Mapping Protocol Research Articles

Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents.

Smoking prevalence among female adolescents in South Korea has increased gradually, despite a decreasing trend seen for male adolescents. Smoking scenes or cigarette advertisements in the media have influenced female adolescents’ initiation into smoking. It is therefore crucial to develop a smoking prevention program to enhance female adolescents’ smoking media literacy by implementing gender-specific approach. The purpose of this study is to describe how intervention mapping protocol (IMP) was used to develop a media literacy-based smoking prevention program (MLSP) for female adolescents. The IMP was used in six steps: needs assessment (literature review and focus groups comprising 24 female adolescents and 12 teachers), program goal setting, selection of intervention methods, production of program components and materials, program implementation planning, and program evaluation by ten experts and three adolescents. Six performance objectives and 14 change objectives were generated. Each module consisted of theory-based methods such as raising consciousness. Half of the modules covered topics regarding smoking media literacy, while half covered topics related to gender-specific intervention. The major advantages of utilizing IMP are that MLSP has been developed to reflect multiple perspectives, including of adolescents, teachers, and professors through a systematic process, and identified to be acceptable and valid.

Design of an Online Initiative to Promote Water Consumption in Mexican Adolescents

Abstract Objectives To describe the development of an initiative for water consumption in Mexican adolescents of public secondary schools. Methods Based on a diagnosis in adolescents 11 to 16 years from public secondary schools we developed an initiative following the Intervention Mapping protocol: (1) Logic model of the problem, (2) Logic model of change, (3) Program design, (4) Program production, (5) Program implementation plan, and (6) Evaluation plan. We established behavioral outcomes for the next levels: Intrapersonal (adolescents), Interpersonal (mothers and fathers), Organizational (principals and teachers) and Social (authorities of the respective Ministries of Education and Health). At Intrapersonal and Interpersonal levels, we based on the Health Belief Model and the Social Cognitive Theory. For Organizational and Social levels, we considered the Stage Theory of Organizational Change. Results We developed a comprehensive initiative with a gender perspective entitled EPCA (for its acronym in Spanish of Schools Promoting Water Consumption). It includes an online course for adolescents, which shows the benefits of water and the health risks of sugary drinks, it guides adolescents to identify their water requirement and gives them tips to achieve it. The course presents funny challenges and healthy advices in audiovisual materials. For principals, teachers, mothers, and fathers there are digital resources available on the Facebook page of the EPCA initiative, which aim to help adults guide adolescents to take the course online, in addition, the resources motivate them to consume water. For the implementation of the EPCA initiative we developed a manual and planned online workshops with authorities of the Ministries of Education and Health, principals, and parents. We developed a process and impact evaluation plan, in which we considered to make a randomized controlled trial. Conclusions The EPCA initiative is a multilevel online intervention that was developed in accordance with a systematic protocol grounded in theory and scientific evidence, which will be implemented in a pilot manner in a random sample of Mexican adolescents to evaluate their impact on water consumption. Funding Sources This study was financed by the United Nations Children's Fund, UNICEF-Mexico.

Increasing physical activity levels following treatment for cervical cancer: an intervention mapping approach

PurposeThe purpose of this study was to utilise the intervention mapping (IM) protocol as a framework with which to develop an intervention underpinned by relevant behaviour change theory to promote physical activity (PA) following treatment for cervical cancer.MethodsThe six steps of the IM protocol were followed. A qualitative semi-structured interview study and a rapid review of the literature were conducted along with the development of a logic model of the problem and a logic model of change to inform intervention development.ResultsAn intervention was developed which aims to increase PA levels following treatment for cervical cancer, tailored to address key findings from the IM needs assessment. These include embedding behavioural and social strategies that help participants to overcome perceived barriers to PA participation; goal setting strategies to gradually increase PA levels with a view of reaching relevant PA guidelines for cancer survivors and feedback to encourage self-assessment of well-being and PA capability.ConclusionThis study maps the development of a novel PA intervention for those who have been treated for cervical cancer. The use of a systematic development framework was necessary as little insight exists regarding PA preferences after treatment for cervical cancer.Implications for Cancer SurvivorsPA behaviour is associated with positive physical and psychological health outcomes for cancer survivors. Optimising targeted promotion of PA behaviour following treatment for cervical cancer may result in an enhanced survivorship experience through increased PA behaviour and improved quality of life (QOL).

