Post-intervention Test Research Articles

Psychometric properties of the Quality-of-Life Questionnaires (SF-36), (MLHFQ) Minnesota Living with Heart Failure Questionnaire among Congestive Heart Failure Patients

Introduction: The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most extensively used heart failure patient quality of life questionnaires (HF). It includes physical and emotional scores, as well as a total score. However, its factor structure has been questioned, and alternatives proposed, including a third factor expressing a social dimension. This Survey used to monitor population health, assess treatment outcomes, and estimate illness burden. Aims: Validation and testing of the SF-36 Quality of Life Questionnaire (QOLQ) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were the main objectives of this work in CHF patients. To identify the psychometric properties of the quality-of-life questionnaires (SF-36) and MLHFQ questionnaire among congestive heart failure patients Methodology: The quasi experimental study was conducted in those individuals who has suffered with heart failure (n= 36). These patients were admitted at the FIC, Faisalabad. The teach-back technique was introduced to teach about the self-care to improve the QOL of the participants. Every participant was administered the SF-36 and MLHFQ after intervention Post-test -1 was conducted at 30 days after accomplishment of the intervention with filling of both tools collected by the researcher/ facilitator on one-month clinical follow-up visit. Posttest-2 was conducted at 90 days after intervention at each participant on three-month follow-up visit. Results: The researcher were evaluated the questionnaires psychometric parameters, as well as the extent to which one may rely on the accuracy of a measurement, computation, or specification. (Internal consistency, test–retest analysis, and inter-item correlation). Exploratory factor analysis was used to determine the construct validity. Conclusion: It is found that the Urdu version of the Questionnaires (SF-36) and the MLHFQ questionnaire were proven to be a trustworthy and valid tool for improving quality of life in patients with congestive heart failure. With the use of these versions of the scale, assessing patient QOL, performance, has become smoother and readmission frequency in congestive heart failure Patients would become lesser.

Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood.

Transfusion of whole blood (WB) is a lifesaving treatment that prolongs life until definitive surgical intervention can be performed; however, collecting WB is a time-consuming and resource-intensive process. Furthermore, it may be difficult to collect sufficient WB at the point of injury to treat critically wounded patients or multiple hemorrhaging casualties. This study is a follow-up to the proof-of-concept study on the effect of airdrop on WB. In addition, this study confirms the statistical significance for the plausibility of using airdrop to deliver WB to combat medics treating casualties in the pre-hospital setting when Food and Drug Administration (FDA)-approved cold-stored blood products are not available. Forty-eight units of WB were collected and loaded into a blood cooler that was dropped from a fixed-wing aircraft under a Standard Airdrop Training Bundle (SATB) parachute or 68-in pilot chute. Twenty-four of these units were dropped from a C-145 aircraft, and 24 were dropped from a C-130 aircraft. A control group of 15 units of WB was storedin a blood cooler that was not dropped. Baseline and post-intervention laboratory tests were measured in both airdroppedand control units, including complete blood count; prothrombin time/partial thromboplastin time (PT/PTT); pH, lactate,potassium, bilirubin, glucose, fibrinogen, and lactate dehydrogenase (LDH) levels; and peripheral blood smears. The blood cooler, cooling packs, and all 48 WB units did notsustain any major damage from the airdrop. There was noevidence of hemolysis. Except for the one slightly damagedbag that was not sampled, all airdropped blood met parameters for transfusion per the Joint Trauma System Whole BloodTransfusion Clinical Practice Guideline and the Associationfor the Advancement of Blood and Biotherapies (AABB) Circular of Information for the Use of Human Blood and BloodComponents. Airdrop of fresh or stored WB in ablood cooler with a chute is a viable way of delivering bloodproducts to combat medics treating hemorrhaging patientsin the pre-hospital setting. This study also demonstrated theportability of this technique for multiple aircraft. The techniques evaluated in this study have the potential for utilizationin other austere settings such as wilderness medicine or humanitarian disasters where an acute need for WB delivery by airdrop is the only option.

