Recommendations For Interventions Research Articles

THE POWER OF SPOKEN LANGUAGE: UNDERSTANDING COMMUNICATION APPREHENSION AND ENGLISH LANGUAGE ANXIETY AMONG THAI-SPEAKING MINORITY STUDENTS IN MALAYSIAN NATIONAL SCHOOLS

Communication apprehension refers to the feeling of anxiety or fear that individuals experience when they need to communicate with others. In the context of foreign language learning, communication apprehension can have significant implications on learners' abilities to learn, use, and acquire the language effectively, yet studies on it as one of the key components contributing to anxiety in language learning especially among minority learners are still scarce. This study examines communication apprehension as one of the four components recognised to spark anxiety in foreign language learning. The focus was directed at a group of Thai-speaking Malaysian secondary school students, who are always addressed as the minority ethnic groups in this country. As a minority race, it is believed that this population may have unique experiences and challenges in learning English as a foreign language, which have not been extensively studied before. The findings contribute to the existing literature by examining foreign language anxiety from the perspective of minority Thai-speaking students, identifying anxiety-inducing situations, and offering recommendations for educational interventions to address communication apprehension. It was found that these students were uncomfortable or anxious in a variety of situations when speaking in English mainly when participating in impromptu tasks. The findings contribute to the identification of specific situations that can trigger anxiety and hinder language learning progress among them. It is hoped that this knowledge can guide educators in designing appropriate instructional approaches and creating a supportive classroom environment. Therefore, educators are recommended to offer more attention to the special needs of learners who struggle with communication anxiety by developing a friendly and secure learning environment where these students can confidently practise their ways of interacting. This is important to help them build confidence and self-esteem and thus alleviate unnecessary anxieties.

Fibrolamellar hepatocellular carcinoma: An epidemiologic and 5-year cancer survival assessment based off SEER data

The fibrolamellar variant of hepatocellular carcinoma makes up a small percentage of liver tumors. Despite being a subset, it has been noted in the literature to have variations in terms of its epidemiology and intervention recommendations. Using the Surveillance, Epidemiology, and End Results database, 339 cases from 1988 to 2016 were studied. Favorable prognostic epidemiological factors included male sex, younger ages, and white race. Those who underwent any lymph node resection (combined with liver resection) did better than those without lymph node resection; chemotherapy proved beneficial for those where surgery was contraindicated. To our knowledge, this report is the largest conglomerate dataset analyzing prognostic profiles and treatment strategies for fibrolamellar hepatocellular carcinoma.

What are the core recommendations for rheumatoid arthritis care? Systematic review of clinical practice guidelines.

Systematic r eview to evaluate the quality of the clinical practice guidelines (CPG) for rheumatoid arthritis (RA) management and to provide a synthesis of high-quality CPG recommendations, highlighting areas of consistency, and inconsistency. Electronic searches of five databases and four online guideline repositories were performed. RA management CPGs were eligible for inclusion if they were written in English and published between January 2015 and February 2022; focused on adults ≥ 18years of age; met the criteria of a CPG as defined by the Institute of Medicine; and were rated as high quality on the Appraisal of Guidelines for Research and Evaluation II instrument. RA CPGs were excluded if they required additional payment to access; only addressed recommendations for the system/organization of care and did not include interventional management recommendations; and/or included other arthritic conditions. Of 27 CPGs identified, 13 CPGs met eligibility criteria and were included. Non-pharmacological care should include patient education, patient-centered care, shared decision-making, exercise, orthoses, and a multi-disciplinary approach to care. Pharmacological care should include conventional synthetic disease modifying anti-rheumatic drugs (DMARDs), with methotrexate as the first-line choice. If monotherapy conventional synthetic DMARDs fail to achieve a treatment target, this should be followed by combination therapy conventional synthetic DMARDs (leflunomide, sulfasalazine, hydroxychloroquine), biologic DMARDS and targeted synthetic DMARDS. Management should also include monitoring, pre-treatment investigations and vaccinations, and screening for tuberculosis and hepatitis. Surgical care should be recommended if non-surgical care fails. This synthesis offers clear guidance of evidence-based RA care to healthcare providers. TRIAL REGISTRATION: The protocol for this review was registered with Open Science Framework ( https://doi.org/10.17605/OSF.IO/UB3Y7 ).

