High Satisfaction Research Articles

Best Agile method selection approach at workplace

Selecting the most suitable agile software development method is a challenging task due to the variety of available methods, each with its strengths and weaknesses. To achieve project goals effectively, factors such as project needs, team size, complexity, and customer involvement should be carefully evaluated. Choosing the appropriate agile method is crucial for achieving high client satisfaction and effective team management, but it can be a challenging task for project managers and higher-level management officials.This paper presents a solution aiming to help them in selecting the most suitable software development method for their project. In this regard, this solution includes a pre-project management approach model and a decision tree that considers the unique requirements of the project. In the proposed solution results, Scrum was found to be suitable for both small and large projects, on the condition that roles and responsibilities are clearly defined and that the approach is people-centric. Furthermore, high-risk mitigation measures should be added for small projects. To facilitate the use of our model, a software application has been developed which implements the decision-making tree.

Focal resurfacing of the knee – A systematic review and meta-analysis

PurposeIn order to assess the published validity of focal resurfacing of the knee, a systematic review and meta-analysis were conducted to (i) evaluate revision rates and implant survival of focal resurfacing of the knee; (ii) explore surgical complications; and (iii) evaluate patient reported clinical outcome measures. MethodsPubMED, Cochrane Library and Medline databases were searched by 2 independent reviewers in February 2022 for prospective and retrospective cohort studies evaluating any of the following implant types: HemiCAP®, UniCAP®, Episealer® or BioBoly®. Data on incidence of revision, complications and various patient reported outcome measures, such as Knee Society Score (KSS) or Knee Injury and Osteoarthritis Outcome Score (KOOS) was sourced. ResultsA total of 24 published studies were identified with a total of 1465 enrolled patients. A revision rate of 12.97% over a 5.9 year weighted mean follow-up period was observed across all implant types. However, in one series a Kaplan-Meir survival as high as 92.6% at a 10-year follow-up period was noted. A statistically significant improvement was documented across multiple subjective clinical outcomes scores, for example a mean 4.56 point improvement of the VAS (0–10) pain score. The Kellgren-Lawrence score was used to evaluate the radiological progression of osteoarthritis and showed a small significant reduction in all anatomical locations, hence not supporting the hypothesis that focal femoral implants can lead to the progression of osteoarthritis in the affected compartment. There was a low reported incidence of post-operative complications such as aseptic loosening or deep wound infection. ConclusionsFocal femoral resurfacing appears to be a viable treatment option for focal symptomatic chondral lesions in patients beyond biological reconstruction, with low revision rates and high patient satisfaction especially at short and medium length follow-up.

Hollman Facilitations: a user-friendly tool of supporting children with visual impairment and their families in daily life

The Robert Hollman Foundation (RHF) designed “Hollman Facilitations” (HF), a user-friendly way of supporting children with visual impairment (VI) and their families on a daily basis. This tool consists of specifically designed pictures on simple A4 sheets, which highlight with images and captions the key aspects of these children's everyday lives. Professionals can easily modify Hollman Facilitations to customize them to the unique developmental needs of every single child with VI and to their individualized strengths and weaknesses. This type of support acts as a reminder, to help families keep in mind what is essential for their children with VI in everyday life. HF are also useful for professionals because they give a clear, at-a-glance overview of visually impaired children's needs, helping their communication with their families. In order to understand the perceived effectiveness of this tool, a questionnaire was designed and sent to 49 families, asking their opinions and satisfaction levels regarding its clarity, adequacy, usability and usefulness. 36 parents answered reporting overall very high satisfaction levels. A second questionnaire was sent to 29 RHF professionals to collect their opinions regarding HF usability and usefulness and the majority of them was very satisfied of its use in their daily work. This data supports overall this tool, which can be also easily replicated and also potentially used in other settings, beyond the field of visual impairment.• HF support children with VI and their families substantially and works as a reminder of what the professionals found in their consultations, to be fundamental for the children to promote the use of their functional vision and their strengths and to consequently improve the quality of their daily lives• HF favour a better communication between health professionals and families of children with VI, sharing therapeutic indications through the adoption of a customized, user-friendly, everyday tool by integrating pictures and text with oral communication• HF help professionals to identify strategies that best promote the overall development of children with visual impairment and to express them in an understandable way

