Initial Session Research Articles

Heterosexual couples' initial role and outcome expectations as predictors of the therapeutic alliance and relationship satisfaction prior to the fourth session.

We sampled routinely collected measures of role and outcome expectations, the expanded therapeutic alliance, and relationship satisfaction completed by 253 heterosexual couples seen by 35 therapists in the Marriage and Family Research Practice Network (Johnson et al., 2017) and investigated these variables as interdependent dyadic processes using the latent congruence model (Cheung, 2009) and the mediated actor-partner interdependence model (Ledermann et al., 2011). Taken together, we found a direct association between a couple's mean role and outcome expectation scores at Session 1 and individual partners' alliance perceptions at Session 3. Further, men rated the alliance more favorably when their outcome expectations were higher and the partners' outcome expectations were less discrepant. In terms of role expectations, both men and women began therapy expecting to be more actively engaged in the process than their partner. Whereas women rated the alliance more favorably when they had high role expectations for their partner as well as themselves, men rated the alliance more favorably when they had high expectations for their female partner's engagement in the therapy. Notably, alliance at Session 3 did not mediate the association between initial expectations and Session 4 relationship satisfaction due to a strong association (r = 0.85) between relationship satisfaction rated prior to Sessions 1 and 4. In other words, although the best predictor of relationship status before the fourth session was how the relationship was perceived before couple therapy began, men's and women's initial role and outcome expectations were important contributors to the early alliance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Affecting Stone-freeness in the Initial Session of RIRS in Childhood Kidney Stones

Factors Affecting Stone-freeness in the Initial Session of RIRS in Childhood Kidney Stones

Tracking the acquisition and retention of novel word representations: an ERP study

ABSTRACT The event-related N400 provides a measure of lexical-semantic processing, indexing the encoding strength of newly learned words. We examined N400 modulations following associative learning of novel written words paired with novel object pictures from early to later stages of acquisition. During the initial learning session, novel picture-word pairs accompanied by semantic attributes were presented as stimuli for learning at multiple timepoints. Following learning at each of these timepoints, we examined behavioural and neural effects for recognition of familiar and novel words, as well as at a follow-up session several days later. Rapid behavioural learning was accompanied by N400 congruity effects for novel words, displaying a similar neurophysiological profile to familiar words. These behavioural and neural effects were largely sustained several days later in the follow-up session. Our findings indicate that explicit learning of novel object-word associations leads to the rapid formation and longer-term retention of new word memory traces.

Robotic Precision vs. Human Dexterity—Benchtop Comparative Study of Free-Hand vs. Robotic-Assisted Puncture in Fluoroscopy-Guided Percutaneous Nephrolithotomy

Introduction: Percutaneous nephrolithotomy (PCNL) is the standard procedure for treating large kidney stones, especially those measuring over 20 mm or staghorn stones. Accurate placement of the tract into the renal collecting system of interest is crucial. Objective: To compare the free-hand puncture technique with robotic-assisted puncture during fluoroscopy-guided PCNL on a phantom kidney model in terms of efficiency and safety. A self-assessment of confidence levels after each puncture was recorded. Study Design: This prospective single-center benchtop study was conducted at the University Malaya Medical Centre (UMMC). Four urological residents participated and performed phantom punctures using both the free-hand bull’s eye technique and the automated needle targeting system with X-ray (ANT-X). Each resident performed a total of 60 punctures on the renal phantom models, with 30 punctures using the free-hand technique and 30 punctures using the ANT-X robotic-assisted system. Results: A total of 240 needle insertions were conducted, with 120 in the ANT-X group and 120 in the free-hand group. The success rate of needle insertions was 100% in both groups. However, the study revealed that the ANT-X group required, on average, an additional 51 s for needle puncture compared to the free-hand group (p < 0.001). In terms of fluoroscopic exposure, the ANT-X group exhibited significantly lower radiation exposure compared to the free-hand group (p < 0.001). Sub-analysis showed that puncture time remained consistent regardless of the technique used, but fluoroscopic screening time decreased with increasing participant experience. The ANT-X group also resulted in significantly lower radiation exposure during initial sessions compared to the free-hand technique. Surgeons’ self-assessment of confidence levels indicated a high level of confidence in needle puncture. Conclusions: Our benchtop study comparing the efficacy and safety between free-hand and ANT-X phantom punctures revealed comparable results. The needle puncture technique facilitated by the ANT-X system showed promising results in terms of reducing fluoroscopic exposure, albeit at the cost of longer operative times. This technology holds promise for novice surgeons who are in the early stages of their learning curve and might be useful for experienced surgeons looking to reduce radiation exposure.

