Hybrid Intervention Research Articles

Trauma-informed acceptance and commitment therapy with peer coaching for college students: A pilot randomized controlled trial.

The current pilot randomized controlled trial evaluated the acceptability, feasibility, and preliminary efficacy of a mental health promotion intervention for college students based on trauma-focused acceptance and commitment therapy (Harris, 2021). This hybrid intervention combined web-based modules with peer coaching in a research lab setting. Seventy-eight students were randomized to either the intervention group, "Present and Open for Values" training, or an active control group, "Crash Course" training. Psychological distress and life satisfaction levels were assessed at baseline, postintervention, and 3 months postintervention. Open-ended feedback, rating scales, and completion rates suggested that both conditions were well-received and feasible. Longitudinal mixed-effects regression models with subject-specific intercepts were used to examine intervention effects. Participants in the Present and Open for Values condition reported significantly greater reductions in psychological distress levels compared to the control group, both at the end of the intervention and 3-month follow-up. Additionally, they reported significantly greater improvements in life satisfaction levels at these same intervals compared to baseline measurements. No significant changes in these outcomes were observed for the control condition. These findings suggest that the Present and Open for Values intervention with peer coaching is a promising approach for addressing mental health issues among college students, with the potential to be scaled up for broader implementation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of milling interventions on the geometry of wall-shaped structures in hybrid wire-arc direct energy deposition

The Hybrid Wire-Arc Direct Energy Deposition (Hybrid Wire-Arc DED) process integrates Wire-Arc Direct Energy Deposition (Wire-Arc DED) with machining (typically milling) interventions, offering the potential for creating intricate geometries and finished surfaces. However, if milling is employed as a hybrid intervention rather than as a final part-finishing process, the interplay between these processes remains under-investigated. This paper examines the influence of milling interventions on the geometry of a wall-shaped structure, quantified by the transverse cross-sectional width, built using a Hybrid Wire-Arc DED. Through experiments on mild steel, the underlying causes of observed wall-width variations are analyzed. Initial observations suggested that thermo-mechanical deformations from milling influence the width variations. However, evidence indicates the significant role of additional remelting cycles experienced by the milled surface layer during subsequent layer depositions. The study also reveals that the observed increase in wall width for each milling intervention occurs at approximately the same depth below the milled surface. A mechanistic explanation for this observation is given. Crucially, the findings suggest that unless milling is done at higher frequencies, like after each layer deposition, the resultant unevenness might render the Hybrid Wire-Arc DED process less efficient in terms of surface quality and dimensional accuracy than its non-hybrid counterpart.

Empowering Women Living with HIV/AIDS in Vietnam: A Hybrid Online-Offline Intervention to Combat Stigma.

Women living with HIV/AIDS (WLHA) encounter numerous challenges, such as stigma and gender disparities, that hinder their access to care, especially in patriarchal societies like Vietnam. We developed a hybrid intervention with online and offline (in-person) components to empower WLHA in Vietnam. The intervention was pilot tested with 91 WLHA in Hanoi. During baseline and 4-month, study investigators delivered two in-person sessions, one Zoom session, and 15 weeks of Zalo (social media platform) discussions to enhance positive coping strategies, treatment utilization and adherence, and engagement of support from family and peers. The participants continued their Zalo discussions from 4-month to 6-month without investigators' involvement. Intervention outcomes, including active coping and perceived barriers to care, were evaluated at baseline, 4-, and 6-month surveys. Mixed-effects regression models showed that the participants' active coping significantly increased from baseline (50.5 ± 9.4) to 4-month (53.8 ± 6.2; p = 0.0001), although there was a slight decrease at 6-month (52.8 ± 7.2), the change from 4-month to 6-month was not significantly significant (p = 0.3256). There was a significant reduction in participants' perceived barriers to care, from 19.8 ± 5.2 at baseline to 17.4 ± 5.2 at 4-month (p < 0.0001), which remained stable at 17.8 ± 4.3 at 6-month (p < 0.0001 compared to baseline). This intervention presents a promising model to empower WLHA in Vietnam and potentially in similar global contexts. Future interventions could benefit from leveraging natural peer leaders and adopting a more person-centered approach to meet WLHA's varying needs.

