Final Focus Research Articles

Distortions in focusing laser pulses due to spatio-temporal couplings: an analytic description

Abstract In ultra-short laser pulses, small changes in dispersion properties before the final focusing mirror can lead to severe pulse distortions around the focus and therefore to very different pulse properties at the point of laser–matter interaction, yielding unexpected interaction results. The mapping between far- and near-field laser properties intricately depends on the spatial and angular dispersion properties as well as the focal geometry. For a focused Gaussian laser pulse under the influence of angular, spatial and group-delay dispersion, we derive analytical expressions for its pulse-front tilt, duration and width from a fully analytic expression for its electric field in the time–space domain obtained with scalar diffraction theory. This expression is not only valid in and near the focus but also along the entire propagation distance from the focusing mirror to the focus. Expressions relating angular, spatial and group-delay dispersion before focusing at an off-axis parabola, where they are well measurable, to the respective values in the pulse’s focus are obtained by a ray tracing approach. Together, these formulas are used to show in example setups that the pulse-front tilts of lasers with small initial dispersion can become several tens of degrees larger in the vicinity of the focus while being small directly in the focus. The formulas derived here provide the analytical foundation for observations previously made in numerical experiments. By numerically simulating Gaussian pulse propagation and measuring properties of the pulse at distances several Rayleigh lengths off the focus, we verify the analytic expressions.

Abstract A007: Expanding clinical trial awareness among Black communities through digital engagement

Abstract Background: Black patients are less likely to be enrolled in clinical trials compared with White patients, resulting in reduced access to breakthrough treatments and limited understanding of treatment effect. Ineffective dissemination of cancer research, education, and interventions among the public contributes to cancer inequities. Dissemination rarely involves non-research audiences and end-users. We conducted community-engaged research through focus groups with Black community members and family members of cancer survivors. Through these efforts, we are creating a culturally responsive public service announcement (PSA) video to increase clinical trial awareness among Black audiences. Methods: We conducted 5 focus groups over two phases with 1) social support networks of Black cancer survivors (n=20) and 2) Black community members (n=30) to inform the PSA to be disseminated through media and public health outlets. A final focus group will be conducted to elicit video feedback after production. Phase 1 focus groups informed PSA content. Data was triangulated with qualitative data from Black women with breast cancer, oncologists, clinical trial staff, and advocates from a concurrent study about clinical trial participation. Phase 2 focus groups sought feedback on video content prior to production. Content and thematic analyses identified themes and recommendations. Results: For Phases 1 and 2, we used maximum variation sampling to recruit Black participants (n = 50) varied in age, geographic region, education, and gender. Phase 1 themes included: 1) clinical trial mistrust due to experiences of racism persists, but diminishes with younger respondents or those who participated in clinical trials; 2) clinical trial trust-building was associated with transparency from medical experts and information relayed by someone in the Black community and from clinical trial participants; 3) invasive procedures impact views on risks and benefits of participation; 4) messages that are not coercive, but support decision-making are more credible; and 5) sharing the PSA on social media with links to primary resources was recommended. Phase 2 participants reported that the: 1) storyline and script were informative, culturally representative, realistic, and understandable; 2) participants saw themselves in the characters and family dynamics; 3) opening scene should be altered to avoid racial stereotypes; and 4) storyline elicited desire to pursue additional information before making a decision about participation. The script triggered discussion about factors impacting low clinical trial participation and ineffective information dissemination to Black communities. The revised script integrated participant feedback; the video is under production. The PSA is planned to be aired on a national cable network. Conclusions: By eliciting and integrating feedback from Black community members, we developed a culturally representative and responsive PSA that facilitates agency for decision making and information seeking about clinical trials that can be widely disseminated. Citation Format: Eliza B. Cohn, Ryan Huu-Tuan Nguyen, Leslie Carnahan, Kauthar Salum, Neha Hippalgaonkar, Tigist Mersha, Ana Williams, Robbin Block, Kent Hoskins, Vida Henderson. Expanding clinical trial awareness among Black communities through digital engagement [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A007.

