Assessment Methods Research Articles

Shared decision-making in long-term care: A systematic review of assessment instruments

This systematic review explored the instruments used to measure Shared Decision Making (SDM) within long-term care (LTC) settings. Relevant publications from the period between January 2000 and October 2022 were searched across five databases. Thirty-six SDM assessment instruments were identified, which encompassed those measuring SDM for LTC recipients/family caregivers and/or healthcare providers. These instruments were either specifically tailored for LTC settings or more broadly applicable across healthcare contexts, including LTC. In terms of psychometric properties of the instruments, internal consistency reliability, content validity, structural validity, and hypothesis testing were commonly tested. The findings of this research can aid health researchers, managers, and scholars in choosing suitable instruments for assessing SDM in specific LTC scenarios, considering factors such as measurement scope, assessment methods, and instrument reliability. Additionally, these findings offer valuable insights for the future development of high-quality SDM assessment instruments in LTC field.

Unleashing the secrets of academic writing: exploring Indonesian language courses in higher education

Academic writing has been a widely substantial course in higher education as it plays a vital role in cultivating students’ academic writing skills. Drawing on qualitative descriptive study, this study aims to explore the fundamental requirements for academic writing to base the creation of an effective learning framework. Data consisted of teaching materials, semester learning plan (SLP), assessment tools, and guidelines for academic writing from three universities in Surakarta, Central Java, Indonesia. Findings reveal that learning materials and the SLP have both strengths and weaknesses. Despite these, there is diversity in learning and assessment methods. Adopted teaching methods encompass project-based learning, problemsolving, and lectures, while learning assessment includes portfolio techniques, project assessment, and written exams. These findings provide insight into the imperative of academic writing in the academic setting. This serves as a basis for the development of more effective learning methods. Thus, the proposed model for academic writing adopts a project-based approach to improve students’ writing by integrating indigenous wisdom to promote students' character development.

Review article: Measuring disease severity in inflammatory bowel disease - Beyond treat to target.

Inflammatory bowel disease (IBD) follows a heterogenous disease course and predicting a patient's prognosis is challenging. There is a wide burden of illness in IBD and existing tools measure disease activity at a snapshot in time. Comprehensive assessment of IBD severity should incorporate disease activity, prognosis, and the impacts of disease on a patient. This review investigates the concept of disease severity in adults with IBD to highlight key components contributing to this. To perform this narrative review, a Medline search was conducted for full-text articles available at 1st March 2024 using search terms which encompassed disease activity assessment, disease severity, prognosis, natural history of Crohn's disease (CD) and ulcerative colitis (UC), and the burden of IBD. Current methods of disease assessment in IBD have evolved from a focus on the burden of symptoms to one that includes inflammatory targets, genetic, serological, and proteomic profiles, and assessments of quality-of-life (QoL), disability, and psychosocial health. Longitudinal studies of IBD suggest that the burden of illness is driven by disease phenotype, clinical markers of complicated disease course (previous intestinal resection, corticosteroid use, perianal disease in CD, recent hospitalisations in UC), gut inflammation, and the impact of IBD on the patient. Disease severity in IBD can be difficult to conceptualise due to the multitude of factors that contribute to IBD outcomes. Measurement of IBD severity may better encapsulate the full burden of illness rather than gut inflammation alone at a single timepoint and may be associated with longitudinal outcomes.

Quantitative biomechanical analysis in validating a video-based model to remotely assess physical frailty: a potential solution to telehealth and globalized remote-patient monitoring.