The effects of video-assisted breastfeeding education given to primiparous pregnant women on breastfeeding self-efficacy: randomized control study

BackgroundBreastfeeding is vitally important for the health of the mother, baby, family and society. Especially the perception of breastfeeding self-efficacy of primiparous pregnant women is an important factor in breastfeeding. This study was conducted to determine the effects of online video-supported breastfeeding education on breastfeeding self-efficacy in primiparous pregnant women.MethodsThis randomized controlled study was conducted with primiparous pregnant women admitted to a university hospital in northern Turkey. The study involved 80 pregnant women, with 40 assigned to the experimental group and 40 to the control group. Participants in the intervention group received online video-assisted education, which covered the first meeting of the mother and baby as well as the initial breastfeeding session. The data for the breastfeeding self-efficacy scale were gathered at the onset of the study and three weeks later. In data analysis, categorical variables were assessed using the chi-square test, continuous variables and intergroup comparisons were conducted through the independent sample t-test, and intragroup comparisons were performed using the paired sample t-test.ResultsWhile the baseline breastfeeding self-efficacy levels of the primiparous pregnant women were similar between the groups, statistically significant differences were observed both within (p = 0.000) and between (p = 0.000) groups in the breastfeeding self-efficacy scores of pregnant women in the intervention group after the education intervention.ConclusionBreastfeeding self-efficacy levels in the education group showed a statistically significant increase compared to both the pre-education and control groups. This highlights the importance of nurses providing support to primiparous pregnant women through video-assisted education during pregnancy to enhance breastfeeding self-efficacy.Trial registrationClinicalTrials.gov: NCT06121973 date of first registration (27/10/2023), retrospectively registered (08/11/2023).

Developing primary care services for stroke survivors: the Improving Primary Care After Stroke (IPCAS) research programme