Barriers, Facilitators, and Strategies for Developing a Culturally Informed Lifestyle Intervention for Native Hawaiian, CHamoru, and Filipino Breast Cancer Survivors: Mixed-Methods Findings from Focus Group Participants.

Breast cancer disproportionately impacts Native Hawaiian, CHamoru, and Filipino women. Few culturally informed interventions addressing breast cancer survivors exist and none have been developed or tested specifically for Native Hawaiian, CHamoru, and Filipino women. This study aimed to conduct focus groups with Native Hawaiian, CHamoru, and Filipino women previously diagnosed with breast cancer to inform future research in Guam and Hawai'i. Convenience sampling and grounded theory approaches were used. Focus group sessions were conducted during summer 2023 and included questions to understand the barriers, motivators, and implementation recommendations for lifestyle interventions aimed at reducing the risk for breast cancer recurrence among the target population. Data saturation was reached after a total of seven focus groups (an average of four survivors/group per site) were conducted (three in Hawai'i and four in Guam), which represented 28 breast cancer survivors. Themes from the focus groups emerged around developing support systems with other survivors, providing physical activity and nutrition intervention activities and materials in multiple formats, and incorporating activities and foods that accommodate the side effects of breast cancer treatments and are culturally relevant. The average desired intervention length was eight weeks. These findings will inform the development and feasibility testing of a culturally informed lifestyle intervention for breast cancer survivors in Guam and Hawai'i.

Mediated communication and refugee resilience: A social psychological model

The global refugee crisis, exacerbated by the Russian aggression in Ukraine, was caused by the unprecedented migration of millions fleeing wars, conflicts, and persecution. In this context, social psychologists are increasingly focusing on the role of mediated communication in promoting resilience among refugees. This article explores how mediated communication can foster resilience, drawing on social psychology theories and empirical research. We present an overview of the global refugee crisis and the challenges refugees face, including those affected by the ongoing war. The concept of resilience and its relevance to refugees is introduced, discussing the role of social support, coping strategies, and positive emotions in fostering this vital quality. We analysed the role of mediated communication and main characteristic, which can play important role for mental health problem prevention. Mediated communication, as a powerful tool to promote refugee resilience, is examined, highlighting its ability to provide access to social support networks, favour connection and belonging, and facilitate access to information and resources. Understanding the cultural and social contexts in which refugees use mediated communication, including issues of gender, age, and cultural norms, is essential for effective interventions. We concluded that interventions can address the unique challenges faced by refugees, such as displacement, war trauma, and social isolation, as well as the specific needs of Ukrainian refugees from different cultural and linguistic backgrounds. Potential challenges and limitations of mediated communication in promoting resilience among refugees, such as privacy and security issues, social isolation, and disinformation, are also discussed. Research perspectives are empirical verification of conceptual model of mediated communication potential for refugees’ resilience and develop the evidence based recommendation for future psychoeducation and mental health promotion interventions

Satisfaction in older patients by geriatric assessment using a novel tablet-based questionnaire system: A cluster-randomized, phase III trial of patients with non–small-cell lung cancer (ENSURE-GA study; NEJ041/CS-Lung001).

12041 Background: To provide optimal treatment for older cancer patients, it is necessary to carry out a geriatric assessment (GA) to evaluate geriatric syndrome. However, GA is not widely performed because it requires expertise. In this ENSURE-GA study, we evaluated if providing a GA summary and recommendations for GA-guided interventions using a novel tablet-based questionnaire system improved satisfaction about communication with physicians for older patients with non-small-cell lung cancer (NSCLC). Methods: Patients with NSCLC who were incapable of radical treatment aged 75 or older were enrolled. All patients underwent a standardized GA using a tablet before starting treatment. Participating institutions were cluster-randomized into the intervention group and the control group. In the intervention group, GA summary and recommendations for GA-guided interventions were immediately returned to guide physicians in selecting treatments and interventions. The control group did not provide a GA summary. The primary outcomes were difference in patient satisfaction pre-treatment and percent change pre- and post-treatment according to the HCCQ questionnaire. Results: A total of 1,021 patients from 78 institutions in Japan were enrolled between 2019–2022. There were no differences in patient backgrounds between the intervention group and the control group: mean age 80.1 yrs. vs. 80.0 yrs.; male 64.1% vs. 66.8%; adenocarcinoma 70.4% vs. 64.8%; and performance status 0-1, 82.4% vs. 79.0%, respectively. All GA domain evaluation results, such as ADL and cognitive function, also did not differ between the two groups. Pre-treatment satisfaction scores were significantly higher in the intervention group than in the control group (29.9 vs. 29.1, p = 0.003). There was no significant difference in the mean percent change between the two groups (-0.13 vs. 2.38, p = 0.165). Conclusions: Providing the oncologist with a GA summary and recommendations for GA-guided interventions improved patient satisfaction from the start of treatment. A novel system using a tablet may be effective at promoting GA more widely. Clinical trial information: UMIN0000037590 .