Problem-based learning using online platforms: An interactive alternative to mandatory e-learning during the COVID-19 pandemic

Introduction: Problem-based learning (PBL) helps in contextual and experiential learning. PBL using online platforms (PBL-op) was introduced to counter the declining interest in the mandatory e-learning during the COVID-19 pandemic. The purpose of this study was to determine the effect of PBL-op on learning outcome; student perception of PBL-op; effect of communication and motivation on learning outcome; and performance in PBL-op. Material and Methods: Study participants were introduced PBL-op and the control group to PBL in classroom setting. Five-way assessment was done: learning outcome by pre-and postintervention tests; performance by project reports and presentations; communication skills; motivation; and student satisfaction through an anonymous survey. Data were analyzed using descriptive statistics, paired or independent t-tests to compare paired variables, Spearman's correlation to establish association, and theme-based analysis for qualitative inputs. Results: Students showed better learning outcome with PBL op than with e learning (t = 11.199; P < 0.001*), traditional teaching (t = 12.193; P < 0.001*) and PBL in classroom setting (t = −15.493; P < 0.001*; d = 1.83). Women outperformed men with PBL-op (t = −2.74; P = 0.0034*; d = 0.48). Performance in PBL was better when conducted using online platforms than in classroom setting (t = 8.5471; P < 0.001*; d = 1.01). However, learning outcome and performance in PBL-op did not show a significant association with motivation or communication skills. Students favored PBL-op as it offered them an opportunity for active participation. Discussion and Conclusion: PBL-op offers all the advantages of PBL and allows productive teamwork using familiar online platforms and freedom from restrictive class timings. It is, therefore, suggested that PBL-op may be used as a feasible and effective alternative to PBL even after the pandemic.

Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments

IntroductionEmergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury. AimThis study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries. MethodsThe study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the “Emergency Department Patients Information and Pressure Injury Assessment Form” and “The Braden Scale for Predicting Pressure Injury Risk”. In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using “The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)” and “The Questionnaire for Identifying and Preventing Pressure Injury”. In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher’s Exact Chi-square test were also used. ResultsThe mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards. ConclusionIt was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.

Foundations for Fitness: A Multi-Cohort Pediatric Weight Management Intervention

This study examined the benefits of a 10-week childhood obesity intervention program on various measures of health. The program involved parents and children who met once weekly for two hours. Each session of the intervention program consisted of a structured dynamic warm-up an aerobic exercise component in a game play setting and a motor-skill specific instruction period. Subjects were recruited from pediatrician recommendation and a total of 99 subjects (n=48 boys, n=51 girls) completed both pretest and posttest intervention measures. The mean age was 9.86 (SD=0.02 years). Each of the following were assessed on pediatric assessment prior to and following the intervention program: height, weight, body mass index (BMI), waist circumference, resting heart rate, resting blood pressure, habitual physical activity, percent body fat, and quality of life. Assessment of the participant’s cardiovascular fitness and the state of home environment in regards to nutrition and physical activity were completed as part of the first and tenth (final) intervention program sessions. Results indicated that the changes observed that were statistically significant included the categories of systolic blood pressure, height, weight, quality of life, habitual physical activity, FNPA score, and PACER scores. Improvements in outcomes measured were modest but this result was expected due to the short intervention program of only ten-weeks duration. Recommendations include increasing the length of the intervention and conducting follow-up assessment to determine long-term impact.

The Effect of a Microlearning Module on Knowledge Acquisition in Surgery Clerkship Students

Microlearning has been found to be beneficial in other areas of healthcare education. The purpose of this study was to investigate the effect of a microlearning module compared to a traditional online learning module in undergraduate medical education. A microlearning module was developed to cover the etiology and management of gallbladder disease. Surgery clerkship students were randomized into 2 groups. One group began with the microlearning module (MLM). The second group began with a 45 minute commercially available module centered on gallbladder disease (WISE-MD™). Halfway through the clerkship, the groups crossed over to the other learning intervention. Student knowledge was assessed with a test at three time points (pre-test, post-test1, post-test2). Third year surgery clerkship students at George Washington University. There were 56 students in the MLM and 57 in WISE-MDTM groups. In the MLM group, mean scores significantly increased from pre-test to post-test1 and pre-test to post-test2, but significantly decreased from post-test1 to post-test2. In the WISE-MD™ group, mean scores significantly increased from pre-test to post-test1 and pre-test to post-test2, with no significant change from post-test1 to post-test2. After the initial intervention, test scores of post-test1 of the MLM group were significantly higher than the WISE-MD™ group, while there were no significant differences between groups at the pre-test or post-test2 time points. Students exposed to the microlearning module first performed significantly better on a post intervention test than students that used a commercially available product in our standard curriculum. Therefore, the use of microlearning modules may lead to improved knowledge acquisition in surgery clerkship students.