Background It is recognised that longer-term needs after stroke may not be well addressed by current services. The aim of this programme of research was to develop a novel primary care model to address these needs and to evaluate this new approach. Objectives The work was divided into three workstreams: development of a primary care model development of a ‘Managing Life After Stroke’ programme (including self-management) for people with stroke evaluation of the effectiveness and cost effectiveness of these interventions. Design The development of the primary care model involved information gathering in the form of literature reviews, patient and public involvement workshops, qualitative studies (interviews and focus groups), a consensus study and a pilot study, all feeding into a multidisciplinary intervention development group that approved the final primary care model. In parallel, a further literature review, consultation workshops with healthcare professionals and patients and public involvement fed into the iterative development of the ‘My Life After Stroke’ programme. In the final phase of the programme, the two interventions were evaluated in a cluster randomised controlled trial, which included a process evaluation and within-trial cost-effectiveness analysis. Setting General practices in the East of England and East Midlands. Participants People with a history of stroke identified from general practice stroke registers. Interventions The Improving Primary Care After Stroke model of primary care delivery. This comprised five components: a structured review; a direct point of contact; improving communication between primary and secondary care; local service mapping; and training of primary care professionals. The ‘My Life After Stroke’ self-management programme for people with stroke comprised an initial individual session, four weekly group-based sessions and a final individual session. Main outcome measures The coprimary end points for the trial were two subscales (emotion and participation) of the Stroke Impact Scale v3.0 at 12 months after randomisation. Secondary outcomes included the Stroke Impact Scale Short Form, the EuroQol-5 Dimension, five level questionnaire, the ICEpop CAPability measure for Adults, the Southampton Stroke Self-Management Questionnaire and the Health Literacy Questionnaire. Data sources General practice records for health economic costing data. Patient questionnaires for outcomes. Results Trial: 46 clusters (general practices) were randomised with 1040 participants. At 12 months, there was a 0.64 (97.5% confidence interval −1.7 to +2.8) improvement in the emotion outcome in the intervention arm compared to the control arm and a 1.3 (97.5% confidence interval −2.0 to +4.6) increase in the participation outcome in the intervention arm compared to control. There was also no evidence of effect of the intervention on short form Stroke Impact Scale, quality of life (EuroQol 5 Dimension 5 level questionnaire), well-being (ICEpop CAPability measure for Adults), Southampton Stroke Self-Management questionnaire or health literacy (Health Literacy Questionnaire). Process evaluation: over 80% of participants received a review. Only a third of patients attended the ‘My Life After Stroke’ course. The direct point of contact service was hardly used. The local directory of services had variable take-up by healthcare professionals. It did not prove possible to support improved communication between primary and secondary care as originally intended. Training fidelity was high. Cost-effectiveness analysis: the intervention increased primary care workload and was associated with a non-significant, higher quality-adjusted life-year at 12 months. The incremental cost per quality-adjusted life-year was £20,863. Limitations There were differences in age, sex and proportion of people from minority ethnic groups in the trial population as compared to a typical general practice stroke register. Uptake of the intervention was variable. Ceiling effects were observed in the primary outcome measure. Follow-up was limited to 12 months. Conclusions This programme of research has reaffirmed the importance of addressing longer-term needs of people after stroke in the community. The most commonly expressed need is fatigue. The primary care model that we developed was not effective at addressing these needs. Our qualitative findings suggest that an intervention focused on patients earlier after their stroke or one which is more intensive might be effective. There was a mismatch between the needs reported by stroke survivors and evidence available for how to address these needs. Future work Research to inform who should be offered poststroke assessment of needs in the community in the longer term (after 6 months). Development and evaluation of interventions to address fatigue, low mood and cognitive problems in people with stroke in the community. Study registration This study is registered as PROSPERO 2015 CRD42015026602. Trial registration This trial is registered as ISRCTNCT03353519. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research programme (NIHR award ref: PTC-RP-PG-0213-20001) and is published in full in Programme Grants for Applied Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.

Enhancing proficiency in ascites puncture through procedural simulation: an audit type study investigating medium-term skill retention.

Medical simulation has become an essential teaching method for all health professionals. It not only allows to acquire technical and non-technical knowledge, but also helps the maintenance of acquired knowledge in the medium and long term. Ascites puncture is part of the basic technical procedures learned by medical students during their internship. To evaluate the role of simulation-based learning of ascites puncture on the improvement of theoretical knowledge and maintenance of skills at 3 months. We conducted an audit type study with two cycles of data collection at the simulation center at the Faculty of Medicine of Sousse between November 2020 and June 2021. We included learners in their third year of medical studies who had a hospital internship in the gastroenterology department at Sahloul Hospital in Sousse. All learners attended the initial simulation session on ascites fluid puncture. Thereafter, they were free to accept or refuse participation in the evaluation session that was scheduled after 3 months, depending on their availability. Forty learners participated in the procedural simulation of the ascites fluid puncture technique. Thirty-four (85%) were female and six (5%) were male. In our study, we showed that following procedural simulation training of ascites puncture, there was a significant improvement in the theoretical knowledge of the learners (p < 0.000). Objective assessment of technical skills after 3 months showed the benefit of performance maintenance (p < 0.000). Our study confirmed the benefit of simulation-based learning on the improvement of theoretical knowledge and the maintenance of technical performance in the medium term.

Improving the Timing of Acute Care Insulin Delivery.

