Prior Experience Research Articles

Reliability of ultrasound measurements of muscle thickness and echointensity in older adults with type 2 diabetes

Ultrasound is an emerging tool for muscle-based measurements. However, the analysis of hyperechoic images (high muscle fat infiltration, as in type 2 diabetes [T2D]) can be challenging. ObjectiveTo evaluate the reliability of ultrasound image analysis of muscle thickness and echointensity in older adults with T2D and non-diabetic controls by experienced and novice analysts. We hypothesized that reliability would be high for the experienced analysts, and lower, but acceptable, for a novice analyst. MethodsWe recruited three groups: 1) adults >60 years with T2D; 2) age- and sex-matched normoglycemic controls; and 3) healthy adults 18–35 years. All participants underwent ultrasound imaging of the abdomen and anterior thigh. Ultrasound images were de-identified, randomized, and separately analyzed by two expert analysts (>3 years experience each). A subset of images was also analyzed by a novice analyst with no prior experience. Inter- and intra-rater reliability was assessed using coefficients of variation (CVs), intraclass correlation coefficients (ICCs), and Bland-Altman analysis. ResultsFor the expert analysts, ICCs were >0.90 and CVs were <10 % for all measurements, regardless of participant group. For the novice analyst, all ICCs were >0.90, except for rectus abdominus thickness measurements in the T2D group (ICC: 0.659 [95%CI: -0.134, 0.911]). CVs were <10 % for all measurements, except for rectus abdominus thickness in the T2D group (CV: 12.7 %). Ultrasound image analysis of muscle thickness and echointensity by experienced analysts was highly reliable. ConclusionNovice and expert analysts produced comparable measurements, except for rectus abdominus thickness in images obtained from older adults with T2D.

Development and Evaluation of an Immersive Cinematic Escape Room for Disaster Preparedness and Self-Efficacy Among Nurses

BackgroundThe occurrence of natural disasters is unpredictable. Nurses need to have the core competency of disaster nursing to effectively respond to natural disasters. This study aimed to develop and evaluate the effectiveness of an immersive cinematic escape room (ICER) instructional approach in disaster preparedness and self-efficacy in nurses. MethodThis quasi-experimental research design used a convenience sample of 115 nurses. The course contents covered establishment of medical stations, incident command system (ICS), personal preparedness and protection in disasters, and mass casualty triage (START). Evaluation of disaster preparedness and self-efficacy occurred before, one week after and four weeks after the course. ResultsThe experimental group, lacking prior disaster preparedness education experiences, demonstrated a statistically significant improvement (p < .01) compared to the control group with more such experiences. At week four, both groups showed improvement in the self-efficacy scores, but the improvement did not achieve statistical significance (p > .05). ConclusionThe ICER approach significantly enhanced nurses’ disaster preparedness and self-efficacy. Educators are encouraged to adopt this approach for comprehensive disaster nursing education.

Effects of delay sequence in a delay discounting task

Delay discounting refers to the decrease in subjective value of a reward as the delay until its receipt increases. In the present study we assessed the effects of the sequence of delay blocks (increasing or decreasing) on the discounting and the data systematicity using a titrating procedure with human participants. All participants completed the delay discounting task in both increasing and decreasing sequence of presentation with delays ranging from one day to ten years. We found significantly steeper discounting when the blocks of delay were presented in increasing sequence compared with when the blocks were presented in decreasing sequence. We also found significantly steeper discounting when participants completed the increasing-sequence condition first. Our results agree with other findings reported in the literature and suggest that delay discounting may be affected by prior and subsequent experience.

Toddlers' prior social experience with speakers influences their word learning.

Toddlers prefer to learn from familiar adults, particularly their caregivers, and perform better on word learning tasks when taught by caregivers than by strangers. However, it remains unclear why toddlers learn better from caregivers than from strangers. One possibility is that toddlers are more receptive to learning from individuals whom they have found to be engaging in previous interactions. The current study tested whether toddlers learn more from an unfamiliar adult who was previously engaging than from an unfamiliar adult who was previously unengaging. Toddlers (27-29months, N=40) were taught labels for novel objects by two different experimenters. Prior to word learning, toddlers watched pre-recorded videos of one experimenter utilizing engaging behaviors (i.e., using infant-directed speech, gestures, eye contact, and positive affect) and one experimenter utilizing unengaging behaviors (i.e., using adult-directed speech, no gestures, no eye contact, and neutral affect). Both experimenters were equally engaging during labeling. Word learning was then tested using a looking-while-listening paradigm. The results of linear mixed-effects model, cluster-based permutation, and growth curve analyses suggest heightened performance for words that were taught by the experimenter who was previously engaging. These results begin to reveal the kinds of social experiences that promote success in early word learning.