Guided web app intervention for reducing symptoms of depression in postpartum women: Results of a feasibility randomized controlled trial

BackgroundChile faces a significant postpartum depression prevalence and treatment gap, necessitating accessible interventions. While cognitive-behavioral internet-based interventions have proven effective in high-income countries, this field is underdeveloped in Chile. Based on the country's widespread use of digital technology, a guided 8-week cognitive-behavioral web app intervention named “Mamá, te entiendo” was developed. ObjectiveThis study aimed to assess the acceptability and feasibility of “Mamá, te entiendo”, for reducing depressive symptomatology in postpartum women. MethodsSixty-five postpartum women with minor or major depression were randomly assigned to either intervention or waitlist. Primary outcomes centered on study feasibility, intervention feasibility, and acceptability. Semi-structured interviews with a sub-sample enriched the understanding of participants' experiences. Secondary outcomes included mental health variables assessed at baseline, post-intervention, and 1-month follow-up. ResultsChilean women displayed great interest in the intervention. 44.8 % of participants completed the intervention. Participants reported high satisfaction and engagement levels, with interviewees highlighting the value of the intervention's content, exercises, and therapist's feedback. However, preliminary efficacy analysis didn't reveal a significant interaction between group and time for outcome measures. DiscussionThis research represents a pioneering effort in Chile to evaluate an internet-based intervention for postpartum depression symptoms. The demonstrated feasibility and acceptability highlight the potential of integrating technology-driven approaches into mental health interventions. However, the intervention did not demonstrate superiority, as both groups exhibited similar positive progress in several outcomes. Therefore, the following research phase should involve a larger and more diverse sample to assess the intervention's effectiveness, identify influencing factors, and determine the individuals who benefit the most.

The influence of customer experience on loyalty through satisfaction as an intervening variable for users of maxim online transportation services in the city of semarang

The high level of online transportation users in Indonesia creates intense competition and to be able to survive in the midst of competition, companies must improve their performance in various aspects to be able to create a good experience for their users so that there is high satisfaction so that user loyalty to the company continues to survive and increase. This research aims to determine the influence of customer experience on user loyalty through satisfaction with users of Maxim online transportation services in Semarang City. This type of research is explanatory research with a sample size of 96 respondents who are Maxim users in Semarang City. with a sampling technique using non-probability sampling with a multistage purposive sampling method. The population in this research is the people of Semarang City who have used Maxim. The data analysis method uses SmartPLS 3.2.9 software. The research results prove that the mediating relationship between customer experience and loyalty through satisfaction as an intervening variable is partial mediation. The suggestion in this research is that Maxim is expected to pay more attention to aspects that can influence user experience so that users feel maximum satisfaction when using Maxim.

Acceptability and Effectiveness of a Dementia-care Program Delivered by Community-based Agency Staff.

Few proven dementia care programs are integrated into community-based agencies. We report acceptability and effectiveness of an evidence-based program, COPE, delivered by community-based agency staff. Pre-test/post-test design with three data points (baseline, 3- months program completion, 6-month follow-up). COPE was delivered by six occupational therapists and four social workers at two agency sites with people living with dementia and caregivers. Staff assessed s the interests and abilities of people living with dementia, home safety, and caregiver challenges, and readiness to learn strategies. Staff provided dementia education, stress reduction and nonpharmacological techniques tailored to caregiver-identified challenges. Acceptability (3-and 6-months), included completed sessions, upset with and confidence managing care challenges, strategies used, and program satisfaction. Effectiveness (3-and 6-months) included people living with dementia's health events (falls, emergency room visits, hospitalizations, 911 calls), rehospitalization risk and functional dependence; and caregiver wellbeing and readiness. Benefits by in-person (n=188) versus virtual/hybrid (n=46) delivery due to COVID were evaluated. Of 843 dyads screened, 271 (32.1%) enrolled, 246 (90.8%) completed COPE and 234 (95.1%) completed >1followups. Regarding acceptability, caregivers completed about 8 sessions, reported improved confidence and upset (ps<0.001s), most implemented strategies 3-months (72.8%) and 6-months (83.5%) and expressed high program satisfaction. For effectiveness, compared to baseline, odds of people living with dementia's health events were lower including rehospitalization risk, although functional dependence increased; caregiver wellbeing (3, 6-months, ps<0.001s) and readiness (3-months, p<01) improved. Outcomes did not differ by delivery mode. Acceptability and effectiveness were strong. COPE resulted in tangible improvements for families regardless of delivery mode.