Variations in nursing practice were observed across our hospital, a 520-bed acute care teaching facility in the northeast United States, regarding the timing and frequency of insulin administration in adult patients with diabetes. Chart audits noted that RNs administered insulin more than one hour after blood glucose results were obtained 97% of the time. In addition, insulin was given at bedtime only 37% of the time. The purpose of this quality improvement (QI) project was to improve the care of inpatients requiring insulin by implementing protocols and adjusting practice to align with best practice recommendations. The clinical nurse education specialist met with a team of staff nurses, providers, nurse leaders, and patient care technicians (PCTs) to formulate protocols and design interventions to ensure improvements in the quality of care for inpatients with diabetes. A sequence of education sessions and an online learning module were developed and assigned to nurses and PCTs to address knowledge gaps, specifically in the pharmacodynamics and safe administration of insulin, as well as how best to provide care to patients with diabetes. Monthly adherence data were disseminated to nurse leaders and educators and reviewed with clinical staff at daily safety huddles and staff meetings. Additional interventions to enhance nursing practice in caring for patients with diabetes included ensuring both bedtime insulin administration and timely insulin delivery. This project began in May 2017 and ended five years later. Two weeks after initial education sessions began in May and June 2017, the frequency of giving bedtime insulin based on the order set and according to the patient's blood glucose levels rose from 37% to 82%, and adherence to best practice protocols continued until final chart audits were performed in May 2022. The frequency of giving insulin less than one hour after obtaining blood glucose results improved from 3% to 64% between October and December 2019, and increased to a sustained level above the project's 92% goal two years later. Protocol development, targeted education, and audits with feedback led to improved care delivery for patients requiring insulin and increased nursing confidence.

Abstract TP90: Feasibility of Robotic Exoskeleton Intervention in the Stroke Population During Acute Hospitalization

Introduction: Patients hospitalized with a stroke have limited mobility during the acute recovery phase. Those requiring significant assistance to mobilize often experience greater periods of immobility. Research in subacute rehabilitation demonstrates safe and feasible use of robotic exoskeletons for upright positioning and reciprocal motions similar to gait kinematics post stroke. This study explores the feasibility and frequency of adverse events with robotic exoskeleton during acute hospitalization post stroke. Methods: Retrospective design using the electronic health record to identify patients hospitalized with a stroke between 1/1/19 and 12/31/22. Patients that completed a single session of robotic exoskeleton in conjunction with traditional physical therapy met criteria. All participants met the manufacturer’s criteria for device use. Those who did not complete robotic intervention were excluded. Thirty-four patients were included and data obtained from physical therapy documentation of the initial session in the robotic device. Data collected included adverse events atypical of physiologic responses found with traditional physical therapy movement strategies including fracture, cardiac event, skin tear, dislocation and declining neurologic function. Further data collected includes stroke etiology, location, post stroke day intervention completed, steps taken and duration of upright weight bearing in the device. Results: Data revealed 0 patients had an adverse event with a total of 5 sessions terminated, all in patients with ischemic infarcts. Reasons for termination included orthostatic hypotension, pain in stance and fatigue. The mean step count was 106 with standard deviation (SD)of 102. The mean upright time was 19 minutes with SD of 8 minutes. Intervention was initiated on average at day 8 with SD of 7 days. Conclusion: Robotic exoskeleton is feasible during acute hospitalization with patients post stroke and yields no adverse events. Adjunct use of this device allows patients to participate in weight bearing, upright posture and neuromuscular facilitation for reciprocal motion allowing movement which otherwise may not be possible at this acute stage given the burden of mobility and level of neurologic impairment.

Devising an impactful religious moderation workshop for teachers and principals: The practice of Ice Berg analysis and U theory perspective

In the academic setting, teachers and school principals are often faced with the problem of identifying and developing strategies to strengthen the atmosphere of religious moderation. Unfortunately, resources for training and support are scarce. Our study presents the design and assessment of a religious moderation workshop utilizing the problem-based discussion method, supported by Ice Berg and U theory perspective analysis. This two-session workshop aims to bolster religious moderation among school personnel. During the initial session, attendees were presented with strategies to empower religious moderation and state defense. In the subsequent meeting, attendees were encouraged to engage in problem-solving exercises focused on acts and behaviors of intolerance. Not to mention, the educators and administrators have acquired content and pedagogical expertise regarding religious moderation and state defense, which can be applied in classroom and school settings. Additionally, participants expressed a positive belief that the training effectively exemplified the integration of character-building subject matter, religious moderation, state defense, and instructional strategies. As a result, the workshop for teachers and school principals was deemed successful and effective.

