Post Questionnaires Research Articles

Impact of a Mentorship Program to Prepare Medical Students for the Military Residency Match.

Mentorship programs have well-documented benefits to both mentees and mentors. Military medical students face unique challenges in medical school given their service-specific requirements and separate military match process. We therefore aimed to determine whether military medical students' participation in a mentorship program impacts their confidence in applying to obstetrics and gynecology (OB/GYN) residency. First, a needs assessment survey regarding the use of a mentorship program was sent to medical students, residents, fellows, and attendings. A structured mentorship program was then developed for military medical students applying to OB/GYN residency based on the survey results. Mentors were randomly paired with mentees and asked to appraise curriculum vitaes, review personal statements, and perform mock interviews. Following completion of these activities, participants were sent a post-intervention questionnaire. This project was exempt by our institution's Institutional Review Board. Our program had 56 participants, with 29 individuals completing our post-intervention survey (response rate 51.8%). After participating in the program, 92.3% of mentors stated they plan to continue a relationship with their mentee. All the mentee respondents stated they would participate in this program again. Before participating in the program, 16.7% of mentees felt "prepared" or "extremely prepared" for the match, compared to 87.6% post-intervention. Most mentee respondents (75%) reported that this program made them a more competitive applicant. Following the mentorship program, 66.7% of participants successfully matched into OB/GYN residency. This reproducible, well-received intervention can be implemented to facilitate mentoring connections regardless of geographic location. As the OB/GYN specialty develops its own application process, civilian medical schools should consider adopting similar programs to aid their students in navigating the match process.

THE PHYSICAL AND MENTAL HEALTH BENEFITS OF PARTICIPATING IN A LUNGS IN ACTION COMMUNITY EXERCISE MAINTENANCE PROGRAM FOLLOWING REHABILITATION

INTRODUCTION AND AIM Lungs in Action (LIA), a signature program of Lung Foundation Australia (LFA) is a community exercise program for people with chronic lung and cardiac conditions. Facilitated by Exercise Physiologists, Physiotherapists and Fitness Instructors, LIA supports patients to maintain the benefits achieved in pulmonary or cardiac rehabilitation. This research aimed to determine the holistic health benefits of participation in LIA through a national participant evaluation, concurrently with functional outcome measures over a 3-month period. METHODS A convenience sample of LIA participants completed an online health questionnaire (Qualtrics) that incorporated the EQ-5D-5L Health Questionnaire, demographics and structured health and wellbeing questions at baseline. A follow-up health questionnaire was undertaken 3-months post baseline. Concurrently, LIA Instructors conducted functional assessments of muscular strength (30sec Sit to Stand (30STS)), mobility, and balance (Timed Up and Go (TUG)) at baseline and 3-months post, to assess if physiological adaptations were evident. RESULTS 108 LIA participants (60±8 years; F=72) consented to complete the baseline questionnaire with n=61 (60±7 years; F=41) completing the 3-month post questionnaire. There were significant improvements in EQ-5D-5L anxiety domain (MD±SD; 0.18±0.22; p=0.04) and overall health rating (EQ-VAS) (MD±SD; 5.62±2.72; p=0.02). 74 participants (60±7 years; F=52) who attended an average of 11±6 classes over the 3-month interval, completed functional testing at both timepoints. There was a significant decrease in time to complete the TUG (MD±SD; -0.81±1.41 sec; p<0.0001) and increase in repetitions for the 30sSTS (MD±SD; 1.68±2.76 reps; p<0.0001). CONCLUSION Results indicate an increase in functional capacity, overall health, and a decrease in anxiety over the 3-month period. These benefits may relate to improved independence and activities of daily living.

Effectiveness of a Smartphone App (Heia Meg) in Improving Decisions About Nutrition and Physical Activity: Prospective Longitudinal Study.

