Four-week Follow-up Research Articles

Evaluating the reliability and validity of the Questionnaire on Well-Being: a validation study for a clinically informed measurement of subjective well-being

ABSTRACT Researchers and clinicians are becoming increasingly aware of the importance of assessing positive functioning to inform clinical outcomes. This paper evaluates the Questionnaire on Well-Being (QWB, available for free https://doi.org/10.17605/OSF.IO/GSC3R), a clinically informed instrument that assesses subjective well-being, across two studies. Study One, consisting of treatment-seeking individuals in an assertiveness training sample (n = 495), explored the factorial structure of the QWB, assessed the four-week test-retest reliability, criterion-related validity, and identified a preliminary cutoff point for the QWB with clinical significance. Study Two, including participants from the general public (n = 1561), confirmed the factorial structure of the QWB and further evaluated criterion-related validity. The results provided support for a unidimensional structure for the QWB. Furthermore, the QWB exhibited excellent internal reliability (Cronbach’s alpha = 0.93 and 0.94 in Study One and Two, respectively), high test-retest reliability (ICC3 = .50 at a four-week follow-up in Study One), and appropriate criterion-related validity demonstrating positive correlations with positive affect and negative correlations with psychopathology. Finally, a cutoff point on the QWB below 50 was associated with marked psychopathology. These findings provide preliminary support for the usage of the QWB in clinical and non-clinical settings, establishing the QWB as a reliable indicator of subjective well-being.

The Impact of Fu's Subcutaneous Needling on Lower Limb Muscle Stiffness in Knee Osteoarthritis Patients: Study Protocol for a Pilot Randomized Controlled Trial.

Knee osteoarthritis (OA) is a leading cause of disability worldwide, with clinicians often observing increased muscle stiffness associated with joint pain and dysfunction. This study examines the impact of Fu's Subcutaneous Needling (FSN), a non-pharmacological technique, on muscle stiffness in the lower limbs of individuals with knee OA. This study protocol is a pilot, single-center, randomized controlled trial. Sixty knee OA patients will be allocated equally for FSN or electroacupuncture (EA) treatments. Interventions will be applied thrice weekly for the first two weeks and twice weekly for the subsequent two weeks for a total of ten sessions. Assessments will be conducted at baseline, post-initial session, after four weeks of intervention, and at the end of a four-week follow-up. The primary outcome will be the muscle stiffness in the lower extremities, as measured by shear wave elastography (SWE). Secondary outcomes include response rate, a reduction in the mean pain intensity on the Numerical Rating Scale (NRS) by at least two points and on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale by six points at week four compared with baseline. Weekly monitoring of the NRS and WOMAC scores will determine the rapidity of pain alleviation and functional improvement, along with 12-item short-form (SF-12) score changes from baseline to week four. This is the first standardized protocol examining the effects of FSN on lower limb muscle stiffness in patients with knee OA by SWE. We hypothesize that FSN could outperform EA in alleviating lower limb stiffness associated with knee OA. Findings will contribute to the body of knowledge regarding the efficacy of acupuncture-derived interventions in managing muscle stiffness and may guide future research directions. The trial has been registered on the Chinese Clinical Trial Registry (Registered number: ChiCTR2300073615). Registered 17 July 2023.

Enhancing self-esteem and self-compassion to mitigate suicide risk: a feasibility and acceptability study among Japanese university students

ObjectivesSuicide is a serious mental health problem among university students. The current study aimed to examine the effectiveness of a novel intervention that targets suicide risk by enhancing self-esteem and self-compassion. MethodsParticipants were recruited from the healthcare center at a Japanese University. Measurements of suicidal risk, self-compassion, self-esteem, and other psychological variables were collected at baseline, post-intervention, four-week follow-up, eight-week follow-up, and twelve-week follow-up. Participants also provided feedback on the program's acceptability. ResultsA total of 17 participants consented to participate in the intervention, 14 completed post-treatment assessment, 10 completed the four-week follow-up assessment, and 8 completed the eight-week and twelve-week follow-up assessment. Following the intervention, the study observed moderate to large improvements in self-esteem, self-compassion, hopelessness, depression, and suicide risk. The participants also reported reliable changes in clinical outcomes and positive perceptions of the program. ConclusionsThe psychoeducation program exhibited high acceptability and feasibility and promising early outcomes. Despite the small sample size and lack of a control group, these findings suggest potential benefits of the program. Further studies for examining the efficacy of the program are highly warranted.