Intracoronary electrocardiogram detects coronary microvascular dysfunction and ischemia in patients with no obstructive coronary arteries disease

Coronary microvascular dysfunction (CMD) is the leading cause of ischemia with no obstructive coronary arteries disease (INOCA) disease. Diagnosis of CMD relies on surrogate physiological indices without objective proof of ischemia. Intracoronary electrocardiogram (icECG) derived hyperemic indices may accurately and objectively detect CMD and reversible ischemia in related territory. INOCA patients with proven ischemia by myocardial perfusion scan (MPS) and completely normal coronary arteries underwent simultaneous intracoronary electrophysiological (icECG) and physiological (intracoronary Doppler) assessment in all 3 coronary arteries during rest and under adenosine induced hyperemia. Sixty vessels in 21 patients were included in the final analysis. All patients had at least one vessel with abnormal CFR. 41 vessels had CMD (CFR < 2.5), of which 26 had increased microvascular resistance (structural CMD, HMR > 1.9 mmHg.cm-1.s) and 15 vessels had CMD (CFR < 2.5) with normal microvascular resistance (functional CMD, HMR <= 1.9 mmHg.cm-1.s). Only one-third of the patients (n = 7) had impaired CFR < 2.5 in all 3 epicardial arteries. Absolute ST shift between hyperemia and rest (∆ST) has shown the best diagnostic performance for ischemia (cut-off 0.10 mV, sensitivity: 95%, specificity: 72%, accuracy: 80%, AUC: 0.860) outperforming physiological indices (CFR: 0.623 and HMR: 0.653 DeLong's test P = .0002). In INOCA patients, CMD involves coronary artery territories heterogeneously. icECG can accurately detect CMD causing perfusion abnormalities in patients with INOCA outperforming physiological CMD markers, by demonstrating actual ischemia instead of predicting the likelihood of inducible ischemia based on violated surrogate thresholds of blunted flow reserve or increased minimum microvascular resistance. In 21 INOCA patients with coronary microvascular dysfunction (CMD) and myocardial perfusion scan proved ischemia, hyperemic indices of intracoronary electrocardiogram (icECG) have accurately detected vessel-specific CMD and resulting perfusion abnormalities & ischemia, outperforming invasive hemodynamic indices. Absolute ST shift between hyperemia and rest (∆ST) has shown the best classification performance for ischemia in no Obstructive Coronary Arteries (AUC: 0.860) outperforming Doppler derived CMD indices (CFR: 0.623 and HMR: 0.653 DeLong's test P = .0002).icECG can be used to diagnose CMD causing perfusion defects by demonstrating actual reversible ischemia at vessel-level during the initial CAG session, obviating the need for further costly ischemia tests. GOV: NCT05471739.

Experience informed procedural skills training.

Paediatric critical care (PCC) physicians must perform several emergent procedures independently and competently-requiring transition from novice to competent over a 3-year fellowship. However, skill acquisition is not uniform. Individualised training, adapted to the unique experiences and requirements of each trainee, may enhance competency. An individualised, longitudinal critical procedure course was initiated at a large academic paediatric medical centre in July 2022 for PCC fellows (n = 5). The course, informed by procedural performance profiles (P3) generated through real-time clinical assessments in the paediatric intensive care unit (PICU), was split into three phases: (1) an Initial Simulation Bootcamp-a 2-day introductory session; (2) Quarterly Structured Booster Sessions (QSBS)-spaced repetition of deliberate practice training individualised to each fellow; and (3) an Annual Refresher Training-a core skills and advanced technique training day. Fellows began with minimal experience, which formed their initial P3s. Ninety-two percent (166/180) of bedside procedures received real-time feedback, enabling longitudinal P3 modification, which identified focus areas for the QSBS. The sessions were well attended and received. Eighty-nine percent (QSBS #1 5/5, QSBS #2 3/4) of respondents reflected positively on the course's impact on procedural understanding. The course was perceived as more effective than traditional modalities, except bedside training. Implementation of a spaced repetition, deliberate practice course informed by longitudinally tracked real-life performance data is feasible for educators and preferred by trainees. This educational construct can be applied to other clinical skills, bringing precision medicine approach to training.

