Passive Intervention Research Articles

Climate-Responsive Architectural Design: Analyzing and Adapting to Diverse Climates in U.S. Cities

The energy consumption challenge within the built environment is growing in urgency, underscoring an imperative for climate-responsive design solutions. This paper presents an in-depth analysis of the climatic characteristics of 12 U.S. cities, with a parametric platform, categorized under different Köppen climate classifications, with the aim of informing effective passive design strategies. Upon meticulously assessing the efficacy of various passive strategies tailored to distinct climate zones, this paper distills actionable guidance for deploying architectural methods that embody climate-responsive design principles. Theoretical models are developed to correlate climatic variables with specific passive design interventions. The research contributes to the theoretical discourse on passive design by advocation for a data-driven, climate-responsive design guidance that aligns with contemporary sustainability goals.

Cost-utility and cost consequence of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

The TRACE (Targeted Research for Addictive and Compulsive Eating) intervention was evaluated in a 3-month randomized controlled trial which demonstrated significant improvement in Yale Food Addiction Scale scores favoring dietitian-led telehealth (active intervention) compared with passive and control groups. This study aimed to determine intervention costs and cost-utility. Costs of each intervention (2021$AUD) and incremental net monetary benefit (iNMB; incremental benefit, defined as Quality-Adjusted Life Years (QALY) gained, multiplied by willingness to pay threshold minus incremental cost) were calculated to estimate differences between groups. The active intervention (n=38) cost $294 (95% UI: $266, $316) per person compared to $47 (95% UI: $40, $54) in the passive intervention (n=24), and $26 in the control group (n=37). At a cost-effectiveness threshold of $50 000 per QALY score gained, the active intervention iNMB was -$186 (95% UI: -$1137, $834) and the passive group $127 (95% UI: -$1137, $834). Compared to the control group, estimates indicate a 30% chance of the active intervention, and a 60% chance of the passive intervention being cost effective. Although the overall cost of the active intervention was low, this was not considered cost-effective in comparison to the passive intervention, given small QALY score gains. Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

Digitally intensive mothering and unequal emotional work of Chinese mothers

ABSTRACT Due to the unequal gender division of labour in parenting practices, intensive mothering has been further reinforced in the digital age, amplifying mothers’ otherwise implicit emotional work. Using data from 70 self-narration cases of Chinese mothers during lockdown learning, this study found that mothers experienced four kinds of negative emotions – anxiety, anger, frustration and guilt during online learning, and adopted two possible coping strategies – active self-reflection and passive intervention by others. This study foregrounded the unequal emotional work of Chinese mothers, especially the vulnerability in emotion management among mothers at lower socioeconomic levels. This study revealed how the ideological discourses constructed by intensive mothering influence Chinese mothers’ emotions in digital educational involvement and the digital inequality it may trigger.

Penerapan Range Of Mation (ROM) terhadap Peningkatan Kekuatan Otot dengan Kasus Stroke Non Hemoragik pada Ny. A Di UPT PSTW Jember

Background: Stroke remains a major health issue both in Indonesia and globally. Non-hemorrhagic stroke is a leading cause of physical disability, resulting in decreased muscle strength and motor function. Physical rehabilitation, including Range of Motion (ROM) exercises, plays a crucial role in the recovery of stroke patients by restoring muscle function and improving muscle strength. Objective: This study aims to evaluate the effectiveness of ROM exercises in improving muscle strength in non-hemorrhagic stroke patients with physical mobility impairment. Methods: A descriptive study with a case study approach was conducted on one non-hemorrhagic stroke patient who was given passive ROM exercises for 7 days, with a frequency of twice a day (morning and evening). The instruments used included Standard Operating Procedures (SOP) and a Manual Muscle Testing (MMT) observation sheet to assess muscle strength before and after the passive ROM intervention. Results: The study showed a significant increase in muscle strength after ROM exercises. Muscle strength consistently improved throughout the intervention, indicating that ROM exercises are effective in enhancing muscle strength in non-hemorrhagic stroke patients. Conclusion: Regular ROM exercises can increase muscle strength in non-hemorrhagic stroke patients. Initially, the patient's left extremity muscle strength was at a scale of 3, and after 7 days of ROM exercises, it improved to a scale of 4. This study provides evidence that ROM exercises are effective for stroke patients