Implementing expressive writing therapy in a virtual setting: A feasibility trial for survivors of intimate partner violence

Survivors of intimate partner violence commonly experience posttraumatic stress disorder (PTSD) and associated negative emotions. Pennebaker’s Expressive Writing Therapy (EWT) was applied in an online virtual setting to survivors of intimate partner violence. The study aimed to assess the program’s feasibility and acceptability, and to examine its effects on participants’ traumatic affects, self-esteem, and cognitive emotion regulation (CER). We employed a one-group pre- and post-test design, measuring outcomes at baseline, immediately after the intervention, and at a four-week follow-up. The implementation of EWT proved feasible; however, we encountered some cultural challenges, possibly influenced by the current sociocultural environment in South Korea. Notably, there was a significant reduction in negative CER, especially in self-blame and catastrophizing.

User Experiences With a Moderated Facebook Group to Promote Vaccination.

To examine user experiences in a moderated Facebook group intervention aimed at Coronavirus disease 2019 (COVID-19) vaccine promotion. Facebook group members were given 2-3 vaccination posts/day for 28days (fourweeks). Posts were aimed at educating about COVID-19 vaccination, soliciting concerns around COVID-19 vaccination, and engaging members. Participants were surveyed about their experience at four weeks. Moderated Facebook group. Unvaccinated individuals who were randomized to the intervention group and completed fourweek follow-up (N = 216, 82.1%). After fourweeks, participants rated their experience in the Facebook group (eg, program satisfaction) and provided open-text responses about their satisfaction with the group. Free-text responses were dual coded and emergent themes were examined. On average, participants were 37.0 years old (SD = 10.3), majority female (70.9%), and white (79.7%). The majority of participants were satisfied with the group (76.7%), agreed that other people were friendly (M = 5.58/7), and felt safe discussing health information (M = 3.96/5). Open-text responses revealed that participants liked the program because they thought the information was useful (27.7%), other members were friendly (16.1%), and the group was a safe place (13.8%). While many responded that there was nothing they did not like about the program (37.6%), nearly one-third (31.9%) reported disliking the program because it appeared to be too much in favor of vaccination and because other members came across as rude (7.1%). Those with conservative political views were less likely to be satisfied with the group (P = .04). Facebook groups represent an acceptable way to engage participants to improve vaccination against COVID-19. Some aspects of the Facebook group could be improved for future iterations.

Oral lichenoid drug eruption due to osimertinib for lung cancer.

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR) are linked with side effects involving skin and mucosa. Herein, we present a unique case of oral lichenoid drug eruption (LDE) in a patient treated with osimertinib. A 75-year-old woman was diagnosed with metastatic EGFR-mutated lung adenocarcinoma, and started on osimertinib 80 mg PO daily. At 24 months of therapy, the patient developed a painful, red, and white striated oral lesion involving the left buccal mucosa and the adjacent buccal aspect of gingivae. Biopsy showed oral LDE. Causality assessment between osimertinib and the oral LDE via Naranjo Adverse Drug Reaction probability scale revealed a score of 5. Osimetinib discontinuation was not felt to be in the best interest of the patient. Therefore, diphenhydramine HCL mouthwash every 6 h PRN (before meals) was started. Spicy and hot foods were discontinued. At a four-week follow-up visit, the patient reported moderate improvement in her symptoms. Oral LDEs are considered premalignant lesions as they can transform into squamous cell carcinoma; therefore, regular follow-up is needed. Awareness of this potential side effect of osimertinib would also prevent unnecessary (and potentially costly) work-up and lead to its prompt diagnosis and treatment.

Worry Postponement From the Metacognitive Perspective: A Randomized Waitlist-Controlled Trial.