Assessment of Depression among IBD patients in Gastroenterology and Hepatology Specialized Hospital, Medical City, Iraq using the PHQ-9

Background: The management of patients with inflammatory bowel disease (IBD) must take mental health into account because it might be difficult to find the best therapies and mental health resources. Anxiety and depression are the two psychological illnesses that IBD patients experience most frequently. The growing incidence of these mental illnesses encourages mental screening of every IBD patient at the initial session. There are easy-to-use, scientifically effective screening techniques for mental health issues. As important as or even more so than a therapy modality may be psychological techniques. Objective: To assess the level of depression among IBD patients in the Gastroenterology and Hepatology Specialized Hospital, Medical City, Ministry of Health and Environment. Patients and methods: The patients were provided with the three-page Patient Health Questionnaire (PHQ) as a self-administrated tool to learn more about their health. When completed, the doctor scans the completed questionnaire, verifies the "yes" responses, and then applies the diagnostic algorithms, which are briefly listed at the bottom of each page. This study was conducted on 98 patients with IBD attending the Gastroenterology and Hepatology Specialized Hospital, Medical City, Baghdad during the period from January – June 2022. Results: Of the total number of cases included in the study 47 (47.9%) were females and 51 (52.1%) were males. The highest frequency was for young adults, 48 cases (49%), and the lowest was for children, 9 (9.2%). There were 43 cases with Ulcerative Colitis and 55 with Crohn's disease. According to the PHQ-9 score, 26 cases (26.5%) had mild scores and 9 (9.2%) cases had severe scores. The highest frequency of PHQ-9 scores was in the moderately severe range with 44 (44.9%). Conclusion: Mild and moderate levels of depression were the most prevalent among IBD patients across all age and sex groups, which should encourage physicians to address the mental health status of their patients and to include mental health care in the routine checkup of their patients. Received: Feb,, 2023 Accepted: Oct, 2023 Published: Jan.2024

Evaluating Parents' Concerns, Needs, and Levels of Satisfaction with the Services Provided for ASD Children in Saudi Arabia.

Supporting children with autism spectrum disorder (ASD) and their parents is vital in improving their children's abilities and their parents' ability to care for them. Thus, parents' perceptions of and levels of satisfaction with the services provided for their children must be assessed. This study aimed to understand parents' perceptions of and satisfaction with the speech-language services (SLS) provided for ASD children in different health facilities in Saudi Arabia. This cross-sectional study included 109 parents of ASD children. The survey included five sections dealing with (1) general information about the child; (2) assessment of the child's ASD characteristics (including their age when diagnosed, when they first noticed symptoms, and their speech, language, and communication abilities); (3) the reasons for enrollment in SLS sessions; (4) questions about SLS; and (5) parents' perceptions of SLS, satisfaction with the service, descriptions of their children's progress, and the respect and support they received. Parents' satisfaction levels were significantly higher when they had easy access to SLS, sufficient information and support, proper training in applying therapy exercises at home, and perceived respect and support from speech and language pathologists (SLPs). The reasons for discontinuing SLS included high session costs, the need for initial behavioral sessions, the lack of qualified SLPs, the end of the sessions, the lack of improvement, the nonavailability of specialized centers, and parents' dependence on home training only. They also sought opportunities for work and education, continuous and intensive SLS sessions, reduced costs, centers for adults with ASD, and accessible schools. Parents' main concerns were their children's poor speech and language skills, independence, and social acceptance. The study highlighted the importance of understanding parents' experiences with SLS, identifying the factors that enhance SLS use by ASD children, and improving parents' satisfaction with such services.

Introducing a novel respiratory function monitor for neonatal resuscitation training

BackgroundA respiratory function monitor (RFM) gives immediate feedback, allowing clinicians to adjust face mask ventilation to correct leak or inappropriate tidal volumes. We audited the satisfaction of clinicians with a neonatal resuscitation training package, incorporating a novel RFM. MethodsThis was a mixed-methods study conducted at The Royal Women’s Hospital, Melbourne, Australia. Clinicians were approached to complete a neonatal resuscitation training session. Participants watched a training video, then provided ventilation to term and preterm manikins first without, and then with, the RFM. Clinicians completed a survey after the session and undertook a follow-up session three months later. The primary outcome was participant satisfaction with the RFM. Secondary outcomes included participants’ self-assessment of face mask leak and tidal volumes when using the RFM. ResultsFifty clinicians completed both the initial and follow-up session. Participants reported high levels of satisfaction with the RFM for both term and preterm manikins: on a scale from 0, meaning “not at all”, and 100, meaning “yes, for all resuscitations”, the median response (interquartile range, IQR) was 82 (74–94) vs 81.5 (69–94.5). Levels of satisfaction were similar for less experienced and more experienced clinicians: median (IQR) 83 (77–93) vs 81 (71.5–95) respectively. When using the monitor, clinicians accurately self-assessed that they achieved leak below 30% and tidal volumes within the target range at least 80% of the time. ConclusionClinicians of all experience levels had a high level of satisfaction with a training package including a novel RFM.