759. Impact of Clostridium difficile (CD) Nucleic Acid Amplification Test (NAAT) Approval on Hospital-Onset C. difficile Infection (HO-CDI): A Diagnostic Stewardship Intervention

BackgroundNAAT is highly sensitive in detecting toxigenic CD but if used inappropriately can lead to overdiagnosis and financial penalties. Despite diligent infection control (IC) measures, HO-CDI rates at our hospital remained above target benchmarks. We implemented mandatory CD testing approval to decrease HO-CDI rates. MethodsOn 7/1/2019, we implemented CD testing approval for stool samples collected after admission day 3 in our 129-bed community hospital. An algorithm instructed providers about approval granted by IC 7 days-a-week. The micro-lab would not process samples unless pre-approved. We prospectively collected data on demographics, ICU, laxative, antibiotic use, CDI signs/symptoms, prior CDI and outcomes (length of stay, in-hospital death) and estimated unadjusted relative risk ratios comparing those whose test was approved vs not approved. We also performed an interrupted time series analysis to assess the trend change of CD testing and HO-CDI per 1000 patient days (x 1000-PD) in the 18 months following the intervention (7/2019 - 12/2020) compared to the pre-intervention period (01/2018 - 6/2019). Lastly, using the National Healthcare Safety Network criteria, we calculated pre and post-intervention Standard Infection Ratios (SIR). ResultsA total of 72 samples required CD testing authorization; 65 (90%) were approved. Baseline demographics, in-hospital death and length of stay were similar in both groups, but approved patients were 4 times as likely to have ≥ 3 loose stools in 24h compared to not approved. The number of CD tests was 13 at baseline with a decrease of 6 tests in the 1st month of intervention (95% CI: -10.0, - 1.35), followed by an insignificant decline in the monthly trend (-0.14; 95%CI: -0.49, 0.20). There were 22 HO-CDI pre-intervention and 10 post-intervention. Pre-intervention, incidence of HO-CDI was 0.51 cases x 1000-PD and increased every month by 0.11 (95% CI: 0.07,0.16). In July 2019, there was a significant decline of 1.16 case x 1000-PD (95% CI: -1.99, -0.33), followed by monthly decline (-0.16; 95% CI: -0.23, -0.09). Our calculated SIR after the intervention decreased to 0.77 from 1.03. Trends of CD testing and HO-CDI in the pre-intervention and post-intervention period ConclusionCD testing approval is a successful strategy to optimize testing and lower HO-CDI rates, without resulting in worst outcomes even when CD test was not approved. Disclosures All Authors: No reported disclosures