Experiences of criminal justice: Perspectives from Wales on a system in crisis By D.Newman, R.Dehaghani, Bristol: Bristol University Press. 2023. pp. 270. £80.00 (hbk); £26.99 (pbk); £26.99 (ebk). ISBN: 9781529214222; 9781529214239; 978152914246

Experiences of criminal justice: Perspectives from Wales on a system in crisis By D.Newman, R.Dehaghani, Bristol: Bristol University Press. 2023. pp. 270. £80.00 (hbk); £26.99 (pbk); £26.99 (ebk). ISBN: 9781529214222; 9781529214239; 978152914246

Evolving Roles and Needs of Psychiatry Chief Residents During the COVID-19 Pandemic and Beyond.

Psychiatry chief residents have diverse leadership roles within psychiatry residency programs. Chief residents have historically been viewed as "middle managers", and other leadership roles include administrative work, teaching, and advocacy for residents. Chief residents also help in managing the logistics of complex healthcare systems and mediating between many groups with conflicting needs and perspectives. The COVID-19 pandemic has changed the functioning of psychiatry residency programs, and this has also led to the evolution of the roles of the chief residents in psychiatry. During the COVID-19 pandemic, the chief residents had to help with adapting to the changes in teaching and clinical work with residents and faculty. They had to liaison with various healthcare providers in making decisions related to COVID-19 in residency programs. Along with these changes, chief residents also had to advocate for the wellbeing and needs of their fellow residents. This perspective article is written by authors who have served during or after the transition to the COVID-19 pandemic. We discuss our experiences as chief residents as well as evolving roles and wellness needs of chief residents in psychiatry. Based on the administrative, advocacy, academic and middle management roles of chief residents in psychiatry and their wellbeing, we also make recommendations for support and interventions needed for chief residents in the context of the COVID-19 pandemic and beyond.

Surgical care and outcomes in older patients with cancer through implementation of a pre-surgical toolkit (OPTI-Surg): Interim results of a phase III cluster randomized trial (Alliance A231601CD).

1541 Background: Frailty is common in older adults undergoing major cancer surgery. Mounting evidence indicates multimodal interventions to optimize patient functional status by addressing vulnerabilities associated with frailty before surgery result in decreased complications and enhanced functional recovery. This study tested the effectiveness of OPTI-Surg, a surgical prehabilitation toolkit for improving surgical care and outcomes in older patients undergoing major cancer surgery. Here, we report results from the planned futility interim analysis (IA). Methods: Thoracic (T), gastrointestinal (GI), and urologic (GU) oncological surgery practices affiliated with NCI’s Community Oncology Research Program were randomized 1:1:1, stratified by practice type, to usual care (control), OPTI-Surg toolkit, or OPTI-Surg with an implementation coach. The toolkit was implemented at the practice level. It consisted of the 12-item Edmonton Frail Scale and guided recommendations for interventions directed at identified vulnerabilities. Eligible patients were adults ≥70 years old undergoing curative intent surgery for lung, gastrointestinal, or urologic cancers. Primary outcome was 8-week post-operative function (weekly caloric expenditure) derived from the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. A linear mixed model was used to compare usual care to the 2 OPTI-Surg arms combined, controlling for baseline function. Results: From July 2019 to October 2021, 225 patients, 50% of the total accrual goal, were enrolled from 29 practices, triggering the IA. Study was suspended to new patient accrual March to June 2020 due to the COVID-19 pandemic. There were no differences in demographics by arm (mean age 76.2 years; 46.4% women; 79.6% white; 20.4% lung resection, 69.8% major GI surgery, 9.8% total cystectomy). Of the 225 patients, 140 (47 Usual Care, 93 OPTI-Surg) were evaluable for the IA. There was no significant difference in post-operative function between OPTI-Surg and usual care (mean decrease of 0.59 kCal/week for OPTI-Surg patients and 0.19 kCal/week for usual care patients, p = 0.762, intraclass correlation = 0.033). Based on the futility analysis, the DSMB recommended closure of recruitment on September 16, 2022. Conclusions: Implementation of the OPTI-Surg toolkit did not significantly improve functional outcomes 8 weeks after surgery for patients aged 70 and older undergoing major cancer surgery compared to usual care. Future analysis of implementation and ethnographic data may identify reasons why significant differences between the intervention and usual care arms were not observed, potentially including disruptions due to the COVID-19 pandemic. Clinical trial information: NCT03857620 .