Language acquisition in Autism Spectrum Disorder: Strategies for early diagnosis and intervention – A review of literature

Autism Spectrum Disorder (ASD) is characterized as a neurodevelopmental disorder, with deficits in communication and social interaction with a defined diagnostic criteria. Although the main diagnosis is made by the pediatric neurologist and/or the psychiatrist, the clinician ability to refer children with a suspected condition, based on language differences to their neurotypical peers, is crucial for shortening the diagnosis time. Because it is a neurodevelopmental condition, the earlier the interventions, the better the responses and prognosis in development. In this literature review, we aim at an updated discussion about the role of ASD on the child brain, the language development differences in neurotypical and ASD children, the emerging early diagnosis technologies, and the early intervention therapies available for verbal and non-verbal ASD children’s, as well as adults, with a final focus on music therapy.

A Web-Based Mindfulness-Based Cognitive Therapy for Couples Dealing With Chronic Cancer-Related Fatigue: Protocol for a Single-Arm Pilot Trial.

Chronic fatigue is a common symptom among patients who have been treated for cancer. Current psychosocial interventions typically target the patient alone, despite growing evidence suggesting that a couples' approach can increase and broaden the efficacy of an intervention. Therefore, based on an existing web-based mindfulness-based cognitive therapy for patients, the couple intervention COMPANION was developed. The primary objectives of this study are to determine the acceptability of COMPANION and its potential efficacy in reducing fatigue in patients with cancer. Our secondary objectives are to examine the feasibility of the trial procedures and the potential working mechanisms of the couple intervention. We will conduct a single-arm pilot trial for couples (ie, patients with cancer with chronic fatigue and their partners). All couples are allocated to the web-based couple intervention that consists of psychoeducation, mindfulness, and cognitive-behavioral exercises. The 9 sessions of the intervention are supervised remotely by a trained therapist. Patients and partners will complete questionnaires before starting the intervention (T0), 2 weeks after completing the intervention (T1), and 1 month after T1 (T2). They will also fill out weekly diaries during the intervention period. A subsample of patients (n≈5) and partners (n≈5) as well as all the therapists providing COMPANION will participate in the final focus groups. Benchmark values have been defined to determine the acceptability (ie, ≥60% of couples complete the intervention and/or ≥70% of the participants are satisfied with the intervention) and potential efficacy (ie, a significant improvement in fatigue and/or a clinically relevant improvement in fatigue in 45% of the patients between T0 and T1) of the intervention. The trial procedures are deemed feasible if an average of at least three couples are included per recruiting month and/or adherence to the assessments is at least 65% for T1 and the diaries and 60% for T2. To establish potential working mechanisms, changes in affect, sleep, catastrophizing, partner communication and interactions, self-efficacy, mindfulness, and closeness will be examined. Quantitative outcomes will be interpreted along with the results from the focus groups. Data collection is expected to be completed by March 2024. This pilot trial will test the first web-based mindfulness-based cognitive therapy for couples targeting chronic cancer-related fatigue. Findings will indicate whether proceeding with a randomized controlled trial is warranted. ClinicalTrials.gov NCT05636696; https://clinicaltrials.gov/study/NCT05636696. DERR1-10.2196/48329.