Supplemental ambient lighting intervention to improve sleep in Parkinson's disease: A pilot trial

ImportanceSleep disturbances in Parkinson's disease (PD) are common and often adversely affect quality of life. Light therapy has benefited sleep quality and mood outcomes in various populations but results to date with conventional light therapy boxes in PD patients have been mixed. We hypothesized that a passive lighting intervention, applied in the morning and designed to maximally affect the circadian system, would improve measures of sleep and mood in PD patients. MethodsIn this single-arm, within-subjects intervention study, baseline objective sleep (actigraphy), subjective sleep quality (questionnaires), and subjective mood (questionnaires) data were collected for 1 week. Lighting was then administered to participants via table/floor lamps installed in the home or via personal light therapy glasses for 2 h in the morning, 7 days per week, over the following 4-week period. Post-intervention data for the same outcomes were collected during the final week of the intervention period. ResultsAmong 20 participants (12 women, 8 men; mean [SD] age 72.1 [9.5] years, disease duration 9.0 [5.2] years), objective sleep duration increased significantly by 28.5 min (p = 0.029) and objective sleep time increased significantly by 19.9 min (p = 0.026). ConclusionPassive and easily administered lighting interventions for improving sleep in PD patients hold promise as a treatment for mitigating symptoms and improving quality of life in PD.

Improving Athletic Trainers' Knowledge of Clinical Documentation Through Novel Educational Interventions: A Randomized Controlled Trial.

Athletic trainers (ATs) have reported the need for more educational resources about clinical documentation. To investigate the effectiveness of passive and active educational interventions to improve practicing ATs' clinical documentation knowledge. Randomized controlled trial, sequential explanatory mixed methods study. Online module(s), knowledge assessment, and interviews. We emailed 18 981 practicing ATs across employment settings, of which 524 ATs were enrolled into a group (personalized learning pathway [PLP = 178], passive reading list [PAS = 176], control [CON = 170]) then took the knowledge assessment. A total of 364 ATs did not complete the intervention or postknowledge assessment; therefore, complete responses from 160 ATs (PLP = 39, PAS = 44, CON = 77; age = 36.6 ± 11.2 years, years certified = 13.9 ± 10.7) were analyzed. Knowledge assessment (34 items) and interview guides (12-13 items) were developed, validated, and piloted with ATs before study commencement. We summed correct responses (1 point each, 34 points maximum) and calculated percentages and preknowledge and postknowledge mean change scores. Differences among groups (PLP, PAS, CON) and time (preintervention, postintervention) were calculated using a 3 × 2 repeated-measures analysis of variance (P ≤ .05) with post hoc Tukey HSD. Semistructured interviews were conducted (PLP = 15, PAS = 14), recorded, transcribed, and analyzed following the consensual qualitative research tradition. No differences in the preknowledge assessment were observed between groups. We observed a group × time interaction (F2,157 = 15.30, P < .001; partial η2 = 0.16). The PLP group exhibited greater mean change (M = 3.0 ± 2.7) than the PAS (M = 1.7 ± 3.0, P = .049) and CON (M = 0.4 ± 2.2, P < .001) groups. Descriptively, ATs scored lowest on the legal (61.3% ± 2.1%), value of the AT (63.7% ± 4.3%), and health information technology (65.3% ± 3.7%) items. Whereas ATs described being confident in their documentation knowledge, they also identified key content (eg, legal considerations, strategies) which they deemed valuable. The educational interventions improved ATs' knowledge of clinical documentation and provided valuable resources for their clinical practice; however, targeted continuing education is needed to address knowledge gaps.

Examining the effectiveness of interventions to reduce discriminatory behavior at work: An attitude dimension consistency perspective.

