Post Questionnaires Research Articles

Hearing Care, as part of basic care in a senior home.

Background: World wide, 1 in 6 people is hearing impaired. Age-related hearing loss is the most frequent cause. The number of deaf and hearing impaired persons increases as the population is getting older.
 Unfortunately, the impact on quality of life is underestimated. 
 Hearing is an important part of communication. Several studies of the World Health Organization show the consequences of bad hearing s.a. isolation, frustration, loneliness and even acceleration of the dementia process. A hearing disability is invisible and problems are often not recognized.
 A great part of the elderly people lives in a senior home. The prevalence of hearing problems there is estimated around 80% as average age is about 87 years. The ringing of the telephone, a knock on the door, the radio, the television, the alarm signals are difficult to hear. This absence of familiar sounds produces a feeling of confusion and anxiety instead of safety and recognition. Communication is often done ‘on the job’ ignoring some special needs of the hearing impaired. Facemasks may make things even more difficult. The elderly hearing impaired, their family and caretakers have often little or no knowledge about the risks of untreated hearing loss, about innovative technologies in hearing aids and other hearing devices and about some interactional adaptations to improve their quality of life.
 Aim: Installing high-quality hearing care in senior homes in order to stimulate the inclusion and participation of hearing impaired elderly.
 Method: A team of AHOSA vzw, a Flemish interest group for persons with a hearing loss who communicate in spoken language, developed a project to put into the spotlight the importance of hearing care in senior homes.
 Basic relevant information is given to all the persons who are involved in the care process, but also to the residents themselves and to their family. 
 Physical and digital workshops include a theoretical approach as well as practical information s.a. how wearing a hearing aid, changing a battery, seeing that the person didn’t understand the message… Tips and tricks are given to improve communication.
 The workshops use tools such as a PowerPointpresentation, an instruction film and leaflets.
 We started with a pilot study: a partnership between the association AHOSA VZW and the Senior Home Sint-Jozef, Assenede Belgium, with support of the Artevelde Highschool Ghent.
 During this trial period, the workshops and tools are adjusted by means of feedback of all participants, and the effects are measured by pre- and post questionnaires.
 Result: This participatory process with co-creation leads to a workable model of hearing care for all senior homes in Flanders, and can be a national or an international policy recommendation in a later stage.
 The scoop can be more durable by also aiming at integration of this model in the education programs of schools and departments that prepare students to work with elderly people.
 Conclusion: A well-developed Hearing Care model as part of basic care in a senior home leads to better quality of life.
 
 

INTRODUCING WELL-BEING TO THE TRANSLATION CLASSROOM: INSIGHTS FROM THE TRENCHES OF COVID-19

The abrupt and profound changes due to the COVID-19 pandemic caused a variety of social and personal situations that negatively affected the well-being of teachers and students in higher education thus producing serious emotional strain. Previous research shows that satisfactory student performance can be obtained in an online class when it is accompanied by psychosocial support tools, such as enrichment and remediation tutorials, academic advising, guidance and counselling programs, fitness and wellness resources, spiritual formation activities and faculty-student consultation. This paper aims to test the effectiveness and the perception of well-being and participative activities in the translation classroom. It presents the findings of a pilot intervention implemented with 42 translation students. The intervention is based on the PERMA theory of well-being and tests 9 well-being and participative techniques. The methodology combines pre- and post-intervention questionnaires and the analysis combines quantitative and qualitative methods. The findings suggest that although there are no significant quantitative differences, students’ perceptions are positive. Suggestions are discussed together with possible implications for the future. Keywords: psychosocial support, well-being, teaching methods, higher education, translation education

Unveiling the potential: Enhancing caregiver knowledge through video education to address topical corticosteroid concerns in children with eczematous dermatitis.