"If they had a place to live, they would be taking medication": a qualitative study identifying strategies for engaging street-connected young people in the HIV prevention-care continuum in Kenya.

Street-connected young people (SCY) experience structural and social barriers to engaging in the HIV prevention-care continuum. We sought to elicit recommendations for interventions that may improve SCY's engagement along the HIV prevention-care continuum from healthcare providers, policymakers, community members and SCY in Kenya. This qualitative study was conducted in Uasin Gishu, Trans Nzoia, Bungoma, Nakuru and Kitale counties in Kenya between May 2017 and September 2018 to explore and describe the public perceptions of, and proposed and existing responses to, the phenomenon of SCY. This secondary analysis focuses on a subset of data interviews that investigated SCY's healthcare needs in relation to HIV prevention and care. We conducted 41 in-depth interviews and seven focus group discussions with 100 participants, of which 43 were SCY. In total, 48 participants were women and 52 men. Our analysis resulted in four major themes corresponding to stages in the HIV prevention-care continuum for key populations. We identified the need for an array of strategies to engage SCY in HIV prevention and testing services that are patient-centred and responsive to the diversity of their circumstances. The use of pre-exposure prophylaxis was a biomedical prevention strategy that SCY and healthcare providers alike stressed the need to raise awareness around and access to for SCY. Several healthcare providers suggested peer-based approaches for engaging SCY throughout the continuum. However, SCY heavily debated the appropriateness of using peer-based methods. Structural interventions, such as the provision of food and housing, were suggested as strategies to improve antiretroviral therapy adherence. This study identified contextually relevant interventions that should be adapted and piloted for use with SCY. Education and sensitization of SCY and healthcare providers alike were identified as possible strategies, along with affordable housing and anti-poverty strategies as cash transfers and provision of food. Peer-based interventions are a clear option but require SCY-specific adaptation to be implemented effectively.

System dynamics model on the interplay between social health and dementia

AbstractBackgroundDementia, as a multi‐factorial condition with complex underlying mechanisms, demands a comprehensive approach of prevention and treatment, especially, focused on psychosocial interventions. This work is aimed at presenting a system dynamics (SD) model on the role of social health in the trajectory from cognitive health to dementia.MethodWe used a staged approach for building a SD model, presenting SH‐cognition bidirectional relationship, based on (1) systematic literature review on factors related to cognitive decline, (2) Group Model Building sessions with interdisciplinary experts, (3) iterative way of integrating results from epidemiological, multi‐national cohort studies, (4) ongoing revisions of SH concept via structured discussions between experts. This knowledge synthesis was harmonized and transformed into a causal pathway model in Kumu program (https://kumu.io/).ResultThe SD model presents maps on three levels: health domains, concepts with dimensions, markers. The last is a representation of interaction and feedback mechanisms between social health and cognition through three pathways: Physiological, psychological, and health‐behavioral, and through, so called ‘cognitive reserve & brain reserve’. Each marker is described with definitions and level of evidence (from expert’s knowledge to systematic review). The outcome shows that multiple SH factors contribute to cognitive decline and dementia (e.g. loneliness, being single), being risk factors, and other serve as protective factors (e.g. high social frequency, social support). In return, presence of dementia symptoms influences SH, f.ex. making the individual more dependent on social network, or being less satisfied with social ties.ConclusionThe SD model elucidates dynamic and complex relationships between dementia and SH, which might serve a role of a reserve in the context of changed roles in social life of an individual with dementia. This novel representation will be translated into key elements and targets for recommendations for interventions, both for prevention and for improved dementia care.

Social Media Use for Cancer Support Among Young Adults with Cancer.

Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.