Cryogenic systems of SuperKEKB final focusing superconducting magnets

SuperKEKB is an accelerator to collide electron and positron particles with a nano-beam collision scheme and equipped with two cryostats to accommodate 55 superconducting (SC) magnets for final focusing. Each cryostat is cooled by an independent cryogenic system employing a refrigerator of 250 W at 4.41 K and a subcooler to supply subcooled liquid helium (LHe), which absorbs heat leak by the relatively small sensible heat (∼2.4 J/g) with an acceptable temperature rise of 0.35 K from 4.41 K to 4.76 K (saturated temperature at 0.161 MPa). The associated limitation of the permissible heat leaks necessitated a careful cryostat design with comprehensive thermal considerations to reduce heat conduction and radiation and maintain stable cryogenic conditions of SC magnets. This paper presents the designs of the cryostats and cryogenic systems to address the technical challenges to cool SC magnets with the compact spatial constraints. Cryogenic systems were designed to supply a subcooled LHe flow of ∼20 g/s and to provide a mixed capacity of refrigeration and liquefaction loads. The liquefaction component amounts to 40 L/h (∼1.3 g/s), approximately half of the total refrigerator capacity to cool the vapor-cooled current leads of SC magnets, which is also found to significantly influence the total LHe flow (∼20 g/s) to cool the cryostats. Dedicated studies were performed to investigate the SC magnet temperature variations with the LHe flow, the system operation modes such as cooldown and quench of SC magnets, and to assess the heat leaks with local and global methods, which facilitate the practical operation of cryogenic systems for the SuperKEKB accelerator and are detailed in this paper.

Allogenic Acellular Dermal Matrix and Xenogeneic Dermal Matrix as Connective Tissue Graft Substitutes for Long-Term Stability Gingival Recession Therapy: A Systematic Review and Meta-Analysis.

Connective tissue graft (CTG) serves as a gold standard for gingival recession therapy. Yet the availability of CTG is limited, and it increases patient morbidity. Allogenic acellular dermal matrix (AADM) and xenogeneic dermal matrix (XDM) have been proven to be effective substitutes of CTG although the long-term stability is unclear. The aim of this study was to analyze the long-term stability outcome of gingival recession therapy using AADM and XDM compared to CTG. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted independently from several online databases (PubMed, Scopus, and Embase). Five of 233 publications were included for final qualitative analysis and meta-analysis focusing on the mean difference of clinical parameters such as recession depth (RD), recession width (RW), probing depth (PD), clinical attachment loss (CAL), tissue thickness (TT), keratinized tissue width (KTW), and mean root coverage (MRC). Meta-analyses of RD, RW, CAL, TT, KTW, and MRC display an overall mean of 0.2 mm (95% confidence interval [CI]: -0.45 to -0.05), 0.29 mm (95% CI: -0.65 to 0.08), 0.2 mm (95% CI: -0.69 to 0.29), 0.25 mm (95% CI: -0.53 to 0.03), 0.26 mm (95% CI: -0.5 to 0.02), and 9.19% (95% CI: -13.95 to -4.43]), respectively, favoring the CTG. PD was the only parameter that favored the AADM or XDM with an overall mean of 0.03 mm (95% CI: -0.05 to 0.11). In all, if the long-term stability is the goal, the CTG is considered superior for gingival recession therapy. However, if it is contraindicated, the AADM and XDM might be considered as alternatives.

Full aperture backscatter diagnostics for characterization of laser plasma instabilities at the extreme light infrastructure (ELI) beamlines.

We report on the commissioning of a full aperture backscatter diagnostics station for the kilojoule, nanosecond high repetition rate L4n laser operating at a wavelength of 527nm at the Extreme Light Infrastructure (ELI) - Beamlines, Dolni Brezany, Czech Republic. Light scattered back from laser-plasma interaction into the cone of the final focusing lens is captured and split into different channels to measure the signatures of laser plasma instabilities from stimulated Brillouin scattering, stimulated Raman scattering, and two plasmon decay with respect to back scattered energy, its spectrum, and its temporal profile. The performance was confirmed in a commissioning experiment with more than 800 shots at laser intensities ranging from 0.5 × 1013 to 1.1 × 1015Wcm-2. These diagnostics are permanently installed at ELI Beamlines, and can be used to understand the details of laser-plasma interactions in experiments with kJ and 527nm light. The large number of shots that can be collected in an experimental campaign will allow us to study the details of the laser-plasma interaction with a high level of confidence.

Patient Perspectives on Seeking Emergency Care for Acute Low Back Pain and Access to Physical Therapy in the Emergency Department.