Obesity is a prevalent and serious chronic condition associated with abnormal or excessive fat buildup that poses significant health risks. The rates of overweight and obesity in adults and children continue to rise, with global rates of children with overweight or obesity aged 5-19 years growing from 4% to 18% between 1975 and 2016. Furthermore, in 2017, nearly 4 million people died due to complications arising from being overweight or obese. This study aims to investigate the potential impact of the mobile app Heia Meg on promoting healthier lifestyle choices regarding nutrition and physical activity. A prospective longitudinal study was conducted in collaboration with the Norwegian Directorate of Health. Participants were recruited through the Heia Meg app and were asked to complete a questionnaire before and after using the app. A total of 199 responses were included in the first (preintervention) questionnaire, while 99 valid responses were obtained in the second (postintervention) questionnaire. The majority (159/199, 79.9%) of participants were female, and their age ranged from 18 years to 70 years and older. The results show a reduction in BMI after the digital intervention. However, some variables influence the BMI reduction effect: sex, age, education, and smoking. The group that obtained the most benefit from the intervention consisted of those who were male, aged 30-39 years, highly educated, and nonsmokers. Although positive, some of the findings are slightly above the statistical significance threshold and therefore should be interpreted carefully. Our study found weak evidence to support the effectiveness of the Heia Meg app in promoting healthier lifestyle choices. However, limitations and confounding factors suggest that further research in different populations with larger sample sizes is needed to confirm or disprove our findings.

A feasibility study to assess a co-designed behaviour change intervention to support people living with achalasia

Abstract Introduction Achalasia is a rare oesophageal condition that affects the motility of the oesophageal body and the relaxation of the lower oesophageal sphincter. Even the most effective treatments are unlikely to be curative. The main goal of medical treatments and interventions are mitigation of symptoms. The medical interventions are pharmacologic, endoscopic and surgical treatments to achieve symptom relief. As all medical treatments only help to alleviate symptoms, it is important for people living with achalasia to use non-pharmacological interventions to manage their condition. Aim This study aimed to evaluate the feasibility of recruitment and assess the acceptability of a co-designed behaviour change intervention, targeting eating in a social setting for people living with achalasia. Methods The mixed-method study used pre- and post-intervention questionnaires and semi-structured post-intervention interviews. Achalasia Action (a UK-based support group) emailed members the study information and participants contacted the researcher to take part. The intervention was a workbook designed collaboratively by the researchers and people living with achalasia, with strategies built on the COM-B model (Capability, Opportunity, Motivation).[1] Participants were given up to two months to complete the workbook. The interview was optional and it was an opportunity for participants to give further feedback on the intervention. Quantitative measures were subjected to descriptive analysis reporting recruitment and retention rates, and self-reported changes in eating behaviours. Qualitative data were analysed descriptively using the APEASE criteria (Affordability, Practicality, Effectiveness and cost-effectiveness, Acceptability, Side-effects/safety, and Equity).[2] Results The study aimed to recruit 20 participants, and this target was achieved, resulting in a 100% recruitment rate. However, the post-intervention questionnaires were completed by only 10 participants, indicating a 50% retention rate from baseline. Quantitative measures demonstrated an improvement in confidence and enjoyment levels while eating in a social setting post-intervention and a decrease in symptoms such as pain, regurgitation, stress and anxiety. Qualitative feedback (n=5) on the intervention described enhanced social support and improved symptom management of achalasia in a social setting. Furthermore, the intervention met the APEASE criteria, indicating its usability and acceptability. Conclusion The recruitment success of this study underscores the feasibility of involving people living with achalasia in intervention research. However, with a retention rate of only 50% at follow-up, it is evident that future studies should consider recruiting a larger baseline sample to ensure the target is achieved. The study acknowledges that the sample size was small and limits the generalisability of the findings. However, this is a characteristic typical of feasibility studies; therefore, the study is designed to assess the feasibility of recruitment and implementing a co-designed intervention rather than drawing conclusions on its efficacy. The positive outcomes of the co-designed intervention highlights the importance of user involvement in developing interventions. The intervention demonstrated the potential to support people living with achalasia in eating in a social setting. The co-designed intervention has significant practical implications by providing healthcare professionals and support groups with a feasible, effective method to enhance the social eating experience of people living with achalasia, potentially improving their overall quality of life.