Microstructural plasticity in nociceptive pathways after spinal cord injury

ObjectiveTo track the interplay between (micro-) structural changes along the trajectories of nociceptive pathways and its relation to the presence and intensity of neuropathic pain (NP) after spinal cord injury...

Family-Centered Social Cognitive Factors Preventing Primary Tooth Caries in Children Based on Intervention Mapping Approach.

Background Given the increasing prevalence of primary tooth caries in Iran and the importance of providing evidence- and theory-based family-centered prevention programs, the present study is aimed at determining the family-centered social cognitive factors preventing deciduous tooth caries among children using the intervention mapping protocol. Methods This cross-sectional study was performed on 240 Iranian mothers in Ilam who were randomly selected to participate in the study. The data were collected using a self-designed questionnaire including items on demographic information and social cognitive constructs (knowledge, attitude, perceived severity, perceived benefits, perceived barriers, practice guidance, perceived self-efficacy, behavior intention, subjective norms, and social norms). The questionnaire was completed by mothers, and the data were analyzed by performing one-way analysis of variance and linear regression. Results The results obtained from linear regression analysis showed that perceived self-efficacy (B = 0.295, p < 0.001), perceived barriers (B = 0.084, p < 0.028), practice guidance (B = 0.774, p < 0.001), and social norms (B = 0.137, p < 0.020) accounted for 71% of the behavioral intention variance and were the most important predictors for preventing primary tooth caries among children. Conclusion The findings suggest that perceived self-efficacy, perceived barriers, practice guidance, and social norms are essential for developing family-centered programs to prevent primary tooth caries in children.

An App-Based Parenting Program to Promote Healthy Energy Balance-Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework.

BackgroundThe family environment plays an important role in the development of children’s energy balance–related behaviors. As a result, parents’ energy balance–related parenting practices are important targets of preventive childhood obesity programs. Families with a lower socioeconomic position (SEP) may benefit from participating in such programs but are generally less well reached than families with a higher SEP.ObjectiveThis paper describes the application of the Intervention Mapping Protocol (IMP) for the development of an app-based preventive intervention program to promote healthy energy balance–related parenting practices among parents of children (aged 0-4 years) with a lower SEP.MethodsThe 6 steps of the IMP were used as a theory- and evidence-based framework to guide the development of an app-based preventive intervention program.ResultsIn step 1, behavioral outcomes for the app-based program (ie, children have a healthy dietary intake, sufficient sleep, and restricted screen time and sufficient physical activity) and sociocognitive (ie, knowledge, attitudes, and self-efficacy) and automatic (ie, habitual behaviors) determinants of energy balance–related parenting were identified through a needs assessment. In step 2, the behavioral outcomes were translated into performance objectives. To influence these objectives, in step 3, theory-based intervention methods were selected for each of the determinants. In step 4, the knowledge derived from the previous steps allowed for the development of the app-based program Samen Happie! through a process of continuous cocreation with parents and health professionals. In step 5, community health services were identified as potential adopters for the app. Finally, in step 6, 2 randomized controlled trials were designed to evaluate the process and effects of the app among Dutch parents of infants (trial 1) and preschoolers (trial 2). These trials were completed in November 2019 (trial 1) and February 2020 (trial 2).ConclusionsThe IMP allowed for the effective development of the app-based parenting program Samen Happie! to promote healthy energy balance–related parenting practices among parents of infants and preschoolers. Through the integration of theory, empirical evidence, and data from the target population, as well as the process of continued cocreation, the program specifically addresses parents with a lower SEP. This increases the potential of the program to prevent the development of obesity in early childhood among families with a lower SEP.Trial RegistrationNetherlands Trial Register NL6727, https://www.trialregister.nl/trial/6727; Netherlands Trial Register NL7371, https://www.trialregister.nl/trial/7371.