Elbow Flexor Release Combined With Selective Neurectomy of Musculocutaneous Nerve for Spastic Elbow Flexion Deformity in Children and Adolescents.

Spasticity of the elbow flexors causes a dynamic and/or static elbow flexion deformity. This position interferes with the functional use of the hand, is aesthetically unpleasant and can cause problems with hygiene and comfort. A lengthening procedure of elbow flexor muscles can improve elbow posture and range of motion. However, causal spasticity is not addressed directly. Selective neurectomy of the musculocutaneous nerve has a direct effect on underlying spasticity but is not sufficient when contracture is present. In this study, we examine the long-term results of a combined surgical approach: a release procedure of the elbow flexors and selective neurectomy of the musculocutaneous nerve. A retrospective study of 14 patients with spastic flexion deformity of the elbow was performed. After a mean follow-up of 52.6 months (SD 33, range 12 to 113), the results of the combined surgical approach were evaluated. Spontaneous position of the elbow and active and passive range of motion were assesses using goniometry. Spasticity was assessed using the Modified Ashworth Scale. Function of the affected upper limb before and after surgery was assessed by the House functional classification. Patient and caretaker's satisfaction were assessed using a visual analogue scale. The mean decrease of passive elbow extension deficit was 34 degrees (SD 21.3, P<0.05). Active elbow extension increased with a mean of 41 degrees (SD 16.5, P<0.05). Spontaneous position elbow flexion decreased by a mean of 40 degrees (SD 21.1, P<0.05).The Modified Ashworth score decreased significantly (P<0.05) from 3.27 (range 1 to 4) preoperatively to 0.64 (range 0 to 4) postoperatively.The difference between the House score preoperatively and postoperatively was not significant (P=0.180). Mean patient satisfaction was 8.2/10 (SD 2.7, range 2 to 10) and mean caregiver satisfaction was 7.1/10 (SD 2.7, range 1 to 10). A combined surgical approach to elbow flexion deformity in the form of a lengthening procedure and selective neurectomy of the elbow flexors result in a significant and sustained improvement of the spontaneous position, active and passive elbow extension and elbow flexor spasticity and high patient and caregiver satisfaction. Case series, level IV.

Arthroscopic debridement, synovectomy and thermal shrinkage for basal joint arthritis.

Ligamentous laxity, cartilage wear, and diffuse synovitis are frequently seen in thumb basal joint arthritis. Although these degenerative changes may be mild for the majority, they have the potential to cause discomfort during movement and compromised hand function. This study assesses the long-term outcomes of arthroscopic debridement, synovectomy, and thermal shrinkage in managing early-stage basal joint arthritis. We retrospectively reviewed patients with basal joint arthritis who underwent arthroscopic debridement, synovectomy, and thermal shrinkage between November 2010 and January 2021 by a single surgeon at our medical institute. We assessed functional outcomes, thumb range of motion, perioperative nonsteroidal anti-inflammatory drug (NSAID) use, return to work and satisfaction level. A total of 12 patients (13 hands), with a mean follow-up of 72 months, were included in this study. Significant improvements were observed in pain scores and functional outcomes, along with a reduction in postoperative NSAID use. Patients also reported a relatively quick return to work and a high satisfaction level. The study highlights the benefits of arthroscopic intervention, providing a minimally invasive approach with favorable long-term outcomes for patients with symptomatic basal joint arthritis.

Provision of Telepsychological Care Via Email during COVID-19 Confinement: An Exploratory Study.