Effectiveness of Remote Implementation of the ACT Raising Safe Kids Program: A Pilot Study

The objective of the study was to evaluate the effectiveness of remote implementation of the ACT Raising Safe Kids (ACT-RSK) program. The ACT-RSK program is an evidence-based group parenting program designed to promote positive parenting. The COVID-19 pandemic precipitated the creation of a remote implementation guide to deliver the program via telehealth. A small (N = 21) sample of caregivers of children aged 1 to 10 living in the USA participated in the 9-week program and completed pre- and post-intervention questionnaires. ACT Facilitators provided feasibility and fidelity feedback through a focus group and questionnaires. There was a significant improvement in positive parenting skills and a decrease in verbal and physical punishment. There were no improvements in parental nurturing or limiting and monitoring children’s media use. Facilitators and participants found remote implementation to be feasible and acceptable. Facilitators were able to maintain high fidelity to the model. The remote implementation of the ACT-RSK program has benefits to positive parental behaviors and discipline, but possibly not limiting and monitoring of children’s media use and nurturing behavior. However, characteristics of families’ experiences during the COVID-19 pandemic may have influenced these results. Remote implementation of the ACT-RSK program can be useful for promoting positive parental behaviors and discipline.

Impact of an EFL Digital Application on Learning, Satisfaction, and Persistence in Elementary School Children

AbstractThere is a lack of research evaluating the effects of digital textbooks and digital apps on learning for early elementary school learners. Therefore, this study conducted a randomized controlled trial to evaluate how an iPad application for learning English as a foreign language impacted children’s grammar understanding, satisfaction, persistence, and confidence compared to a digital textbook. A total of 119 Japanese first- and second-graders participated in the study. They were randomly divided into groups studying English using “digital books” or “applications” over five days. Pre- and post-intervention tests and questionnaires were used to measure their understanding of the study content, satisfaction, persistence, and confidence in English. Application-based learning was more effective than digital books in terms of grammar comprehension and was significantly better for satisfaction and persistence. The results suggested the use of specific criteria for selecting multimedia learning materials, including a high degree of learner control, autonomy to manipulate the learning environment, feedback on learning activities, and guaranteed interactions with the learning materials.

Brief Report: Single-Session Interventions for Mental Health Challenges in Autistic People: An (Almost) Empty Systematic Review.

Single-session interventions (specific, structured programs that intentionally involve just one visit or encounter with a clinic, provider, or program) have been proven to prevent or reduce mental health challenges and reduce barriers to access. This review aimed to identify and synthesise literature on the acceptability, feasibility, effectiveness, or efficacy of (non-pharmacological) single-session interventions for autistic people. Four databases (Scopus, MEDLINE, PsycINFO, and ProQuest) were searched in 12.7.2023, with no date restrictions. Search terms were selected to identify articles reporting on single-session interventions in autistic people. Two raters screened titles/abstracts of 286 articles and full text of 17 articles, resulting in just two included articles, reporting on 46 participants. Risk of bias was assessed with the Quality Assessment with Diverse Studies (QuADS). The two included papers report on specific techniques taught within a single visit to a clinic using pre- and immediate post-intervention questionnaires. One study also reported on cortisol levels pre and post. Neither study reported on acceptability or feasibility of single-session interventions. However, there was insufficient quality evidence to evaluate the effectiveness or efficacy of single-session interventions for autistic people. Although there is substantial research on single-session interventions in the broader population, there is a lack of research into such approaches for autistic people. This is a missed opportunity to evaluate a potential means of support for those at elevated risk of mental health challenges and unmet mental health service need. Future research should co-produce and co-evaluate such approaches as a priority.

PERSIST: a pre–post study to assess an educational methodology to enhance youth climate literacy and systems thinking ability

BackgroundEducation has a pivotal role in preparing society to address the forthcoming health impacts of the climate crisis. Education provides the tools necessary to instil both individual and collective attitudes for mitigating climate change, fosters the development of adaptive skills and mindsets, and promotes a critical understanding of climate change. The aim of the PERSIST project was to assess the effectiveness of a school educational intervention to strengthen literacy on the climate crisis, pro-environmental behaviours, and systems thinking in high school students (aged 14–18 years). MethodsThree meetings were carried out in a scientific high school in the suburbs of Rome (Italy) between March 21, and April 12, 2023, using complex systems models, group activities, and collective discussions. Pre-intervention and post-intervention questionnaires were administered to students to record knowledge, climate-related emotions, and pro-environmental behaviours. Questionnaires that were complete were considered valid. The anonymously collected data were processed using descriptive statistics and t test. FindingsA total of 273 students in ten different classes attending between grades 1 and 4 took part in the project. 78 (36%) participants were female, 133 (62%) were male, and four (2%) did not disclose their gender. The mean age was 15 years. We received 211 pairs of valid pre-intervention and post-intervention questionnaires. The preliminary analysis showed an average increase of 19% in correct responses to knowledge questions, a 21·2% increase in pro-environmental behaviours, and no discernible differences in climate-related emotions between pre-intervention and post-intervention questionnaires. InterpretationAn interactive approach and the use of complex systems might improve students' literacy and attitudes towards the climate crisis, without increasing negative ecological emotions. This pilot project can guide similar, repeatable programmes in other schools and countries and it represents the first measure of climate-related emotions after school intervention. FundingNone.