Concerns about the use of topical corticosteroids (TCS) in pediatric eczematous dermatitis management often hinder effective treatment. Limited data exist regarding the prevalence of these concerns and the effectiveness of interventions. This study aimed to assess the prevalence of TCS concerns among caregivers and determine the effectiveness of video education in mitigating these concerns. A single-center prospective study was conducted from 2022 to 2023, involving caregivers of children under 18 years with eczematous dermatitis. Baseline and post-intervention questionnaires were administered after a 4-week period. Caregivers received video education on TCS use, and the TOPICOP score was evaluated before and after viewing the video. The study included 150 caregivers, 85.3% female and 74% had a child with atopic dermatitis. The prevalence of TCS concerns among Thai caregivers was 62%. Following video education, the prevalence of TCS concerns significantly decreased to 10.7%. Mean belief score decreased from 43.81 ± 13.45 to 31.85 ± 16.56, mean worry score decreased from 56.22 ± 18.27 to 40.41 ± 18.55 and mean total TOPICOP score decreased from 50.02 ± 12.65 to 36.13 ± 13.52 (p-value <.001). The intervention also resulted in reduced disease exacerbations, duration of the rash, and duration of TCS use. The optimal TOPICOP cut-off score to predict TCS concerns was identified as 43.06. Video education effectively alleviated TCS concerns among caregivers, addressing beliefs, worries, disease exacerbations, and side effects. Integration of this intervention into the management of pediatric eczematous dermatitis can yield optimal outcomes.

Long-term benefits for children of including dental health in education

The present quasi-experimental study evaluated the effectiveness of a dental education program implemented at the Tuntatacto Educational Unit during the last quarter of the 2022-2023 academic year. The intervention included interactive workshops, distribution of dental hygiene kits, and teaching proper brushing and flossing techniques, specifically targeting the experimental group, while the control group did not receive these activities. The results indicated significant improvements in oral hygiene knowledge and practices in the experimental group compared to the control group, demonstrating the importance of incorporating dental education into the school curriculum. Data collected through pre- and post-intervention questionnaires showed an increase in awareness about the importance of dental care, regularity of brushing, flossing, and parental supervision in dental hygiene in the group that received the education. Additionally, a reduction in anxiety toward dental visits and greater acceptance of common dental procedures was observed. This study highlights the preeminence of early, practical educational interventions in dental health promotion, which not only improves children's immediate oral health but also establishes a solid foundation for long-term healthy oral hygiene practices. The implications detected suggest that similar programs could be effectively replicated in different educational contexts to strengthen dental education and prevent dental diseases from an early age

Opioid use disorder and motivational interviewing: Training physician assistants for the epidemic.

(1) To evaluate the effectiveness of a curriculum on physician assistant (PA) students' knowledge about opioid use disorder (OUD) treatment and management and (2) present student satisfaction with the curriculum. Three cohorts of PA students completed pre- and post-intervention questionnaires about their knowledge of motivational interviewing (MI) for OUD. One cohort of students completed the 11-item questionnaire without exposure to the intervention (control group). Students' satisfaction with the curriculum was assessed as was their pre- and post-intervention knowledge about using MI for OUD. Bivariate statistical tests were used to analyze the quantitative data. Three hundred complete and usable responses were obtained from the four cohorts of PA students (n = 300, 87.7 percent response rate). The intervention groups answered a higher number of items correctly (median = 7) than the control group (median = 6, Wilcoxon sign test M = 31, p < 0.0001). Among the intervention group, there was not a statistically significant between cohort difference on: (1) the number of identical pre- and post-intervention questionnaire items answered correctly (Chi-square = 3.77, DF = 2, p = 0.15), and (2) the total number of items answered correctly on the post-intervention questionnaire (Chi-square = 0.32, DF = 2, p = 0.85). Student comments suggest students were supportive of the curriculum, with improvements noted on how to deliver the material. An educational intervention using MI for PA students was found to be valuable, and students who completed the intervention had greater knowledge about using MI with OUD patients than those who did not complete the training. The size of the effect was small, and more research on the curriculum is necessary prior to widespread adoption.