Exploring healthcare workers’ experience and barriers in disclosing patient safety-related incidents: A qualitative study in Indonesian hospitals

ABSTRACT Background Open disclosure of patient safety incidents is a strategy to enhance patient safety by preventing future occurrences. This study aimed to identify factors that facilitate or hinder the implementation of open disclosure in Indonesian hospitals. Methods Using a qualitative descriptive research method, 12 healthcare professionals with at least one year of experience and prior incident disclosure experience participated in online interviews. Thematic analysis revealed that open disclosure practices are uncommon in Indonesian hospitals. Results The findings suggest that open disclosure practices are not common practice in Indonesian hospitals. Key issues include unclear responsibility for disclosure, determining which incidents should be disclosed, understanding patient and family responses, implementing follow-up procedures and addressing barriers such as cultural factors, fear of disclosure, lack of protection and insufficient awareness and training among healthcare professionals. Conclusion Promoting open disclosure can improve patient-provider relationships and patient safety. Therefore, healthcare organizations, policymakers and educational institutions should collaborate to foster open disclosure, safeguard patients and educate healthcare professionals, leading to a more secure, transparent and patient-centric healthcare system.

Morphological and molecular preservation through universal preparation of fresh-frozen tissue samples for multimodal imaging workflows.

The landscape of tissue-based imaging modalities is constantly and rapidly evolving. While formalin-fixed, paraffin-embedded material is still useful for histological imaging, the fixation process irreversibly changes the molecular composition of the sample. Therefore, many imaging approaches require fresh-frozen material to get meaningful results. This is particularly true for molecular imaging techniques such as mass spectrometry imaging, which are widely used to probe the spatial arrangement of the tissue metabolome. As high-quality fresh-frozen tissues are limited in their availability, any sample preparation workflow they are subjected to needs to ensure morphological and molecular preservation of the tissues and be compatible with as many of the established and emerging imaging techniques as possible to obtain the maximum possible insights from the tissues. Here we describe a universal sample preparation workflow, from the initial step of freezing the tissues to the cold embedding in a new hydroxypropyl methylcellulose/polyvinylpyrrolidone-enriched hydrogel and the generation of thin tissue sections for analysis. Moreover, we highlight the optimized storage conditions that limit molecular and morphological degradation of the sections. The protocol is compatible with human and plant tissues and can be easily adapted for the preparation of alternative sample formats (e.g., three-dimensional cell cultures). The integrated workflow is universally compatible with histological tissue analysis, mass spectrometry imaging and imaging mass cytometry, as well as spatial proteomic, genomic and transcriptomic tissue analysis. The protocol can be completed within 4 h and requires minimal prior experience in the preparation of tissue samples for multimodal imaging experiments.

Equity split evolution in entrepreneurial teams: Assessing financial contributions and human capital

ABSTRACT Proper equity splits play a vital role in the success of entrepreneurial teams, yet the literature lacks a comprehensive understanding of their evolving nature. This study addresses this gap by analyzing the dynamic and evolutionary process of equity splits using longitudinal data. Through the development of a game-theory model incorporating human-capital signals, we illuminate the impact of these factors. Utilizing data from the Kauffman Firm Survey and employing fixed- and mixed-effects modeling, we uncover significant findings. Initially, financial contributions shape equity splits, but their influence diminishes as hidden human capital gains prominence. Education attainment and work experience have no direct effect, while prior entrepreneurial experience influences the initial year but not subsequent equity resplitting. Our research offers practical insights for making informed equity-split decisions in the early and later stages of ventures. Nonetheless, it’s important to note some limitations in our research stemming from the lack of information on individual entrepreneurs’ performance within entrepreneurial teams, which could enrich the measurement of hidden human capital.