Assessing physical frailty (PF) is vital for early risk detection, tailored interventions, preventive care, and efficient healthcare planning. However, traditional PF assessments are often impractical, requiring clinic visits and significant resources. We introduce a video-based frailty meter (vFM) that utilizes machine learning (ML) to assess PF indicators from a 20s exercise, facilitating remote and efficient healthcare planning. This study validates the vFM against a sensor-based frailty meter (sFM) through elbow flexion and extension exercises recorded via webcam and video conferencing app. We developed the vFM using Google's MediaPipe ML model to track elbow motion during a 20s elbow flexion and extension exercise, recorded via a standard webcam. To validate vFM, 65 participants aged 20-85 performed the exercise under single-task and dual-task conditions, the latter including counting backward from a random two-digit number. We analyzed elbow angular velocity to extract frailty indicators-slowness, weakness, rigidity, exhaustion, and unsteadiness-and compared these with sFM results using intraclass correlation coefficient analysis and Bland-Altman plots. The vFM results demonstrated high precision (0.00-7.14%) and low bias (0.00-0.09%), showing excellent agreement with sFM outcomes (ICC(2,1): 0.973-0.999), unaffected by clothing color or environmental factors. The vFM offers a quick, accurate method for remote PF assessment, surpassing previous video-based frailty assessments in accuracy and environmental robustness, particularly in estimating elbow motion as a surrogate for the 'rigidity' phenotype. This innovation simplifies PF assessments for telehealth applications, promising advancements in preventive care and healthcare planning without the need for sensors or specialized infrastructure.

Infrared temperature distribution characteristics and state assessment method of sandstone under tension and compression stress

Abnormalities in infrared radiation temperature (IRT) often accompany the loading In this investigation, stress experiments and splitting tests were conducted on sandstone to investigate the IRT characteristics of sandstone under various loading conditions. The results shows that the Maximum Infrared Radiation Temperature (MAXIRT) increases by up to 5 °C, while in splitting tests, the minimum infrared radiation temperature (MINIRT) decreases by approximately 1.5 °C. Compared to the average infrared radiation temperature (AIRT), MAXIRT is more sensitive to compressive stress, whereas (MINIRT) is more responsive to tensile stress. The correlation between IRT indicators and stress were further analyzed. The findings reveal a positive correlation between IRT and compressive stress. At low stress levels, the correlation coefficient fluctuates between −0.4 and 0.6, generally showing low correlation. As stress increases, the correlation coefficient rises, reaching above 0.8, indicating a high correlation. Tensile stress exhibits a negative correlation, with a consistent trend. Additionally, a statistical analysis of the frequency distribution of IRT under different stress conditions was conducted, followed by hypothesis testing. The results demonstrate that the probability distribution of IRT during loading follows a skewed normal distribution. The changes in skewness can be divided into three stages: initial fluctuation, stable variation, and abrupt failure. Under compressive stress, a right-skewed distribution is observed, with skewness exceeding 3.5 before fracture and reaching above 10 near fracture. Under tensile stress, a left-skewed distribution is noted, with skewness reaching −4.5 near fracture. These findings contribute to the assessment of rock stress states and provide early warning information for predicting rock failure.

Integrating Contrast-enhanced US to O-RADS US for Classification of Adnexal Lesions with Solid Components: Time-intensity Curve Analysis versus Visual Assessment.

Purpose To compare the diagnostic performance of time-intensity curve (TIC) analysis and subjective visual assessment of contrast-enhanced US (CEUS) when integrated with the Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification system for characterizing adnexal lesions with solid components. Materials and Methods In this prospective multicenter study conducted from September 2021 to December 2022, female individuals with suspected adnexal lesions containing solid components detected at routine US were enrolled. All participants underwent preoperative CEUS examinations. Histopathologic findings were used as the reference standard for diagnosis. Lesions were classified according to the O-RADS US system. Enhancement of solid tissue compared with the outer myometrium was evaluated using both TIC analysis and subjective visual assessment. The diagnostic performance of O-RADS alone and each CEUS assessment method when integrated with the O-RADS US system was assessed and compared using receiver operating characteristic curve analysis. Results A total of 180 lesions (80 malignant and 100 benign histopathologic outcomes) in 175 participants (median age, 47 years [IQR, 33-56]) were analyzed. Incorporating CEUS (assessed through both TIC analysis and subjective visual assessment) with O-RADS US showed significantly improved diagnostic performance over O-RADS US alone, with an area under the receiver operating characteristic curve (AUC) of 0.86 (95% CI: 0.80, 0.91) compared with 0.78 (95% CI: 0.71, 0.84). No evidence of a difference was observed between the AUCs of TIC analysis and subjective visual assessment in the enhancement evaluation of solid tissue with CEUS for adnexal malignancy categorization (P = .83). Conclusion Subjective visual assessment and TIC analysis of CEUS features when integrated with the O-RADS US scoring system showed comparable diagnostic performance in assigning adnexal malignancy risk. Keywords: Adnexal Lesions, Contrast-enhanced US, O-RADS, Time-intensity Curve Analysis Supplemental material is available for this article. © RSNA, 2024.