Investigating the impact of an online hydration intervention in care homes using the COM-B model: a mixed methods study

BackgroundAntimicrobial resistance is a serious threat to public health. To reduce antimicrobial resistance, interventions to reduce gram-negative infections, specifically urinary tract infections, are vital. Early evidence suggests increased fluid intake is linked with a reduction in UTIs and subsequently has potential to reduce antibiotic usage. Care homes have a high prevalence of UTIs and provide an opportunity in a closed setting to deliver an intervention focused on increasing fluid intake, where it is supported and monitored by health care workers. The study aimed to evaluate the impact and feasibility of an online staff focused intervention over a 30 day period to increase the hydration of care home residents with a view to reducing the burden of AMR in this setting.MethodsThe study was a pre and post intervention with a sequential explanatory mixed methods design. The intervention was delivered online in 3 care homes, containing 3 main components underpinned by the COM-B model including hydration training, 7 structured drinks rounds and a hydration champion to change behaviour of care home staff. A pre and post questionnaire assessed the impact of the intervention on staff and data was collected on fluid intake, drinks rounds delivered to residents, UTIs, antibiotic used to treat UTIs, falls and hospitalisation. Descriptive statistics summarised and assessed the impact of the study. Focus groups with care home staff provided qualitative data which was thematically analysed.ResultsStaff increased in self-perceived knowledge across the six components of hydration care. 59% of residents had an increase in median fluid intake post intervention. During the time of the intervention, a 13% decrease in UTIs and antibiotic usage to treat UTIs across the 3 care homes was recorded, however falls and hospitalisations increased. Themes arising from focus groups included the role of information for action, accessibility of online training, online training content.ConclusionsThis study demonstrates that a brief, low cost, online multi-component intervention focused on care home staff can increase the fluid intake of residents. A reduction in UTIs and antibiotic consumption was observed overall. Empowering care home staff could be a way of reducing the burden of infection in this setting.

Feasibility and user-experience of a virtual environment for social connection and education after stroke: A pilot study

ObjectivesTo evaluate the feasibility and usability of stroke survivor participation in an 8-week virtual environment intervention that provides opportunities for social support exchanges, social network interactions, and recovery education. Materials and methodsA single-group, pre- and post-test measure design was used. Descriptive statistics were used to examine enrollment and retention rates, proportion of questionnaires completed, and virtual environment process data (e.g., number of log-ins) and usability scores. Changes in pre- and post-intervention questionnaire (e.g., usability, social support, depression, anxiety, loneliness, and self-efficacy) scores were explored using Wilcoxon signed-rank tests and paired t-test. ResultsFifteen (65 %) of the eligible stroke survivors enrolled (60 % white, 27 % black), 12 (80 %) had an ischemic stroke, ages ranged from 33 to 74 years (mean 44 years), and mean months since stroke was 33 ± 23. Retention and questionnaire completion rates were both 93 % (n = 14). Survivors logged into the virtual environment a total of 122 times, logged an average of 49 min/log-in, and 12 (80 %) attended support groups and social activities. Median usability score indicated lower than average usability. Improvement trends in social support, loneliness, and depressive symptoms were found, but significant changes in mean questionnaire scores were not found. ConclusionsOverall, the results suggest that using a virtual environment to foster social support exchanges, social network interactions, and recovery education after stroke is feasible. Similar to other chronic disease populations, stroke survivor adoption of a virtual environment likely requires ongoing technical assistance, repetition of instructions, and opportunities for practice to reinforce engagement. Trial registrationNCT05487144.

An explanatory sequential pilot inquiry on music therapy and performance anxiety in university music education majors

Music Performance Anxiety (MPA) is prevalent among amateur and professional musicians. While music therapy has established itself as an effective therapy for reducing anxiety in numerous individuals with varying health issues, in depth research on the potential benefits of music therapy for managing MPA is lacking. This explanatory sequential pilot inquiry with 15 undergraduate music education majors from two large music faculties in Canada assessed the benefits of group music psychotherapy offered for 6 weeks in person or via telehealth on the experience of MPA. Test measures included the Spielberger State and Trait Anxiety Inventories (STAI) pre and post study, a pre and post study questionnaire, pre and post music psychotherapy session Likert scales for anxiety and mood, and a post study interview. Music psychotherapy interventions included breathing exercises, grounding and guided visualizations/meditations, and musical improvisation. Quantitative data, assessed for all participants combined and by group, revealed that anxiety and mood scores on the Likert scale improved after participation in six music psychotherapy sessions, while the STAI scores remained constant pre and post study. Qualitative themes suggest the benefits of music psychotherapy for changed perception and cognitions, sense of support, reduction in symptoms and overall continued and future management of MPA. The results of this study are promising, pointing to music psychotherapy as a potential short-term therapy for MPA symptom management, having practical implications for post-secondary music education and future research.