668. Restricting Ordering of Multiplex Gastrointestinal Panel Improves Test Utilization

BackgroundThe multiplex gastrointestinal pathogen panel (GIP) is a convenient and quick diagnostic test for determining the infectious etiology of diarrhea. It identifies several of the most common pathogens associated with gastroenteritis. However, it is expensive, and test results may not impact care, given that several of the pathogens in the panel are managed expectantly. We describe our experience with a diagnostic stewardship initiative to resolve the overuse of this testing method. MethodsWe performed a pre/post study of GIPs ordered for inpatients 18 years old and older from December 19, 2018, to December 18, 2020, at Mayo Clinic hospital in Rochester, Minnesota. GIP orders for inpatients were limited to the first 72 hours of hospitalization starting December 19, 2019. Orders after 72 hours were encouraged to be changed to Clostridioides difficile NAAT testing or sent to an infectious disease provider to override on a case-by-case basis. Our hospitals used BioFire® FilmArray® Gastrointestinal Panel (BioFire Diagnostics, Salt Lake City, Utah).ResultsA total of 2,641 GIPs were performed during the study period. There were 1,568 GIPs (3.3/100 hospitalizations) in the pre-intervention period compared to 1,073 (2.6/100 hospitalizations) post-intervention, representing a drop of 21.2%. The most common pathogen detected was C. difficile (toxin A/B) (48.8%, n=402), followed by norovirus (17.5%, n=144). The overall test positivity rate was 27.9% (n=736). The test positivity rate decreased 1.8% from 28.6% (n=448) to 26.8% (n=288) after the restriction (p=0.33). The proportion of C. difficile among all pathogens detected increased from 48.5% to 49.7% (p=0.67).Table 1. Pre- and Post-Intervention Test Positivity Rate of Specific Pathogens in GIP ConclusionOur study showed that restricting the ordering of GIP to the first 72 hours of hospitalization and directing providers to standalone C. difficile NAAT testing resulted in a reduction of GIPs performed. There were marginal changes in the test positivity rate of GIP. A limitation of our study is that the timing of post-intervention coincided with the COVID-19 pandemic, which had unpredictable effects on hospital practice and patient admissions. Ideally, future quality improvement projects should increase the test positivity of pathogens other than C. difficile while lowering the GIP use in diagnosing C. difficile colitis. Disclosures John C. O'Horo, Sr., MD, MPH, Bates College and Elsevier Inc (Consultant)

The formation of youth entrepreneurial intention in an emerging economy: the interaction between psychological traits and socioeconomic factors

PurposeYouth entrepreneurship has been identified as a key driver in overcoming the economic crisis spurred by youth unemployment. However, the understanding of youth entrepreneurship is largely based on research in high-income countries. Furthermore, entrepreneurship studies to date are largely limited to the independent effects of individual traits on entrepreneurial intention (EI). Hence, this study aims to model the cognitive and social conditions, mediating processes and interactions to understand how youth EI can be formed and strengthened in an emerging economy.Design/methodology/approachA cross-sectional sample of 295 Malaysian youths participating in an online entrepreneurship program were included to assess their family socioeconomic background, individual personality traits and EI using regression, mediation and moderation models. Within the sample, 29 youths who completed the program were examined for pre- and post-training intervention differences to identify whether entrepreneurial traits can be developed.FindingsResults showed that a proactive personality or proactiveness was a key mediator in how an internal locus of control (ILOC) and self-esteem influence EI. Furthermore, ILOC and proactiveness were found to compensate for the lack of parental financial support in the formation of EI among low-income youth. Finally, there was a significant increase in proactive personality scores post-intervention, indicating that this trait can be strengthened through entrepreneurship programs.Research limitations/implicationsThis study focused on parental income as an indicator of family socioeconomic background, which may not accurately represent the diversity of the socio-ecological environment of an individual. Therefore, future research should assess the multi-dimensional indicators of socioeconomic status and their relations with psychological attributes in shaping EI. Furthermore, this study observed a small sample size for the pre- and post-intervention analysis. Hence, more studies with large sample sizes are needed to examine the impact of entrepreneurship education.Practical implicationsConsidering that entrepreneurship is envisioned as an instrument to lift youths out of poverty, this study has important implications for entrepreneurship programs that target low-income youths. The findings suggest that such programs need to first emphasize developing ILOC and proactiveness among these youths, thus enabling them to overcome various structural barriers toward entrepreneurship, as opposed to a purely knowledge-based learning approach.Social implicationsTo effectively lift youths out of poverty through entrepreneurship, policymakers and educational institutions need to first recognize that the EI of youth from varying socioeconomic backgrounds are formed differently. Hence, the approach of entrepreneurship programs catered toward youth from lower socioeconomic backgrounds will differ from programs catered to youths who are financially secure. Instead of a one-size-fits-all approach, entrepreneurship programs targeted at low-income youths must first emphasize building their mindsets of ILOC and proactivity to overcome financial challenges as opposed to focusing solely on building entrepreneurial skills and knowledge.Originality/valueThe findings offer a more holistic and nuanced view of the contingencies where the efforts of policymakers, educational institutions and practitioners are more likely to succeed in stimulating EI among youths in emerging economies. In addition, the study also bridges the gap between the theoretical understanding of EI and the practical implications of developing effective entrepreneurship programs by combining the cross-sectional analysis and pre- and post-intervention test in the same study. Importantly, the study highlighted the importance of considering youth’s socioeconomic background in the design and implementation of entrepreneurship programs.

