Feasibility Study Research Articles

Machine Learning powered Patient Records Analysis for Injury Monitoring in Children and Adolescents

Abstract Background Injuries to children and adolescents are common and are associated with individual suffering and costs. Switzerland lacks data of injuries in children and adolescents. This study investigates the feasibility of utilizing machine learning (ML) methodology to automatically extract relevant data from electronic pediatric patient records needed for monitoring and prevention purposes. Methods The feasibility study follows three steps. 1. Utility evaluation of text data from electronic pediatric patient records regarding ML, injury monitoring and prevention requirements in a test-sample. 2. The development of an ML-based approach to extract relevant information based on electronic pediatric patient records (N = 30’884) of children treated for injuries at the University Children’s Hospital Zurich emergency department between 2018-2022. 3. The performance of the ML methodology is evaluated. Results Qualitative and ML expert assessment of the sample showed that the desired data on injuries is contained in the test-sample and necessary requirements are met. Data records differ in detail with severe injuries providing especially rich information records. The international IDB code-tree was proved to be too elaborate and adult-orientated and was adapted. Preliminary data analyses indicate that the number of accidents is highest in the age group from 0 to 4 years (36%). More male (58%) children were treated. Majority of accidents were classified as less severe (73%), few (<1%) as very severe. Further lessons learned, along with more detailed prevalence data on injuries in children and adolescents, will be available by August 2024. Conclusions Extraction of injury information from electronic patient record by means of ML may provide valuable information for injury monitoring and prevention, so far missing in Switzerland. Prerequisites for the successful application of ML are digital record access, usable coding-tree, and detailed text input by the emergency departments. Key messages • An ML-based approach has the potential to improve the data basis by extracting valuable accidents information from existing texts of patient records. • To successfully apply this method, digital record access and detailed text data are needed.

Fidelity of the Face-it health promotion intervention for women with recent gestational diabetes

Abstract Introduction According to the 2021 British Medical Research Council 2021 framework, a feasibility study aims to assess intervention-specific progression criteria. Fidelity is a critical criterion because it concerns how an intervention is implemented as intended. Fidelity conceptualisation has expanded beyond intervention adherence to encompass participant engagement, i.e., how well they receive and enact the intervention, but these latter aspects achieve little attention. We aimed to assess the fidelity of the Face-it intervention, a health promotion intervention for women with a history of gestational diabetes mellitus and their families. The intervention consisted of three home visits and health technology delivered by health visitors/coaches. Our fidelity assessment included: i) training of the health visitors/coaches ii) the delivery, iii) receipt, and iv) enactment of the intervention. Methods The National Institutes for Behaviour Change Consortium’s (NIHBCC) framework for fidelity was used to assess four elements of fidelity. Data were collected from 150 women using intervention checklists, health technology logs and the virtual climate care questionnaire, which measured autonomy supportiveness from the intervention. Results The health visitors/coaches received four training days before the implementation and 16 hours throughout the intervention delivery. 73.3% of women completed three home visits, and 91.3% of women registered as health technology users. The participants perceived the intervention to be autonomy supportive, encourage health behaviour change and provide effective possibilities for health behaviour change, even though the delivery of the health technology varied greatly. Conclusions The Face-it intervention was largely implemented as intended. Using the NIHBCC framework, we expanded our fidelity conceptualisation and gained important insight into the feasibility of the intervention and interplay between delivery, receipt, and enactment.

Insights Into Critical Discussion: Designing a Computer‐Supported Collaborative Space for Middle Schoolers

Collaborative learning environments that support students' problem solving have been shown to promote better decision‐making, greater academic achievement, and more reasonable argumentation about controversial issues. In this research, we developed a technology‐based critical discussion platform to support middle school students' argumentation, with a focus on evidence‐based reasoning and perspective taking. A feasibility study was conducted to examine the patterns of group interaction and individual students' contributions to the critical discussion and their perceptions of the critical discussion activity. We found that more students used text‐based communications than audio, but students who used audio collaborated with each other more frequently. In addition, student engagement in argumentative discourse varied greatly across groups as well as individuals. At the end of the discussion, most groups provided a solution that integrated both sides of the controversial issue. Survey and interview results suggest an overall positive experience with this technology‐supported critical discussion activity. Using the insights from our research, we develop a conceptual dialogue analysis framework that identifies relevant skills under the argumentation and collaboration dimensions. In this report, we discuss our design considerations, feasibility study results, and implications of engaging students in computer‐supported collaborative argumentation.