Within teletherapy, email interventions have been studied scarcely. For this reason, this exploratory study aims to characterize the assistance provided by email in a university telepsychology service and to compare the data with the assistance provided by telephone in the same service and period. For this purpose, the records of 81 users assisted via email during the COVID-19 pandemic lockdown in Spain were analyzed. The data were compared with those of the 338 users assisted by telephone in the same period. Despite its many limitations, results indicate high satisfaction with the email modality. Users express that they prefer a preference for using email when they do not feel safe in other ways. We found a lot of variation between the number of emails exchanged and the days that each case was active. Additionally, differences were found with telephone users in aspects such as age (email users being younger) and in a depression screening (email users scoring more positively). This study concludes on the high potential of this channel for the application of certain techniques (e.g., psychoeducation) or for people with certain characteristics.

Autologous fat transplantation prior to permanent expander implant breast reconstruction enhances the outcome after two years: a randomized controlled trial.

Radiotherapy is important in breast cancer treatment. A side effect of the treatment is fibrosis that decreases the possibility for a successful breast reconstruction with expanders and with high patient satisfaction with the result. The most common option for mastectomized, irradiated women wishing for a breast reconstruction is autologous tissue transplantation. However, some patients are not suitable for flap surgery. Fifty mastectomized and irradiated women were included in a randomized controlled trial. They underwent breast reconstruction with expanders and were allocated 1:1 to either receive pre-treatment with autologous fat transplantation (AFT) or not. Primary outcomes were frequency of reoperations and complications. Secondary outcomes were number of days in hospital, number of outpatient visits to surgeon or nurse and patient reported outcome as reported with Breast Q. Follow-up time was 2 years. Fifty-two per cent of the intervention group and 68% of the controls underwent reoperations (p = 0.611). Thirty-two per cent of the intervention group and 52% of the controls had complications (p = 0.347). The median number of consultations with the nurse was four in the intervention group and six in the control group (p = 0.002). The AFT patients were significantly more satisfied with their breasts and psychosocial well-being after 2 years. They also had higher increase in satisfaction with breasts, psychosocial well-being, and sexual well-being when comparing baseline with 2 years postoperatively. This randomized controlled trial indicates benefits of AFT prior to breast reconstruction with expanders, especially on patient reported outcome even if the study sample is small.

Racial and Ethnic Concordance Between the Patient and Anesthesia Team and Patients' Satisfaction With Pain Management During Cesarean Delivery.

Racial and ethnic concordance between patients and health care providers increases patient satisfaction but has not been examined in obstetric anesthesia care. This study evaluated the association between racial and ethnic concordance and satisfaction with management of pain during cesarean delivery (PDCD). This was a secondary analysis on a cohort of patients undergoing cesarean deliveries under neuraxial anesthesia that examined PDCD. The outcome was satisfaction, recorded within 48 hours after delivery using the survey question, "Overall, how satisfied are you with the anesthesia care during the C-section as it relates to pain management?" Using a 5-point Likert scale, satisfaction was defined with the answer "very satisfied." Participants were also asked, "If you have another C-section, would you want the same anesthesia team?" The exposure was racial and ethnic concordance between the patient and anesthesia team members (attending with a resident, nurse anesthetist, or fellow) categorized into full concordance, partial concordance, discordance, and missing. Risk factors for satisfaction were identified using a multivariable analysis. Among 403 participants, 305 (78.2%; 95% confidence interval [CI], 73.8-82.1) were "very satisfied," and 358 of 399 (89.7%; 95% CI, 86.3-92.5) "would want the same anesthesia team." Full concordance occurred in 18 (4.5%) cases, partial concordance in 117 (29.0%), discordance in 175 (43.4%), and missing in 93 (23.1%). Satisfaction rate was 88.9% for full concordance, 71.8% for partial concordance, 81.1% for discordance, and 78.5% for missing (P value = .202). In the multivariable analysis, there was insufficient evidence for an association of concordance with satisfaction. Compared to full concordance, partial concordance was associated with a nonsignificant 57% (95% CI, -113 to 91) decrease in the odds of being satisfied, discordance with a 29% (95% CI, -251 to 85) decrease, and missing with a 39% (95% CI, -210 to 88) decrease. Risk factors for not being "very satisfied" were PDCD, anxiety disorders, pregnancy resulting from in vitro fertilization, intravenous medication administration, intrapartum cesarean with extension of labor epidural, having 3 anesthesia team members (instead of 2), and a higher intraoperative blood loss. Our inability to identify an association between concordance and satisfaction is likely due to the high satisfaction rate in our cohort (78.2%), combined with low proportion of full concordance (4.5%). Addressing elements such as PDCD, anxiety, intravenous medication administration, and use of epidural anesthesia for cesarean delivery, and a better understanding of the interplay between concordance and satisfaction are warranted.