Digital assessment of soft and hard tissue alterations after anterior maxillary tooth extraction

Objectives: This study aimed to assess dimensional alterations in soft and hard tissues 12 weeks post-extraction using novel computerized methods. Secondary objectives included exploring potential correlations between soft tissue changes and underlying bone variations, as well as investigating relationships between soft and hard tissue alterations and various contributing factors. Methods: For all patients, preoperative and postoperative CBCT scans and intra-oral scans were obtained. Soft and hard tissue dimensions before extraction and at 12 weeks post-extraction were measured using 3D-slicer software. Both DICOM and STL files were superimposed, and measurements were taken at 2mm and 4mm from the facial crestal level. Results: At twelve weeks, soft tissue thickness increased by 73.5% at 2mm and 51.2% at 4mm from the facial crestal bone. In contrast, there was a 42.5% and 33% bone resorption at 2mm and 4mm, respectively. Furthermore, the study found that smokers had a higher rate of soft tissue thickening and hard tissue resorption compared to non-smokers. The female group exhibited greater soft tissue thickening and bone resorption than the male group. Finally, the central incisor showed the highest bone loss rate, followed by the canine and the lateral incisor. Conclusions: Three months following tooth extraction, a physiological thickening of the facial soft tissue occurs concurrently with significant bone loss beneath it. Clinical Significance: This article’s novel digital assessment methods for evaluating soft and hard tissue alterations offer the potential to optimize treatment planning, enhancing patient outcomes and minimizing complications. By providing a comprehensive understanding of post-extraction tissue changes, it empowers clinicians to tailor treatments for individual patients, improving predictability and personalized care.

Comparing the Validity of CAM-ICU and CAM-ICU-7 for Delirium Assessment based on Simulation

Purpose : This study aimed to compare the validity and user evaluations of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and its 7-item version (CAM-ICU-7) for delirium assessment. Methods : Thirty-six intensive care unit (ICU) nurses from four university hospitals participated in this simulation-based methodological study. Four standardized patients with normal cognition, subsyndromal delirium, hypoactive delirium, and hyperactive delirium were recruited. The participants assessed all four standardized patients using the CAM-ICU and CAM-ICU-7. We analyzed the validity, assessment time, and user evaluations of both tools. DeLong’s test and the paired t-test were used for comparisons. Results : The CAM-ICU showed sensitivity, specificity, and accuracy of 80.6%, 94.4%, and 84.0%, respectively, with an Area Under Curve (AUC) of 87.5%. CAM-ICU-7 demonstrated a sensitivity, specificity, and accuracy of 90.7%, 97.2%, and 92.4%, respectively, with an AUC of 94.0%. The CAM-ICU-7 showed a better AUC than the CAM-ICU for detecting subsyndromal delirium (<i>p</i> =.029). However, the CAM-ICU-7 required more time for assessment across all patient types (<i>p</i>＜ .001). ICU nurses reported that the CAM-ICU was faster to administer, whereas the CAM-ICU-7 was easier to use, better at detecting delirium, more effective at reflecting changes in delirium, and had a higher intention to use in clinical practice. Conclusion : The CAM-ICU-7 demonstrated superior validity compared to the CAM-ICU. Despite requiring more time, ICU nurses evaluated the CAM-ICU-7 as more useful. These findings support using the CAM-ICU-7 for delirium assessment in ICU settings.