Walking-adaptability therapy after stroke: results of a randomized controlled trial

BackgroundThe ability to adapt walking to environmental properties and hazards, a prerequisite for safe ambulation, is often impaired in persons after stroke.Research questionThe aim of this study was to compare the efficacy of two walking-adaptability interventions: a novel treadmill-based C-Mill therapy (using gait-dependent augmented reality) and the standard overground FALLS program (using physical context). We expected sustained improvements for both treatment groups combined but hypothesized better outcomes for C-Mill therapy than the FALLS program due to its expected greater amount of walking practice.MethodsIn this pre-registered single-centre parallel group randomized controlled trial, forty persons after stroke (≥ 3 months ago) with walking and/or balance deficits were randomly allocated to either 5 weeks of C-Mill therapy or the FALLS program. The primary outcome measure was the standard walking speed as determined with the 10-meter walking test (10MWT). Additionally, context-specific walking speed was assessed in environments enriched with either stationary physical context (10MWT context) or suddenly appearing visual images (Interactive Walkway obstacles). The walking-adaptability scores of those enriched walking tests served as secondary outcome measures. Furthermore, a cognitive task was added to all three assessments to evaluate dual-task performance in this context. Finally, the participants’ experience and amount of walking practice were scored. The outcome measures were assessed at four test moments: pre-intervention (T0), post-intervention (T1), 5-week post-intervention retention (T2), and 1-year post-intervention follow-up (T3).ResultsNo significant group differences were found between the interventions for the primary outcome measure standard walking speed, but we found a greater improvement in context-specific walking speed with stationary physical context of the C-Mill therapy compared to the FALLS program at the post-intervention test, which was no longer significant at retention. Both interventions were well received, but C-Mill therapy scored better on perceived increased fitness than the FALLS program. C-Mill therapy resulted in twice as many steps per session of equal duration than the FALLS program. The “change-over-time” analyses for participants of both interventions combined showed no significant improvements in the standard walking speed; however, significant improvements were found for context-specific walking speed, walking adaptability, and cognitive dual-task performance.SignificanceThis study showed no between-group differences between the novel treadmill-based C-Mill therapy and the standard overground FALLS program with respect to the primary outcome measure standard walking speed. However, the greater amount of walking practice observed for the C-Mill group, an essential aspect of effective intervention programs after stroke, may underlie the reported increased perceived fitness and observed increased context-specific walking speed for the C-Mill group directly after the intervention. Although the “change-over-time” results for all participants combined showed no improvement in the standard walking speed, context-specific walking speed and walking adaptability showed sustained improvements after the interventions, underscoring the importance of including walking-adaptability training and assessment in rehabilitation post stroke.Trial registrationThe Netherlands Trial Register NTR4030. Registered 11 June 2013.

The efficacy of multimodal intervention program on mental health states

Filipino youths are the hope of Philippine society. However, cigarette smoking and binge drinking continually corrupt this aspiration. Mental health states interplay with the growing setback of substance consumption. The main objective of the study is to determine the efficacy of the multimodal intervention program among the participants in this study. Specifically, it answers the following objectives: i) Develop an intervention program to address the high anxiety, mild depression, and normal self-esteem of the participants and ii) Determine the significant difference between the control group and the experimental group in the pre-test and post-test intervention measures. A matched-group experimental design was carried out among the participants who were randomly assigned to the control group and the experimental group. There were forty participants who met the criteria set by the researchers. When the multimodal intervention program was tested using t-test to analyze the findings at .05 level, it yielded significant results. Based on the findings of the study, the developed multimodal intervention program appeared to be effective. A follow-up study may be conducted to further test the efficacy.