Development and evaluation of a mobile patient application to enhance medical-dental integration for the treatment of periodontitis and diabetes

IntroductionPeople around the world are increasingly affected by multimorbidity, where conditions in different medical specialties can correlate in complex ways. This increases the relevance of multidisciplinary integrated care pathways. Modern software solutions provide vast opportunities to enhance information exchange between patients and various healthcare professionals, thereby improving patient-centered and inter-professional care. This paper describes the development and validation of a mobile patient application which exploits Patient Reported Outcomes to enhance patient-centered medical-dental integration with a focus on integrated management of periodontitis and diabetes. MethodsThis study was part of a multidisciplinary project for enhancement of medical-dental integration. The Intervention Mapping Protocol was supplemented by the RAND/UCLA Appropriateness Method, including literature reviews, focus group discussions and a Delphi panel in cooperation with various stakeholders. A mobile application was developed in close collaboration with patients, physicians and dentists. The usability of the application’s core components was validated in two medical and two dental practices using the System Usability Scale (SUS). Results39 questions were identified to provide relevant patient-reported information which can be collected via a mobile application to enhance integrated management of periodontitis and diabetes. Usability testing of the application’s core components (14 questions) among 137 participants in medical and dental practices indicated a good SUS score of 77.88 (±12.17). DiscussionThe systematically developed mobile application offers the potential to provide physicians and dentists with treatment-relevant information to enhance medical-dental integration, thereby reducing the workload of medical staff, improving the quality of routinely collected data, and enabling automated data processing. This unique, novel, and validated approach can serve as an open framework for the development and evaluation of interdisciplinary healthcare software.

Bridging the gap from hospital discharge to cardiac rehabilitation using the intervention mapping approach (BRIDGE2CARE)

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Dutch Research Council INTRODUCTION Cardiac rehabilitation (CR) is the cornerstone of secondary prevention. After hospital discharge, patients have to wait for participation in CR while often feeling overwhelmed by their cardiac event and in need of tailored information and support. PURPOSE The objective of this study was to develop a remote (digital) intervention to bridge the gap from hospital discharge to CR. METHODS We developed an intervention by completing the first three steps of the intervention mapping protocol. Step 1: identification of information- and support needs from the literature and semi-structured interviews. Step 2: Describing performance objectives for the intervention and selecting determinants. Step 3: Generation of program themes and theory based change methods. RESULTS (Step 1) The following Information- and support needs were identified from the literature (n = 33) and semi structured interviews (n = 22): information about pathology and intervention, medication and side effects, daily physical activities, psychological distress, body signals and social support. Advanced communication and pedagogical skills of the health care provider and the ability to build trust were described as important prerequisites for the intervention. (Step 2) The following performance objectives were formulated: (1) Patients gain knowledge on how their cardiac illness and procedure affects their bodies and health, (2) Patients gain knowledge about medication and side effects, (3) Patients know which daily physical activities they can and can’t do after hospital discharge and are physically active, (4) Patients and informal caregivers can deal with psychological distress and know how to discriminate between harmful and harmless body signals. Objectives were described per determinant (knowledge, skill, attitude, social influence, self-efficacy and outcome expectation). (Step 3) A comprehensive remote intervention was developed using theory based coaching strategies, a digital patient platform and information videoclips. CONCLUSION This study describes the information and support needs of patients after cardiac hospitalization and offers a remote intervention that bridges the gap form hospital discharge to CR. Abstract Figure. BRIDGE2CARE

Intraoperative CARTO Mapping for Atrial Fibrillation Ablation in Patients Undergoing Cardiac Surgery

Objective: Intraoperative CARTO Mapping for Atrial Fibrillation ablation in cardiac surgery. Background: Surgical ablation of Atrial Fibrillation is usually performed without mapping. The study aims to determine if intraoperative CARTO can be useful to guide the ablating procedure. Methods and Findings: Fourteen patients with symptomatic and drug-refractory concomitant AF were operated on in 2003 and 2004. CARTO mapping was performed before and after surgical bipolar radio-frequency ablation. Application of energy was repeated when residual electrical activity was detected at the pulmonary veins-atrial junction. Pacing wires were applied on right and left pulmonary veins distally to the ablation line to confirm the exit block. The mapping protocol was completed in 12 patients. Acute left atrium-pulmonary vein isolation was achieved after single or double energy application in 2/12 (16.6%) and 9/12 (75%) patients, respectively. The mean duration of the mapping and ablation procedure was 67 minutes. At discharge, PV isolation persisted in 10 patients: exit block was confirmed by the absence of pacing through the pulmonary veins electrodes. After a mean follows up of 181 months, no further recurrent AF events were registered in 9/12 (69.2%) patients. Conclusions: CARTO system is useful during open-heart surgery to guide the ablating strategy.