A Parent-Report Diary Study of Young Children’s Prospective Memory Successes and Failures

ABSTRACT Although laboratory studies have examined the development of children’s prospective memory (PM) and the factors that influence its performance, much less is known about children’s PM performance and development in their everyday life. The current study used an online parent diary report approach to examine American 2- to 6-year-olds’ PM successes and failures. In an initial session, 206 parents completed a series of questionnaires on their child’s memory and cognition. For the next four days, parents reported instances of PM successes and failures and answered questions about a number of task factors (task motivation, importance to the parent and child, who assigned the PM task, task typicality, and parental assistance). We found that: (1) parents reported children as young as 2 years old had PM successes in daily life and there were no age differences in the number of reported PM successes and failures, (2) parents reported more PM successes than failures, and (3) several factors influenced the likelihood of children’s success in everyday PM tasks, including child motivation and task importance to parents, whereas task typicality and parental assistance were related to PM failure. Finally, we explored the domains of PM successes and failures as well as the type of assistance that parents provided. These results are discussed in relation to past findings of children’s PM in laboratory and naturalistic settings. Parent diary-report methodology is a feasible and efficient alternative to naturalistic laboratory tasks to examine young children’s PM in everyday life.

A perspective on the scope of videoconferencing-based telemedicine in respiratory diseases outpatient clinic.

Telemedicine is rapidly expanding across various fields worldwide. While it finds application in respiratory diseases due to the imperative need for protection against the risk of transmission and the close monitoring of patients with chronic diseases, there is a scarcity of publications detailing telemedicine experiences in respiratory diseases. This study aims to retrospectively evaluate the prospective management of patients with respiratory diseases through videoconference-based telemedicine, intending to establish a foundation for its judicious application in pulmonology cases. In this descriptive study, anonymized medical records of all 478 patients assessed via videoconference-based telemedicine over an eight-month period from June 2020 to February 2021 were reviewed. The analysis included demographic characteristics, disease history, attendance methods, the necessity for in-person physical examination after the initial videoconference (VC) session, the inclusion of investigations, pre-diagnosis, diagnosis processes, follow-up period, and outcomes. Follow-up data for all patients included in the study were reviewed at the end of June 2021. Median age of the patients was 55 (44-67), with a male predominance of 55%. Approximately 30% resided in a city other than the one in which the physician offering telemedicine was situated. Seventy-nine (16.7%) individuals received telemedicine via VC sessions without the requirement for any in-person examinations. The most prevalent disease among those who applied for telemedicine was asthma. Median duration of the initial VC session was 13 (8-18) minutes. At least half of the individuals seeking videoconference-based telemedicine for chronic respiratory disorders, such as asthma, COPD, and interstitial lung disease, had previously been followed by either the telemedicine provider or another physician in the same hospital. However, the vast majority of telemedicine applications in disease categories such as COVID, post-COVID, pulmonary nodules, and lung cancer were submitted by first-time applicants. This pioneering study suggests that videoconference-based telemedicine may be an alternative/complementary tool for patients, particularly those with chronic respiratory diseases.