Mirikizumab Exposure-Response Relationships in Patients with Moderately-to-Severely Active Ulcerative Colitis in Randomized Phase II and III Studies.

Mirikizumab is a humanized anti-interleukin-23p19 monoclonal antibody being developed for ulcerative colitis (UC) and Crohn's disease. We characterized the relationship of mirikizumab systemic exposure with efficacy and safety end points in patients with UC using phase II (NCT02589665) and III (NCT03518086, NCT03524092) trial data. Exposure-response models were developed for clinical remission, clinical response, endoscopic remission, and change in modified Mayo score following induction (50-1,000 mg i.v. every 4 weeks) and maintenance (200 mg s.c. every 4 or 12 weeks) treatment. These models evaluated observed and pharmacokinetic model-predicted mirikizumab exposures as the exposure measure. Key safety event rates were compared across mirikizumab exposure quartiles in the phase III trial. Mirikizumab efficacy in patients with UC showed an apparent positive association with systemic exposure following both induction and maintenance. However, further analysis found this relationship to be overstated by the presence of confounding factors that were not among the tested patient covariates. While prior biologic experience and baseline disease severity showed statistically significant influences on estimated placebo effect, no patient factors affected the mirikizumab effect parameters in any of the phase III exposure-response models. There was no apparent mirikizumab concentration relationship with any adverse event of special interest. When the phase II and III data and confounding are considered together, efficacy was unlikely to be strongly affected by variation in exposures across individual patients at the phase III dose. Together with the previously demonstrated mirikizumab exposure insensitivity to patient factors, these findings indicate that mirikizumab dose adjustment to patient characteristics is not required.

Referral pathways to early intervention services for psychosis and their influence on perceptions of care: An interpretive phenomenological analysis.

Most young adults experiencing psychosis enter early intervention services (EIS) via inpatient and emergency departments. These experiences are suggested to negatively impact their views of treatment and engagement in EIS. However, limited research has examined the impact of young adults' prior help-seeking experiences on these outcomes. The present study aimed to explore how young adults engaged in EIS have experienced initial help-seeking and make sense of these experiences in the context of their current treatment. Using an interpretative phenomenological analysis approach, semi-structured interviews were conducted with 12 young adults (mean age = 24.83) within their first 3-12 months of treatment in EIS. Interviews aimed to examine their experiences of help-seeking and referral to EIS as well as the impact of these experiences on their subsequent perception of, and engagement with EIS. 3 superordinate themes emerged: (1) Navigating the Maze of Healthcare (2) Dignity and (3) Impact of Help-Seeking and Referral Experiences. Participants with referral pathways involving urgent care services described more adversity during their referral pathway and tended to describe help-seeking experiences as contributing to negative views towards EIS and diminished engagement in treatment. The impact of early negative experiences with healthcare on views towards EIS and engagement is evident in participants' accounts. Sense making was further contextualized by participants' illness insight, degree of recovery, and social support throughout experiences. Emergent themes highlight the need for psychiatric services to emphasize service users' dignity and for EIS to provide opportunities for patients to process past negative mental healthcare experiences to strengthen engagement.

Constructing climate change: Exploring how cities frame climate change in the Arctic

ABSTRACT Framing climate policy actions to be acceptable by various stakeholders in cities poses a critical task for urban governance. Despite the proliferation of studies on urban climate change governance in the past decades, framing as a mechanism for agenda-setting in local policymaking has received little attention. This paper draws on the literature on climate change discourse to analyze the content of framing and its reasoning in the two municipalities located in the Arctic: Murmansk (Russia) and Tromsø (Norway). Using qualitative research methods, including semi-structured interviews, document reviews, and discourse analysis, the paper finds that climate change is absent in the political discourse in Murmansk. At the same time, Tromsø authorities recognize climate change as a global and a local problem and incorporate it into local policies. It also identifies three factors that explain the (non)framing of climate change by the municipal authorities: (1) local authority to frame climate issues, (2) local political party branches’ climate preferences, and (3) prior experiences with weather extremes and scientific knowledge. Given that cities in the Arctic are on the front lines of climate change, learning from their framing experiences, other cities across the globe can seize the opportunities for their efforts to address climatic impacts.