Low back pain is a common reason for visiting the emergency department (ED), yet little is known about patient motivations for seeking emergency care. The purpose of this study was to explore patient perspectives on visiting the ED for low back pain to inform a more patient-centered approach to emergency care. We conducted focus group discussions and individual interviews among patients visiting an urban academic ED for acute low back pain. We recruited participants from an ongoing prospective study of 101 patients receiving either ED-initiated physical therapy or usual care. We conducted discussions, and interviews using an a priori developed discussion guide. We audio recorded, transcribed, and iteratively content analyzed the data using a consensual qualitative approach until thematic saturation was reached. We conducted 4 focus group discussions among 18 participants (median age 46.5 years, 66.7% women, 61.1% Black) and individual interviews with 27 participants (median age 45 years, 55.6% women, 44.4% White). No new themes emerged during the fourth and final focus group. We identified 5 summary themes: (1) the decision to seek emergency care for low back pain is motivated by severe pain, resulting disability, and fears about a catastrophic diagnosis, (2) participants sought various goals from their ED visit but emphasized the primacy of pain control, (3) participants were reluctant to use pain medications but also acknowledged their benefit, (4) participants perceived a number of benefits from direct access to an ED physical therapist in the ED, and (5) participation in physical therapy ultimately facilitated recovery, but the pain was a barrier to performing exercises. These patient perspectives and resulting themes may be used to inform a more patient-centered emergency care experience and contextualize quantitative research findings on ED care for low back pain.

Frequency scanning interferometry based deformation monitoring system for the alignment of the FCC-ee machine detector interface

In a particle accelerator, two particle beams are accelerated and collided at one or several physics detectors. The machine detector interface (MDI) is the place where the accelerator ring is linked to the physics detector. It is the area where the alignment requirements are the most stringent, and the MDI of the lepton version of the future circular collider (FCC-ee) is no exception. It will implement a complex design and alignment requirement for typical components in the MDI are of the order of 30 μm. Until now, no working solutions have been proposed for the alignment of such MDI. In this contribution, two different systems are studied: the Surveillance d’Ouvrages par Fibre Optique (Structural Monitoring by Optical Fibers, SOFO) and the in-lined multiplexed and distributed frequency scanning interferometry (FSI). Both systems allow individual and simultaneous distance measurements of multiple portions along a fiber, and a new system using the FSI technology is proposed for the alignment monitoring. Using a network of helical shaped fiber allows the measurement of deformations if a sufficient amount of fibers is placed on the cylinder. With a sensor measurement accuracy of 1 μm, 3D coordinates of points at the end of a 4 m long and 0.25 m radius cylinder (FCC-ee MDI dimensions) can be determined at an accuracy under 5 μm. This system will provide a link between the alignment of the final focusing quadrupoles and the rest of the machine.

Regulation of shared electric kick scooters in urban areas: Key drivers from expert stakeholders

Shared electric kick scooters (SEKS) have become widespread in many cities worldwide with great expectations from both users and municipalities. Most cities have not yet passed specific legislation to regulate this new phenomenon, thereby increasing uncertainties across different players such as users, operators, etc. This research provides guidelines for regulating SEKS in urban areas for their successful implementation, taking advantage of a collaborative approach with expert stakeholders that look at the regulation problem from different perspectives. The study focuses on the case of Spain where SEKS have been booming over the last few years. The methodology applied follows a three-step process consisting of the identification of crucial issues and key expert stakeholders, a general survey to them, and a final focus group intended to reach consensus. The paper provides regulatory recommendations in four main areas: market access, technical requirements, traffic and safety, and supervision. It finds large agreement on key aspects such as promoting a homogeneous regulation across the municipalities within the same metropolitan area; establishing fixed bases for parking in the city centre while allowing free floating in low density areas located in the outskirts; and promoting an integration with the public transportation system.

A&F: obstacles to implementing interventions in the health system.