Pathological worry is associated with appraisals of worrying as uncontrollable. Worry postponement (WP) with a stimulus control rationale appears to be effective in non-clinical samples. However, preliminary research in participants with generalized anxiety disorder (GAD) does not support its efficacy in reducing negative metacognitions or worry. The aim of this study was to investigate the efficacy of WP with a metacognitive rationale. Participants with GAD (n = 47) or hypochondriasis (HYP; n = 35) were randomly assigned to either an intervention group (IG) or waitlist (WL). The IG received a two-session long WP intervention aiming at mainly reducing negative metacognitions concerning uncontrollability of worrying. Participants were instructed to postpone their worry process to a predetermined later time during the six days between the two sessions. Participants completed questionnaires of negative metacognitions and worry at pre-assessment, post-assessment, and follow-up. We observed a significant Time*Group interaction for negative metacognitions and worry. Post-hoc analyses on the total sample and separately for GAD and HYP revealed significantly lower worry scores in the treated GAD sample compared to the WL, representing the only significant effect. In the GAD group, pre-post-effect sizes were small for negative metacognitions and large for worry. Effects persisted to a four-week follow-up. WP with a metacognitive rationale seems to be effective in reducing worry in participants with GAD. The effectiveness for HYP seems limited, possibly due to the small sample size.

Technology-based interactive communication simulation addressing challenging communication situations for nursing students

BackgroundSimulation-based interventions for nursing students addressing challenging communication situations involving geriatric patients and end-of-life care are limited. PurposeThis study evaluated the effects of technology-based interactive communication simulations on nursing students' communication knowledge, self-efficacy, skills, compassion, and program satisfaction. MethodA randomized controlled repeated-measures design was used with third- and fourth-year nursing students enrolled in five nursing colleges located in five regions in Korea as participants. Participants were randomly assigned to either a technology-based interactive communication simulation or an attention control group. Changes in communication knowledge, self-efficacy, skills, compassion, and program satisfaction were assessed using three self-reported measures and communication skills were measured by the raters. Statistical analyses included descriptive analyses, chi-square tests, t-tests, and a generalized estimating equation model. ResultsEighty students participated in one of the two programs, and 77 in the four-week follow-up test. The intervention group indicated significant improvements in communication knowledge, self-efficacy, skills, and compassion, as well as higher program satisfaction compared with the attention control group. Communication skills as assessed by raters also showed significant change at all assessment time points. ConclusionThe technology-based interactive communication simulation program is effective in improving communication skills among nursing students managing geriatric patients and end-of-life care.

Association between escitalopram dose personalisation based on quantification of drug plasma levels and the outcome of escitalopram treatment

IntroductionGiven the negative impact of anxiety and depression on society and the shortage of new antidepressants, it is of paramount importance to make the best use of available treatment options. Therapeutic drug monitoring (TDM) in escitalopram treatment can potentially be clinically useful, as underexposed patients show reduced efficacy of escitalopram treatment and as adverse drug reactions (ADRs) of escitalopram are dose-dependent.ObjectivesThis prospective cohort study aimed to investigate whether escitalopram treatment efficacy or safety are associated with escitalopram dose adjustment based on TDM readouts.Methods89 included patients aged between 15 and 65 years who suffered from depression were enrolled in the study before starting treatment with escitalopram. Patients were assessed one day before starting treatment with the recommended dose of 10 mg/day escitalopram (baseline, visit 0) and at follow-up after four and eight weeks. Dose adjustment at four-week follow-up was based on the measured escitalopram plasma level two weeks after treatment initiation; patients who required dose increase to 15 or 20 mg/day comprised comparator group, patients who did not required dose increase comprised control group, while patients who did not reach optimal exposure at eight-week follow-up were characterized as non-compliers. Treatment efficacy was approximated by the relative change on the Hamilton Depression Rating Scale (HAMD), while safety was approximated based on the changes on the Scandinavian UKU side effect rating scale and ECG readouts. Changes in HAMD, UKU score and QTc interval were compared between groups by one-way ANOVA or chi-square tests.ResultsCompared to baseline, significant reductions in HAMD scores of 36% (95%CI, 30%-43%) and 53% (95%CI, 47%-60%) were observed at four- and eight-week follow-up, respectively; however, there were no significant differences between groups (p > 0.1). In the groups adjusted to 15 and 20 mg, 15/26 and 19/33 patients, respectively, reported adverse effects, compared with 6/17 patients in the control group and 6/13 in the non-complier group (p>0.1). A significant mean QTc prolongation of 6.40 ms (95%CI, 3.27-9.53) was observed between the baseline and eight-week follow-up (p=0.0013), without significant differences in QTc interval prolongation between groups (p > 0.1).ConclusionsEscitalopram dose adjustment resulted in optimal drug exposure and solid treatment response in the majority of patients; however, no differences in efficacy were found between the patients who required dose adjustments, the ones who did not, and the ones who ultimately did not achieve optimal exposure. In addition, the selective increase of the dose to the patients who did not reach optimal drug exposure on the recommended dose of 10 mg/day did not lead to significant increase in adverse drug reactions and QTc prolongation.Disclosure of InterestNone Declared