Pengaruh Bermain Drama terhadap Frekuensi Menggosok Gigi pada Anak Usia Prasekolah di Rumah Sakit

Play is funnies, any spontaneous and activity provides enjoyment. Play is of vital importance forhealth development of preschool child. Play offer ample physical, emotional, cognitive and socialbenefits. The child in hospitalization expressed feelings of anger, fear, insecurity, anxiety, guilt,hopelessness and deep loneliness exacerbated. Personal hygiene is a basic human need. Insufficientbrush tooth can affect child`s health (caries). During Hospitalization, a child may be affected byless brush tooth. These Problem sholud be addressed to allow preschool child to get brush toothtwice days. Role play Dramatic Therapy is a nursing intervention, that may be applied to manageless brush tooth. This study aims to determine effect play role in frequency brush tooth in hospital.This study was conducted in preschool children who treated in hospital with 32 samples. The studywas conducted in 2 September – 27 September 2019. The study was conducted with quantitativeresearch using category comparison, pre and post test intervention. Result; there was a significantcomparison before and after play therapy and frequency brush tooth with 3 days intervention.There was p value 0.007 Role Play Dramatic Therapy in hospital can be implemented on preschoolchildren to increase healty mouth with frequency brush tooth.

Simulated Randomized Controlled Trial to Learn Critical Appraisal (SiRCA): A Randomized Controlled Study of Effectiveness Among Undergraduate Medical Students.

Introduction: The ideal method to teach evidence-based medicine (EBM) to medical students is unclear. We determined the effectiveness of a simulated randomized controlled trial (RCT) in improving critical appraisal and EBM skills among medical students compared to traditional training.Methods: One hundred and eighteen medical students were randomized into two groups. Sixty-one students (immersion arm) were trained in critical appraisal using a simulated RCT aimed at determining efficacy of a “brainy pill” on ability to crack puzzles. Fifty-seven students (traditional group) were trained using a journal club with a checklist. Primary outcome of change in knowledge and skills of critical appraisal and EBM was determined by comparing scores on pre- and post-intervention Fresno tests.Results: Mean age of students was 21.76 (SD - 0.78) years. Seventy (59.3%) were females and 48 (40.7%) males. Mean pre-test scores of traditional and immersion groups were 8.0 (SD - 4.88) and 9.31 (SD - 5.49) respectively and post-test scores were 50.2 (SD - 16.2) and 68.12 (SD - 14.72) respectively (post-intervention mean difference - 17.92; 95% CI 12.26 - 23.57; p<0.0000001). Odds of achieving 65% or more in post-intervention Fresno test score was significantly higher in immersion group (29.8% vs 8.2%; OR 4.76; 95% CI 1.62-13.97; p = 0.001). Perceived competence regarding EBM skills improved significantly in immersion group.Conclusions: Simulated RCT is effective in imparting critical appraisal and EBM practice skills to medical students. Trainers should consider integrating and reinforcing this approach in EBM curriculum to make learning contextual and immersive.

Effects of Three Different Combined Training Interventions on Jump, Change of Direction, Power Performance, and Inter-Limb Asymmetry in Male Youth Soccer Players.

Background: This study compared the effects of performing different unilateral combined training interventions on diverse vertical and horizontal jumping performance parameters, change of direction, concentric and eccentric mean power, and their associated inter-limb asymmetries in young soccer players. Methods: Forty-seven young male soccer players (age: 15.5 ± 0.9 years) were distributed into three groups. Two groups performed the same training volume with both legs, beginning with the weaker leg (Stronger Volume Weaker leg group (SVW), n = 14) or with the stronger leg (Stronger Volume Stronger leg group, (SVS), n = 15). The third group executed double the volume with the weaker leg and also commenced with such leg (Double Volume Weaker leg group (DVW), n = 16) during a 10-week period. Pre- and post-intervention tests included a single-leg hop, single-leg lateral hop, triple hop, bilateral and unilateral countermovement jumps, a change of direction speed test, concentric and eccentric mean power during the lateral squat test, and their corresponding asymmetries. Results: Single-leg hop weaker leg, triple hop weaker leg, and bilateral countermovement jump improvements were achieved in the SVW (ES: 0.29 to 0.46) and DVW (ES: 0.55 to 0.73) groups. Between-groups analysis showed better results in single-leg hop in the SVW and DVW compared to group SVS. The DVW group achieved better improvements in countermovement jump in comparison to groups SVS and SVW. Conclusions: Groups that started with the weaker leg seemed to achieve a greater volume of significant changes than when starting with the stronger leg. Performing a double volume on the weaker limb does not guarantee further improved performance compared to other groups.