Comparative analysis of Environmental Impact of Each Building Material using Life Cycle assessment(LCA)_Focusing on Types of Construction Wood and Concrete

Objectives:The construction sector is a very important sector in achieving carbon neutrality. In modern society, construction has grown rapidly, and basic materials such as cement and concrete have contributed greatly to the development of construction. These materials emit a large amount of global warming substances during the raw material extraction and production process, causing serious environmental pollution. In order to establish a carbon reduction strategy to slow down global warming, we compared the environmental impacts of each building material and showed the current situation.Methods:The LCI DB for the construction materials used in the two-story wooden house (Building area 128.67m2, total floor area 235.73m2) located in the National Institute of Forest Science was extracted. Then, the data for LCA was processed and performed through the life cycle assessment methodology for the resources consumed from raw material collection, material production, and transportation stages. Then, based on the environmental performance labeling impact assessment method, a study was conducted on the environmental impact categories of the actual construction materials used and comparisons with other construction materials.Results and Discussion:When analyzing the environmental impact of concrete [25-21-120] and construction wood used in wooden house, the environmental impact was found to be 98.79% higher on average in the pre-manufacturing stage than in the manufacturing stage, and construction wood was confirmed to have a reduction effect of 62.21 kg CO2-eq per 1 m3 compared to concrete. Through the scenario, there was a carbon reduction effect of up to 36% when the entire area was replaced with wood. In addition, the environmental impact by major construction material was quantitatively quantified.Conclusion:When building a wooden house, reducing the amount of concrete equivalent to the amount of wood is expected to have a greenhouse gas reduction effect, so it is time to activate construction wood from the production process to the post-production stage to replace concrete. In addition, follow-up research on the development of construction technology with low environmental impact during construction should be continued. This study is expected to be used as a useful indicator for R&D and policies in the construction field in the future, as it quantitatively quantified the amount of CO2 reduction per m3 when replacing concrete with construction wood and numerically compared and analyzed six major environmental impact categories by major construction materials.

Interventions and evaluation to improve oral health in patients with stroke: a scoping review

Objectives: This scoping review aimed to identify and analyze intervention strategies and assessment methods for oral hygiene management (OHM) and oral function management (OFM) in patients with stroke admitted to general wards, with the goal of providing directions for future research. Methods: We conducted a comprehensive literature search on studies published over the past 10 years across databases, including Cochrane, Embase, Medline, PubMed, and ProQuest. A total of 18 studies met the inclusion and exclusion criteria. Results: In the OHM studies (N=7), oral hygiene care was primarily provided by nurses, dental assistants, and nursing care aides. Oral hygiene was assessed using plaque and gingival bleeding indices with products such as electronic toothbrushes and mouth rinses. In the OFM studies (N=11), care was provided by speech-language pathologists, occupational therapists, and dental hygienists. Assessment tools included the Functional Oral Intake Scale, the PenetrationAspiration Scale, and Video Fluoroscopic Swallowing Studies. Conclusions: Improving the oral health of patients with stroke requires both hygiene and functional management. Therefore, it is necessary to develop a method that provides specialized oral care tailored to the hospitalization environment and the specific conditions of patients with stroke.

ОПЫТ ПРИМЕНЕНИЯ ФУНКЦИИ ЖЕЛАТЕЛЬНОСТИ ХАРРИНГТОНА ПРИ ВЫБОРЕ ОПТИМАЛЬНОГО СОСТАВА ПЛЁНОК И ГЕЛЯ С НАФТОХИНОНОВЫМ КОМПЛЕКСОМ

When a new pharmaceutical product development comes to the stage of selecting the optimal combination of components, researchers often need a comprehensive assessment method for experimental samples. The difficulty is caused by overall complexity of choosing the correct qualitative and quantitative parameters expressed in different units of measurement and establishing priorities between the criteria for the combined assessment. In this case membership functions can help, for example the generalized Harrington desirability function, which allows to combine individual indicators that differ in value and dimension. The article provides examples of the practical application of the generalized Harrington desirability function in assessing several parameters of experimental samples of films and gel developed by us with a naphthoquinone complex of Lithospermum erythrorhizon in order to determine the best composition of these forms. The chosen method made it possible to calculate the generalized desirability for each experimental sample, taking into account all the studied criteria and to determine the most successful experimental samples for further work.

Delirium and Weakness Acquired in the Intensive Care Unit: Individual and Combined Effects on 90-Day Mortality in Survivors of Critical Illness.