Reconstituted and frozen botulinum toxin A is as effective and safe as fresh for treating axillary hyperhidrosis: A retrospective study.

The use of reconstituted and frozen left-over botulinum toxin A, for treatment of patients with axillary hyperhidrosis seems to be common practice in healthcare. Thus, the objective of this study was to investigate the efficacy and safety of frozen and thawed versus fresh reconstituted abobotulinum toxin (Dysport®) and onabotulinum toxin (Botox®) in the treatment of axillary hyperhidrosis. A retrospective study was conducted analysing efficacy and data from pre- and 24 weeks post-treatment questionnaires together with medical records of individuals with moderate to severe axillary hyperhidrosis. The patients had received fresh prepared botulinum toxin A in their right axilla while frozen and thawed botulinum toxin A had been administered in their left axilla. Treatment was conducted at our Hyperhidrosis Clinic, Umeå University Hospital, Sweden 2019-2021. Pre- and post-treatment questionnaires from 106 patients were analysed. The patients were 18 to 55 years old, with a mean age of 30.7 ± 9.9 years. No significant differences in patient-reported variables, Hyperhidrosis Disease Severity Scale and VAS 10-point scale, were found between the different preparations (frozen compared to fresh) for abobotulinum toxin and onabotulinum toxin, before treatment and at 6 months follow-up. Multivariable regression analysis resulted in no significant difference regarding side-effects between the preparations or brands of botulinum toxin. The findings of this study support our clinical experience that both abobotulinum toxin and onabotulinum toxin, reconstituted, frozen and thawed, seem to be as effective and safe as fresh prepared botulinum toxin when treating axillary hyperhidrosis. Our findings indicate that left-over preparations of abo- and onabotulinum toxins, stored and frozen for up to 6 months, is a cost-and time-effective way of handling botulinum toxin for treatment of axillary hyperhidrosis.

KNEE ARTHROSCOPY: SHOULD KNEE ARTHROSCOPY SIMULATION BE PART OF THE TRAINING CURRICULUM IN THE UK?

IntroductionKnee arthroscopy can be used for ligamentous repair, reconstruction and to reduce burden of infection. Understanding and feeling confident with knee arthroscopy is therefore a highly important skillset for the orthopaedic surgeon. However, with limited training or experience, furthered by reduced practical education due to COVID-19, this skill can be under-developed amongst trainee surgeons.MethodsAt a single institution, ten junior doctors (FY1 to CT2), were recruited as a part of a five, two-hour session, training programme utilising the Simbionix® ARTHRO Mentor knee arthroscopy simulator, supplemented alongside educational guidance with a consultant orthopaedic knee surgeon. All students had minimal to no levels of prior arthroscopic experience. Exercises completed included maintaining steadiness, image centring and orientation, probe triangulation, arthroscopic knee examination, removal of loose bodies and meniscectomy. Pre and post experience questionnaires and quantitative repeat analysis on simulation exercises were undertaken to identify levels of improvement.ResultsComparing pre and post experience questionnaires significant improvements in levels of confidence were noted in the following domains: naming arthroscopic instruments, port positioning and insertion, recognising normal anatomy arthroscopically, holding and using arthroscopic instruments and assisting in a live theatre setting (p&lt;0.05). Significant improvements were also noted in time taken to complete and distance covered in metres, of the simulated exercises on repeat performance (p&lt;0.05).ConclusionOverall, with only five sessions under senior guidance, using a simulator such as the ARTHRO Mentor, significant improvements in both levels of confidence and skill can be developed even among individuals with no prior experience.

Team-Based Learning Intervention to Improve Obesity Education in Medical School.