Understanding how well a clinician or health care team is performing provides an essential foundation for improvement. If done well, Audit and Feedback (A&F) provides data in non-judgemental, motivating insights and leads to changes in clinical processes that benefit patients. This article will explore obstacles to optimizing the potential positive effects of A&F to improve patient care and outcomes by examining three interrelated steps in the process: the audit; the feedback; and the action. The audit requires data that will be perceived as both valid and actionable. Acquiring and using such data properly often requires partnerships. Feedback recipients need to know how to turn data into action. The A&F, therefore, should include components that direct the recipient toward feasible next steps to undertake the change that will lead to improvement. The proposed actions may be individual (learning new diagnostic or therapeutic strategies, trying a more patient-centered approach, etc.) or organizational (more proactive approaches often including the involvement of additional team members). The ability to turn feedback into action will depend on the culture of the recipient-group, and its level of experience with these change processes. Feedback facilitation or coaching may be useful for some groups or certain kinds of desired changes in practice. Inadequate leadership and support for health professionals, as they try to respond to A&F, is also often a barrier. Finally, with the final focus on the challenges of the individual Work Packages (WP) within the Easy-Net network program, the article focuses on what were the facilitating and hindering factors, the obstacles encountered, and the resistance to change overcome, useful considerations in support of the increasingly widespread implementation of A&F activities in our Healthcare System in the future.

Precise pointing control of high-energy electron beam from laser wakefield acceleration using an aperture

We demonstrated the precise directional control of high-energy electron beams of several hundred MeV by moving a circular serrated aperture smaller than the laser diameter perpendicular to the laser propagation direction before the final focusing optics in a laser system. This technique is simple and effective because the direction of the electron beam can be precisely controlled without any additional manipulation of the optics in the laser system and the gas target. This will be a useful guideline and of great significance for the future development towards practical uses and applications of laser–plasma accelerators.

Integration of corpus literacy consultation into language teacher education: Course design, implementation, and evaluation

This qualitative study presents a corpus literacy course designed and implemented at an undergraduate language teacher education program in Turkey, and its evaluation by pre-service ELT teachers. The course introduces the main concepts of corpus linguistics, raises future teachers’ linguistic and pedagogical awareness through corpus applications, and introduces them to corpus-informed practices to improve their pedagogical skills. In the first phase of the study, students’ corpus literacy levels were determined through a pre-course survey revealing that most of the participants did not know about corpora and their uses. The second and third phases were devoted to evaluating the course. Initially, student teachers were asked to write minute papers and reflection papers during the semester to evaluate the process. In the final phase, semi-structured interviews and focus group discussions were conducted after the course to explore their overall evaluations. Findings implied that corpus literacy integration into teacher education programs clearly yields positive outcomes, yet only one course is not enough to popularize it among EFL teachers. Hence, extensive exposure to corpus literacy and curriculum-wide integration in the TEFL programs could contribute to its popularization among future practitioners.

Open Learning, Distance Education with reference to General and Special Education and inclusive education

Open learning and distance education have grown as transformative tools in the field of education. These techniques enable learners in a range of settings, including general and special education, with possibilities that are adaptable and inclusive. the notions of open learning, remote education, and inclusive education, with an emphasis on the roles these ideas play in facilitating access, equity, and the provision of a high-quality education for all students. It studies the underlying tenets and practises of diverse educational approaches, concentrating specifically on how they meet the requirements of a wide spectrum of pupils, including those who have physical or mental impairments. the potential benefits and problems involved with implementing inclusive education approaches through open and remote learning, with the final focus being placed on the critical role that technology and educator support play in developing an inclusive and empowering learning environment.