To compare the individual and combined effects on 90-day mortality among four critically ill survivor groups: normal (without ICU-acquired delirium or ICU-acquired weakness), delirium-only (with ICU-acquired delirium only), weakness-only (with ICU-acquired weakness only) and delirium-weakness (combined ICU-acquired delirium and weakness). A prospective cohort study consecutively recruited delirium-free critically ill patients admitted to six medical ICUs at a university hospital. Delirium was assessed once daily for 14 days (or until death or ICU discharge) using the Confusion Assessment Method for the ICU. Participants who were discharged from the ICUs were assessed for weakness using the Medical Research Council scale. A summed score below 48 defines ICU-acquired weakness. These survivors were evaluated again for 90-day mortality. The study is reported using the STROBE checklist. Delirium developed in 107 (43.2%) participants during their first 14 days of ICU stay; 55 (22.2%) met criteria for weakness by ICU discharge. Participants with delirium were at increased risk for also developing ICU-acquired weakness, and the 90-day mortality was 18.2%. Independent of age and Acute Physiology and Chronic Health Evaluation II score at ICU admission, delirium-only and weakness-only were not associated with higher 90-day mortality, while participants in the delirium-weakness group had a 3.69-fold higher risk of death, compared to those who were normal during the ICU stay. A non-significant interaction was found, suggesting the joint effect of delirium and weakness on mortality is not higher than the sum of both effects individually. Mortality is substantially high among critically ill survivors who experience both delirium and weakness, although no additive effect on mortality was observed when these conditions occur together. Our findings highlight the urgent need to optimise ICU care by prioritising the prevention, early identification and management of these two common ICU-acquired conditions. Study participation and completion of all assessments. ClinicalTrials.gov identifier: NCT04206306.

Baseline right ventricular-pulmonary artery uncoupling and mortality following transcatheter aortic valve replacement: a meta-analysis

Abstract Background In severe aortic stenosis (AS) patients, elevated left-sided filling pressures can lead to pulmonary hypertension and right ventricular (RV) systolic dysfunction. These conditions signal advanced disease and predict poor outcomes in transcatheter aortic valve replacement (TAVR) cases. However, recent studies indicate potential recovery post-TAVR, with improved prognosis. The newly recognized index, RV to pulmonary artery (RV-PA) coupling, reflects the RV's ability to handle pulmonary afterload and is associated with adverse outcomes. Purpose This study aimed to delineate the prognostic role of baseline RV-PA uncoupling in patients undergoing TAVR. Methods We conducted a systematic literature search for studies assessing RV-PA coupling indices at baseline in patients undergoing TAVR. We recorded the year of publication, method of RV-PA assessment, the proposed cutoffs, patients’ age-sex, and follow-up duration. The primary outcome of interest was all-cause mortality at maximal follow-up and the adjusted hazard ratios of RV-PA uncoupling for all-cause mortality were extracted. Pooling of the hazard ratios was conducted according to a random effects model. I2 was chosen as the measure of between-study heterogeneity, with values exceeding 50% being significant. Results We identified a total of 316 studies, of which 5 were ultimately selected for data extraction and inclusion in the meta-analysis after screening of title/abstract/full-text. All but one study utilized the Tricuspid Annular Plane Systolic Excursion/Pulmonary artery systolic pressure (TAPSE/PASP) as the method of RV-PA assessment. The mean age of the participants across the studies was approximately 81 years old, with a balanced male:female ratio. The median follow-up duration was 23 months (range: 6-40 months). According to the results of the meta-analysis, the presence of baseline RV-PA uncoupling was associated with a 2.8-fold increased risk of all-cause mortality at maximal follow-up (Figure). Significant between-study heterogeneity was detected. An asymmetric funnel plot was inspected, indicative of publication bias (Egger’s test intercept: 6.76, 95% confidence interval 5.07-8.44, p=0.004). The results, although attenuated, remained significant even after a trim-and-fill analysis (3 studies added, hazard ratio: 1.27, 95% confidence interval: 0.03-2.51, p=0.04). Furthermore, the results were unaffected following a sensitivity analysis with the leave-one-out method. Conclusion This meta-analysis suggests that baseline RV-PA uncoupling prior to TAVR is associated with all-cause mortality and it could serve as an imaging biomarker of prognosis in this patient population.Figure