A flour composite mixture for gluten-free confectionery

The article is devoted to the development of a recipe for a gluten-free flour composite mixture based on buckwheat, rice, and corn flours for the preparation of confectionery products, as well as the enhancement of its nutritional value using locally produced flaxseed and chickpea flours. For the production of gluten-free sugar cookies, two types of gluten-free flour composite mixture have been developed: a) rice, buckwheat, and flaxseed flour and b) rice, corn, and chickpea flour. The optimal flour ratio is 40:30:30. The physic-chemical and organoleptic indicators of gluten-free sugar cookies obtained using the gluten-free flour composite mixture align with the indicators specified in the standard. The developed gluten-free composite flour mixture is characterized by a fairly high satisfaction level with the balanced nutrition formula regarding basic nutrients. The levels of protein, carbohydrate, and fat satisfaction increased by 64, 37, and 118%, respectively, with the addition of flax to the rice and buckwheat mixture. Adding chickpeas to the rice and corn mixture increased protein and fat satisfaction by 35.5 and 27%, respectively, while carbohydrates remained almost unchanged.

Student satisfaction with artificial intelligence chatbots in Ethiopian academia

This study explores student satisfaction with artificial intelligence chatbots in Ethiopian academia, examining their usage patterns, satisfaction levels, benefits, concerns and recommendations for improvement. A quantitative survey was conducted among 367 Ethiopian students from various educational levels and regions. The survey collected data on artificial intelligence chatbot usage, satisfaction, benefits, concerns and improvement recommendations. The findings reveal that artificial intelligence chatbots are frequently used for academic purposes, with students primarily using them for research assistance, assignment help and exam preparation. The students reported moderate to high satisfaction with chatbots, particularly regarding responsiveness, accuracy and adaptability. The benefits included time-saving, improved academic performance and 24/7 access to information. Concerns focused on access to technology, privacy and data security. The students also provided recommendations for enhancing chatbots, such as localisation, cultural sensitivity, affordability and security.

Evaluating the Effectiveness of Using Virtual Reality Interventions on Children and Adolescents with Autism Spectrum Disorder: A Systematic Review

Background: Autism spectrum disorder (ASD) is a Psychopathic disorder characterized by abnormal communication and verbal behaviors. ASD is very common in children, affecting about 1 in 160 individuals, and the symptoms of this disorder appear before the age of three, and the main cause is still unknown. The effectiveness of this technology on the abilities required for people with ASD to communicate in a social setting has been the subject of several systematic and comprehensive studies. Methods: A systematic review by searching in PubMed, EMBASE and CINAHL for publications was conducted from 1 January 2012 to 30 May 2021 involving use of virtual reality interventions on children and adolescents with autism spectrum disorder in which autism, autism spectrum disorder, ASD, virtual reality, VR keywords were utilized. Three reviewers independently investigated search results for inclusion in analysis and resolved disagreements by consensus. Results: Literature research of databases specifies a total of 808 records. According to the abstract and the full text of the studies, after applying the inclusion and exclusion criteria and eliminating duplicates and screening articles, 15 articles were selected for final review based on the PICO criteria (population, intervention, comparison and results). The studies focused on the five topics of emotion and social interaction, social communication, daily life skills, specific fears and anxieties, physical activity, and attention. Conclusion: According to reports, the findings rightly claim that the use of virtual reality technologies not only improves the social and communication skills of children with ASD, but also provides them with an engaging and enjoyable experience. Moreover, Parents indicated high satisfaction with VR applications and this technology can contain many benefits in the treatment of ASD.

