [6/11]) evaluated exercise interventions, and the remaining assessed geriatric assessment-guided interventions (27.2% [3/11]), nutrition optimization (9.1% [1/11]), and patient empowerment (9.1% [1/11]). Primary outcomes were as follows: postoperative complications, quality of life, feasibility of exercise programs, delirium incidence, inspiratory muscle endurance, hospital length of stay, and consistency of nutritional management. All studies had postoperative complications as a primary or secondary outcome. In studies with exercise-based interventions, all but one (83.3% [5/6]) found reduction in postoperative complications, and one showed improvement in quality of life (16.7% [1/6]). Studies focusing on geriatric assessment did not achieve significant differences in outcomes. We found implementation challenges that influenced several studies, including high drop-out rates and intervention fidelity. Conclusions: In this review, we found 11 studies focused on perioperative interventions in older adults with cancer undergoing surgery. Notably, interventions involved exercise, geriatric assessment-guided care, nutrition optimization, and patient empowerment. RCTs to date seem to primarily focus on exercise interventions and geriatric assessment-guided strategies. Although most studies met their primary endpoint, we found heterogeneity in intervention modality and outcome assessment, thus demonstrating a need for ongoing work to address the unique needs of the geriatric oncology population.

A Hybrid Rehabilitation Program for Adults with Peripheral Artery Disease (HY-PAD): A Pre-Post Intervention Study to Assess Its Feasibility

BackgroundSupervised exercise programs improve walking impairment and quality of life (QoL) in patients with peripheral artery disease (PAD). However, such programs are underutilized, due to their limited accessibility. A feasible and effective exercise program is needed. This study assessed the feasibility of a hybrid onsite and home-based exercise program (HY-PAD) and changes in walking capacity and PAD-specific QoL following HY-PAD. MethodsDue to recruitment challenges imposed by the COVID-19 pandemic, this randomized controlled trial was modified to a pre–post intervention design that excluded the control group. Eligible patients with PAD were assigned to HY-PAD, consisting of 1-hour, supervised onsite exercise sessions 3 days per week for 4 weeks, followed by a home-based program with weekly 15-minute telephone calls to discuss exercise planning for 8 weeks. Feasibility was determined based on recruitment, adherence, and adverse events. Walking capacity was measured by a 6-minute walk test. PAD-specific QoL was assessed using the Walking Impairment Questionnaire. ResultsOf 24 patients enrolled (3 women, aged 70 ± 8 years), 21 (87.5%) completed HY-PAD. Twenty participants attended ≥ 87.5% of prescribed sessions. Two participants experienced adverse events (foot injury and limb ischemia). The 6-minute walk test distance (357 ± 105 vs 413 ± 53 meters, P = 0.021), and 2 domains of the questionnaires (walking speed: 38.4 ± 24.1 vs 60.6 ± 26.6 points and stair-climbing: 60.6 ± 29.4 vs 74.0 ± 23.1 points, both P < 0.001) increased significantly. ConclusionsHigh attendance and low dropout rates support the feasibility of using HY-PAD, which was associated with improved walking capacity and PAD-specific QoL. Future studies are warranted to confirm its efficacy.

A mixed methods evaluation of the music and psychology and social connections (MAPS) pilot - A dyadic intervention for couples affected by young-onset dementia.

People living with young-onset dementia and their care-partners are at risk of a range of adverse mental health outcomes and social isolation. There are few interventions aimed at supporting couples affected by young-onset dementia, which poses unique psychosocial challenges for younger people. This pre-post interventional mixed methods pilot study aimed to assess the feasibility and acceptability of an online group program for people with young-onset dementia and their care-partners living at home in Australia. The Music And Psychology and Social connections (MAPS) program aimed to address: (1) the challenges and changes associated with young-onset dementia; and (2) coping and wellbeing. The program involved six weekly two-hour sessions co-facilitated by a psychologist and music therapist, and a private Facebook group. The primary outcomes of feasibility and acceptability were assessed through a post-program focus group, separate individual feedback sessions with each couple, and a program evaluation questionnaire. Thematic analysis was conducted on the focus group transcripts and field notes from couple feedback sessions. We also examined the preliminary utility of MAPS in improving mental health and social connectedness, using quantitative pre-post-measures. Five couples completed the MAPS program. The most common dementia type was Alzheimer's Disease. Participant attendance was 87% across all sessions. Qualitative findings supported acceptability of the program with four emergent themes: being connected to others with shared experiences; reframing thoughts and feelings about dementia; music as a therapeutic tool; and benefits of MAPS. The high retention rate, qualitative findings and positive program evaluation suggest MAPS may be a promising, feasible and acceptable program for couples affected by young-onset dementia.