Brief online negative affect focused functional imagery training (FIT) improves four-week drinking outcomes in hazardous student drinkers: A pilot randomised controlled trial replication in South Africa

BackgroundPrevious study has shown that functional imagery training (FIT) to utilise positive mental imagery in response to negative affect could improve alcohol-related outcomes. The current study aimed to replicate whether this negative affect focused FIT would improve alcohol-related outcomes in hazardous student drinkers in South Africa at four-week follow-up. Methods50 hazardous student drinkers who reported drinking to cope with negative affect were randomised into two groups. The active group (n = 25) was trained online over two weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas the control group (n = 25) received standard risk information about binge drinking. Outcome measures including alcohol consumption, drinking motives, anxiety and depression, self-efficacy and use of protective behavioural strategies were obtained at baseline and four-week follow-up. ResultsFIT effects were revealed by three significant group-by-timepoint interactions in a per-protocol analysis: there was a significant decrease in depressive symptoms, drinking to cope and drinking for social reasons from baseline to follow-up in the active group, but not the control group. No effects were observed on alcohol consumption, self-efficacy, protective behaviour strategies and anxiety. ConclusionsPreliminary evidence supports that online negative affect focused FIT can improve depression as well as coping and social drinking motives in South African hazardous student drinkers who drank to cope, at four-week follow-up, suggesting that the principles of this FIT approach might be adapted and incorporated into a clinical intervention to test for efficacy in mitigating substance use problems.

Comparison of Efficacy of Topical Betamethasone Dipropionate and Topical Minoxidil in Patients With Alopecia Areata.

Background and objective Alopecia areata (AA) is a reiterative and nonscarring type of hair loss that can affect any hairy area of the body, particularly the scalp. It manifests as patchy or confluent hair loss with variations in demographics and ethnicity. There are numerous treatment options available, including topical and systemic steroids, topical minoxidil, dithranol, tacrolimus, psoralen and ultraviolet therapy (PUVA), contact immunotherapy, and oral immunosuppressive drugs. However, no previous contrast for efficacy is present between the topical betamethasone versus topical minoxidil alone in our population. This study aims to compare the efficacy of topical betamethasone dipropionate versus topical minoxidil in patients with AA. Methodology A nonrandomized controlled study was conducted at the Department of Dermatology, Jinnah Hospital Lahore, incorporating the data of patients between July 26, 2016, and January 26, 2017, after obtaining institutional ethical approval. One hundred patients with alopecia, either on the scalp or any other hairy part, from both genders, aged between 18 and 50 years, were included in the study. Two groups were created, and patients were assigned to these groups based on the clinician's choice. Group A patients were administered betamethasone dipropionate (0.05%) lotion twice daily on affected areas for 12 weeks. Group B patients were administered minoxidil (5%) solution twice daily on affected areas for 12 weeks. A four-week follow-up plan was followed. A five-point scale score system was used for alopecia grading. After 12 weeks, the hair regrowth score (RGS) was used to compare the efficacy of treatment between the two groups. Results A total of 100 patients with grades S1 to S3 AA of less than three months duration were enrolled. Two groups were created, with 50 patients in each group. The mean age in Group A was 29.08 ± 6.51 years, while in Group B, it was 29.38 ± 6.62 years. In Group A, there were 76% males and 24% females, while in Group B, there were 74% males and 26% females. Comparison of efficacy of topical betamethasone dipropionate versus topical minoxidil in patients with AA demonstrated a greater efficacy of 74% (Grade 3 and Grade 4 responses) in Group A, while in Group B, only 42% of patients showed efficacy. A statistically significant difference was found, with a P-value of 0.001. No serious side effects were noted. Conclusions Our study concluded that topical betamethasone dipropionate (0.05%) lotion has statistically significantly higher efficacy compared to topical minoxidil (5%) solution in patients with AA.