Students’ eating styles and palatable eating motives during the COVID-19 pandemic

This study aimed to describe students’ driving factors of eating behavior, namely eating-styles and palatable-eating-motives, and to determine clusters based on both. Conducted during the COVID-19 pandemic, this cross-sectional study was carried out in response to the intervention program, the nusantara movement to reduce obesity rate (gerakan nusantara tekan angka obesitas (GENTAS)), launched by the Indonesian government to reduce obesity rate. Involving general population, 135 undergraduate students at a university in Bandung, Indonesia (the average age was 20.5 years, 71.9% of them were female) were selected using multi-stage-cluster-sampling. Data was collected through online questionnaires and was analyzed using SPSS 22.00 for Mac. Results indicated that participants’ eating behavior was generally more characterized by uncontrolled-eating-style, and participants’ eating palatable foods was more driven by the motive of reward-enhancement. This study obtained three clusters, including the cluster composed of emotional-eating-style and coping-motives, the cluster involving cognitive-restraint-eating-styles, and the cluster composed of uncontrolled-eating-style and all palatable-eating-motives. Findings about the clusters brought possibilities to develop new approach in eating behavior intervention for GENTAS’ implementation among students, focusing on tailored intervention based on the cluster of the individual participant, and utilizing the available channels at the institution. An online or hybrid intervention was an introduced choice that was relevant during COVID-19 pandemic and non-COVID period.

Understanding the challenges and successes of implementing ‘hybrid’ interventions in healthcare settings: findings from a process evaluation of a patient involvement trial

Introduction‘Hybrid’ interventions in which some intervention components are fixed across sites and others are flexible (locally created) are thought to allow for adaptation to the local context while maintaining fidelity....

Profiling adolescents' vulnerability to racial misinformation: An hybrid intervention aimed at promoting mediated intergroup contact

AbstractThis study addresses the issue of adolescents' susceptibility to racial misinformation, testing a socio‐analytical intervention within an educational community through the inducement of analytical processing of misleading news on one side, and mediated contact on the other. Rolling Minds web app has been designed to implement a hybrid schools intervention thanks to which classmates engage with conversational agents, guiding them in deconstructing racial stereotypes, reframing misleading narratives and empathizing with immigrants' point of view. All the intervention activities aim to enhance intergroup contact. For this purpose, in this study, which involved 208 young participants (mean age 14.65; SD = 0.74), we pursued two research objectives. Firstly, by employing a person‐centred approach, our first research question (RQ1) is to identify subgroups of adolescents based on their propensity to engage in analytical reasoning, stereotypical beliefs and self‐transcendence values, finding different vulnerability clusters to racial misinformation. In relation to the emerging profiles, their reactions to the misleading news were initially observed (ie, sharing and fact‐checking). Secondly, regarding the second research question (RQ2), through path analysis we aim to understand whether and how adolescents characterized by different profiles vary in performing activities of socio‐analytical intervention aimed at enhancing contact intentions. These results can guide the development of tailored hybrid educational strategies to engage young people in approaching racial online misinformation in a more reflective and unbiased manner, considering the adolescents' individual differences in vulnerability to racial hoaxes.

Feeling Close from a Distance: Pilot Study of a Hybrid Intervention to Promote Functional Goals of Autistic Adolescents and Young Adults

Abstract Date Presented 03/22/24 SPAN-ASD is a short-term hybrid intervention for autistic adolescents and young adults. The current study presents its efficacy in achieving autonomous personal goals and their perceived self-efficacy regarding those goals. Primary Author and Speaker: Einat Yaar Additional Authors and Speakers: Eynat Gal, Gary Bedell, Liron Lamash

Hybrid interventions on distal sections of the main arteries in extended chronic occlusions of the superficial femoral artery in patients with critical limb ischemia