Right ventricular-pulmonary artery coupling and clinical outcomes after mitral transcatheter edge-to-edge repair: A meta-analysis

Abstract Introduction Mitral transcatheter edge-to-edge repair (TEER) has gained prominence in the realm of cardiovascular care, as it has been proven to improve patient prognosis and quality of life. While the primary focus of such interventions is the mitral valve itself, understanding the broader impact of right ventricular function and pulmonary artery dynamics is crucial for a comprehensive assessment of clinical efficacy and patient outcomes. A newly recognized index, right ventricular-pulmonary artery (RV-PA) coupling, reflects the RV's ability to handle pulmonary afterload and is associated with adverse outcomes. Purpose This meta-analysis consolidates findings from diverse studies to systematically evaluate the association between RV-PA coupling parameters and the success of mitral TEER. Methods We conducted a systematic literature search for studies assessing RV-PA coupling indices at baseline in patients undergoing mitral TEER. We recorded the year of publication, method of RV-PA assessment, and the proposed cutoffs. The primary outcome of interest was the combined primary endpoint of included studies at maximal follow-up and the adjusted hazard ratios of RV-PA uncoupling were extracted if they were available. Secondary outcomes included mortality and post-operative mitral regurgitation at follow-up. Pooling of the hazard ratios was conducted according to a random effects model. I2 was chosen as the measure of between-study heterogeneity, with values exceeding 50% being significant. Results We identified a total of 316 studies, of which 8 were ultimately selected for data extraction and inclusion in the meta-analysis after screening of title/abstract/full-text. All but one study utilized the Tricuspid Annular Plane Systolic Excursion/Pulmonary artery systolic pressure (TAPSE/PASP) as the method of RV-PA assessment. According to the results of the meta-analysis, the presence of baseline RV-PA uncoupling was associated with a 2.3-fold increased risk of facing the combined primary endpoint at maximal follow-up (Figure, Panel A). All-cause mortality was also approximately 2.2-fold higher in cases of RV-PA uncoupling (Figure, Panel B). Finally, post-operative MR was 1.4-fold higher in cases of RV-PA uncoupling (Figure, Panel C). Significant between-study heterogeneity was detected in all the examined endpoints. Conclusion: This meta-analysis indicates that RV-PA uncoupling at baseline represents an important prognostic marker in patients undergoing mitral TEER.Figure

Effectiveness of Implant Therapy in Patients With and Without a History of Periodontitis: A Systematic Review With Meta-Analysis of Prospective Cohort Studies.

This systematic review investigates the effectiveness of implant therapy in patients with and without a history of periodontitis in terms of implant loss, peri-implant marginal bone loss (MBL), and occurrence of peri-implant diseases. The protocol of the present meta-analysis was registered on PROSPERO (CRD42021264980). An electronic search was conducted up to April 2024. All prospective cohort studies reporting implant loss, MBL, and occurrence of peri-implant diseases in both patients with a history of periodontitis (HP) and patients with no history of periodontitis (NHP) after at least 36-month follow-up were included. The risk of bias was evaluated using the Newcastle-Ottawa Scale and the quality of the evidence was also assessed. A meta-analysis was performed on the selected outcomes at the available follow-up time points. Subgroup analyses were conducted based on follow-up time, rate of progression and severity of periodontitis, and implant surface characteristics. Publication bias was evaluated using the Funnel plot and Egger's test. From 13 761 initial records, 14 studies (17 articles) were finally included. Eight studies had a low risk of bias level, and six had a medium risk of bias level. Meta-analysis showed that HP patients had a significantly greater risk for implant loss (HR: 1.75; 95% CI: 1.28-2.40; p = 0.0005; I2 = 0%), MBL (MD: 0.41 mm; 95% CI 0.19, 0.63; p = 0.0002; I2 = 54%), and peri-implantitis (3.24; 95% CI: 1.58-6.64; p = 0.001; I2 = 57%) compared to NHP, whereas no significant intergroup difference for peri-implant mucositis was found. Subgroup analyses revealed a particularly greater risk for implant loss for HP patients over a ≥ 10-year follow-up (HR: 2.02; 95% CI: 1.06-3.85; p = 0.03; I2 = 0%) and for patients with a history of grade C (formerly aggressive) periodontitis (HR: 6.16; 95% CI: 2.53-15.01; p < 0.0001; I2 = 0%). A greater risk for implant loss for stages III-IV (severe) periodontitis, and implants with rough surfaces was also found. Within the limits of heterogeneous case definitions and methods of assessment, a history of periodontitis has been proved to significantly increase the risk for implant loss, particularly at long follow-up (≥ 10 years) and in case of rapidly progressive forms (grade C), and for MBL and peri-implantitis.