Thrombectomy of the Profunda Femoral Vein in Iliofemoral Deep Venous Thrombosis Using an Antegrade Popliteal Approach.

Residual or undertreated inflow disease is a major cause of stent occlusion following endovascular thrombectomy for iliofemoral deep venous thrombosis (DVT). The profunda femoral vein (PFV) is an important inflow vessel alongside the femoral vein but is traditionally challenging to treat via an antegrade popliteal approach. This technical note describes a novel approach for PFV clearance in iliofemoral thrombectomy via the popliteal vein. Eight patients underwent PFV clearance as part of iliofemoral DVT thrombectomy via an antegrade popliteal approach. In seven patients, a popliteal-profunda communicating vessel was identified permitting PFV access and thrombectomy. In one patient, a popliteal-profunda communicator was not identified and an 'up and over' approach via the femoral bifurcation from the same popliteal access was utilised. Thrombectomy was performed using the Inari ClotTriever device or Penumbra's Indigo system. Technical success in PFV thrombectomy was 100%. Six patients (75%) underwent stenting for an iliac stenotic lesion or May Thurner compression point. At the four-week ultrasound follow-up, the pelvic iliofemoral segment was patent in 7 patients (87.5%). The PFV was patent in 7 patients (87.5%) whereas the FV was only patent in 4 patients (50%). One patient underwent reintervention for iliofemoral stent occlusion. No PFV injury occurred and no post-procedure profunda reflux was identified. PFV clearance can be achieved via an antegrade popliteal approach in iliofemoral thrombectomy to optimise inflow, negating the need for alternative or additional venous access. PFV may maintain upstream iliofemoral vein patency even with an occluded femoral vein. Level 4, Case Series.

Training Response Abilities of Children With Intellectual Disabilities: A Randomized Controlled Trial

Response abilities, i.e., response time (RT) and response force (RF), which are essential for efficient motor control, are impaired in children with intellectual disabilities (ID). The study aimed to evaluate the effects of object control skills training, computer-based games training, or standard care on the RT and RF of children with ID when measured across task conditions. A randomized controlled trial was conducted in a special education school where 75 children with ID, between 9 and 17 years of age, were randomly assigned to object control skills training, computer-based games training, or standard care, where intervention groups were provided thrice a week for four weeks. The RT and RF were measured using a response analyzer for simple response task, (passive and active) dual-task, and choice response task at baseline, post-intervention, and four-week follow-up. The RT significantly reduced with object control skills training (ηp 2= .325) and computer-based games training (ηp 2= .159). Participants who received the object control skills training had greater stability in force production than the other groups. With training, children with ID take less time and show better stability in their ability to modulate force in various task settings, with more pronounced effects with the object control skills training.

Efficacy and safety of crisaborole ointment in pediatric atopic dermatitis: A 4-week open-label study

Objectives: Managing mild-to-moderate atopic dermatitis (AD) often necessitates topical therapies, and one such recently introduced option is crisaborole ointment. This study sets out to assess the efficacy and safety of crisaborole ointment in pediatric cases of AD over four weeks. Material and Methods: Nineteen children between 2 and 16 years old with mild-to-moderate AD were enrolled and treated with crisaborole ointment twice daily in affected areas for 30 days. The primary objective was to appraise the shift in the investigator’s static global assessment (ISGA) scores (0–4) every week for the four-week follow-up. The severity of pruritus score (SPS) was another secondary objective. Furthermore, individual indicators of clinical signs that included erythema, exudation, excoriation, induration/papulation, and lichenification, were examined with subjective scores (0–3). Children’s dermatology quality of life index (CDLQI) was employed to study the quality of life. Results: Following four weeks of crisaborole ointment treatment, the average ISGA score declined from 2.58 ± 0.61 to 0.95 ± 0.78, signifying a substantial reduction in AD severity (P < 0.001). The SPS score also decreased from a mean of 2.32 ± 0.478 to 0.84 ± 0.60 (P < 0.001), underscoring a significant reduction in itching. Moreover, individual markers for clinical signs of AD, including erythema, exudation, excoriation, induration/papulation, and lichenification, all exhibited statistically significant improvement. Crisaborole ointment was well tolerated. Only 6 of the 19 patients reported a localized burning sensation, which was manageable. No patient needed to be withdrawn during the study period. The CDLQI showed a substantial drop in scores, decreasing from an average of 13.79 ± 3.57 at the commencement to 6.74 ± 1.97 (P < 0.001). Furthermore, 14 out of 19 patients met the study’s primary goal, achieving at least a 2-point reduction in ISGA along with the attainment of clear or nearly clear skin (ISGA 0–1). Conclusion: Our study found crisaborole ointment significantly improved pediatric AD symptoms and was well-tolerated. The only adverse event was localized burning in a few patients. Further, research is needed for validation.