Open Learning, Distance Education with reference to General and Special Education and inclusive education

Open learning and distance education have grown as transformative tools in the field of education. These techniques enable learners in a range of settings, including general and special education, with possibilities that are adaptable and inclusive. the notions of open learning, remote education, and inclusive education, with an emphasis on the roles these ideas play in facilitating access, equity, and the provision of a high-quality education for all students. It studies the underlying tenets and practises of diverse educational approaches, concentrating specifically on how they meet the requirements of a wide spectrum of pupils, including those who have physical or mental impairments. the potential benefits and problems involved with implementing inclusive education approaches through open and remote learning, with the final focus being placed on the critical role that technology and educator support play in developing an inclusive and empowering learning environment.Keywords : Open learning, Distance education, Distance education, Special education, Inclusive education

Reconstruction of tendon losses

This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses, with a final focus on the innovative regenerative approach. Significant improvements in primary tendon repair techniques have radically reduced the failure rate and therefore decreased the use of reconstructive procedures. However, in specific conditions, such as crush injuries with loss of substance, avulsion injuries and inveterate injuries, the tendon gap cannot be repaired with a primary suture, making the procedure much more challenging for the surgeon. This article aims to guide the treatment of tendon losses, which is still a complex topic in hand surgery.

Results of Unintentional Injuries among Preschool Children Enrolled in Day-care Centers from Selected Villages around Gaborone, Botswana

This study employed a descriptive cross-sectional study qualitative and quantitative designs to gather data through structured interviews, questionnaires over a certain period in time in the past (retrospective) and the present (concurrent), and then analyze the results. The study was undertaken in the selected villages around Gaborone Botswana, situated in the south of the country. Its final focus was to publish the research results from a research survey done on unintentional injuries among preschool children enrolled in day-care centers from selected villages around Gaborone, Botswana. The population consisted of 47-day care centers in the selected villages around Gaborone which are all situated in Mogoditshane/Thamaga Subdistrict. A sample of 45 care centers was drawn using Yamane formula. Data were then collected through auditing, structured interviews, and questionnaires. The Statistical Package for Social Sciences (SPSS) program was used to analyze the data. The summary of the results of the current study show that: i) Males are more likely to get injured than females ii) Older children are more likely to sustain UI (iii) UI are sustained in the late afternoons iv) UI are more likely to be sustained in the early and late part of the week v) Season or term of study is not a factor of UI vi) Amount of time spent at school is a factor of UI (Davis, Godfrey & Rankin 2013).The findings indicate that there are factors that can have a negative influence on the occurrence of unintentional injuries in day care centers. It is suggested that a supportive teaching programme in the form of a workshop for service providers, teachers and parents should be designed, that will support the system of unintentional injury prevention program for preschool children in day care centers in order to prevent unintentional injuries in the selected villages around Gaborone, Botswana. Keywords: Contributing factors to unintentional injuries, Day care centers / pre-schools/ preprimary units, Interventions on unintentional injury prevention, Unintentional injuries, Unintentional injuries prevention, the Prevalence of unintentional injuries in childcare settings.

Measurement of laser absorption in underdense plasmas using near-field imaging of the incident and transmitted beams.

Measurements of laser absorption in high-temperature, underdense plasmas produced at the Omega Laser Facility are made using two near-field imaging detectors that diagnose the spatial profile and energy of the port P9 beam before and after it transmits through the plasma. The incident beam is sampled using a partial reflection from a full-aperture, (30 cm-diam) uncoated wedge pickoff located before the target chamber vacuum window and final focus lens assembly. A concave mirror reduces the reflected beam size, allowing it to be recorded directly using a charged-coupled device (CCD) camera. The P9 transmitted beam diagnostic (P9TBD) characterizes the transmitted light by terminating the expanded beam on a semi-transparent diffuser and imaging the illuminated surface using a lens and CCD camera. The P9TBD samples a numerical aperture twice as large as the input beam, allowing the energy of transmitted beams with moderate levels of beam spray to be measured accurately. Calibration shots with no plasma provide a path to infer absorption without absolute photometric calibration of either detector. The cross-calibration between the two detectors was measured to remain stable at ±200 ppm, enabling measurements of total beam absorption below 1% with ±0.07% error.