Youth mental health and exposome

Abstract Mental health is a complex Public Health challenge, especially youth. A better understanding of factors that contribute to youth mental health and reduce the burden of youth mental health conditions such as executive and emotional functioning is needed to develop primary and secondary prevention interventions. One of the main challenges for better understanding mental health of youth is the complexity and diversity of exposures that individuals experience throughout their lifetime. There is a wide range of factors in the environment, and individuals are exposed to different combinations of external factors depending on their location, occupation, and lifestyles. These factors include physical (e.g., noise and indoor and outdoor air), chemical and social factors (e.g., neglect and abuse, relationship conflicts) based on the exposome framework. The exposome is a guiding framework for the multi-country study EARLY involving Albania, Belgium, Germany, Israel, Moldova, Portugal, Romania, Serbia, Spain, and Switzerland. EARLY is one of the first projects to theoretically explore and empirically investigate youth mental health in line with the exposome framework. We aim to identify factors influencing youth mental health with validated exposure measures. An exploratory list of measures was collected in Albania, Belgium, Germany, Israel, Moldova, Portugal, Romania, Serbia, Spain, and Switzerland. The measures vary widely. Besides the variation, there is still a lack of standardized methods for measuring environmental exposures. Limitations of measures affect reliability and validity. Therefore, an overview of available assessment methods and steps toward improving measures will be discussed in this talk. Speakers/Panelists Karin Boode GGD GHOR Nederland, Utrecht, Netherlands Peter Van Den Hazel INCHES, Ellecom, Netherlands

Ensuring that psychological interventions are delivered as intended on mental health inpatient wards.

Talk, Understand and Listen for InPatient Settings (TULIPS) was a multi-centred randomized control trial of an intervention that aimed to increase patient access to psychological therapies on acute mental health wards. This paper aims to: (i) describe a strategy for designing a psychological intervention that is implementable in inpatient mental health settings; (ii) describe methods for assessing the fidelity of interventions within these settings; (iii) report on the extent to which fidelity was achieved in the TULIPS trial. The TULIPS intervention was designed using information from a systematic review, stakeholder interviews, pilot work and a consensus workshop. We assessed fidelity to the model in terms of the delivery and dose of essential elements of the intervention, quality of intervention delivery, engagement of participants with the intervention and differentiation between the intervention and usual care. Although the TULIPS intervention targeted known barriers to the delivery of psychological interventions on mental health wards, we found issues in implementing aspects of the intervention that were dependent upon the participation of members of the multidisciplinary team. Psychologists were able to overcome barriers to delivering individual therapy to patients as this provision was not reliant on the availability of other staff. The intervention period in the study was 6 months. A greater period of time with a critical mass of psychological practitioners is needed to embed psychological interventions on inpatient wards. Our fidelity framework and assessment methods can be used by other researchers implementing and testing psychological therapies within inpatient environments.