AbstractBackground. Over two thirds of patients with CLI present with SFA disease, often a long CTOwith patent proximal popliteal artery and extensive occlusive lesions in the crural vessels. Westudied a series of hybrid interventions to treat this multilevel disease as an alternative to conventionalapproach.Aim. To improve the results of revascularization of the lower limb in cases of extended occlusionof the SFA in combination with crural runoff.Materials and Methods: A total of 40 patients (25% women; mean age 69.5 years), all with Rutherfordclass 5-6 disease, were included in the study. Angiography showed long (&gt;200 mm) SFA CTOin all cases (100%) accompanied by CTO of distal popliteal artery (n=9; 22.5%); all crural arteries(n=26; 65%) or all crural arteries but the peroneal (n=7; 17.5%).We performed femoropopliteal bypass with autologous vein in all patients (100%) followed byballoon angioplasty of distal popliteal and/or crural arteries done either on the same day (n=22;55%) or 2-14 days later (n=18; 45%). Direct angiosomic revascularization was achieved in 36 patients(90%).We used a series of 46 consecutive patients who underwent femoral tibial bypass as historic control.Results. The 30-day mortality and graft failure rate were 2.5% vs 4.3% (p&gt;0.05) and 5% vs 13%(p&lt;0.05) after hybrid and tibial bypass interventions, respectively.At 1 year the primary patency of bypass and amputation-free survival were 77.7% (95% CI 61.7-93.7) vs 57.1% (95% CI 42.9-71.3) and 82.1% (95% CI 66.8-97.4) vs 69.6% (95% CI 56.1-83.1) afterhybrid intervention and tibial bypass, respectively (all non-significant).Conclusions. Compared to femoral tibial bypass, a hybrid intervention comprised of a bypass to apatent popliteal artery and subsequent crural angioplasty decreased the early failure rate withoutany negative effect on the long-term outcomes in CLI patients with long SFA CTO and extensiverunoff disease.

Designing a Hybrid Program to Utilize Tacit Knowledge

This design case focused on the design of an intervention set aimed at capturing and sharing tacit knowledge in the workplace. The design case demonstrated the design process of expanding a single chatbot intervention into a comprehensive hybrid intervention set to cooperate with learners of different technology competencies and learning needs. This design case also details insights gained by the design team on how to utilize shared design knowledge through different design disciplines to resolve a design problem, and how to make revisions to improve the design.

A multidomain lifestyle intervention to maintain optimal cognitive functioning in Dutch older adults—study design and baseline characteristics of the FINGER-NL randomized controlled trial

BackgroundEvidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in older people without dementia is mixed. Embedded in the World-Wide FINGERS initiative, FINGER-NL aims to investigate the effectiveness of a 2-year multidomain lifestyle intervention on cognitive functioning in older Dutch at risk individuals.MethodsMulti-center, randomized, controlled, multidomain lifestyle intervention trial with a duration of 24 months. 1210 adults between 60–79 years old with presence of ≥ 2 modifiable risk factors and ≥ 1 non-modifiable risk factor for cognitive decline were recruited between January 2022 and May 2023 via the Dutch Brain Research Registry and across five study sites in the Netherlands. Participants were randomized to either a high-intensity or a low-intensity intervention group. The multidomain intervention comprises a combination of 7 lifestyle components (physical activity, cognitive training, cardiovascular risk factor management, nutritional counseling, sleep counseling, stress management, and social activities) and 1 nutritional product (Souvenaid®) that could help maintain cognitive functioning. The high-intensity intervention group receives a personalized, supervised and hybrid intervention consisting of group meetings (on-site and online) and individual sessions guided by a trained lifestyle coach, and access to a digital intervention platform that provides custom-made training materials and selected lifestyle apps. The low-intensity intervention group receives bi-monthly online lifestyle-related health advice via the digital intervention platform. Primary outcome is 2-year change on a cognitive composite score covering processing speed, executive function, and memory.ResultsWithin 17 months, participant recruitment has been successfully completed (N = 1210; mean age: 67.7 years (SD: 4.6); 64% female). Modifiable risk factors commonly present at baseline were physical inactivity (89%), low mental/cognitive activity (50%), low social engagement (39%), hypertension (39%) and high alcohol consumption (39%). The mean body mass index of participants was 28.3 (SD: 4.2) and the total serum cholesterol was 5.4 mmol/L (SD: 1.2).ConclusionsBaseline lifestyle and clinical measurements showed successful recruitment of participants with sufficient potential for prevention. Results of FINGER-NL will provide further insight into the efficacy of a multidomain lifestyle intervention to prevent cognitive decline in older adults.Trial registrationClinicalTrials.gov (ID: NCT05256199)/2022–01-11.