Prompting Socially Shared Regulation of Learning and Creativity in Solving STEM Problems.

Problem-based learning (PBL) is a widely recommended method in science, technology, engineering, and mathematics (STEM) education through which students develop their scientific knowledge by collaboratively solving real-world problems. PBL benefits from both the activation of creative thinking and from socially shared regulation of learning (SSRL)-a group-level phenomenon whereby students collectively share common perceptions of their collaborative learning process and co-construction of knowledge. The current study examines the influence of three types of support (question prompts designed to promote SSRL, creative thinking, or a combination of both) on the participation of individuals in SSRL processes and on their knowledge acquisition, using a sample of 104 seventh-graders in accelerated science classes. Individuals' participation through the different stages of SSRL (forethought, performance, and reflection) was assessed using video recordings, and their scientific knowledge was measured through pre-and post-intervention knowledge tests. While all groups improved their scientific knowledge, individuals receiving only SSRL support improved their participation in most stages of SSRL compared with those receiving creativity or combined support, and a control group which received no support. The findings strengthen the case for SSRL-directed question prompts as a means to enhance student engagement in problem-solving tasks.

Self-management Strategies for Risk Reduction of Subclinical and Mild Stage of Breast Cancer-Related Lymphedema: A Longitudinal, Quasi-experimental Study.

Early intervention with self-management strategies can potentially reduce the risk of progression of breast cancer-related lymphedema (BCRL). To determine if The-Optimal-Lymph-Flow (TOLF) program focused on self-management strategies applied to patients with a subclinical or mild stage of BCRL can improve lymphedema-related behaviors, symptom experience, and limb circumference changes. A total of 41 women with subclinical or mild lymphedema were enrolled in TOLF program. Lymphedema-related behaviors and lymphedema-related symptom experiences were measured by the Breast Cancer and Lymphedema Symptom Experience Index, and limb circumference changes were measured by sequential circumferential limb measurements at baseline and 1, 3, 6, and 12 months after the intervention. Generalized estimating equations were used to estimate the effects of the intervention on outcomes. Generalized estimating equations revealed that lymphedema-related behaviors and the number and severity of lymphedema-related symptoms were significantly improved at 4 postintervention test points compared with baseline (all P < .001). Reduced lymphedema-related symptom distress in functional, social, emotional, and psychological and self-perception (all P < .01) also resulted. The majority (77.5%) of patients maintained their preintervention lymphedema status; 17.5% of them reversed from mild lymphedema to subclinical lymphedema; 5.0% of them had lymphedema status progression. Positive outcomes in terms of lymphedema-related behaviors, relieving lymphedema-related symptom experience, and halting the progression of lymphedema status were documented following TOLF. Nurses could educate patients to incorporate the self-management strategies of TOLF program into daily life to help patients prevent or reverse subclinical or mild stage of BCRL.

Implementing Structured Curriculum in an After-School Physical Activity Program

The purpose of this study was to evaluate the influences of a structured after-school program on student physical activity for third- through fifth-grade students at five schools in southern Colorado. The study utilized a pretest–posttest intervention design in which six elementary schools in a low socioeconomic status school district in southern Colorado were recruited to implement a structured curriculum into their existing after-school physical activity program. Four observations at each school were taken approximately 6 weeks apart during the 2014–2015 academic year. Randomly selected students (n = 187) were measured for height and weight at each observation and wore accelerometers during after-school physical activity. Descriptive statistics and independent sample t tests were calculated for a comparison of physical activity before and after the implementation of the structured after-school program. Students wore accelerometers an average of 45.72 ± 10.28 min/session. Total physical activity increased significantly from 36.21 ± 6.41 to 41.14 ± 6.76 min/session (p &lt; 0.001). Moderate physical activity increased significantly from 9.29 ± 3.84 to 12.10 ± 5.96 min/session (p &lt; 0.001), whereas vigorous activity significantly decreased from 8.02 ± 4.39 to 5.54 ± 5.32 min/session (p &lt; 0.001). Overall, implementing a structured after-school program may be beneficial in increasing total physical activity, though its role in improving physical activity intensity is questionable. Subscribe to TPE