Academic interest in reducing discrimination has produced substantial research testing interventions to mitigate biased outcomes. However, disparate findings and a scarcity of studies examining work-related behavioral measures make it challenging to determine which interventions are better suited to reduce workplace discrimination. Derived from the tripartite theory of attitudes and the principle of compatibility, I develop a conceptual model mapping the attitude focus of interventions and code studies in this literature from the past two decades for these common properties. Based on a meta-analysis of 70 articles totaling 208 effect sizes, I test this conceptual model, finding that it helps explain why some interventions to reduce discrimination yield superior outcomes relative to others. In particular, results indicate that passive interventions, such as short-term education or reminders of bias processes, are largely ineffective in shifting behavior. Conversely, the class of interventions that targets behavior directly by attempting to inhibit the manifestation of bias (e.g., making individuals accountable for their decisions or changing social norms) emerged as the most helpful category of interventions in this area. Overall, results support a key prediction of the attitude dimension consistency perspective, demonstrating that aligning the attitude dimension primarily targeted by an intervention and the outcome measured could lead to improved results in this area. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of a 4-week, remotely administered, post-exercise passive leg heating intervention on determinants of endurance performance.

Post-exercise passive heating has been reported to augment adaptations associated with endurance training. The current study evaluated the effect of a 4-week remotely administered, post-exercise passive leg heating protocol, using an electrically heated layering ensemble, on determinants of endurance performance. Thirty recreationally trained participants were randomly allocated to either a post-exercise passive leg heating (PAH, n = 16) or unsupervised training only control group (CON, n = 14). The PAH group wore the passive heating ensemble for 90-120min/day, completing a total of 20 (16 post-exercise and 4 stand-alone leg heating) sessions across 4weeks. Whole-body (peak oxygen uptake, gas exchange threshold, gross efficiency and pulmonary oxygen uptake kinetics), single-leg exercise (critical torque and NIRS-derived muscle oxygenation), resting vascular characteristics (flow-mediated dilation) and angiogenic blood measures (nitrate, vascular endothelial growth factor and hypoxia inducible factor 1-α) were recorded to characterize the endurance phenotype. All measures were assessed before (PRE), at 2weeks (MID) and after (POST) the intervention. There was no effect of the intervention on test of whole-body endurance capacity, vascular function or blood markers (p > 0.05). However, oxygen kinetics were adversely affected by PAH, denoted by a slowing of the phase II time constant; τ (p = 0.02). Furthermore, critical torque-deoxygenation ratio was improved in CON relative to PAH (p = 0.03). We have demonstrated that PAH had no ergogenic benefit but instead elicited some unfavourable effects on sub-maximal exercise characteristics in recreationally trained individuals.

The Influence of Active, Passive, and Manual Therapy Interventions on Escalation of Health Care Events After Physical Therapist Care in Veterans With Low Back Pain.

The objective of this study was to examine the associations between active, passive, and manual therapy interventions with the escalation-of-care events following physical therapist care for veterans with low back pain (LBP). A retrospective cohort study was conducted in 3618 veterans who received physical therapist care for LBP between January 1, 2015 and January 1, 2018. The Department of Veterans Affairs (VA) Corporate Data Warehouse was utilized to identify LBP-related physical therapist visits and procedures, as well as opioid prescription and non-physical therapy clinic encounters. The association between physical therapist interventions with 1-year escalation-of-care events were assessed using adjusted odds ratios from logistic regression. Nearly all veterans (98%) received active interventions, but only a minority (31%) received manual therapy. In the 1-year follow-up period, the odds of receiving an opioid prescription were 30% lower for those who received manual therapy in addition to active interventions, as compared with patients who received only active interventions. Moreover, the odds of receiving primary care, specialty care, and diagnostic testing were 30% to 130% higher for patients who received electrical stimulation or more than 1 passive intervention in addition to active treatments, as compared with patients who received only active interventions. The use of manual therapy along with active interventions was associated with reduced prescription of opioids, while utilization of specific passive interventions such as electrical stimulation or multiple modalities in conjunction with active interventions resulted in increased escalation-of-care events. The use of active interventions, which is supported by most clinical practice guidelines, was the cornerstone of physical therapist care for veterans with LBP. However, the use of clinical practice guideline-recommended manual therapy interventions was low but associated with reduced opioid prescriptions. The use of 2 or more different passive interventions along with active interventions was common (34%) and associated with less-than-optimal escalation-of-care outcomes.