The Medical Writing Center Model in an Academic Teaching Hospital.

Editing services within academic health centers are uncommon, and few studies have reported on their impact. In this article, we describe our medical writing center's editing service for faculty and trainees at a pediatric teaching hospital and associated outcomes of scholarly products (e.g., manuscripts and grants) over an 8-year period. Data for manuscripts and grant proposals edited by the writing center from 2015 through 2022 were collected electronically from our service request database. Outcome data on publications and grant proposals were regularly collected up to 12 months post-submission. Users were also asked if the writing center edits were helpful, improved readability, and if they planned to use the service in the future. From 2015 through 2022, the writing center received 697 requests, 88.4% to edit a document. Of the documents edited, 81.3% of manuscripts and 44.4% of grant proposals were successfully published or funded. When rating their experience, 97.8% of respondents rated the edits "helpful," 96.7% indicated the edits "improved readability," and 99.3% stated they planned to use the writing center in the future. Our results showed steady use of the writing center and high satisfaction with services. A writing center can be an effective tool to support psychology faculty development.

Patient satisfaction with clinical services provided by chiropractic students under supervision compared to licensed chiropractors: An observational study.

This study investigated patient satisfaction with care provided by chiropractic students under supervision vs supervisors in a Danish hospital setting. A cross-sectional observational study of patient satisfaction was conducted at the Spine Center of Southern Denmark, where chiropractic students from the University of Southern Denmark complete an 8-week internship in their final year of pregraduate training. Patients were assigned to students or supervisors based on administrative convenience (ie, natural allocation). Blinded from the aim of the study, all patients seen by a chiropractor (with or without a student) were invited to answer a questionnaire rating satisfaction with the clinical encounter. Results were analyzed using ordinal logistic regression with group allocation blinded by the investigators. Results from 438 participants (response rate = 88%) showed no significant difference in patient satisfaction between the student and supervisor groups. Although a small difference favored the supervisor group, the student group had a higher proportion of high and very high satisfaction combined. Satisfaction differed minimally whether patient care was administered by students under the supervision of a licensed chiropractor or by licensed chiropractors alone. Our findings suggest that patients do not negatively view student involvement in clinical consultations at a Danish hospital.

From the experience of more than 1000 glue ablation procedures for varicose veins: how to do it

Cyanoacrylate adhesive closure (CAC) is currently one of the main non-thermal ablation modalities of incompetent saphenous veins. High efficacy and safety of the method is supported by international clinical practice guidelines as well as the real-world practice. In contrast to thermal ablation, CAC is advantageous in terms of low periprocedural pain and bruising, fast procedure time and postprocedural recovery, high patient comfort and satisfaction rates as well as avoidance of postprocedural compression. This publication summarises the practical tips and tricks of glue ablation procedure based on 5-year experience (2019–2023) at the “SM-Clinic” Phlebology Centre, Moscow. Indications for the preferred use of CAC are formulated, such as: low pain threshold; contraindications (or unwillingness) to postprocedural compression; extensive comorbidity and fragile patients; concomitant morbid obesity; the presence of axial reflux along the saphenous veins; the need for simultaneous ablation of several incompetent truncal veins; below-the-knee incompetence of saphenous veins, including recurrent varicose veins; extensive lipodermatosclerosis and/or venous leg ulcer; patient’s HIV and viral hepatitis positive status. A step-by-step interventional protocol of glue ablation is described, including the modified protocols of the procedure. The immediate and long-term outcomes of the CAC according to current data are discussed. Special attention is paid to adverse events following CAC, as well as technical aspects of their prevention. Despite high efficacy and safety profile, today’s limitations for adoption and wider use of CAC are cost issues and lack of reimbursement.