Obesity is a multifactorial chronic disease and a major contributor to numerous health conditions. Despite the high prevalence, costs, and health effects of obesity, physicians are largely unprepared to treat it. Most medical students and residents lack sufficient training in obesity and obesity management. We evaluated a two-part team-based learning seminar (TBL) on obesity pathogenesis and treatment for first-year medical students at Case Western Reserve University School of Medicine (CWRU SOM). A questionnaire on attitudes toward obesity and self-perceived knowledge of obesity was administered before and after the TBL, utilizing Likert scales. Of 183 medical students who attended both TBLs, 155 (85%) completed the baseline questionnaire, and 127 (69%) completed the postintervention questionnaire. Confidence in treating obesity increased significantly from preintervention (M = 2.7, SD = 1.0) to postintervention (M = 3.7, SD = 0.8). The attitude that obesity is caused by poor personal choices decreased significantly from preintervention (M = 2.8, SD = 0.9) to postintervention (M = 2.1, SD = 0.9). Self-perceived knowledge of obesity in all nine areas-epidemiology, energy homeostasis, etiologies, nutrition, physical activity, behavior, pharmacology, surgery, and language-increased significantly. Despite obesity being one of the most prevalent health concerns, obesity education in medical school is scant. This TBL resulted in improved attitudes toward obesity and self-perceived knowledge of obesity among first-year medical students at CWRU SOM and offers a practical mechanism to introduce more obesity education into undergraduate medical curricula.

Exclusive Breastfeeding Support to Increase Exclusive Breastfeeding at Muhammadiyah Gresik Hospital

The first 1000 days of life is a critical period, exclusive breastfeeding and infant stimulation are important. The purpose of the study was to analyze the effectiveness of Communication, Information and Education (CIE) on: (1) the mother's knowledge about exclusive breastfeeding, (2) breast care, (3) how to breastfeed correctly, (4) mother's attitude in exclusive breastfeeding. The research design was quasi experimental with pre-post test group intervention. The research time was 8 months, from August 2022 to March 2023. The dependent variable was the provision of CIE by Aisyiyah cadres and the independent variables were 1) mother's knowledge about exclusive breastfeeding, (2) breast care, (3) the correct way of breastfeeding, and (4) mother's attitude. The sample was quota sampling, totaling 100 subjects. The data collection technique used a pre questionnaire given directly during the first or second post partum day and a post questionnaire given after 6 months through visits and MCH books. Data analysis found that mothers' knowledge about breast milk and breastfeeding before and after CIE showed an average value increased from 56.68 to 90.12. The mean value of breast care skills before and after the CIE was 41.24 and 88.48. The mean value of breastfeeding skills before and after the CIE was 43.64 and 88.46. The mean scores of maternal attitudes before and after the CIE were 63.61 and 90.27. Breastfeeding success rate was 91%. The effectiveness of CIE using the Wilcoxon analysis test, shows; there is effectiveness of CIE on knowledge of breast milk and breastfeeding (p&lt;0.05), the value of negative ranks (decrease) is 0. The value of positive ranks (increase) is 50.50. Likewise, the effectiveness of CIE on breast care skills, the effectiveness of CIE on correct breastfeeding skills, and the effectiveness of CIE on maternal attitudes showed the same value (p&lt;0.05), the value of negative ranks (decrease) was 0. The value of positive ranks (increase) was 50.50. The value of ties (equal) is 0.

Feasibility and safety study of wearable cyborg Hybrid Assistive Limb for pediatric patients with cerebral palsy and spinal cord disorders.