Combined robot-assisted therapy virtual reality for upper limb rehabilitation in stroke survivors: a systematic review of randomized controlled trials.

Upper limb impairments are among the most common consequences following a stroke. Recently, robot-assisted therapy (RT) and virtual reality (VR) have been used to improve upper limb function in stroke survivors. This review aims to investigate the effects of combined RT and VR on upper limb function in stroke survivors and to provide recommendations for researchers and clinicians in the medical field. We searched PubMed, SCOPUS, REHABDATA, PEDro, EMBASE, and Web of Science from inception to March 28, 2024. Randomized controlled trials (RCTs) involving stroke survivors that compared combined RT and VR interventions with either passive (i.e., sham, rest) or active (i.e., traditional therapy, VR, RT) interventions and assessed outcomes related to upper limb function (e.g., strength, muscle tone, or overall function) were included. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included studies. Six studies were included in this review. In total, 201 patients with stroke (mean age 57.84years) were involved in this review. Four studies were considered 'high quality', while two were considered as 'moderate quality' on the Cochrane Collaboration tool. The findings showed inconsistent results for the effects of combined RT and VR interventions on upper limb function poststroke. In conclusion, there are potential effects of combined RT and VR interventions on improving upper limb function, but further research is needed to confirm these findings, understand the underlying mechanisms, and assess the consistency and generalizability of the results.

The role of information systems in emergency department decision-making-a literature review.

Healthcare providers employ heuristic and analytical decision-making to navigate the high-stakes environment of the emergency department (ED). Despite the increasing integration of information systems (ISs), research on their efficacy is conflicting. Drawing on related fields, we investigate how timing and mode of delivery influence IS effectiveness. Our objective is to reconcile previous contradictory findings, shedding light on optimal IS design in the ED. We conducted a systematic review following PRISMA across PubMed, Scopus, and Web of Science. We coded the ISs' timing as heuristic or analytical, their mode of delivery as active for automatic alerts and passive when requiring user-initiated information retrieval, and their effect on process, economic, and clinical outcomes. Our analysis included 83 studies. During early heuristic decision-making, most active interventions were ineffective, while passive interventions generally improved outcomes. In the analytical phase, the effects were reversed. Passive interventions that facilitate information extraction consistently improved outcomes. Our findings suggest that the effectiveness of active interventions negatively correlates with the amount of information received during delivery. During early heuristic decision-making, when information overload is high, physicians are unresponsive to alerts and proactively consult passive resources. In the later analytical phases, physicians show increased receptivity to alerts due to decreased diagnostic uncertainty and information quantity. Interventions that limit information lead to positive outcomes, supporting our interpretation. We synthesize our findings into an integrated model that reveals the underlying reasons for conflicting findings from previous reviews and can guide practitioners in designing ISs in the ED.

Exploring self-experience practices in dementia care: A scoping review.

Recognised as essential for high-quality dementia service, person-centred care aims to understand and respect the unique needs of each individual. Self-experience practices may offer caregivers an opportunity to acquire knowledge, empathy, and skills related to person-centred care, especially through recreating experiences similar to dementia. Given the need to enhance the understanding of self-experience practices in dementia care, a more comprehensive investigation of these training interventions for (future) caregivers is needed. We conducted a scoping review to map the evidence on the use of self-experience practices in dementia training. We systematically searched Cochrane Library, MEDLINE via PubMed, CINAHL, and Web of Science. We also searched for grey literature, as well as registry entries, and conducted backward citation tracking of included reviews. We analysed data on intervention characteristics, factors influencing the implementation, and learning outcomes based on Kirkpatrick's model. We included 44 reports across 30 intervention programmes. The majority of reports (91%) were published from 2016 onwards, with 32% originating from the USA and 25% from the UK. We identified passive, interactive, immersive, and multicomponent self-experience interventions in dementia education and training. Learning outcomes based on Kirkpatrick's model were fairly distributed across all identified modalities. Both consumers and providers emphasised aspects related to the development and implementation of practices, particularly organisational-related considerations such as temporal and spatial planning of trainings. Our review highlights diverse interventions incorporating self-experience practices, with an increasing role for technological tools. While self-experience interventions engage participants, the impact on individuals with dementia and organisational levels remain largely unreported. Our overview, informed by current literature, underscores unique considerations and challenges associated with dementia-related self-experience practices. Implementing and evaluating complex training interventions using self-experience practices should consider ethical aspects. Registry: Registered within the Open Science Framework (available at https://osf.io/fycxa/).