Forest management scenarios drive future dynamics of Mediterranean planted pine forests under climate change

ContextPlanted pine forests are highly abundant communities in the Mediterranean Basin. Being the result of past reforestation, these forests show high species and structural homogeneity. Diversification to conifer-broadleaved mixed forests is recommended to promote adaptation to climate change and increase their resilience to perturbations.ObjectivesThis study aims at evaluating how these planted pine forests will develop in the future as a result of the combined impacts of management and climate.MethodsWe applied a forest landscape model (LANDIS-II) to simulate different climate scenarios and management strategies designed in cooperation with forest managers to assess their effects on the performance of planted pine forests and their change in terms of forest composition.ResultsClimate change scenarios caused a shift in the phenological growth pattern of planted pine forests by reducing forest growth during summer and increasing photosynthetic productivity in spring and fall, particularly under high emission scenarios. Biomass increased through time and more strongly under climate change, but this increase differs among species, resulting in changes of forest types across the landscape. Our results portray natural succession as the main driver of forest change, but intensive management accelerated this process by limiting pine growth and promoting growth of oak species.ConclusionsOur results highlight the importance of active management on planted pine forests to favour mixed and climate-adapted ecosystems in shorter time scales than offered by succession alone. Moreover, our spatially explicit modelling approach helps to identify areas where lack of seed dispersal and/or competitive exclusion prevent natural diversification, providing useful recommendations for interventions. However, the modelling approach has some limitations since it does not consider natural disturbances.Graphical abstract

A Review paper on the Impact of Artificial Intelligence on the Job Market

Artificial intelligence (AI) has revolutionized various industries, and its impact on the job market is significant. While AI has the potential to automate repetitive and time-consuming tasks, it also presents new job opportunities that require expertise in data analysis, software engineering, and machine learning. The paper provides an overview of the current state of the job market and the challenges it faces, and explains how AI is transforming the job market, including its impact on job creation and destruction, skill requirements, and wage distribution. The paper analyzes the job market trends from 2019 to 2023 based on the latest research and reports, and discusses the implications of AI for the workforce and policymakers. The paper concludes with some recommendations for future research and policy interventions. It discusses the benefits of AI, such as increased productivity, efficiency, and accuracy, and highlights the challenges that AI poses, including the displacement of certain jobs and the need for retraining workers. The review paper also discusses how AI is impacting workplace safety and health, including both the potential benefits and the new hazards that AI presents. Finally, the review paper explores the policies and regulations needed to ensure that AI is used ethically and responsibly in the job market. Overall, this review paper aims to provide a comprehensive understanding of the impact of AI on the job market and its implications for workers, businesses, and society

Considerations and recommendations for mHealth interventions for substance use among Sexual and Gender Minority (SGM) individuals: A narrative review of the past 5years.

The prevalence of problematic substance use is disproportionately higher among sexual and gender minority (SGM) adults compared to adults in the general population. mHealth as a treatment modality could reduce barriers to accessing substance use treatments among SGM populations. Through a qualitative literature search, the current narrative review aimed to understand the lived experiences of SGM individuals who use substances and to synthesize recommendations made in the literature to inform future mHealth interventions. Positive and negative reinforcement motives were prominent reasons for substance use, which included SGM identity expression and conformity motives. Individual- and system-level treatment barriers included a lack of safe and nonjudgmental environment, shame and stigma, and limited knowledge about treatment options. Barriers were directly linked to the reported substance use treatment needs in this population. On-demand app features, real-time intervention and assessment, and anonymity should be considered in future mHealth trials. The online version contains supplementary material available at 10.1007/s40429-023-00497-0.

A Qualitative Examination of Tobacco Use and Smoking Cessation Among Gender Minority Adults.

Despite the elevated prevalence of smoking among gender minority adults, little is known about the factors that influence their tobacco use and cessation. We identified and examined factors that influence tobacco use and cessation for gender minority adults, using a conceptual framework based on the Model of Gender Affirmation and Gender Minority Stress Model. Nineteen qualitative, semi-structured in-depth interviews were conducted with gender minority adults who smoke or no longer smoke and were recruited from the Portland, OR metropolitan area. Interviews were audio-recorded, professionally transcribed, and analyzed utilizing thematic analysis. Four main themes were generated. Gender minority adults smoke to cope with general and gender minority-specific stressors. Smoking was described as a social behavior that was influenced and sustained by community and interpersonal relationships. Smoking cessation was motivated by health concerns (both general and gender minority-specific) and moderated by conducive life circumstances. Recommendations for tobacco cessation interventions highlighted the importance and role of social support. Participants expressed a strong desire for gender minority-specific tobacco cessation programs. There are unique and complex factors that contribute to the higher prevalence of smoking observed among gender minority adults. Tobacco cessation interventions are urgently needed for this population and should be tailored to address the unique factors that impact tobacco use and cessation among gender minority people to increase the likelihood of success.