Continuous transcranial ultrasound in large vessel stroke: Image guidance for high-intensity focused sonothrombolysis.

Sonothrombolysis is a potential adjunctive therapy for large vessel occlusion (LVO) stroke. Bedside ultrasound image-guided high-intensity focused ultrasound (HIFU) therapy could deliver higher energy therapeutic ultrasound to the thrombus with higher precision than what was previously accomplished in human trials. The aim is to test the feasibility of diagnostic transcranial contrast-enhanced ultrasound (CEUS) to image the occlusion site and continuously maintain the guidance image on-target for a sufficient exposure time for HIFU to be effective during LVO stroke evaluation and treatment. This prospective, single center, observational cohort study included adult patients, presenting within 6 hours of stroke symptom onset, with LVO identified on computed tomography angiography (CTA). A hand-held CEUS imaging study was initiated following CTA and lasted up to 30 minutes. The primary outcome is the proportion of patients where a guidance CEUS image of the occlusion was achieved. A CEUS image of the occluded artery was obtained in 32/35 of the included patients. The median total imaging time was 23 minutes (interquartile range 15-30). Patients undergoing thrombectomy had a lower total imaging time (17 vs. 29.5 minutes, p=.002). When imaging was successful, on-target image was maintained for only 58% (standard deviation 23.8%) of total imaging time. No complications related to CEUS were observed. This feasibility study explored the use of diagnostic transcranial CEUS for continuous imaging of occlusion sites in LVO strokes. Challenges in maintaining target image during HIFU were identified, highlighting the need for technical advances for clinical application.

Evaluation and Long-Term Prediction of Annual Wind Farm Energy Production

A comparison and evaluation of the AEP(Annual Energy Production) of a wind farm were conducted in this study with a feasibility study and using the actual operation data from the S wind farm on Jeju Island from January 2020 to December 2022. The free wind speed data were selected from the data measured from a nacelle anemometer, the correlation equation between wind speed and AEP was obtained, and the annual average wind speed for the past 20 years was predicted using the MCP method. As a result, comparing the AEP from the operation data with that estimated in the feasibility study, we found that the AEP was reduced by approximately 2.40% in 2020 and 12.14% in 2021, and increased by 6.76% in 2022. The wind speeds over the 20-year lifetimes of the wind turbines were obtained, and the AEP that could be generated at the S wind farm indicated that it could be used for operation. In the future, the S wind farm will operate at between 25% and 30% availability for the remaining 17 years of operation. If the availability falls below 25%, there will be a need to check the reasons for the deterioration of wind turbine performance and the frequency of failures.

An Exoskeleton Design and Numerical Characterization for Children with Duchenne Muscular Dystrophy

This research addresses a feasibility study for validating an exoskeleton with kinematic considerations. The designed exoskeleton will be used for children with congenital disorders, especially for a case study characterized by Duchenne muscular dystrophy (DMD). The research core focuses on virtual simulations carried out through the multibody systems theory under an MSC Adams software environment, with an exoskeleton constructive solution. The designed exoskeleton mechanism is characterized by simplicity, low-cost, and easy-operation features criteria. The results obtained through a numerical processing analysis validate the feasibility study of the proposed prototype.

A New Feasible Opportunity for Recycling Lead and Silver from Zinc Plant Residues by Flotation

Millions of tons of zinc plant leach residues (ZPLR) have been stockpiled in Iranian hydrometallurgical zinc plants during the last few decades. Due to the low grades of zinc, lead, and silver in these residues, these residues have been abandoned without treatment. The authors of this paper studied zinc plant leach residues (ZPLR) to propose a flotation process for separating and producing lead and silver concentrate. A response surface methodology (RSM) was employed to obtain six models for optimizing the best conditions for lead recovery, lead grade, zinc recovery, zinc grade, silver recovery, and silver grade. In these models, the effect of the different main variables, including density, flotation time, pH, sodium sulfide dosage, and potassium amyl xanthate dosage, was investigated to optimize grades and recoveries. The studied ZPLRs were categorized into two types based on the disposal time, including new and old residues. The chemical analysis showed that the grades of lead, zinc, and silver in the new residues are higher than in the old residues. In a previous mineralogical study, it was found that silver forms in lead and zinc minerals as a solid solution within their structures. The resulting 3D graphs showed that the interacting variables have significant effects on responses. The ANOVA analysis exhibited the order of model significance to be lead grade (F-value of 36.46) > silver grade (19.76) > lead recovery (7.88) > zinc grade (5.63) > silver recovery (5.58) > zinc recovery (4.83). Based on these models, under the conditions of 1126.26 g/cm3 density, 20.83 min retention time, 9.9 pH, 6 kg/t sodium sulfide, and 749.66 g/t potassium amyl xanthate dosage for a new residue type, the recoveries of lead, zinc, and silver were determined to be 51.10%, 11.13%, and 72.85%, with grades of 38.87% Pb, 8.46% Zn, and 1209.11 g/t Ag, respectively. According to the feasibility study results, the presented work is reasonable in terms of technical, economic, and investment potential.