The wearable cyborg Hybrid Assistive Limb (HAL) is the world's first cyborg-type wearable robotic device, and it assists the user's voluntary movements and facilitates muscle activities. However, since the minimum height required for using the HAL is 150 cm, a smaller HAL (2S size) has been newly developed for pediatric use. This study aimed to (1) examine the feasibility and safety of a protocol for treatments with HAL (2S size) in pediatric patients and (2) explore the optimal method for assessing the efficacy of HAL. This clinical study included seven pediatric patients with postural and motor function disorders, who received 8-12 sessions of smaller HAL (2S size) treatment. The primary outcome was the Gross Motor Function Measure-88 (GMFM-88). The secondary outcomes were GMFM-66, 10-m walk test, 2- and 6-min walking distances, Canadian Occupational Performance Measure (COPM), a post-treatment questionnaire, adverse events, and device failures. Statistical analyses were performed using the paired samples t-test or Wilcoxon signed-rank test. All participants completed the study protocol with no serious adverse events. GMFM-88 improved from 65.51 ± 21.97 to 66.72 ± 22.28 (p = 0.07). The improvements in the secondary outcomes were as follows: GMFM-66, 53.63 ± 11.94 to 54.96 ± 12.31, p = 0.04; step length, 0.32 ± 0.16 to 0.34 ± 0.16, p = 0.25; 2-MWD, 59.1 ± 57.0 to 62.8 ± 63.3, p = 0.54; COPM performance score, 3.7 ± 2.0 to 5.3 ± 1.9, p = 0.06; COPM satisfaction score, 3.3 ± 2.1 to 5.1 ± 2.1, p = 0.04. In this exploratory study, we applied a new size of wearable cyborg HAL (2S size), to children with central nervous system disorders. We evaluated its safety, feasibility, and identified an optimal assessment method for multiple treatments. All participants completed the protocol with no serious adverse events. This study suggested that the GMFM would be an optimal assessment tool for validation trials of HAL (2S size) treatment in pediatric patients with posture and motor function disorders.

A96Whole System Transformed: Making Discharge Everyone’s Business

Delayed discharges are a challenge in every hospital. The Scottish Government are ‘committed to significantly reducing the number of people who are waiting to move from hospital wards to more appropriate settings [1]. This transformative simulation has been designed for all multidisciplinary team members involved in a patient’s care to engage in discharge planning; and to ‘respond to health service needs [2]. This simulation was created to break down barriers between acute and community care, reduce silo mentality and share the decision-making and risk around discharge. Empower any member of staff to have discharge conversations. Emphasis on early discharge conversations. Join up acute and community staff involved in the discharge process. The simulation involves a three-hour session with three scenarios. The session has run in both acute and community hospitals. Participants are multidisciplinary, and have included doctors, nurses, allied-health professionals (AHP), flow team, carers representatives, social workers, social care staff, home care staff and NHS Education for Scotland (NES) staff. The participants, in pairs, have a simulated conversation with a patient’s relative about discharge. The learning objectives from the scenarios are around realistic medicine, managing risk and dealing with anxious families. To assess the immediate impact of the simulation, participants complete a pre-simulation questionnaire on arrival and a post-simulation questionnaire at the end of the session. The results were from the pilot session pre and post simulation questionnaires in March 2023. Participants ( Prior to the simulation participants were asked ‘What makes it difficult to have these conversations?’ Themes from the qualitative answers were family expectations and managing uncertainty, both of which were learning objectives in the scenarios. Our participant feedback has shown that this Discharge without Delay Simulation has ‘made discharge everyone’s business.’ This simulation can provide transformative change to help healthcare professionals have early discharge conversations. This provides better patient-centred care by returning the patient to a homely environment, to reduce delayed discharges and increase patient safety. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Comparative Efficacy and Side Effect Profiles of Interventions for Pediatric Saliva Control: A Cohort Study

To compare efficacy and side effect profile data on conservative, behavioral, pharmacological, and surgical treatments used for pediatric saliva control. A cohort study of children (n=483) referred to a specialty Saliva Control service between May 2014 and November 2019 was performed, using quantitative data from pretreatment and post-treatment questionnaires (the Drooling Impact Scale [DIS], Drooling Rating Scale [DRS]) and recording of side effects. Overall, 483 children were included; treatment choices were based on published international guidelines. The greatest improvement was seen after intraglandular botulinum toxin A (BTX-A) injections (n=207; 551 courses; mean DIS change, 34.7; 95% CI=29.2-35.7) or duct transpositional surgery (n=31; mean change in DIS, 29.0; 95% CI,22.3-35.7). Oral anticholinergics were associated with good outcomes, with no significant statistical difference between glycopyrronium bromide (n=150; mean DIS change, 21.5; 95% CI,19.1-24.0) or trihexyphenidyl (n=87; mean DIS change, 22.4; 95% CI,18.9-25.8). Inhaled ipratropium bromide was not as efficacious (n=80; mean DIS change, 11.1; 95% CI,8.9-13.3). Oromotor programs were used in a selected group with reliable outcomes (n=9; mean DIS change, 13.0). Side effects were consistent with previous studies. Overall, in cases of milder severity, enterally administered therapies provided a good first-line option. With more severe problems, BTX-A injections or saliva duct transpositional surgery were more effective and well tolerated. We describe a large, single-center pediatric saliva control cohort, providing direct comparison of the efficacy and side effect profiles for all available interventions and inform clinical practice for specialists when considering different options. BTX-A injections or saliva duct transpositional surgery seem to be more effective for saliva control that is more severe.