Mediated communication and refugee resilience: A social psychological model

The global refugee crisis, exacerbated by Russian aggression in Ukraine, has been caused by an unprecedented migration of millions of people fleeing wars, conflicts, and persecution. In this context, social psychologists are paying increasing attention to the role of mediated communication in promoting resilience among refugees. This paper explores how mediated communication can promote resilience, drawing on theories of social psychology and empirical research. An overview is provided of the global refugee crisis and the challenges faced by refugees, including those affected by ongoing wars. The concept of resilience and its importance for refugees is presented, and the role of social support, coping strategies, and positive emotions are discussed in fostering this vital quality. The role of mediated communication and its main feature was analysed, which can substantially prevent mental health problems. Mediated communication is considered a powerful tool for promoting refugee resilience, highlighting its ability to provide access to social support networks, promote connection and belonging, and facilitate access to information and resources. Understanding the cultural and social contexts in which refugees use mediated communication, including issues of gender, age, and cultural norms, is crucial for effective intervention. It is concluded that interventions can address the unique challenges faced by refugees, such as displacement, war trauma, and social isolation, including the specific needs of Ukrainian refugees from different cultural and linguistic traditions. Potential challenges and limitations of mediated communication in promoting resilience among refugees, such as issues of confidentiality and security, social isolation, and misinformation, are also discussed. Future research perspectives include empirically testing the conceptual model of the mediated communication potential of refugee resilience and developing scientifically based recommendations for future psychosocial interventions and mental health promotion

(031) Update from the Female Genitopelvic Pain Subcommittee of the International Consultation of Sexual Medicine on a systematic review of the efficacy and safety of treatments for vulvodynia

Abstract Introduction Literature on vulvodynia treatment is heterogeneous regarding intervention type and study quality. A recently published systematic review (SR) of treatments focusing on randomized controlled trials (RCTs) and non-RCTs for provoked vestibulodynia (a vulvodynia subtype) concluded that most studies had very low certainty of evidence, which limited the ability to draw conclusions. In addition, the authors noted that their strict eligibility criteria resulted in a restricted number of included studies. It suggests a need for broader, more inclusive SRs to be conducted, which could inform much needed intervention recommendations for vulvodynia. Objective The Female Genitopelvic Pain Subcommittee is conducting a SR of treatments for vulvodynia to assess their effectiveness, safety, and acceptability. The results will provide stakeholders with empirically based treatment recommendations for patients with vulvodynia. Methods Selection criteria: Interventions of interest consist of pharmacological, surgical, psychological, physical therapy, and acupuncture treatments of premenopausal women with clinician-diagnosed vulvodynia (primary, secondary), defined as idiopathic, chronic (≥3 months) vulvar pain. Included studies are RCTs, SRs, and comparative observational studies. Primary outcomes are pain and sexuality, safety, and adverse events, with additional outcomes focusing on mood and quality of life. Selection of studies was done in DistillerSR by two independent reviewers. Conflicts were resolved by discussion or by involving a third reviewer, with excluded studies documented. Full-text screening adheres to the same process. Search methods: A comprehensive search strategy was developed by an information specialist and was peer reviewed. Numerous electronic databases were searched from 1997 to present. No language limit was used. Published filters for controlled trials and other study designs were applied. PubMed/MEDLINE was used to develop the search strategy, which was translated into other databases. A limited grey literature search was also conducted. Data collection and analysis: Data extraction and risk of bias assessment (ROB) will be done in DistillerSR using pre-piloted data extraction forms. Studies will be extracted by one reviewer and independently checked by a second reviewer. Disagreements will be resolved by discussion or by involving a third reviewer. We will extract study characteristics and outcome data. For ROB, we will use the Cochrane Risk of Bias tool and the ROBINS-I tool. We will narratively synthesize the results by comparisons and outcomes. If appropriate, we will conduct a meta-analysis for studies regarded as suitably homogeneous. Last, the certainty of the body of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results The search yielded 10,171 references after duplicates were removed for title and abstract screening. Of these, 599 full-text articles were assessed for inclusion. All screening and preliminary data extraction will be completed by October 2022. General characteristics of the included studies, including interventions identified, will be presented. Conclusions We will report on interim progress of the SR. It will be an opportunity to gather initial input from stakeholders on this evidence-based approach. Discussion of possible multi-organization involvement will also help unify intervention recommendations for those with vulvodynia. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Andrew Goldstein – Daré Bioscience (employee), Incyte (consultant), Gynecologic Cancers Research Foundation (Board of Directors, Research Funding).