Effectiveness of workplace choice architecture modification for healthy eating and daily physical activity

BackgroundModifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design.MethodsIntervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees’ behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees’ perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome.ResultsMultinomial logistic regression models found the intervention significantly associated with a favourable change in employees’ fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p < 0.001).ConclusionsThe results suggest that a contextualised, multicomponent choice architecture intervention can positively influence eating behaviour in diverse real-world settings over a one-year period, and that higher implementation quality can enhance intervention perception and response. However, outcomes may depend on the type of intervention strategies used and the extent of their delivery.

Utility of testing for third-generation anticyclic citrullinated peptide (anti-CCP3) antibodies in individuals who present with new musculoskeletal symptoms but have a negative second-generation anticyclic citrullinated peptide (anti-CCP2) antibody test

ObjectivesTo investigate the role of third-generation anticyclic citrullinated peptide (anti-CCP3) antibodies in predicting progression to inflammatory arthritis (IA) in individuals with new musculoskeletal (MSK) symptoms and a negative second-generation anti-CCP...

Functional Capacity COVID-19 Survival Among Workers in Koja Public Health Center

Introduction: Coronavirus disease 19 (COVID-19) primarily affects the respiratory system and other organ systems which limit respiratory and physical status. The aim of this study is to evaluate functional capacity COVID-19 survivor among workers in Koja Public Health Center Methods: participant were enrolled on March-April 2022. Demographics, symptoms, functional scale post COVID-19 questionnaire, risk stratification, and 6-min walk test (6mwt) were analysed. Patients unable to walk were excluded from the study. Results: 79 participants, 38% was a health care worker, had a median age 33 (21-57) years and 43 women (54.4%). Men had higher 6mwt 518.2 (120-625.8) meter while women had 457 (340-600) meter p (&lt;0.001), VO2max 17.47 (9.74-20.67) in men and 16.45 (14.07-19.19) in women p (&lt;0.001), and METs 5.02 (2.78-5.90) in men and 4.69 (4.02-5.48) in women p (&lt;0.001). Most of the participant had good fitness, 10 participant (12.7%) had functional limitation; 2 participants (2.5%) still had symptom. Conclusion: Despite being COVID-19 survivors, the workers at the Koja Public Health Center have good functional capacity.

School staff delivery of a solution focused intervention to support pupils' behaviour

AbstractA single case experimental design with multiple baselines was employed to explore the relationship between a solution focused intervention delivered by school staff and the externalising behaviour of four primary school pupils. The intervention took place over four to five sessions, which were delivered by non‐specialist school staff with the use of training, supervision, and a manual. Observations of a specific positive behaviour were carried out both before and during the intervention, which were then analysed through visual and statistical analysis. A pre and post intervention questionnaire measure of pupils’ externalising behaviour was collected. For each participant, one videoed session was used to explore the fidelity of the intervention to the manual. Analysis of observations of behaviour showed a significant increase in a specific positive behaviour for three of four participants. A measure of pupils’ externalising behaviour showed a significant reduction for two of the eight questionnaires collected. Video analysis suggested variation of fidelity across participants. This research provides tentative support for specific outcomes from a solution focused intervention, when delivered by non‐psychologists who are provided with appropriate support. It has also been found that non‐specialist school staff practitioners were able to deliver the intervention through applying elements from a manual to have a positive impact on a specific behaviour for three of four participants. There is a need for further high quality research to establish the effectiveness of solution focused interventions when delivered by non‐specialists with the use of consistent intervention and outcome measures.