Hybrid Interventions for Pulmonary Vein Stenosis: Leveraging Intraoperative Endovascular Adjuncts in Challenging Clinical Scenarios.

Background: Pediatric pulmonary vein stenosis (PVS) is often progressive and treatment-refractory, requiring multiple interventions. Hybrid pulmonary vein interventions (HPVIs), involving intraoperative balloon angioplasty or stent placement, leverage surgical access and customization to optimize patency while facilitating future transcatheter procedures. We review our experience with HPVI and explore potential applications of this collaborative approach. Methods: Retrospective chart review of all HPVI cases between 2009 to 2023. Results: Ten patients with primary (n = 5) or post-repair (n = 5) PVS underwent HPVI at median age of 12.7 months (range 6.6 months-9.5 years). Concurrent surgical PVS repair was performed in 7/10 cases. Hybrid pulmonary vein intervention was performed on 17 veins, 13 (76%) with prior surgical or transcatheter intervention(s). One patient underwent intraoperative balloon angioplasty of an existing stent. In total, 18 stents (9 bare metal [5-10 mm diameter], 9 drug eluting [3.5-5 mm diameter]) were placed in 16 veins. At first angiography (median 48 days [range 7 days-2.8 years] postoperatively), 8 of 16 (50%) HPVI-stented veins developed in-stent stenosis. Two patients died from progressive PVS early in the study, one prior to planned reintervention. Median time to first pulmonary vein reintervention was 86 days (10 days-2.8 years; 8/10 patients, 13/17 veins). At median survivor follow-up of 2.2 years (2.3 months-13.1 years), 1 of 11 surviving HPVI veins were completely occluded. Conclusions: Hybrid pulmonary vein intervention represents a viable adjunct to existing PVS therapies, with promising flexibility to address limitations of surgical and transcatheter modalities. Reintervention is anticipated, necessitating evaluation of long-term benefits and durability as utilization increases.

Allyship against interpersonal pregnancy discrimination: exploring observers’ spontaneous responses toward pregnancy self-disclosure, interpersonal discrimination and male allyship

PurposePregnant employees experience considerable interpersonal discrimination. This study explores the range of possible reactions of observers to pregnancy self-disclosure, interpersonal discrimination and various allyship interventions, and the attentional processes that lead to those reactions. Consequently, it uncovers socio-cognitive processes underlying support for and backlash toward pregnancy in the workplace.Design/methodology/approach This study used a thought-listing technique to explore observers’ spontaneous thoughts related to pregnancy. Working adults were randomly assigned to read through one of the six scenarios depicting pregnancy self-disclosure, interpersonal discrimination and male allyship interventions (i.e. stating the organization’s anti-discrimination policy, confronting the transgressor by calling out sexism, pivoting the conversation to highlight the strengths of the pregnant employee and a hybrid intervention combining highlighting strengths and confrontation) after which participants listed the top three thoughts that came to their mind (1,668 responses). Responses were thematically analyzed to explore spontaneous reactions toward the pregnant employee, transgressor and ally in the scenario.Findings Surprisingly, across all scenarios, the most sexist thoughts emerged during pregnancy self-disclosure, even in the absence of any transgression. After a transgression occurred, any allyship intervention was better than none in eliciting lesser sexist backlash against the pregnant employee. Stating the organization’s anti-discrimination policy was most beneficial for the pregnant employee in eliciting the least sexist backlash but at the cost of generating unfavorable impressions of the ally. Calling out the transgressor’s bias elicited the most sexist backlash toward the pregnant employee, yet it created favorable impressions of the ally. In contrast, highlighting the strengths of the pregnant employee created the most favorable impression of the ally while eliciting a few sexist thoughts about the pregnant employee. Overall, the hybrid intervention was the most effective at balancing the competing goals of generating support for the pregnant employee, creating favorable impressions of the ally, as well as holding the transgressor accountable.Originality/value This study demonstrates that the type of allyship intervention critically redirects the attentional focus of observers to certain aspects of a discrimination episode and relevant schemas which can generate support or backlash toward targets, transgressors and allies, thereby advancing or obstructing equity and inclusion in organizations.