Passive heat therapy to improve cardiometabolic health in persons with a spinal cord injury — a pilot study

Objective: To test the effect of repeated heat therapy on markers of inflammation, glucose metabolism and vascular health in persons with a spinal cord injury (SCI). It was hypothesized that the heat therapy intervention would lead to a reduction in the fasting concentration of inflammatory markers as well as an improvement in glucose tolerance and microvascular function.Methods: Five adults with thoracic SCI ((1 female, age: 43 (27 – 60) yrs, BMI: 29 (23 to 30) kg/m2, years since injury: 7 (1 – 11) yrs)) enrolled in an 8-week passive heat therapy intervention consisting of 24 session during which the oral temperature was elevated by 1°C by means of a water-perfused suit and heating blankets. The number of completed sessions, time to reach the desired oral temperature and adverse events were reported. Thermoregulatory and perceptual responses to a single passive heat therapy session were assessed during the first session of the intervention. Fasting interleukin-6 (IL-6), C-reactive protein (CRP) and glucose concentration were measured in plasma before and after the chronic intervention. Additionally, thermal hyperemia in sensate (i.e., arm) and insensate (i.e., leg) skin through laser Doppler flowmetry were determined at 39°C and 45°C pre- and post-intervention. Descriptive data are expressed as median (range).Results: The median time to reach a 1°C increase in oral temperature during passive heating was 53 (49 – 75) min, which was accompanied by a final mean skin temperature of 38.6 (36.5 – 38.9)°C, a thermal comfort of 2 (0 – 4) on a 0 to 5 ratings scale and a basic affect of +3 (+1 - +4) on a -5 to +5 rating scale. Four out of the five participants completed all prescribed passive heating sessions. However, in two participants a number of sessions (N = 10 and 2 out of 24 sessions) were stopped at 0.8°C due to thermal discomfort. There were no skin burns or signs of autonomic dysreflexia. All participants remained hemodynamically stable throughout the sessions. Resting IL-6 and CRP changed from 3.2 (2.7 – 10.5) pg/ml to 8.1 (7.6 – 11.1) pg/ml and 0.40 (0.14 – 1.16) to 1.11 (0.51 – 1.26) pg/ml, respectively. Fasting glucose concentration changed from 90.0 (85.5 – 206.0) mg/dl to 94.5 (69 – 266) mg/dl. Cutaneous vascular conductance at 39°C as a percentage of maximal vasodilation at the arm and leg changed from 23.2 (11.2 – 36.0)% to 30.4 (13.8 – 46.1)% and 34.3 (30.4 – 49.4)% to 47.4 (6.7 – 52.8)%, respectively. Conclusion: These preliminary findings suggest that it is feasible, well-tolerated and safe for persons with SCI to engage in repeated heat therapy. A full data set of this ongoing study is needed to provide more conclusive insight into its effects on cardiometabolic health outcomes. VA Rehabilitation R&amp;D (I21RX003724-01A1). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Does acute heat stress alter lactation performance in postpartum mothers?