Feasibility of establishing a waste recycling plant in the north of Najaf city and supporting the sustainable environment

The increase in population growth, industrial progress in various fields, rising income, and improved living standards have led to societal development, and consequently, an increase in consumer needs and demands. This has resulted in irrational resource consumption and a significant increase in waste quantities, posing a major threat to the environment and human health, this research came as an attempt to enhance sustainability, create investment opportunities, solve the problem of resource shortages, and eliminate waste in an emerging country like Iraq. A feasibility study was prepared based on the technical study and conducting meetings with officials in Najaf Governorate. A set of conclusions and recommendations were reached, the most important of which were the following. By reviewing the extracted financial ratios, it became clear that the project has a high economic feasibility that is beyond comparison, and the reason can be justified by the huge amount of waste present in the targeted area, in addition to the fact that Iraq is a new experience in such industries related to sustainable development and an industry that provides resources and raw materials for other industries that are considered of great importance and are in demand in Iraq and other neighboring countries, The most important recommendations were Starting to refer the project to an investment company according to the government conditions of the Najaf Governorate Investment Authority and generalizing the successful experience to the governorates of Iraq, and giving this project the utmost importance when compared to other projects as it provides the basic and important resources for local industries, and this is consistent with Iraq’s strategy of focusing on industry and establishing industrial cities.

Proton ARC based LATTICE radiation therapy: feasibility study, energy layer optimization and LET optimization

Objective.LATTICE, a spatially fractionated radiation therapy (SFRT) modality, is a 3D generalization of GRID and delivers highly modulated peak-valley spatial dose distribution to tumor targets, characterized by peak-to-valley dose ratio (PVDR). Proton LATTICE is highly desirable, because of the potential synergy of the benefit from protons compared to photons, and the benefit from LATTICE compared to GRID. Proton LATTICE using standard proton RT via intensity modulated proton therapy (IMPT) (with a few beam angles) can be problematic with poor target dose coverage and high dose spill to organs-at-risk (OAR). This work will develop novel proton LATTICE method via proton ARC (with many beam angles) to overcome these challenges in target coverage and OAR sparing, with optimized delivery efficiency via energy layer optimization and optimized biological dose distribution via linear energy transfer (LET) optimization, to enable the clinical use of proton LATTICE.Approach.ARC based proton LATTICE is formulated and solved with energy layer optimization, during which plan quality and delivery efficiency are jointly optimized. In particular, the number of energy jumps (NEJ) is explicitly modelled and minimized during plan optimization for improving delivery efficiency, while target dose conformality and OAR dose objectives are optimized. The plan deliverability is ensured by considering the minimum-monitor-unit (MMU) constraint, and the plan robustness is accounted for using robust optimization. The biological dose is optimized via LET optimization. The optimization solution algorithm utilizes iterative convex relaxation method to handle the dose-volume constraint and the MMU constraint, with spot-weight optimization subproblems solved by proximal descent method.Main results.ARC based proton LATTCE substantially improved plan quality from IMPT based proton LATTICE, such as (1) improved conformity index (CI) from 0.47 to 0.81 for the valley target dose and from 0.62 to 0.97 for the peak target dose, (2) reduced esophagus dose from 0.68 Gy to 0.44 Gy (a 12% reduction with respect to 2 Gy valley prescription dose) and (3) improved PVDR from 4.15 to 4.28 in the lung case. Moreover, energy layer optimization improved plan delivery efficiency for ARC based proton LATTICE, such as (1) reduced NEJ from 71 to 56 and (2) reduction of energy layer switching time by 65% and plan delivery time by 52% in the lung case. The biological target and OAR dose distributions were further enhanced via LET optimization. On the other hand, proton ARC LATTCE also substantially improved plan quality from VMAT LATTICE, such as (1) improved CI from 0.45 to 0.81 for the valley target dose and from 0.63 to 0.97 for the peak target dose, (2) reduced esophagus dose from 0.59 Gy to 0.38 Gy (a 10.5% reduction with respect to 2 Gy valley prescription dose) and (3) improved PVDR from 3.88 to 4.28 in the lung case.Significance.The feasibility of high-plan-quality proton LATTICE is demonstrated via proton ARC with substantially improved target dose coverage and OAR sparing compared to IMPT, while the plan delivery efficiency for ARC based proton LATTICE can be optimized using energy layer optimization.