The Effectiveness of Therapy Based on Acceptance and Commitment regarding Reducing Hopelessness and Anxiety of Working Children in Yazd city

Introduction: The phenomenon of working and street children is one of the problems that plagues most big cities. Working children means children and teenagers who, according to social laws, under the age of 18 engage in activities to earn money. The purpose of this research is to investigate the effectiveness of treatment based on acceptance and commitment regarding reducing hopelessness and anxiety of working children in Yazd City.
 Method: The method of the current research was semi-experimental, and its design was pre-test-post-test with a control group and a four-week follow-up. The statistical population included working children in the age group of 8 to 12 who were covered by the welfare management of Yazd city in the spring of 2019. The study sample included 30 working children who were placed randomly in 2 control and experimental groups using convenience sampling. Data collection tools included Kazdin's Children’s Hopelessness Scale and Spence's Children’s Anxiety Scale. The experimental group received 8 one and half an hour sessions of treatment based on commitment and acceptance, but the control group was placed on the waiting list. Data analysis was done using analysis of covariance test and SPSS software.
 Results: The results of the present study, according to the analysis of covariance, showed that the treatment based on acceptance and commitment significantly reduced the level of frustration and anxiety in working children (p<0/05).
 Conclusion: Based on the findings, it can be concluded that the treatment based on commitment and acceptance has been able to reduce hopelessness and anxiety of working children. It is suggested to organize psychological interventions and trainings with the help of relevant organizations in order to improve working children’s mental health and reduce their anxiety and frustration.

Acceptability of the power over pain portal among patients awaiting tertiary care consultation: A qualitative study of patients' perceptions.

Chronic pain affects approximately 7.6 million Canadians and access to care remains an issue. The Power Over Pain (POP) Portal offers immediate access to evidence-based resources ranging from low- (e.g. education, self-management), to high- (e.g. individual counseling) intensity. We explored the POP Portal's acceptability, usability, and perceived usefulness among patients newly referred to a tertiary care pain clinic. We used a descriptive, qualitative approach with a prospective cohort of 60 adult patients recently referred to The Ottawa Hospital Pain Clinic. Patients were offered an orientation session and asked to participate in a seven-week follow-up interview. Data were thematically analyzed in an iterative process, whereby responses were reviewed and coded by two members of the research team. Of the 60 patients referred to the POP Portal by clinic clerks, 45 participated in the orientation session, and 40 completed a four-week follow-up. All 40 patients had used the POP Portal and recommended that we continue to offer the POP Portal to patients awaiting care. We identified overarching themes of acceptability (five subthemes), usability (ten subthemes), accessibility (three subthemes), and patient value of the POP Portal (three subthemes). This includes (1) the POP Portal provides easy access to chronic pain resources; (2) the POP Portal is helpful in developing an understanding of chronic pain; and (3) improvements to the POP Portal are needed to increase usability and foster a user-friendly experience. The POP Portal offers accessible and diverse resources for people living with pain awaiting a tertiary care consultation; however, patients would like to see resources specific to diagnosis. Improvements are suggested to allow greater increase the POP Portal usability.

The Development and Testing of a Point-of-Sale E-Cigarette Health Communication Campaign