Tackling climate crisis through systems thinking: PERSIST, a pilot project in an Italian high school

Abstract Background The climate crisis is today's most important global health threat. In Europe, the Mediterranean region represents a climate hotspot. Education plays a crucial role in preparing the population for future climate impacts on health: it provides the tools to implement social and individual attitudes for climate change mitigation; it facilitates the development of skills and attitudes for adaptation, and it stimulates critical understanding of climate change. Objectives The PERSIST project aimed to improve awareness of the environmental emergency and provide tools to tackle the complex relationships between human activity, climate crisis and health, stimulating pro-environmental behaviours through systems thinking. Three meetings with students from a scientific high school in Rome between March and April 2023 were provided, using systems thinking, group activities and discussions. A pre- and post-intervention questionnaire was administered to measure knowledge, attitudes, and pro-environmental behaviours. The anonymously collected data were processed using descriptive statistics. Results Ten classes between 1st and 4th grade took part in the project. The valid responses to the pre- and post-intervention questionnaires were 222 and 211, respectively. The preliminary analysis suggests improvements in knowledge and attitudes and a broad appreciation of the intervention, with 78,1% of students who found the project engaging. There were no changes in the ecological emotions referred by the students. Conclusions An interactive approach and the use of complex systems improves students’ knowledge and attitudes towards the climate crisis, without increasing negative ecological emotions. This pilot project can guide similar, repeatable projects in other schools and countries. Key messages • Education is fundamental in tackling the health impacts of climate change. • Training young people on health and climate crisis issues could improve their adaptive capacities.

Anatomical knowledge retention in Obstetrics and Gynaecology residents and impact of an e-learning tool.

Anatomical knowledge of medical students and residents is insufficient and further anatomical sciences throughout medical curriculum may be necessary. The first aim of this study was to assess pelvic and perineal anatomical knowledge retention of Obstetrics and Gynaecology (Ob/Gyn) residents. The second was to assess the impact of an e-learning tool on anatomical knowledge. A survey was sent by mail to medical students and Ob/Gyn residents. After completion, Ob/Gyn residents were randomised to "e-learning" group or to "Control" group. "E-learning" group had an unlimited access to a tool about female pelvic and perineum anatomy, implemented by iMAIOS society in their online platform. A second assessment of residents' anatomical knowledge was done 2months after randomisation. Ob/Gyn residents (N = 23) had a significant lower global score than third-year medical students (N = 103) (22.1% (± 10.2) vs 43.8% (± 12.1), p < 0.0001). Two months after randomisation, residents of "control" group demonstrated no significant difference between the two questionnaires (3.6%, p = 0.31), whilst the "e-learning" group demonstrated a significant increase overall (10.6%, p = 0.09). There was no significant difference on the post-intervention questionnaire between control and "e-learning" group (25.4% vs 33% respectively, p = 0.34). Knowledge of pelvic and perineal anatomy is poor. This e-learning tool aimed at improving anatomical knowledge retention but is not sufficient. A combination of traditional approaches and innovative solutions should be proposed throughout medical school and residency to maintain anatomical knowledge.

Digital Training Program for Line Managers (Managing Minds at Work): Protocol for a Feasibility Pilot Cluster Randomized Controlled Trial.