Digital, Social Micro-Interventions to Promote Physical Activity Among Midlife Adults With Elevated Cardiovascular Risk: An Ambulatory Feasibility Study With Momentary Randomization.

Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing. This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512). Midlife adults (N = 30, MAge = 51, MBMI = 31.5kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days of observation, participants were randomized at each survey to receive 1 of 3 comparison micro-interventions (days 4-5) or 1 of 3 support micro-interventions (days 6-7). Outcomes were indicators of feasibility (e.g., completion rate), acceptability (e.g., narrative feedback), and potential micro-intervention effects (on motivation and steps within-person). Feasibility and acceptability targets were met (e.g., 93% completion); ratings of micro-intervention helpfulness varied by intervention type and predicted PA motivation and behavior within-person (srs=0.16, 0.27). Participants liked the approach and were open to ongoing micro-intervention exposure. Within-person, PA motivation and behavior increased from baseline in response to specific micro-interventions (srs=0.23, 0.13), though responses were variable. Experimental manipulation of social influences in daily life is feasible and acceptable to midlife adults and shows potential effects on PA motivation and behavior. Findings support larger-scale testing of this approach to inform a digital, socially focused PA intervention for midlife adults.

Mitigating Interobserver Variability in Radiomics with ComBat: A Feasibility Study

This study investigates Intraobserver Features Variability (IFV) in radiomics studies and assesses the effectiveness of the ComBat harmonization method in mitigating these effects. Methods: This study utilizes data from the NSCLC-Radiomics-Interobserver1 dataset, comprising CT scans of 22 Non-Small Cell Lung Cancer (NSCLC) patients, with multiple Gross Tumor Volume (GTV) delineations performed by five radiation oncologists. Segmentation was completed manually (“vis”) or by autosegmentation with manual editing (“auto”). A total of 1229 radiomic features were extracted from each GTV, segmentation method, and oncologist. Features extracted included first order, shape, GLCM, GLRLM, GLSZM, and GLDM from original, wavelet-filtered, and LoG-filtered images. Results: Before implementing ComBat harmonization, 83% of features exhibited p-values below 0.05 in the “vis” approach; this percentage decreased to 34% post-harmonization. Similarly, for the “auto” approach, 75% of features demonstrated statistical significance prior to ComBat, but this figure declined to 33% after its application. Among a subset of three expert radiation oncologists, percentages changed from 77% to 25% for “vis” contouring and from 64% to 23% for “auto” contouring. This study demonstrates that ComBat harmonization could effectively reduce IFV, enhancing the feasibility of multicenter radiomics studies. It also highlights the significant impact of physician experience on radiomics analysis outcomes.

PRevention Intervention and Support in Mental health for people with aphasia (Aphasia PRISM): protocol and mixed methods analysis plan for two feasibility studies