Evaluating the Accuracy, Comprehensiveness, and Validity of ChatGPT Compared to Evidence-Based Sources Regarding Common Surgical Conditions: Surgeons' Perspectives.

This study aims to assess the accuracy, comprehensiveness, and validity of ChatGPT compared to evidence-based sources regarding the diagnosis and management of common surgical conditions by surveying the perceptions of U.S. board-certified practicing surgeons. An anonymous cross-sectional survey was distributed to U.S. practicing surgeons from June 2023 to March 2024. The survey comprised 94 multiple-choice questions evaluating diagnostic and management information for five common surgical conditions from evidence-based sources or generated by ChatGPT. Statistical analysis included descriptive statistics and paired-sample t-tests. Participating surgeons were primarily aged 40-50 years (43%), male (86%), White (57%), and had 5-10 years or >15 years of experience (86%). The majority of surgeons had no prior experience with ChatGPT in surgical practice (86%). For material discussing both acute cholecystitis and upper gastrointestinal hemorrhage, evidence-based sources were rated as significantly more comprehensive (3.57 (±.535) vs 2.00 (±1.16), P = .025) (4.14 (±.69) vs 2.43 (±.98), P < .001) and valid (3.71 (±.488) vs 2.86 (±1.07), P = .045) (3.71 (±.76) vs 2.71 (±.95) P = .038) than ChatGPT. However, there was no significant difference in accuracy between the two sources (3.71 vs 3.29, P = .289) (3.57 vs 2.71, P = .111). Surveyed U.S. board-certified practicing surgeons rated evidence-based sources as significantly more comprehensive and valid compared to ChatGPT across the majority of surveyed surgical conditions. However, there was no significant difference in accuracy between the sources across the majority of surveyed conditions. While ChatGPT may offer potential benefits in surgical practice, further refinement and validation are necessary to enhance its utility and acceptance among surgeons.

A Longitudinal Study of Conditional Student Entrepreneurship in an Emerging Economy

This study explores how students from low-income families with no prior entrepreneurial experience engage in conditional student entrepreneurship (CSE). Longitudinal data from 30 undergraduates across two Nigerian public universities revealed that resource constraints and significant loss events threaten students’ educational pursuits. However, rather than dropping out to pursue unskilled jobs, the students opt for CSE to generate income and persist in their education. Through the findings, a model of CSE for financial stability was developed to shed light on an overlooked phenomenon in emerging economies. The findings contribute to academic, policy, and practical implications.

Certainty-Based Self-Assessment in Higher Education

This study explores students’ behavior in response to a study-learning system during one semester at university, based on the certainty-based marking strategy. The learning support system pursues to encourage diagnostic formative self-assessment. In total, 258 students complete the full study program and respond to an additional sociodemographic questionnaire. An exploratory study was performed. Two individual variables were considered for basic statistical analysis: gender and prior academic experience. Results show progression of students’ confident responses, especially by the third trial. No differences were found with respect to gender. In contrast, strong differences were found related to prior academic experience. These latter results must be taken carefully, in expectance of further research to look for connections with other individual variables.

Investigation of the effects of an 8-week cross-country skiing exercise program on various reaction time parameters, selective attention and academic achievement in adolescents

Exercise slows or helps reverse the shrinkage of key cognitive brain regions such as the hippocampus, which is important for information processing, learning, reasoning and planning. For this reason, it is thought that regular exercise of individuals, especially during adolescence, which is considered one of the most important processes of development, can increase their performance in areas where cognitive activities are at the forefront. Cross-country skiing, one of the leading branches of winter sports, has a much more complex structure, unlike the branches that are widely preferred today (football, basketball, volleyball, etc.) and is a branch where many motor skills are exhibited at the same time For this reason, the effect of cross-country skiing, which is defined as more complex and difficult in terms of biomotor than other branches, on cognitive activities is a matter of curiosity. Therefore, the aim of the research is; to examine the cognitive effects of cross-country skiing exercise. The study involved 54 (26 male, 28 female) adolescents who had no prior experience in any licensed sports. The average age of the participants was determined as 12.61 ± 1.32. The participants were divided in experimental and control groups. Reaction performances were determined using the ÇAĞIN Hand and Foot Reaction Tests, selective attention performances were evaluated using the Flanker Test and academic achievement was determined using the e-Okul system. Two-way ANOVA revealed significant group × time interactions for hand and foot simple, selective, discriminative reaction time, selective attention and academic achievement (p < 0.05) due to improved values at post-test for the experimental group but not for the control groups. No significant group × time interactions were observed for correct reaction rate for all reaction parameters (p > 0.05). The study concludes that the cross-country skiing exercise, which was applied to adolescents for eight weeks, had a positive impact on the parameters of reaction, selective attention and academic achievement. Therefore, parents are suggested to encourage their children to exercise and engage in sports practices like cross-country skiing to improve cognitive and academic performance during adolescence.