Аналіз якості життя в пацієнтів з ішемічною хворобою серця та супутньою патологією аортального клапана у віддалений період після протезування аортального клапана з реваскуляризацією міокарда

The aim – to conduct an analysis of the quality of life in the long-term period after the use of a hybrid approach, involving a combination of surgical aortic valve replacement (AVR) and endovascular methods of myocardial revascularization, in patients with coronary heart disease and an aortic valve disease.Materials and methods. For this one-center study, medical records of adult patients (over 18 years old) who underwent surgical AVR along with myocardial revascularization in the period from 2018 to 2022 were selected.Results and discussion. We selected 130 patients who underwent AVR together with myocardial revascularization (the first group (n = 51) – a combination of AVR and percutaneous coronary interventions (PCI); the second group (n = 79) – a combination of AVR and coronary artery bypass grafting (CABG). Damage to the left main coronary artery was recorded by 5.60 times less often (p = 0.018) in the patients of the first group compared to the patients of the second group. The duration of cardiopulmonary bypass and aorta cross clamping in the patients of the first group was, respectively, by 1.5 times and by 1.4 times significantly lower compared to the second group (p = 0.0001). The pain index after 6 months according to the SF-36 questionnaire was found to be 13.5 % (p = 0.017) significantly higher in patients of the first group compared to the second group, while other indicators did not differ among the study groups.Conclusions. Patients with the hybrid approach of treatment were characterized by a similar level of postoperative complications with the surgical group. At the same time, this cohort of patients had a better SF-36 pain index 6 months after the hybrid intervention.

Prevention of Perioperative Bleeding in Patients With Chronic Limb-Threatening Ischemia

Materials and methods: At stage I, we retrospectively studied histories and outpatient medical records of 766 patients with chronic limb-threatening ischemia (from 2006 to 2020) to identify hemorrhagic complications and potential risk factors for their development. We analyzed the effectiveness of different scores for assessment of the bleeding risk. Based on the obtained data, measures to prevent hemorrhagic complications in this cohort of patients were improved. During stage II, 114 patients with 1 or several risk factors for major bleeding underwent surgery between 2021 and 2023. We used the proposed and improved preventive measures for all the patients. Follow-up periods were during the hospital stay and in 6 and 12 months.Results: At stage I, 44 (5.74%) patients were found to have hemorrhagic complications in the early postoperative period: retroperitoneal hematoma, bleeding from an operating wound, and pulsating hematoma (15.9%); gastrointestinal hemorrhage (31.8%); gross hematuria (13.7%), and hemorrhagic stroke (6.8%). The most significant risk factors for bleeding were endovascular intervention using brachial and femoral approaches (P = .000), hybrid intervention (P = .000), dual antiplatelet therapy (P = .014), surgery duration above 60 minutes (P = .001), triple antithrombotic therapy (P = .001), and significant vascular calcification (P = .023). The PRECISE-DAPT score has proven to be of prognostic value (P = .073; odds ratio, 2.88). At stage II, due to the proposed preventive measures, bleeding that required blood transfusion was found in 5 (4.38%) of 114 patients: of them, 1 (0.9%) patient had acute coronary syndrome. There were no major amputations, whereas 3 (2.63%) patients underwent minor amputation. In 6 and 12 months of the follow-up, the total frequency of major cardiovascular complications (cardiac death, myocardial infarction), major and minor amputation was 0.9% and 2.6%, 0% and 1.75%, and 0.9% and 2.6%, respectively.Conclusions: Surgical treatment of patients with chronic limb-threatening ischemia and risk factors for hemorrhagic complications who underwent surgery with the proposed preventive measures demonstrated high efficiency in reducing the number of hemorrhages and associated cardiac complications and low frequency of major and minor amputations in the long-term follow-up.

Acceptability and feasibility of a brief intervention to enhance resilience among young people and their families in India and Kenya.