Assessing the Impact of a Health Education Anti-Smoking Program for Students: A Follow-Up Investigation.

In this follow-up study, we aimed to assess the effectiveness of the "I do not smoke, I exercise" anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t-test revealed a significant improvement in students' knowledge about smoking (t217 = -5.605, p < 0.001, d = 0.38) and perceived behavioral control (t220 = -2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high (M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.

A STUDY ON TEST-TAKING STRATEGIES TO IMPROVE ENGLISH MAJORED STUDENTS’ READING COMPETENCE

Previous studies have investigated the significance of reading proficiency in acquiring the English language and brought attention to the reading difficulties learners have in their learning process. This study examines the use of speed-reading strategies as a method to enhance learners' reading ability. Seventy senior English-major students from the Faculty of Foreign Languages at Dong Nai Technology University were participating in the study during their final semester. The study employed a mixed methodology, which included collecting quantitative data from a pretest-posttest paradigm without a control group, questionnaires before and after the use of speed reading strategies, and qualitative data through observations. The students' reading competence was assessed using a standardized IELTS reading test at the start of the study, followed by a pre questionnaire and 10 hours of speed reading training with observations. After the training, the students took a posttest to determine the discrepancy between the pre-test and post-test, and post questionnaire was sent to the participants to understand their opinion about the use of strategies in doing tests. Speed reading techniques were found to enhance students' performance on reading tests and cultivate a positive attitude towards reading comprehension. The students gained valuable reading skills and strategies that contribute to academic success.

Acceptability of internet-delivered cognitive behavioural therapy for adults with symptoms of obsessive-compulsive disorder: A meta-analysis.

Obsessive-compulsive disorder (OCD) is a chronic mental health disorder. Internet-delivered cognitive behaviour therapy (ICBT) is demonstrated to be effective for OCD; however little is known about the acceptability of the treatment. Therefore the aim of this study was to examine the acceptability of ICBT for adults with OCD symptoms using a meta-analytic approach. Seventeen studies (N = 1661; Mage range = 28-41 years; 58%-93% female) were included in this analysis. The random effects pooled estimates indicated that 16.3% (95% CI: 9.8%-25.7%) of participants did not commence the treatment once they were enrolled in the study, 27.6% (95% CI: 19.0%-38.2%) did not complete the treatment, and 27.0% (95% CI: 18.2%-38.0%) did not complete the post-treatment questionnaires of the study. The mean score on the Client Satisfaction Questionnaire ranged from 22.4 to 26.5. Overall, pooled estimates indicated that 81.6% (95% CI: 76.1%-86.0%) of participants were satisfied with the ICBT intervention and 84.7% (95% CI: 72.8%-92.0%) indicated that they would recommend the treatment to a friend. Some of the acceptability moderator analyses indicated that self-guided ICBT interventions had lower levels of acceptability compared with clinician-guided interventions. However, given low power, these results should be considered preliminary. This study has important implications in the dissemination of ICBT for OCD.

Parent implementation of a treatment for late talkers based on cross-situational statistical learning principles: Treatment fidelity and acceptability

Purpose Early intervention based on principles of cross-situational statistical learning (CSSL) for late-talking children has shown promise. This study explored whether parents could be trained to deliver this intervention protocol with fidelity and if they found the intervention to be acceptable. Method Mothers of four English-speaking children aged 18–30 months who scored <10th centile for expressive vocabulary were recruited to an 8-week group training program. Parents were taught principles of CSSL and asked to perform 16 home treatment sessions (30 minutes each) in total, providing auditory bombardment of target words in full sentences at high dose number and syntactic variability, using a range of physical exemplars. Home diaries and two videotaped sessions measured treatment fidelity. Pre- and post-treatment questionnaires measured acceptability. Result One parent discontinued the study after the second group training session. Three parents completed 15/16 group training sessions and reported completing 87% of home sessions. Two parents demonstrated implementing the intervention as per the target dose number by the first fidelity session (Weeks 2/3), and the third parent was very close to meeting target dose number by the second fidelity session (Weeks 7/8). Conclusion Parents can be trained to deliver an intervention based on cross-situational statistical learning principles.