Effectiveness of Superbrain Asana on the Academic Performance in Dental Students — An Interventional Study

&lt;em&gt;Superbrain asana&lt;/em&gt; (SBA) is an ancient yogic exercise which is claimed to boost holistic well-being. It is established on the principles of subtle energy movement in the body and ear acupuncture. Proponents assert that this exercise improves cognition and academic performance. Our study aimed at assessing the effectiveness of SBA on the academic performance in dental students by comparison of the pre-intervention and post-intervention test scores. This interventional research had a pretest – posttest design and was conducted on 99 dental undergraduate students. SBA exercise was implemented for three months for six days in a week. Pre and post-intervention tests with multiple choice questions were administrated to the students without giving any prior intimation. The test scores were compared and the observations were subjected to statistical analysis. The data collected were analysed with the Wilcoxon signed-rank test of significance. It was found that there was a statistically significant increase in the median test scores after the intervention (p-value &amp;lt;0.001).With our study, we conclude that &lt;em&gt;Superbrain asana&lt;/em&gt; intervention is highly effective in improving the academic performance of the dental students and it can be successfully incorporated into the professional education curriculum.

Using Feasibility Data and Codesign to Refine a Group-Based Health Literacy Intervention for New Parents.

Few health literacy interventions exist for new parents. We developed a group-based health literacy program (“Parenting Plus”), which was initially tested in a feasibility study in 2018. In this brief report, we describe how feasibility findings were incorporated into the Parenting Plus program. Using a codesign process with patient partners (feasibility study participants) and health staff to revise the program, version 2 was tested in a single-site pilot using pre- and post-intervention testing. Parents older than age 16 years whose child was between ages 4 and 26 weeks were recruited from nurse home visits in western Sydney, Australia. Interested participants attended the free 4-week health literacy program (four 2-hour sessions) delivered by a trained facilitator. Piloting suggested the revised program is acceptable to new parents, has good retention (93% over the course of 4 weeks), and can improve health literacy skills, including access to reliable health information and services. Our iterative development and codesign approach integrated learnings from various sources to inform the design of an evidence-based health literacy intervention. We now move to an effectiveness implementation hybrid trial to test intervention effectiveness (health literacy skill development) and support translation of research findings into routine practice. [HLRP: Health Literacy Research and Practice. 2021;5(4):e276–e282.]

Mindfulness-Based Stress Reduction Intervention in Chronic Stroke: a Randomized, Controlled Pilot Study

ObjectivesMindfulness-Based Stress Reduction (MBSR) involves training in mindful meditation and has been shown to improve functioning across a range of different disorders. However, little research has focused on the use of MBSR in stroke patients, and previous MBSR studies typically have not included an active control condition to account for non-specific factors that could contribute to the observed benefits.MethodsWe conducted a pilot study of MBSR in chronic stroke patients, comparing MBSR to an active control condition. Half of participants were randomly assigned to a standard 8-week MBSR class, and the other half of participants were assigned to an 8-week Brain Health class matched for schedule, instructor, and format. Participants were assessed pre- and post-intervention by blinded examiners on a neuropsychological battery that included primary outcome measures of psychological and cognitive functioning. Participants were also given an anonymous questionnaire following the post-intervention testing session to measure class satisfaction.ResultsBoth the MBSR and Brain Health classes were rated favorably by participants. Recruitment and retention rates were high, and methods for participant randomization and examiner blinding were successful. Class implementation in terms of execution was also successful, as rated by outside experts.ConclusionsThis study established the feasibility of conducting MBSR and Brain Health classes in a chronic stroke population.Trial Registrationhttps://ClinicalTrials.gov, NCT #: 02600637