Enhancing active learning through collaboration between human teachers and generative AI

To address the increasing demand for AI literacy, we introduced a novel active learning approach that leverages both teaching assistants (TAs) and generative AI to provide feedback during in-class exercises. This method was evaluated through two studies in separate Computer Science courses, focusing on the roles and impacts of TAs in this learning environment, as well as their collaboration with ChatGPT in enhancing student feedback. The studies revealed that TAs were effective in accurately determining students’ progress and struggles, particularly in areas such as “backtracking”, where students faced significant challenges. This intervention’s success was evident from high student engagement and satisfaction levels, as reported in an end-of-semester survey. Further findings highlighted that while TAs provided detailed technical assessments and identified conceptual gaps effectively, ChatGPT excelled in presenting clarifying examples and offering motivational support. Despite some TAs’ resistance to fully embracing the feedback guidelines-specifically their reluctance to provide encouragement-the collaborative feedback process between TAs and ChatGPT improved the quality of feedback in several aspects, including technical accuracy and clarity in explaining conceptual issues. These results suggest that integrating human and artificial intelligence in educational settings can significantly enhance traditional teaching methods, creating a more dynamic and responsive learning environment. Future research will aim to improve both the quality and efficiency of feedback, capitalizing on unique strengths of both human and AI to further advance educational practices in the field of computing.

Leveraging Project ECHO to Implement a Suite of Substance Use Learning Communities for Statewide Impact.

Overdoses and alcohol consumption rose during the pandemic. However, uptake of practices which reduce mortality (eg, medications for opioid use disorder, harm reduction practices) remains insufficient. Provider training and telementoring is needed to ensure sufficient capacity for treating substance use disorders (SUDs) with evidence-based practices. The Project ECHO (Extension for Community Healthcare Outcomes) model involves the use of web technologies to deliver didactic and case-based learning through a panel of experts to build such competency in a community of learners. Project ECHO was leveraged to implement a statewide telementoring center of addictions-focused ECHO programs, including programming in prescribing, harm reduction, recovery support services, collaborations with first responders, and systems-level challenges. Participants represented health and behavioral health disciplines practicing across the state of Texas in metropolitan and rural areas. Learners were administered: (1) an online registration form that inquired about basic demographics, (2) a post-session survey at the conclusion of each session capturing satisfaction and likelihood to implement, and (3) annual surveys measuring changes in knowledge and self-efficacy. Attendance and other learner data were stored and extracted from the partner relationship management database: iECHO. Training programs were attended by 968 learners, with an average of 48 learners per session. Geographic reach included 47 Texas cities. Post-training survey results indicated high rates of learner satisfaction, with an average rating of 4.68 on a 5-point Likert-like scale. Annual surveys indicated improvements in provider knowledge and self-confidence across all programs. Early results indicate robust uptake, wide geographic reach, high learner satisfaction, and provider knowledge and confidence gains. This preliminary evidence supports the use of the ECHO model as a potential tool for scaling comprehensive SUD telementoring centers to meet workforce development needs over large geographic areas.

Effective improvement methods for striae distensae: A novel approach utilizing laser-induced micro-jet injectors with poly-d,l-lactic acid.

Striae distensae (SD), or stretch marks, result from rapid stretching of the skin due to various factors. Conventional treatments often yield unsatisfactory results, leading to the exploration of alternative methods. Laser-induced microjet technology offers a promising approach for drug delivery to target areas. This study investigates the efficacy of using a microjet injector with poly-d,l-lactic acid for treating SD. Four female participants with SD were treated with poly-d,l-lactic acid solution using a microjet injector over five sessions. Patients were assessed based on severity scales before and after treatment. Topical anesthetics were applied to minimize discomfort. Injection techniques were optimized to reduce side effects such as bleeding and pain. All patients showed significant improvement in SD appearance after 5-7 treatments. Assessment scales indicated positive outcomes both immediately after treatment and at the 32-week follow-up. Minimal side effects, primarily petechiae, were observed. Laser-induced microjet technology offers several advantages, including rapid drug delivery and mechanotransduction effects, promoting skin regeneration. Poly-d,l-lactic acid injections demonstrated effectiveness in treating SD, particularly when delivered via microjet injectors. Patients expressed high satisfaction due to the procedure's minimal invasiveness and quick recovery. Utilizing a needleless microjet injector with poly-d,l-lactic acid shows promise as a treatment for SD, typically requiring 5-7 sessions for optimal results. Mild petechiae may occur as a common side effect. This approach offers an effective and minimally invasive alternative for addressing this common cosmetic concern.