BackgroundPeople with aphasia commonly experience depression and anxiety. The individual therapy program, Aphasia PRevention Intervention and Support in Mental health (Aphasia PRISM) offers low intensity psychotherapeutic interventions using communication supports. Trained stroke clinicians from disciplines other than psychology (e.g., allied health professional, nurse, doctor) can deliver such interventions. The aim of the planned studies is to test the acceptability, feasibility and preliminary effectiveness of Aphasia PRISM for preventing depression and anxiety and supporting wellbeing in people with aphasia after stroke.MethodThis protocol describes two feasibility studies of the Aphasia PRISM using parallel, convergent, mixed methods designs. Participants will be adults with aphasia after stroke from a metropolitan healthcare site (Study A, pre-post case series, approximate n = 6) and two regional/rural sites (Study B, randomised controlled trial, n = 30; random allocation to either: treatment arm Aphasia PRISM + usual care; or attention control of secondary stroke prevention information + usual care) in Victoria, Australia. Eligible participants will be offered 7 weekly intervention sessions (via telehealth or in person). Other participant groups include stroke clinicians / site managers and family members. Feasibility will be assessed with treatment acceptability ratings (primary outcome) and secondary outcomes such as recruitment rate and participant clinical response. Participant clinical responses to intervention will be collected pre-intervention (baseline), concurrently (4 week acceptability measure), immediately post (8 weeks), follow-up (3 months) and follow-up at 6 months (Study B only). Descriptive statistics will be used to analyse quantitative data based on the type and distribution of data. Reflexive thematic analysis, an inductive approach will be used to analyse qualitative data.DiscussionAphasia PRISM offers the potential for trained stroke clinicians to deliver low intensity psychotherapeutic interventions with communication supports to people with aphasia. Studies A and B were registered with the Australian New Zealand Clinical Trials registry under one registration (ACTRN12620000209998) 20th February 2020.

Kearifan Lokal Minangkabau: Simbiosis Sosial Ekonomi Antara Pasar Nagari dengan Terminal di Sumatera Barat

Abstract: Market and terminal are two places that can both be described as something crowded, noisy, complicated, and prone to crime. However, behind this general condition, it turns out that markets and terminals are inseparable symbiosis in the economy of cities and regions. If this symbiosis is separated, inevitably, the terminal will not develop. This is the case with several inter-provincial (AKDP) and inter-provincial (AKAP) public transportation terminals. This paper explains the relationship between the two as a socio-economic symbiosis, a Minangkabau local wisdom, and the following phenomena. It can be concluded that (a). reflecting on the planning and development of traditional markets in West Sumatra, especially the nagari market; the nagari market is crowded because one is always next to the terminal (b). local wisdom between the market and the terminal is like water and fish. Fish cannot live without water. But a terminal without a market around it is like a fish without water. This is the case in nine of the ten AKDP and AKAP terminals in West Sumatra (c). terminal construction is always located in the district's capital city, except for the Kiliran Jao terminal (Sijunjung Regency), which does not consider the location's economic, pathological, and sociological aspects. However, each development is always accompanied by a feasibility study per the Ministry of Transportation requirements.

Detecting and sizing the Earth with PLATO: A feasibility study based on solar data

The PLAnetary Transits and Oscillations of stars (PLATO) mission will observe the same area of the sky continuously for at least two years in an effort to detect transit signals of an Earth-like planet orbiting a solar-like star. We aim to study how short-term solar-like variability caused by oscillations and granulation would affect PLATO's ability to detect and size Earth if PLATO were to observe the Solar System itself. We also compare different approaches to mitigate noise caused by short-term solar-like variability and perform realistic transit fitting of transit signals in PLATO-like light curves. We injected Earth-like transit signals onto real solar data taken by the Helioseismic and Magnetic Imager (HMI) instrument on board the Solar Dynamics Observatory (SDO). We isolated short-term stellar variability in the HMI observations by removing any variability with characteristic timescales longer than five hours using a smooth Savitzky-Golay filter. We then added a noise model for a variety of different stellar magnitudes computed by assuming an observation by all 24 normal cameras. We first compared four different commonly used treatments of correlated noise in the time domain by employing them in a transit fitting scheme. We then tried to recover pairs of transit signals using an algorithm similar to the transit least squares algorithm. Finally, we performed transit fits using realistic priors on planetary and stellar parameters and assessed how accurately the pair of two injected transits was recovered. We find that short-term solar-like variability affects the correct retrieval of Earth-like transit signals in PLATO data. Variability models accounting for variations with typical timescales at the order of one hour are sufficient to mitigate these effects. We find that when the limb-darkening coefficients of the host star are properly constrained, the impact parameter does not negatively affect the detectability of a transit signal or the retrieved transit parameters, except for high values ($b > 0.8$). For bright targets (8.5 - 10.5 mag), the transit signal of an Earth analogue can reliably be detected in PLATO data. For faint targets a detection is still likely, though the results of transit search algorithms have to be verified by transit-fitting algorithms to avoid false positive detections being flagged. For bright targets (V-mag leq 9.5), the radius of an Earth-like planet orbiting a solar-like star can be correctly determined at a precision of 3<!PCT!> or less, assuming that at least two transit events are observed and the characteristics of the host star are well understood.