Strategies for Implementing an Oral Medication Adherence Intervention in Academic and Community Cancer Settings

Background: Oral anticancer (OAC) agents revolutionized the treatment of once-fatal chronic leukemias by extending survival and delaying progression; however, this requires a medication adherence rate >90%. Innovative models to improve patient knowledge and adherence to OACs exist. A critical limitation of these previous models is a lack of clear strategies to improve their adoption, implementation, and maintenance. Previously, we identified barriers and facilitators to the implementation and maintenance of a medication adherence intervention for OACs. Here, we use focus group discussions with clinical teams, administrators, and patients to design practical strategies for the program's adoption, implementation, and maintenance. Methods: We assembled an advisory panel with clinicians (n=9), administrators (n=7), and patients (n=2) in two settings (an academic and a community cancer center) to design practical strategies for the adoption, implementation, and maintenance of a structured adherence intervention using a 5-step systematic approach called implementation mapping. We report findings from the first three steps. In step 1 (needs assessment), we conducted a consensus building discussion followed by a survey to identify perceived importance and changeability of predetermined barriers to implementation of adherence interventions (from literature review and qualitative interviews). In step 2 (determine outcomes/objectives), we identified agreeability with predetermined performance outcomes and objectives associated with the adoption, implementation, and maintenance of the program. Both surveys consisted of questions measured using a 5-point Likert scale response, ranging from 1 (not at all important/extremely difficult) to 5 (Extremely important/extremely easy). Results from these surveys were used to select and produce implementation strategies (steps 3-5) using the CFIR-ERIC Strategy Matching Tool (https://cfirguide.org/choosing-strategies/ which helps match evidence-based strategies to identified barriers) to address previously identified barriers to program implementation. Implementation strategies were further refined through focus group discussions with health care practitioners. Results: Three sets of consensus-building sessions followed by surveys were conducted with the advisory panel. In the first set, after the qualitative focus group discussion, 14 participants completed a survey (Figure 1), where 4 barriers to adherence were assessed. Survey participants found all barriers surveyed to be important to address, with >70% of survey respondents selecting 4 or 5 for every barrier. However, all but one barrier was perceived as difficult to change, with low awareness of the evidence behind the adherence intervention perceived as neither easy nor difficult. In the second set, a consensus-building discussion was held with the advisory panel followed by a survey aimed at selecting program outcomes and objectives. Seven participants completed the survey (Table 1) and 10 performance outcomes and 18 performance objectives were assessed. There was moderate to high agreement (range: 4.0 to 5) on all 28 items, with >85% of participants selecting 4 or 5 on 25 of the 28 items. In the third set (focus group and survey), we aimed to identify and refine implementation strategies. Nine participants completed a survey, and 21 strategies were proposed (8 for adoption; 11 for implementation; 2 for maintenance) with moderate to high levels of agreement (range: 3.78 to 5) for all strategies. After a final focus group discussion with the advisory panel, four strategies were reached for final production: 1) Development of a standard operating procedure; 2) Creation of a short course on implementing motivational interviewing techniques to improve adherence; 3) Defining measurable performance indicators and metrics; and 4) Scheduling quarterly meetings with clinical teams. Conclusions: Using a systematic approach and an interprofessional advisory panel, our team confirmed known and modifiable barriers to the adoption, implementation, and maintenance of a structured adherence intervention. Through quantitative surveys and qualitative focus group discussions, we built consensus program outcomes and objectives as well as practical implementation strategies. Using these results, we plan to pilot and evaluate an oral chemotherapy adherence program. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Discovering Concept-Space to Improve Student Experience and Teaching in Design Projects

Design is an art that combines technical challenges, learning and creativity. The activity is challenging for many students, who struggle to frame and understand the complexity of their project. To add to the challenge, the work done and the vision in the team is only partially shared. Unsurprisingly, it is hard to teach. This paper presents concept-space; a novel way to build and organize design information, from problem understanding to solution elaboration and validation. It is conceived as both an efficient workspace and a graphical communication medium to help process the complex and fuzzy nature of design. This study uses a SoTL approach to evaluate concept-space when used in multidisciplinary capstone design projects. Final questionnaires and focus groups with 26 students and 6 teachers were used to collect data after using concept-space for a full semester. The study provides strong support that concept-space is a serious asset to help students learn design and to help teachers teach design.