Transgene Mapping and Genotyping Protocol Design in a Transgenic Mouse Strain by Short‐Read Whole‐Genome Sequencing

[Aim] When creating transgenic mice, multiple lines with the same transgene are often created. For example, our laboratory has three lines of hAce2 transgenic mice (hAce2-Tg). For one of them (hAce2-Tg#16), we mapped the transgene using short-read whole-genome sequencing and designed genotyping PCR to identify the line. [Methods] We extracted genomic DNA from kidneys of hAce2-Tg#16. Using PCR-free libraries prepared with the genomic DNA, paired-end 150-bp reads were performed by DNBSEQG-400 sequencer (MGI Tech) (outsourced). In order to find the junction between the genome and the transgene, we created two search programs: one to search for matches between the transgene and each read and its complementary sequence from the front (5′ side, head-match), and the other to search for matches from the back (3′ side, tail-match). We selected reads with a match length of 5 to 145 bases. After the search, we selected reads containing the mouse genome sequence in the non-matching part by BLAST search of the Ensembl database. Based on this sequence information, we designed primers for genotyping PCR based on the flanking primer method. All animal experiments were conducted in accordance with the guidelines for animal experiments of the National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan (authorization number: DS22-55). [Results and Discussion] In a total of 882,577,032 reads (total read length: about 132 GBase), the total numbers of head-matching and tail-matching reads were 1,498 and 3,060, respectively. Among them, eight reads in the head-matching reads had the same genomic sequence. Its genomic location was in the intron of the Nrxn3 gene on chromosome 12. The transgene was truncated by 82 bases from the 3′ end. On the other hand, none of the tail-matching reads contained the neighboring genomic sequence. Genotyping PCRs with flanking primers we designed based on the sequence near the junction between transgene and genome sequences confirmed that the presence or absence of the transgene only in the line (hAce2-Tg#16). The authors have already reported examples of transgene mapping by Genomic Walking (Exp Anim 53: 103-111, 2004) and whole genome sequencing of long reads (Exp Anim 69: 279-286, 2020). This study confirmed that short-read whole-genome sequencing was also useful for mapping transgenes and designing PCR for genotyping of transgenic mice.

Development and testing the effectiveness and feasibility of a structured violence risk management intervention to support safety in psychiatric hospitals

IntroductionThis presentation focuses on two major problems in psychiatric hospital care: patient violence and lack of patient engagement. Interventions already exist for managing patient violence. However, the challenge in using these interventions is poor integration to clinical practice and these methods do not entail elements of patient engagement.ObjectivesThe aim of the presentation is to give on overview of a project aiming to develop and test new structured intervention for violence risk management. Intervention aims to increase safety in care environments and engagement of patients.MethodsIntervention Mapping protocol together with staff and patients will be used in the project. Quasi-experimental design is used to test the intervention in 4 month period in two psychiatric hospital units.ResultsBy the end of the year 2020, development of the the new violence risk management intervention is nearly finished. The presentation will give an outline of the developed intervention and how staff and patient engagement in the development phases were ensured.ConclusionsThe project described in this presentation is an example how a feasible violence risk management method can be developed together with staff and patients receiving psychiatric care. By ensuring engagement of the target groups, here staff and patients, it is possible to promote real integration of a new working method to psychiatric inpatient care. This project was funded by the Academy of Finland (316206).

Tracers and corresponding detection devices: technetium colloids, blue dyes & NIR fluorescence.

Tracers and corresponding detection devices for the mapping of sentinel lymph nodes have been evolving since the first use of lymphangiogram methods in 1977 in penile carcinoma. Nowadays a variety of dyes and radiotracers have been validated for use in breast, vulvar and cervical cancer as well as melanoma. Each tumor site with its anatomical conditions requires different mapping protocol. While the combination of radiotracer and blue dye or radiotracer alone is an established method for breast surgery, vulvar cancer and melanoma, in pelvic sentinel lymph node mapping indocyanine green is currently gaining popularity. Near infrared fluorescence imaging is an emerging technique that enables a real-time image-guided procedure and is currently approved by the Food and Drug Administration as a sentinel lymph node mapping substance with standard of care. New tracers and devices are constantly under investigation to better understand the pathway of lymphatic drainage and increase the sensibility and sensitivity of the method. In the present review the evolution of available tracers and detection devices is discussed. An exhaustive review of current clinical indications of each method, its particularities and adverse effects is made. Finally, an update on ongoing clinical studies in sentinel lymph node mapping methods is presented.

Multi-modal Mapping of the Face Selective Ventral Temporal Cortex-A Group Study With Clinical Implications for ECS, ECoG, and fMRI.

Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation (ECS), electrocorticography (ECoG), and functional magnetic resonance imagining (fMRI). This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest (ROI), which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations.

Application of the Intervention Mapping Protocol to Develop &lt;i&gt;Sahtak bi Sahnak&lt;/i&gt;, a School-Based Intervention to Prevent Pediatric Obesity among Lebanese Adolescents

Background: Pediatric obesity is a major public health concern worldwide. Improving dietary and physical activity habits at a young age could prevent many health complications during adulthood and later years. Objective: This paper describes the application of the Intervention Mapping protocol for the systematic development of the Lebanese intervention “Sahtak bi Sahnak” (meaning Your health in your plate) that focuses on preventing pediatric obesity and promoting a healthy lifestyle through a systematically designed and culturally appropriate, school-based program. Method: The development of this intervention is based on the six steps of the Intervention Mapping (IM) protocol. This intervention targets Lebanese adolescents aged 15–18 years enrolled in Lebanese public and private high schools, located in urban and rural areas. Its effectiveness will be tested in a Clustered Randomized Controlled Trial in 16 high schools. Discussion and conclusion: The IM protocol allowed us to develop a theory based, low resource intervention which can be integrated as part of the educational curriculum of public and private high schools in Lebanon. This study provides a detailed example of the application of the IM approach in the Lebanese high school context. Even though it is a time-consuming process, IM serves as a valuable tool in the health promotion field and provides a high level of transparency to improve and replicate the process in the future.

A robust method for the detection of small changes in relaxation parameters and free water content in the vicinity of the substantia nigra in Parkinson's disease patients.

Alterations in the substantia nigra are strongly associated with Parkinson’s disease. However, due to low contrast and partial volume effects present in typical MRI images, the substantia nigra is not of sufficient size to obtain a reliable segmentation for region-of-interest based analysis. To combat this problem, the approach proposed here offers a method to investigate and reveal changes in quantitative MRI parameters in the vicinity of substantia nigra without any a priori delineation. This approach uses an alternative method of statistical, voxel-based analysis of quantitative maps and was tested on 18 patients and 15 healthy controls using a well-established, quantitative free water mapping protocol. It was possible to reveal the topology and the location of pathological changes in the substantia nigra and its vicinity. Moreover, a decrease in free water content, T1 and T2* in the vicinity of substantia nigra was indicated in the Parkinson’s disease patients compared to the healthy controls. These findings reflect a disruption of grey matter and iron accumulation, which is known to lead to neurodegeneration. Consequently, the proposed method demonstrates an increased sensitivity for the detection of pathological changes—even in small regions—and can facilitate disease monitoring via quantitative MR parameters.

The relationship between hippocampal-dependent task performance and hippocampal grey matter myelination and iron content.

Individual differences in scene imagination, autobiographical memory recall, future thinking and spatial navigation have long been linked with hippocampal structure in healthy people, although evidence for such relationships is, in fact, mixed. Extant studies have predominantly concentrated on hippocampal volume. However, it is now possible to use quantitative neuroimaging techniques to model different properties of tissue microstructure in vivo such as myelination and iron. Previous work has linked such measures with cognitive task performance, particularly in older adults. Here we investigated whether performance on scene imagination, autobiographical memory, future thinking and spatial navigation tasks was associated with hippocampal grey matter myelination or iron content in young, healthy adult participants. Magnetic resonance imaging data were collected using a multi-parameter mapping protocol (0.8 mm isotropic voxels) from a large sample of 217 people with widely-varying cognitive task scores. We found little evidence that hippocampal grey matter myelination or iron content were related to task performance. This was the case using different analysis methods (voxel-based quantification, partial correlations), when whole brain, hippocampal regions of interest, and posterior:anterior hippocampal ratios were examined, and across different participant sub-groups (divided by gender and task performance). Variations in hippocampal grey matter myelin and iron levels may not, therefore, help to explain individual differences in performance on hippocampal-dependent tasks, at least in young, healthy individuals.

Using the ADDIE Model to Develop a Rusnani Concept Mapping Guideline for Nursing Students.