Cadence-Based Pedometer App With Financial Incentives to Enhance Moderate-to-Vigorous Physical Activity: Development and Single-Arm Feasibility Study.

High levels of physical activity are key to improving health outcomes, yet many people fail to take action. Using pedometers to target steps per day and providing financial incentives is a simple and scalable approach to promoting public health. However, conventional pedometers do not account for "intensity" and "duration," making it challenging to efficiently increase people's moderate-to-vigorous physical activity (MVPA), which is expected to improve health outcomes. Based on these rationales, we developed a smartphone app that sets step cadence as a goal (defined as a daily challenge of walking more than 1500 steps in 15 minutes twice a day, which is a heuristic threshold for moderate physical activity) and provides financial incentive when the challenge is met. This study aimed to evaluate the feasibility of our novel app and explore whether its use can increase users' daily MVPA. A single-arm pre-post study evaluated the feasibility and efficacy of the app. A total of 15 participants used app 1 (an app without financial incentives) for the first period (4 weeks) and then switched to app 2 (an app with financial incentives) for the second period (4 weeks). The primary outcome was the difference between the first and second periods in the number of successful challenge attempts per week. Secondary outcomes were differences between the first and second periods in daily steps and distance walked. Exploratory outcomes included the difference between the first and second periods in daily "heart points" as measured by Google Fit, a publicly available app that measures users' daily MVPA. The number of successful challenge attempts per week increased significantly compared to the first period (5.6 times per week vs 0.7 times per week; P<.001). Although not statistically significant, there was a trend toward an increase in the mean steps per day and distance walked per day (6586 steps per day vs 5950 steps per day; P=.19; and 4.69 km per day vs 3.85 km per day; P=.09, respectively). An exploratory end point examining daily MVPA by "heart points" collected from Google Fit also showed a significant increase compared to the first period (22.7 points per day vs 12.8 points per day; P=.02). Our app using step cadence as a goal and providing financial incentives seemed feasible and could be an effective app to increase users' daily MVPA. Based on the results of this study, we are motivated to conduct a confirmatory study with a broader and larger number of participants. UMIN 000050518; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057420.

Video Game-Based Trunk Exercises for Rehabilitation in Chronic Stroke Survivors: A Mixed-Methods Feasibility Study

Video Game-Based Trunk Exercises for Rehabilitation in Chronic Stroke Survivors: A Mixed-Methods Feasibility Study

What helps or hinders intervention success in primary care? Qualitative findings with older adults and primary care practitioners during a feasibility study to address malnutrition risk

BackgroundIn the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those identified as ‘at risk’ may help reduce malnutrition risk and associated healthcare use, and improve quality of life. The aim of this study is to explore how primary care practitioners (PCPs) and older adults perceive, use and respond to an intervention to support those identified as ‘at risk’.MethodsWe developed and optimised an intervention (screen and treat protocol, online tools and printed materials) to support primary care practitioners to identify malnutrition risk among older adults, and intervene where necessary. We recruited older adults (described as ‘patients’ here) taking part in a feasibility study, and carried out semi-structured interviews to assess PCPs’ and patients’ engagement with the intervention, and identify any contextual issues that supported or undermined their engagement.ResultsFour themes were developed, encompassing patients’ and PCPs’ perceptions of undernutrition, study measures and appointments, constraints on PCPs’ enthusiasm to make a difference, and patients’ expectations of nutritional appointments. Key findings included patients commonly not accepting advice for undernutrition/malnutrition but welcoming support for their nutritional needs; checklists potentially distracting patients from recalling discussions about their nutritional needs; a tension between PCPs’ desire to recruit less-well patients and logistical difficulties in doing so; and patients compromising their nutritional needs to suit others.ConclusionsDiverse factors influence whether an intervention succeeds in primary care. PCPs learn about an intervention/study in different ways, vary in how they understand and accept its aims, and desire to make a difference to their patients. Patients bring perceptions and expectations about the study’s aims, coloured by their habits and preferences, prior experience of research and healthcare, and pressure from social expectations. Each aspect must be considered when developing a successful primary care intervention that is viewed as relevant and meaningful, and presented using language that aligns with participants’ values and goals. Our findings suggest that references to ‘malnutrition risk’ should be avoided in any patient-facing materials/interactions as participants do not accept or identify with this label.