Enhancing resilience is one way to prevent future mental illnesses and encourage recovery in the face of adversity. To develop and test the acceptability and feasibility (A&F) of a combined family and individual resilience intervention in two rural/semi-rural low-income settings in India and Kenya. We developed a five-session intervention including Life Skills Education (LSE) and a model of family resiliency. Among adolescents aged 14-16 years and their families in India and Kenya, we collected socio-demographics and audio records of delivery and undertook a process evaluation. Due to COVID-19, we developed a hybrid intervention. The facilitators and participants preferred the in-person model. India: Of 17 families, 10 fully completed the intervention. They identified three critical components: 1) story-telling, 2) cooperation and working together and 3) expressing feelings. Kenya: All 15 families completed the intervention. Critical elements were 1) seeing social value in learning to make good decisions, 2) promoting an optimistic view of life, 3) hearing stories that resonated with their situation and 4) enhancing family performance through knowledge-building. We mapped the active ingredients, showing fidelity and acceptability. The intervention showed promising A&F parameters. Flexibility and local adaptation were important for delivery.

Strategy of Surgical Correction of Postcoarctation Thoracic Aortic Aneurysms

The aim. To analyze the experience of surgical treatment of postcoarctation aneurysms and to propose an optimal strategy in choosing a correction method.&#x0D; Materials and methods. An analysis of 91 cases of postcoarctation aneurysm over a 25-year period was carried out. Eighty-five people (93.4%) were operated on, 6 patients (6.6%) were not operated on for various reasons. The patients were divided into clinical groups depending on the method: group I included 69 patients (75.8%) who underwent open correction of postcoarctation aneurysm. Group II consisted of 16 patients (17.6%) after endovascular or hybrid treatment.&#x0D; Results. The obtained results demonstrated significant achievements and pronounced clinical effect of the performed surgical correction of postcoarctation aneurysms. We identified indications and contraindications for the correction of postcoarctation aneurysms by various methods: open, endovascular, and hybrid. It was found that the advantages of the endovascular technique are: minimally invasive approach, absence of a large surgical wound, shorter duration of the operation, faster activation of the patient after the intervention, shorter length of hospital stay in the postoperative period, faster return to a full active life. When studying the long-term results, based on the SF-36 questionnaire scores, it was established that the quality of life was higher among patients who underwent endovascular and hybrid correction of postcoarctation aneurysms.&#x0D; Conclusion. Clear indications for surgical correction of postcoarctation aneurysm and the choice between open surgery, endovascular or hybrid intervention should be determined based on detailed analysis and with the participation of the entire heart team with mandatory consideration of: patient age, comorbidities, expected duration and quality of life of each patient after surgery.

ADAPTING COGNITIVE REMEDIATION GROUP THERAPY AS A HYBRID INTERVENTION FOR PEOPLE WITH HIV AND COGNITIVE CONCERNS

Abstract Cognitive impairment is a significant health issue for people aging with HIV/AIDS. With pharmacological treatment lacking, psychosocial group therapies may best help people aging with HIV and cognitive challenges cope with symptoms. The COVID-19 pandemic demonstrated how in-person group therapies need adaptation for hybrid or online delivery. Peer-led focus groups discussed adapting cognitive remediation group therapy (CRGT) as a hybrid or online intervention. CRGT combines mindfulness-based stress reduction and brain training activities. Purposive sampling recruited people aging with HIV (40+) who self-identified cognitive concerns and resided in two Canadian provinces. Content analysis was employed on transcripts by 7 independent coders. Ten, two-hour focus groups were conducted between August and November 2022. Participant (n=45) demographics included age (M=53.22, SD=7.62) gender (45% women, 42% men, 13% trans/non-binary), sexuality (42% gay, 40% heterosexual, 18% other), ethnicity (45% white, 33% black, 13% Indigenous, 9% mixed-race), and employment (33% employed, 67% retired/disability), and all were retained in care. Overall, participants responded favourably to CRGT’s modalities and preferred a hybrid model blending in-person and online interactions. Preferred intervention facilitators were peers and mental health professionals. Knowledge of HIV’s impacts on cognitive health, including HIV-associated neurocognitive disorder, was very low despite high reports of cognitive concerns (e.g., trouble remembering, impaired attention, difficulty problem-solving). Given the aging of the HIV population in Canada and the United States, increasing support will be required to improve quality of life. This presentation will discuss a hybrid CRGT adaptation, alongside considerations for how COVID-19 has impacted intervention research.