ABSTRACT Adolescents and young adults continue to use e-cigarettes, and communication campaigns are needed to decrease use among these populations. We developed and tested a point-of-sale communication campaign focused on e-cigarette chemical exposure. We developed messages based on formative research and tested them (versus text-only messages) in a nationally-representative online survey among adolescents and young adults (16–25) (Phase 1). Based on survey findings, we selected a message focused on nicotine and brain development for the point-of-sale trial (Phase 2). We then conducted a cluster-randomized trial at six gas stations with convenience stores, randomly assigned to the intervention (messages displayed) or no message control condition. We conducted intercept surveys with repeated cross-sectional samples of 50 participants (ages 16–25) per store, at baseline and a four-week follow-up. Phase 1 included 1,636 participants in the online study. Intervention messages were rated as more attention grabbing than plain text messages (p < .05), though were rated similarly on other outcomes. Exposure to intervention messages resulted in larger changes from pre- to posttest for beliefs about addiction and relative harms versus cigarettes (p < .05). Phase 2 included 586 participants in the point-of-sale study. Real-world campaign exposure was low (31.8%), and no differences were found between conditions. E-cigarette prevention messages focused on nicotine’s impact on brain development show promise. However, garnering attention for communication campaigns in saturated point-of-sale environments, often dominated by tobacco advertising, is challenging. Future efforts should utilize additional communication channels to directly target adolescents and young adults.

An educational intervention in the emergency department seeking to improve COVID-19 vaccination rates among unvaccinated patients aged 20-64.

The COVID-19 vaccination rate in the US has plateaued, especially among minorities and young populations. Previous efforts within the Emergency Department (ED) setting to address this disparity have shown positive results. The ED can play a crucial role in engaging vaccine-hesitant individuals, particularly those with limited access to healthcare. By providing education, addressing concerns, and using positive framing, vaccination rates can be improved in the ED. This quality improvement project aimed to increase vaccination rates through one-on-one educational interventions and open discussions with patients. Between November 2021 and June 2022, unvaccinated adult patients aged 20 to 64 visiting a local ED in Kalamazoo, MI were approached for a discussion on COVID vaccines. A research team, trained in motivational interviewing techniques, provided an educational intervention, offering evidence-based information and resources to unvaccinated participants. A total of 37 participants were enrolled, and their demographics were recorded. The participants expressed various concerns about the vaccine, including potential side effects, speed of testing and production, perceived ineffectiveness, mistrust, and low personal risk. At the four-week follow-up, three participants (8%) had received their first dose of the COVID-19 vaccine. The study fell short of its desired sample size and the intervention failed to raise vaccination rates among ED patients. Factors like low perceived risk, vaccine hesitancy, and limited resources may have influenced these outcomes. Future research should focus on staffing, operational hours, repeated educational interventions, and targeted approaches for different populations. Improving participant recruitment through institutional engagement and involvement of multiple EDs should be explored. Addressing these factors can help inform effective interventions to increase COVID-19 vaccination rates in the ED.

Surgical exposure for vitrectomy in retinopathy of prematurity.

Our purpose was to evaluate the efficacy of lateral canthotomy, sub-tenon anesthesia injection, and the use of modified speculum for gaining adequate surgical exposure during surgery for retinopathy of prematurity (ROP). Fourteen eyes of 10 consecutive patients undergoing microincisional vitrectomy surgery (MIVS) for stage 4 and stage 5 ROP were included. There was a significant widening of the palpebral fissure height and length using this technique. No patient developed a lens injury during the surgery. All the canthotomy incisions completely healed at a four-week follow-up visit. This is a safe and effective technique for increasing surgical exposure in cases of ROP requiring vitrectomy.

How Positive Activities Shape Emotional Exhaustion and Work-Life Balance: Effects of an Intervention via Positive Emotions and Boundary Management Strategies

AbstractThe positive-activity model (PAM) proposes how and for whom positive activity interventions work best. This article evaluates the effectiveness of a web-based self-regulation intervention that teaches participants positive activities. Over six weeks, participants engage in different positive activities to meet the particular challenges in flexible work designs (FWD) such as remote work or mobile work. In line with the PAM, we expected the intervention to decrease emotional exhaustion and increase satisfaction with work-life balance via increases in both positive emotions and boundary management. Moreover, individuals’ depressive symptoms were expected to moderate this relationship. In a randomized controlled trial, participants were assigned to a waitlist control group or an intervention group. Study participants received questionnaires before and after the intervention and at a four-week follow-up. The final sample included 288 participants (intervention group: n = 105; control group: n = 183). Results of mixed variance analyses were in line with our predictions. Findings indicate that the intervention is an effective tool for improving well-being and work-life balance for workers with FWD. Changes in positive emotions and boundary management explained intervention effects. The intervention was effective regardless of participants’ baseline level of depressive symptoms.