Using Qualitative Geospatial Methods to Explore Physical Activity in Children with Developmental Disabilities: A Feasibility Study

Children with developmental disabilities (DDs) experience barriers to physical activity (PA) participation. Greater contextual information regarding their PA behaviors is needed for effective PA promotion. We investigated the feasibility of using activity trackers and Global Positioning Systems (GPS) devices with follow-up interviews to explore PA behaviors in children with DDs. Fifteen children with DDs (aged 10 ± 2 years) wore an activity tracker and GPS device for 7 days. Data were time-aligned to measure PA and identify PA locations. Maps were created to guide follow-up semi-structured interviews with the children and their parents/guardians to understand PA contexts and perceptions of daily PA. The children took 8680 ± 4267 steps/day across 6 ± 1 days. The children provided preferences for PA locations and the parents/guardians gave context by expressing how DDs affect PA and identifying environmental factors in PA locations. The children with DDs who lived near parks, participated in PA that leveraged the strengths of their individual skillsets, and had parents/guardians who provided social support had more positive PA experiences. Combining activity tracking and GPS data with follow-up map-based interviews is feasible to explore PA behaviors and the experiences of children with DDs. This methodology may provide novel insight into daily PA in children with DDs, which can inform how future interventions can support them to be more active and have positive experiences while being active.

My virtual escape from patient life: a feasibility study on the experiences and benefits of individualized virtual reality for inpatients in palliative cancer care

BackgroundCancer patients benefit from Virtual Reality (VR) in burdensome situations, but evidence is scarce for palliative situations. Based on earlier work in palliative care, individualized VR interventions like seeing the patient’s home may address a patient’s wish to be at home and thus have a greater effect compared to standard VR content. Yet, some patients and relatives may be concerned about their privacy. Also, patient stakeholders raised concerns about triggering depressed mood or homesickness.AimTo test the feasibility and safety of individualized vs. standard 360°video VR interventions in palliative cancer inpatients.MethodsProspective observational study with patient-reported outcome measurement using validated instruments of well-being (MDBF), symptoms and psychosocial burden (IPOS), cybersickness (SSQ), presence experience (SPES), subjective benefit (2 items), content analysis of interviews, and field notes. Individualized VR content was recorded with action camcorder-technology to protect the patients’ privacy.ResultsSeventeen patients participated, median age 65 years (range 20–82), 9 women (53%), 8 single or widowed (47%), 4 childless (23.5%), 4 academics (23.5%), with a median length of stay of 9 days (1–75) in the hematology (10), palliative care (3), or radiotherapy (2) unit of a German university hospital. Eight patients (53.3%) chose their own home environments or family for individualized VR-content. All participants enjoyed the intervention. Compared to standard VR content the individualized VR tended to have a stronger effect on well-being and emotional touch. It was not inferior in terms of psychosocial burden and cybersickness. No subjective and relevant side effects occurred. The patients well tolerated the assessments. However, most patients demanded a lighter headset and a desire for more interactivity.ConclusionsIndividualization of VR content shows potential for enhancement of immersion, which improves the VR experience and does not harm in terms of depressed mood or worsening of symptoms. The patients’ and family desire for privacy is feasible with the support of family members who recorded the individualized videos, which is easily manageable today. We suggest a pragmatic randomized clinical trial to compare the effects of individualized vs. standard VR-content.Trial registrationRegistered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11/07/2023.

Combining music and dance movement therapy for people with dementia living in the community: A mixed methods feasibility study

Dementia is affecting an increasing number of people world-wide and presents a need to find more evidence-based therapies that can improve quality of life and care. Music therapy and dance movement therapy are two forms of arts therapies that share an active, embodied and improvisatory approach, however, maximising the benefits of combining music and dance movement therapy has not been researched with this population. In this feasibility study a convergent mixed methods design was used to evaluate the feasibility of using an intervention that combined music and dance movement therapy drawing on a systematic literature review. A dance movement therapist and a music therapist ran two session blocks involving eight participants in total. The Cornell Scale for Depression in Dementia was used at three assessment points (baseline, 5 weeks and 10 weeks) indicating an overall reduction in scores. Qualitative methods included multiple forms of data (video, reflective tool, journal) and focused on significant moments of connection between thoughts, feelings and physical sensations. It generated three main themes in the therapeutic process: making connections, acknowledging grief and loss, and growth and empowerment. This study contributes original knowledge to arts therapies research in the development of a research-based treatment approach involving a collaborative model of practice, an exploration of new arts-based data collection tools and testing this intervention in a community setting.