Mental health problems affect 1 in 6 workers annually and are one of the leading causes of sickness absence, with stress, anxiety, and depression being responsible for half of all working days lost in the United Kingdom. Primary interventions with a preventative focus are widely acknowledged as the priority for workplace mental health interventions. Line managers hold a primary role in preventing poor mental health within the workplace and, therefore, need to be equipped with the skills and knowledge to effectively carry out this role. However, most previous intervention studies have directly focused on increasing line managers' understanding and awareness of mental health rather than giving them the skills and competencies to take a proactive preventative approach in how they manage and design work. The Managing Minds at Work (MMW) digital training intervention was collaboratively designed to address this gap. The intervention aims to increase line managers' knowledge and confidence in preventing work-related stress and promoting mental health at work. It consists of 5 modules providing evidence-based interactive content on looking after your mental health, designing and managing work to promote mental well-being, management competencies that prevent work-related stress, developing a psychologically safe workplace, and having conversations about mental health at work. The primary aim of this study is to pilot and feasibility test MMW, a digital training intervention for line managers. We use a cluster randomized controlled trial design consisting of 2 arms, the intervention arm and a 3-month waitlist control, in this multicenter feasibility pilot study. Line managers in the intervention arm will complete a baseline questionnaire at screening, immediately post intervention (approximately 6 weeks after baseline), and at 3- and 6-month follow-ups. Line managers in the control arm will complete an initial baseline questionnaire, repeated after 3 months on the waitlist. They will then be granted access to the MMW intervention, following which they will complete the questionnaire post intervention. The direct reports of the line managers in both arms of the trial will also be invited to take part by completing questionnaires at baseline and follow-up. As a feasibility pilot study, a formal sample size is not required. A minimum of 8 clusters (randomized into 2 groups of 4) will be sought to inform a future trial from work organizations of different types and sectors. Recruitment for the study closed in January 2022. Overall, 24 organizations and 224 line managers have been recruited. Data analysis was finished in August 2023. The results from this feasibility study will provide insight into the usability and acceptability of the MMW intervention and its potential for improving line manager outcomes and those of their direct reports. These results will inform the development of subsequent trials. ClinicalTrials.gov NCT05154019; https://clinicaltrials.gov/study/NCT05154019. DERR1-10.2196/48758.

Concrete–Representational–Abstract (CRA) Instructional Approach in an Algebra I Inclusion Class: Knowledge Retention Versus Students’ Perception

Mathematical manipulatives and the concrete–representational–abstract (CRA) instructional approach are common in elementary classrooms, but their use declines significantly by high school. This paper describes a mixed methods study focused on knowledge retention and perceptions of students in a high school Algebra I inclusion class after a lesson on square roots using a novel algebra manipulative. Twenty-five students in a high school Algebra I inclusion class engaged in an interactive lesson on square roots paired with the manipulative to support their conceptual understanding. Participants completed a pretest, a post-treatment questionnaire, and a delayed post-test. The two-sample t test showed a significant difference in students’ pretest–post-test scores. However, conventional content analysis of the questionnaires showed that most students did not believe the CRA instructional approach supported their learning. Implications include increased use of manipulatives to teach abstract algebraic topics to support students’ conceptual understanding and destigmatizing the use of manipulatives in secondary mathematics classrooms.

Psychiatric mental health nurse practitioner student knowledge and perceptions of pharmacogenetic testing.

Psychotropic medications are typically prescribed in a trial-and-error fashion, and some providers are beginning to utilize pharmacogenetic testing (PGx) as a supplemental prescribing tool in treatment decision making. PGx testing shows potential in enhancing provider insights into personalized prescribing for patients by examining genetic information related to drug metabolism. Literature points to providers' lack of knowledge in PGx interpretation as a main barrier, including psychiatric mental health nurse practitioners (PMHNPs). The aim of this study was to measure a difference, if any, in the knowledge and perceptions of PGx after implementation using a pre-post design. This study implemented an educational intervention on graduate nursing students (n = 15). Data were collected by using a pre- and post-interventional questionnaire. Results demonstrated a significant difference in findings related to students' knowledge (p < 0.001), students' skills related to pharmacogenetics, (p < 0.001), as well as students' perceived ability to implement pharmacogenetics into their practice, (p = 0.028). The authors propose that the knowledge gained from the study demonstrates the importance of introducing PGx education into the PMHNP curricula and to prepare future PMHNPs to confidently utilize PGx in their clinical practice.