Recommendations of the committee on complementary medicine and nutrition in ayurvedic medicine, homeopathy, nutrition and Mediterranean diet

Methods of complementary and alternative medicine (CAM) are appealing for many patients with rheumatic diseases. The scientific data are currently characterized by alarge number of publications that stand in contrast to aremarkable shortage of valid clinical studies. The applications of CAM procedures are situated in an area of conflict between efforts for an evidence-based medicine and high-quality therapeutic concepts on the one hand and ill-founded or even dubious offers on the other hand. In 2021 the German Society of Rheumatology (DGRh) launched acommittee for CAM and nutrition, which aims to collect and to evaluate the current evidence for CAM applications and nutritional medical interventions in rheumatology, in order to elaborate recommendations for the clinical practice. The current article presents recommendations for nutritional interventions in the rheumatological routine for four areas: nutrition, Mediterranean diet, ayurvedic medicine and homeopathy.

(188) The Female Genitopelvic Pain Subcommittee of the International Consultation of Sexual Medicine: Update on a systematic review of the efficacy and safety of pharmacological, surgical, psychological, and physical therapy treatments for vulvodynia

Abstract Introduction Literature on vulvodynia treatment is heterogeneous in terms of intervention type and study quality. A recently published systematic review (SR) of treatments focusing on randomized controlled trials (RCTs) and non-RCTs for provoked vestibulodynia (a vulvodynia subtype) concluded that most studies had very low certainty of evidence, which limited the ability to draw conclusions. The authors noted that their strict eligibility criteria resulted in a restricted number of included studies. It suggests a need for broader, more inclusive SRs to be conducted, the results of which could inform much needed intervention recommendations for vulvodynia. Objective The Female Genitopelvic Pain Subcommittee is conducting a SR of treatments for vulvodynia to assess their effectiveness, safety, and acceptability. The results will provide stakeholders with empirically based treatment recommendations for patients with vulvodynia. Methods Selection criteria: Interventions of interest include pharmacological, surgical, psychological, and physical therapy treatments of premenopausal women with clinician-diagnosed vulvodynia (primary, secondary), defined as idiopathic, chronic (≥3 months) vulvar pain. Included studies are RCTs, SRs, and comparative observational studies. The primary outcomes are pain and sexual outcomes, and safety and adverse events, with additional outcomes focusing on mood and quality of life. Selection of studies was done in DistillerSR by two independent reviewers. Conflicts were resolved by discussion or by involving a third reviewer with excluded studies documented. Full-text screening is adhering to this same process. Search methods: A comprehensive search strategy was developed by an information specialist and was peer reviewed. Numerous electronic databases were searched. No language limit was used, and a date limit was set (1997 or later). Published filters for controlled trials and other study designs were applied. PubMed/MEDLINE was used to develop the search strategy, which was then translated into other databases. A limited grey literature search was also conducted. Data collection and analysis: Data extraction and risk of bias assessment (ROB) will be done in DistillerSR using pre-piloted data extraction forms. Studies will be extracted by one reviewer and independently checked by a second reviewer. Disagreements will be resolved by discussion or by involving a third reviewer. We will extract study characteristics and outcome data. For ROB, we will use the Cochrane Risk of Bias tool and the ROBINS-I tool. We will narratively synthesize the results by comparisons and outcomes. If appropriate, we will conduct a meta-analysis for studies regarded as suitably homogeneous. Last, the certainty of the body of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results After duplicates were removed, the search yielded 10,171 references for title and abstract screening. Of these, 599 full-text articles were assessed for inclusion. All screening and preliminary data extraction will be completed by October 2022. General characteristics of the included studies including interventions identified will be presented. Conclusions We will report on interim progress of the SR. It will be an opportunity to gather initial input from stakeholders on this evidence-based approach. Discussion of possible multi-organization involvement will also help unify intervention recommendations for those with vulvodynia. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Andrew Goldstein – Daré Bioscience (employee), Incyte (consultant), Gynecologic Cancers Research Foundation (Board of Directors, Research Funding).