Impact of virtual reality on promoting understanding of research in rural Africa: The KEMRI-Wellcome Trust virtual tour of research laboratories

Background Virtual Reality (VR) is poised to transform how science is communicated to the public. There is limited evidence of the use of VR for science education or engagement in sub-Saharan Africa. We produced a virtual reality video tour of the KEMRI-Wellcome Trust Research Programme (KWTRP) laboratories and tested its suitability as an engagement tool for secondary school students. Methods A group of 14 students from various secondary schools, but residents of Kilifi County, situated on the coast of Kenya, were invited for a guided tour of KWTRP laboratories. After that, they were split into three groups to discuss their understanding of the tour and what was relatable to what they were learning in school. The discussion informed the script of a 360 degree video of the KWTRP laboratories. The video was uploaded to the VR headsets and shown to select students (n=59) from three secondary schools in Kilifi County. We administered pre and post survey questionnaires to assess the impact of the virtual tour of the research laboratories. Results Most students reported having never watched videos on laboratory or research before, with few having ever used a virtual reality (VR) headset. After watching the virtual reality video of the laboratory, most students indicated that they found the VR experience good and agreed that it made them feel like they were touring the laboratory in person. They also indicated that they had an increased interest in working in a research laboratory. We observed significant gains in knowledge related to KWTRP among the students after watching the VR video. Conclusions Enabling the public to understand how research is conducted is important for garnering community confidence and scientific support. The virtual reality experience of research laboratories offers a promising tool for science engagement in young adults.

Process and outcome of outpatient psychotherapies under clinically representative conditions in Austria: protocol and feasibility of an ongoing study.

While most studies assessing psychotherapy efficacy are randomized-controlled trials conducted in research institutions or short clinical treatments, the understanding of psychotherapy effectiveness under regular, clinically representative conditions, particularly in outpatient practice, remains limited. Representative data examining the effectiveness of psychotherapy under real-world conditions in Austria is lacking. This paper introduces a naturalistic observational combined process- and outcome study, implementing a dual-perspective approach through standardised pre- and post-treatment questionnaires and evaluating changes in the therapeutic alliance after each session. Further, semi-structured qualitative interviews aim to illuminate the personal experiences of patients and therapists. The primary objective of the presented study is to discern whether symptoms markedly decrease following therapy. A significant secondary goal is to trace the therapeutic alliance's evolution from both patient and therapist viewpoints, emphasising the alliance-outcome association and gender dynamics within the pairs. This paper discusses the project's feasibility after three years and shares key insights. Recruitment for this study has posed substantial challenges due to psychotherapists' concerns regarding data protection, extensive documentation, and philosophical reservations about the study design. Consequently, we recruited fewer participants than initially planned. Despite these hurdles, qualitative data collection has shown notable success. Given psychotherapists' busy schedules and reluctance to participate, more potent external incentives or a legal obligation may be necessary to encourage participation in future studies.

Assessment of pre and post Neonatal Resuscitation program (NRP) training in a neonatal intensive care unit of Pakistan

Assessment of pre and post Neonatal Resuscitation program (NRP) training in a neonatal intensive care unit of Pakistan

The Effect of Yoga Exercises on Reducing Stress Levels in Premenopouse Women

Premenopausal syndrome causes symptom physical and psychological. Disturbance psychology in general occurs in women transition is worry. One of possible efforts done that is do yoga exercises. Know the influence of yoga exercise on decline stress levels in women pre menopause in the Village Potatoes Subdistrict Toroh Grobogan Regency. Research design pre-experimental, with design one-group pre-posttest design. Samples required as many as 33 people with random sampling technique. Data collection using pre and post intervention questionnaires. Data analysis used the paired t test. The average stress level before yoga exercise was 17.97 with standard deviation 1.36. The minimum score is 15, meanwhile score maximum namely 21. The average stress level after yoga exercise is 10.72 with standard deviation 1.97. The minimum score is 7, meanwhile score maximum namely 15. Paired sample t-test obtained a p value of 0.000 (&lt; 0.05), meaning There is the influence of yoga exercise on stress levels in women pre menopause. The influence of yoga exercise on stress levels in women pre menopause in the Village Potatoes Subdistrict Toroh Grobogan Regency.