Introduction: Heat stress has been shown to acutely decrease lactation performance in various mammalian species, however whether a similar effect is present in humans remains largely unexplored. Objective and hypothesis: The objective of the present study was to determine whether an acute whole-body heat stress reduces lactation performance in postpartum mothers in the proceeding 24 h. Methods: To date, 9 postpartum mothers (32±4 y; 1.6 ±0.1 m; 67±13 kg; 8±3 months postpartum) have participated in the study. During the 24 h period before and after the acute passive heat stress, participants were asked to record their voluntary fluid intake and their milk production defined as the volume of expressed milk and/or breastfeeding volume based on the baby’s weight before and immediately after nursing, accounting for evaporative water losses. The passive heat stress protocol involved participants laying supine while donning a tube-lined garment continuously perfused with 49°C water for 60 minutes. Rectal temperature and heart rate were measured during the passive heat stress intervention to confirm thermal strain, and whole-body sweat losses were calculated as the net difference in body mass following passive heat stress. Results: The 60-minute passive heat stress protocol increased rectal temperature by 0.4±0.3°C, increased heart rate (17±12 BPM), and resulted in a whole-body sweat loss of 278±201 g. The frequency of lactation was similar during the 24 h before (5.4±1.6 times) and 24 h after (5.1±1.1 times, P=0.20) acute passive heat stress. The total volume of human milk production in the 24 h prior to heat stress was not different to the 24 h following heat stress (pre: 327±123 ml, post: 312±148 ml, P=0.33). Maternal fluid intake was higher during the 24 h after passive heat stress (1561±73 ml) in comparison to the 24 h before (1377±244 ml, P=0.05). Conclusion: Preliminary data suggests that an acute bout of whole-body heat stress does not modulate lactation performance in postpartum mothers. This research was supported by Dr. Ravanelli’s Natural Sciences and Engineering Research Council of Canada Discovery Grant (PIN#2022-05096). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Systematic Review of Music Therapy and Musical Interventions for Patients with Moderate and Severe Mental Disorders.

Objective: This systematic review aims to assess the impact of music therapy and musical interventions on neuropsychiatric outcomes among patients with moderate and severe mental disorders, in comparison with conventional treatment in isolation. Methods: The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted on November 16, 2021, using the following databases and search interfaces: Cumulative Index to Nursing and Allied Health Literature, Embase, SCOPUS, Web of Science; PubMed, PsycINFO, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Scientific Electronic Library Online. Two authors independently assessed the studies for inclusion criteria, extracted the data, and evaluated the quality of the included studies using critical appraisal tools. Results: In total, 17 studies were included, 9 of which were randomized controlled trials. The experimental studies involved 5,082 adult and elderly patients. The most prevalent symptoms assessed in the studies were anxiety, depression, and positive and negative symptoms of psychotic disorders. Music interventions were predominantly conducted by music therapists and nurses, providing passive interventions with the selection of musical repertoire by therapists and patients. The frequency with which musical interventions occurred varied greatly in terms of session duration, number of times per week, and number of times during the day. The identified study designs included clinical and quasi-experimental studies. In terms of methodological quality, clinical studies showed weaknesses regarding deviations from intended interventions. Conclusion: The effectiveness of music therapy and musical interventions for neuropsychiatric symptoms in patients with moderate and severe mental disorders was evident in quasi-experimental and clinical studies with satisfactory methodological quality. Musical interventions, in various forms of application, represent an interdisciplinary therapeutic tool that complements and enhances conventional treatment. Unlike conventional treatments, the immersive and integrative nature of music interventions allows access to both intrapersonal and interpersonal dimensions during periods of psychic suffering. These findings highlight the importance of researchers addressing methodological limitations, such as deviations from intended interventions, and advocate for the expansion the use of music in community treatment settings.

The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial.

Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months. Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported. The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001). A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.

A visit to David’s World: exploring the impact of a passive art intervention on hospitalized children’s wellbeing, engagement, and joy

ABSTRACT Background A gap exists in research regarding the impact of passive art on hospitalized children. This descriptive study explored the ability of an intervention using original paintings and the same paintings altered with personalized content to capture the attention of hospitalized children, engage them, and bring them joy. Methods This grounded theory mixed-method exploratory pilot study included interview, observation, Leuven Scales for Involvement and Well-being, and the VAS-Joy Scale. Ten hospitalized children, ages four to 12 years, viewed a painting and later the painting with personalized content. Results Leuven scores pre- (M = 4) and post-intervention (M = 4.5) suggested high levels of well-being and involvement, with post scores higher. Joy scores (M = 6.3) obtained post-intervention indicated high levels of joy when viewing the personalized altered painting. Five response themes emerged: (1) Felt special; (2) Brightened mood; (3) Reinforced positive identity; (4) Stimulated imagination; and (5) Revealed homesickness. Conclusions Findings support the emergent theory that passive art interventions using “organic art” can contribute to improving the hospital experience for children.