BackgroundConcept mapping has been established as a learning strategy that encourages critical thinking and creativity among students, leading to the development of a concept mapping guideline designed to guide nurse educators in using this teaching strategy.ObjectivesThis paper illustrates the development of a guideline to build a concept mapping based-learning strategy. Called the Rusnani concept mapping (RCM) protocol guideline, it was adapted from the Mohd Afifi learning model (MoAFF) and the analysis, design, development, implementation and evaluation (ADDIE) model, integrated with the Kemp model.MethodsThis model uses the five phases of analysis, design, development, implementation and evaluation. The validity of the guideline was determined by using content and face validity and the Delphi technique. Content validity for this RCM guideline was established using expert review. This formula suggested that if the content validity is greater than 70%, it shows good content validity, and if it is less than 70%, the content validity is low and it is advisable to recheck the content according to the objective of the study.ResultsThe reliability of the RCM was 0.816, showing that the RCM guideline has high reliability and validity.ConclusionIt is practical and acceptable for nurse educators to apply RCM as an effective and innovative teaching method to enhance the academic performance of their nursing students.

Preconception Care Program for Women with Inflammatory Bowel Disease Using Intervention Mapping: A Protocol for Program Development.

The prevalence of inflammatory bowel disease in Korea is rapidly increasing. Women with inflammatory bowel disease have a higher risk of adverse birth outcomes than healthy women, and the magnitude of this risk is related to the severity of the disease at the time of pregnancy. For a woman with inflammatory bowel disease to have a healthy pregnancy, interventions are needed to manage the disease before pregnancy—implying a need for pregnancy planning. In this study, the intervention mapping protocol was used to develop a program for this purpose. This protocol contains the following stages: needs assessment, setting of program outcomes and performance objectives, selection of methods and strategies based on theory, and development of the program and its materials. Through individual in-depth interviews and a literature review, individual and environmental determinants were assessed and six change objectives of the program were set. The methods and practical strategies were developed based on the information-motivation-behavioral skills model, self-efficacy theory, and social support theory. The final program, consisting of four sessions and the corresponding materials, was completed by making revisions based on a content validity assessment by experts and a pilot test. Follow-up studies on the implementation of this program will be conducted in the future.

Evaluation of Diagnostic Accuracy of the Approved Tumor Mapping Protocol in Grading of Glial Tumors

Objective: Evaluation of Diagnostic Accuracy of the Approved Tumor Mapping Protocol in Grading of Glial Tumors.&#x0D; Methods: This descriptive cross-sectional study was performed on patients aged 2 to 82 years with glial tumor. Patients were referred to the hospital for tumor mapping and underwent imaging with simultaneous methods of MRS and magnetic resonance (MR) perfusion and conventional MRI under the supervision of NIAG group. Then, the results of the second evaluation, including the ratios of the desired metabolites and the amount of blood flow, permeability of the target area were compared with the results of pathology. The results were analyzed by SPSS software version 24.&#x0D; Results: In this study, 30 patients were included. Sensitivity, specificity, positive and negative predictive value for the determination of high-grade glioma with peripheral/internal rCBV were 100/100%, 100/93%, 93/100% and 100.100%, respectively. Sensitivity, specificity, positive and negative predictive value for the diagnosis of glioma by using peripheral/internal rCBV and thresholds of 2.65 and 1.06 were 100/100%, 93/100%, 93/100% and 100/100%, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were determined for diagnosis of high-grade glioma tumor using Ch + Cr / NAA Cho / Cr and Cho / NAA ratios with detection threshold of 2.97 (93.3%), 3.5 (78.9%,100%, 100%, and 73.3%), and 2.1 (100%). Threshold values of 3.5, 2.1 and 2.97 were obtained using Cho / Cr, Ch + Cr / NAA and Cho / NAA, respectively, for the detection of high-grade gliomas. The combination of rCBV, Cho / Cr, Ch + Cr / NAA and Cho / NAA had sensitivity, specificity, positive and negative predictive value of 67.7%, 80%, 77% and 70.5%, respectively. Significant differences in rCBV and Cho / Cr, Cho / NAA and NAA / Cr ratios were observed between low- and high-grade gliomas (P &lt;0.0001).&#x0D; Conclusion: Preoperative grading of glioma based on routine MR imaging is often unreliable. As a result, measuring rCBV and Cho / Cr and Cho / NAA ratios independently and somewhat together can significantly improve the sensitivity and predictive values of preoperative glioma grading.

Development of a Family-Based Mental Health Program for Runaway Adolescents Using an Intervention Mapping Protocol.

The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents’ mental health status and perceived family functioning.