Including highly educated migrants in academia to improve their health—protocol for a pilot intervention

IntroductionNorway’s healthcare system needs a diversified work force to meet societal demands for improved cultural competence. However, many migrants in Norway who were educated as health professions in their home countries are not practicing these professions. This may negatively affect their physical and mental health and hinder their personal social integration. Though good health is often seen as a precondition for work, relevant working activities can also improve health. However, including health professionals with foreign education in academic institutions prior to receiving necessary accreditation is a complex task. This study will pilot an intervention aiming to improve health through meaningful integration of these professionals in academic environments.Materials and methodsThis paper is a protocol for a non-randomized pilot intervention study targeting migrants who are waiting for their health education accreditation in Norway. To test the benefits of meaningful activity on health and explore possibilities for implementing such activity, we have designed a six-month long intervention consisting of including nurses, doctors, and other highly educated migrants with healthcare backgrounds between 20 and 67 years of age, into health-related working tasks, at two higher education institutions in Bergen, Norway. The intervention will be tailored according to the participant’s expertise. This hybrid type 2 pilot protocol paper will present how feasibility, fidelity, dose received (satisfaction), and dose of exposure (participation), will be assessed and whether the intervention is experienced as beneficial for the participants’ health as primary outcome utilizing both quantitative and qualitative methods.ConclusionWe present a complex, personalized intervention that has the potential for large scale implementation in the future. By thoroughly presenting our designed intervention and assessment methods, this protocol will add to the study’s transparency and facilitate replicability and comparison with future studies. This study will be of benefit to the migrants themselves, policy makers, government agencies and academia at large as it can point to a unique and sustainable way of speeding up the integration of highly educated migrants in their respective fields in a new host country.

Indicators of the clinical utility of genetic or genomic testing: a scoping review

Abstract Background Genetic or genomic tests are the cornerstones of personalized prevention. Previous reviews primarily focused on theoretical frameworks rather than actual assessments and assessed dimensions rather than specific indicators within these dimensions. Our scoping review aimed to review the dimensions and the specific indicators measured in the published assessment reports of genetic or genomic tests. Methods We selected formal assessments of genetic and genomic test used for prevention through PubMed, Web of Science, Scopus, websites of 20 different organizations, Google, and Google Scholar. Also, through a separate analysis we identified ten comprehensive dimensions of clinical utility through an analysis of 30 theoretical frameworks for genetic and genomic tests. From the included assessments, we extracted all the indicators, clustering them based on the comprehensive dimensions. Results From 3054 unique references and 12000 grey literature search results, we collected 57 assessments, all from high income-countries (in Europe (53%) and North America (47%)). The assessment methods were HTA (42%), EGAPP (25%), ACCE (21%) and other (12%). 951 disease-specific indicators were extracted from the assessments. Analytic validity (60%), clinical validity (79%) clinical efficacy (79%), economic impact (58%) were the most common dimensions (had at least one indicator). However, only 12 assessments (21%) include indicators that compared health outcomes between tested and untested groups. Equity, acceptability, legitimacy, and personal value were evaluated in less than 15% of the documents. Conclusions Our study illustrate that, although dimensions such as equity and acceptability, are significantly emphasized in traditional evaluation frameworks, these are often not considered in the assessments. Additionally, our study has underscored a significant dearth of primary evidence concerning the clinical efficacy of these technologies. Key messages • Our study highlights the prevalence of evaluations lacking indicators for equity, acceptability, and legitimacy dimensions and a lack of direct evidence of clinical efficacy. • The catalog of indicators was openly provided as a resource for researchers and institutions working in evidence-based evaluations of personalized preventive healthcare.

A Review of Reliability Research in Regional Integrated Energy System: Indicator, Modeling, and Assessment Methods

The increasing complexity of integrated energy systems has made reliability assessment a critical challenge. This paper presents a comprehensive review of reliability assessment in Regional Integrated Energy Systems (RIES), focusing on key aspects such as reliability indicators, modeling approaches, and evaluation techniques. This study highlights the role of renewable energy sources and examines the coupling relationships within RIES. Energy hub models and complex network theory are identified as significant in RIES modeling, while probabilistic load flow analysis shows promise in handling renewable energy uncertainties. This paper also explores the potential of machine learning methods and multi-objective optimization approaches in enhancing system reliability. By proposing an integrated assessment framework, this study addresses this research gap in reliability evaluation under high renewable energy penetration scenarios. The findings contribute to the advancement of reliability assessment methodologies for integrated energy systems, supporting the development of more resilient and sustainable energy infrastructures.