Study Design of FINGER‐NL: a Multidomain Lifestyle Intervention in Dutch Older Adults to Maintain Optimal Cognitive Functioning

AbstractBackgroundEvidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in non‐demented older individuals is mixed. The multidomain FINGER study1 found small positive effects on cognition among older people at risk for dementia. As part of the World‐Wide FINGERS initiative to replicate and build on these results, FINGER‐NL aims to investigate the effectiveness of a 2‐year high versus low intensive multidomain lifestyle intervention on cognitive functioning in Dutch older at‐risk individuals.MethodFINGER‐NL is a Dutch multi‐center, randomized, controlled, multidomain lifestyle intervention trial aiming to include 1,206 adults at risk for cognitive decline. Adults aged 60‐80 years with at least 3 modifiable dementia risk factors (based on ‘LIfestyle for BRAin Health’ (LIBRA))2 and either a family history of dementia or self‐reported cognitive decline are eligible for inclusion. Participants are randomized (1:1 ratio) to either a high (HI‐group) or low‐intensity (LI‐group) intervention group. The multi‐domain intervention comprises a combination of 7 lifestyle components (physical exercise, cognitive training, cardiovascular risk management, nutritional counseling (with a specific focus on the MIND diet), sleep counseling, stress management, social activities) and 1 nutritional product (Souvenaid, 125ml). The HI‐group receives a personalized, supervised and hybrid intervention consisting of group meetings and individual sessions guided by a lifestyle coach. The LI‐group receives online lifestyle‐related health education. Primary outcome is 2‐year change from baseline on the cognitive composite score covering processing speed, executive function and memory. Secondary outcomes including changes in specific cognitive domains, instrumental activities of daily living, LIBRA score, and lifestyle component specific outcomes. For recruitment, we use the Dutch Brain Research Registry.3 ResultParticipant recruitment started in January 2022. So far, 2405 people were interested, 1711 individuals have been screened for eligibility, 949 underwent baseline testing and 880 participants (73% of target sample) have been randomized and started with the intervention. The intervention is well‐accepted based on drop‐out rate (0.5%) and use of the online intervention portal. We expect to finalize randomization in Q2 of 2023 and complete the two‐year trial in 2025.ConclusionResults so far show that FINGER‐NL is well on track, the intervention is well‐accepted and the trial will reach its inclusion target.

Technical aspects of hybrid interventions for multilevel lesion of brachiocephal arteries. Literature review

Carotid artery stenosis is one of the leading causes of ischemic strokes and accounts for about 20 % of all strokes. The widespread use of radiological diagnostic methods and recommendations for the carotid artery stenosis patients management led to the identification of atypical forms of damage to the brachiocephalic arteries — a combination of multi-level stenoses of extra and intracranial localization. Multilevel lesion of brachiocephalic arteries is characterized by a combination of hemodynamically significant stenosis of the internal carotid artery in combination with stenosis of the common carotid artery or brachiocephalic trunk. The prevalence of tandem lesions varies from 0.5 to 6.4 %. Despite the rarity of this pathology, the risk of ischemic complications against the background of tandem stenosis of the brachiocephalic arteries is higher than with a single-level lesion. The surgical intervention strategy should provide for the correction of both stenosis, which can be achieved in three ways: endovascular method, open prosthetics and hybrid method. The essence of the hybrid technique is the simultaneous correction of the distal and proximal zones of stenosis by one surgical team in a hybrid operating room. The aim of the study is to review the available literature data and to demonstrate the developed hybrid intervention technique with a detailed description of the technical aspects of all stages of the surgery.

Restorative Justice Treatment for Domestic Violence Crimes: A Qualitative Study

Domestic Violence Intervention Programs have become a key component in addressing domestic violence (DV) crimes. Recent research suggests that combining standard intervention programs with other approaches can improve overall effectiveness. The aim of this study was to examine the experiences of individuals court-mandated to treatment who completed either a standard intervention program or a restorative justice (RJ)-based hybrid intervention program combining a standard treatment program with RJ elements and Circles of Peace. Multiple interviews were conducted with participants ( N = 14) who completed one of the two programs. Qualitative data analysis was performed. Four major themes emerged: Communication and understanding, Changes in the nature of the violence, Changes in self-perception, and Program content and atmosphere experiences. The findings suggest that the hybrid intervention program may have a positive influence on the way participants perceive treatment effectiveness. Participants’ experiences may serve as a framework for improving approaches to DV treatment.