An exploration of low back pain beliefs held by health care professionals in Northern America.

Prior research demonstrated that people in the United States and Canada (Northern America) hold predominantly biomedical beliefs about Low back pain (LBP); such beliefs were attributed to healthcare professionals (HCP). Further investigation is needed to understand HCP' LBP beliefs, preferred management strategies, and sources of beliefs. Participants were recruited via social media to complete a qualitative cross-sectional online survey. The survey was distributed to assess LBP beliefs in a U.S. and Canadian-based clinician population. Participants answered questions about the cause of LBP, reasons for recurrence or persistence, use of imaging, management strategies, and sources of beliefs. Responses were analysed using an inductive thematic analysis. One hundred and sixty three participants were included, reporting multiple causes for LBP. However, many references were anchored to biological problems. When psychological variables were mentioned, it typically involved patient blaming. Like prior research studies, minimal attention was given to societal and environmental influences. Management strategies often aligned with guideline care except for the recommendation of inappropriate imaging and a reliance on passive interventions. These findings align with prior research studies on general population beliefs, demonstrating a preference for biological causes of LBP. Further updates are needed for clinical education, while future studies should seek to assess the translation of clinician beliefs into clinical practice and health system constraints.

A Mixed-Methods Comparison of Interventions to Increase Advance Care Planning.

Although interventions can increase advance care planning (ACP) engagement, it remains unclear which interventions to choose in primary care settings. This study compares a passive intervention (mailed materials) to an interactive intervention (group visits) on participant ACP engagement and experiences. We used mixed methods to examine ACP engagement at baseline and six months following two ACP interventions. Eligible patients were randomized to receive mailed materials or participate in two ACP group visits. We administered the 4-item ACP Engagement survey (n = 110) and conducted interviews (n = 23). We compared mean scores and percent change in ACP engagement, analyzed interviews with directed content analysis to understand participants' ACP experiences, and integrated the findings based on mailed materials or group visits intervention. All participants demonstrated increased ACP engagement scores. At six months, group visit participants reported higher percent change in mean overall score compared with mailed materials participants (+8% vs +3%, P < .0001). Group visits participants reported that being prompted to think about end-of-life preferences, gaining knowledge about ACP, and understanding the value of completing ACP documentation influenced their ACP readiness. While both interventions encouraged patients to start considering and refining their end-of-life preferences, group visits made patients feel more knowledgeable about ACP, highlighted the importance of completing ACP documentation early, and sparked further ACP discussions with others. While primary care patients may benefit from mailed ACP materials, patients reported increased readiness after ACP group visits. Group visits emphasized the value of upstream preparation, ongoing conversations, and increased knowledge about ACP.

Understanding immunotherapy and CAR-T-cells: A narrative review

This comprehensive narrative review aims to delve into the various aspects of immunotherapy, with a special focus on the role of chimeric antigen receptor T (CAR-T) cells in modern medical interventions. To strengthen the understanding of the foundations of immunotherapy, a detailed exposition of the mechanisms underpinning the normal human immune response has been provided, encompassing both innate and adaptive immunity, along with the pivotal role of immune cells in neoplastic surveillance and immune editing. Furthermore, the review elucidates various active and passive immunotherapeutic interventions, providing a thorough overview of various agents and their mechanisms of action. It also delves into the structure of CAR-T-cells, their signaling cascades, and the means to fine-tune their effector functions. In addition, the review briefly throws light on the diverse clinical applications of CAR-T-cells that extend beyond its infamous applications in oncology to diseases with high healthcare burdens, such as autoimmune disorders, HIV, and cardiac fibrosis. This holistic exploration of the current state of immunotherapy and the dynamic landscape of CAR-T-cell therapy thus underscores the promise of these advancements in shaping a patient-centric approach to disease management and treatment.