Comparison of the effect of interactive and non-interactive education on the self-efficacy of COVID-19 patients

The purpose of the present study was to investigate the effect of interactive and non-interactive education on the self-efficacy of COVID-19 patients. This is a randomized clinical trial that was conducted on 80 COVID-19 patients in Zahedan in 2022. The samples were randomly assigned to intervention (interactive) and control (non-interactive) groups (n=40 people per group). The patients of each group received two initial education sessions in the hospital and at the time of discharge. Patients of the intervention group participated in 5 sessions of face-to-face interactive education along with practical education using a video projector by the researcher. The control group only received education ions by ward nurses during discharge and only one educational PDF file was given to them to study. The results showed that the mean and standard deviation of the self-efficacy score of the patients of the two interactive and non-interactive education groups did not differ significantly before the intervention (P = 0.024), but it was significantly higher in the interactive education group than the non-interactive education group (p&lt;0.0001). That is, the mean and standard deviation of the self-efficacy score of patients in the interactive education group increased significantly from 49.8 ± 14.77 to 96.77 ± 18.29. The same score in the non-interactive education group increased from 57.85 ± 16.35 to 62.45 ± 14.52, which was not a significant increase. The results showed this intervention helps patients to make informed decisions about their goals, treatments, and self-care behaviors.

Domestic Environment of Multisensory Stimulation based on Snoezelen principles pilot study

AbstractBackgroundMultisensory stimulation (MSS) aims to stimulate the senses such as vision, hearing, touch, taste, smell, vestibular and proprioceptive systems that may be areas affected by dementia. The 24‐hour Snoezelen spaces in home environments aim to offer a proposed MSS intervention for seniors with dementia syndromes. In addition, studies on this therapy, its benefits and effects both for the elderly living in the community and for their caregivers/family members, are scarce.ObjectiveTo understand and evaluate the benefits of Snoezelen sensory stimulation in home settings of community‐dwelling elderly.Materials and MethodsThe 24‐hour Snoezelen intervention will be conducted over three/four months, in 9 sessions. The sessions will be organized in stages: The 1st stage, involves the evaluation process, performed in the 1st week, which will consist of two evaluation sessions that include home assessment, establishment of sensory preferences and sensory profile of the elderly. The 2nd stage will be carried out from the 2nd to the 5th week with the implementation of the 24‐hour Snoezelen sessions that aim to teach caregivers how to use the Snoezelen space with two focuses: stimulation and relaxation. The initial session will be determined by the demands presented by the caregiver and the elderly regarding the need to start with a relaxation or stimulation session. The third stage involves the follow‐up of the implementation of the post‐training sessions for caregivers that will be developed from the 6th to the 9th week with 3 sessions. The interval between the 3 sessions will be 15 days so that the caregivers can practice what they have learned during the training. To analyze the impact of the Home Spaces of MRE the effect size will be used considering the averages in the NPI before and after the Intervention. Measures of variance will be applied to evaluate the impact of MRE home stimulation in relation to time (pre‐ and post‐intervention). The degree of significance was set to values of p&lt;0.05Result: And ConclusionThe study in question is in progress and the results and conclusion will be presented at the congress.

Bloodless Treatment of Jehovah’s Witness Patients with Lymphoma and Multiple Myeloma

Background/Aims: Jehovah’s Witnesses refuse blood transfusions for religious reasons. Soonchunhyang University Hospital Seoul has operated a bloodless treatment center since 2000, and a database of bloodless treatment patients has been created. This study aimed to analyze the bloodless treatment outcomes of lymphoma and multiple myeloma patients.Methods: We retrospectively analyzed data of patients diagnosed with lymphoma (22 patients) or multiple myeloma (seven patients) who were treated bloodlessly at Soonchunhyang University Hospital Seoul from 2006 to 2021.Results: The 2-year survival rate for lymphoma patients was 66.6%, with 22.7% dying within 6 months of diagnosis. Those who died early (within 6 months) had a median hemoglobin level of 5.5 g/dL and a median platelet count of 50,142/µL. Dyspnea due to anemia was the most common symptom reported by patients at the end of life. Patients with multiple myeloma had a median survival of 60.3 months and a 2-year survival rate of 57.1%. Although three of the seven multiple myeloma patients were eligible for autologous stem cell transplantation, they were treated with chemotherapy only due to limitations of the bloodless treatment. The drug type and intensity were adjusted due to hematological toxicities in 71.4% of multiple myeloma patients.Conclusions: A significant proportion of patients completed their planned course of chemotherapy and achieved long-term survival. The treatments of some patients were adjusted due to the use of bloodless treatment at the initial chemotherapy session, which affected their response to treatment.