Short-Term Preexposure to Novel Enriched Environment Augments Hippocampal Ripples in Urethane-Anesthetized Mice.

Learning and memory are affected by novel enriched environment, a condition where animals play and interact with a variety of toys and conspecifics. Exposure of animals to the novel enriched environments improves memory by altering neural plasticity during natural sleep, a process called memory consolidation. The hippocampus, a pivotal brain region for learning and memory, generates high-frequency oscillations called ripples during sleep, which is required for memory consolidation. Naturally occurring sleep shares characteristics in common with general anesthesia in terms of extracellular oscillations, guaranteeing anesthetized animals suitable to examine neural activity in a sleep-like state. However, it is poorly understood whether the preexposure of animals to the novel enriched environment modulates neural activity in the hippocampus under subsequent anesthesia. To ask this question, we allowed mice to freely explore the novel enriched environment or their standard environment, anesthetized them, and recorded local field potentials in the hippocampal CA1 area. We then compared the characteristics of hippocampal ripples between the two groups and found that the amplitude of ripples and the number of successive ripples were larger in the novel enriched environment group than in the standard environment group, suggesting that the afferent synaptic input from the CA3 area to the CA1 area was higher when the animals underwent the novel enriched environment. These results underscore the importance of prior experience that surpasses subsequent physical states from the neurophysiological point of view.

Unpacking Technical Assistance (TA) Strategies Within a State-Level Prevention Support System: A Mixed-Method Study in Determining Types and Amount of TA.

The research-practice gap between evidence-based intervention efficacy and its uptake in real-world contexts remains a central challenge for prevention and implementation science. Providing technical assistance (TA) is considered a crucial support mechanism that can help narrow the gap. However, empirical measurement of TA strategies and their variation is often lacking. The current study unpacks the black box of TA, highlighting different TA strategies, amounts, and their relation to intervention characteristics. First, we qualitatively categorized interactions between TA providers and implementers. Second, we explored how characteristics of implementing organizations and the intervention related to variations in the amount of TA delivered. Using data spanning six years, we analyzed over 10,000 encounters between TA providers and implementers. Content analysis yielded four distinct strategies: Consultation (27.2%), Coordination Logistics (24.5%), Monitoring (16.5%), and Resource Delivery (28.2%). Organizations with prior experience required less monitoring and resource delivery. Additionally, characteristics of the intervention were significantly associated with the amount of consultation, monitoring, coordination logistics, and resource delivery provided. The specific features of the intervention showed significant variation in their relation to TA strategies. These findings provide initial insights into the implications of intervention characteristics in determining how much of which TA strategies are needed to support implementations in real-world settings.

Current perception and barriers to implementing lung ultrasound in Canadian neonatal intensive care units: a national survey.

Despite the growing body of literature supporting the use of point-of-care lung ultrasound (POC-LU) in neonates, its adoption in Canadian neonatal intensive care units (NICUs) remains limited. This study aimed to identify healthcare providers' perceptions and barriers to implementing POC-LU in Canadian NICUs. We conducted an electronic survey targeting neonatologists, neonatal fellows, neonatal nurse practitioners, and registered respiratory therapists in 20 Canadian NICUs. The survey comprised a 28-item questionnaire divided into four sections: (1) participants' demographics and availability of POC-LU equipment, (2) experience and interest in POC-LU learning, (3) perception of POC-LU as a diagnostic tool, and (4) barriers to POC-LU implementation in NICUs.A total of 194 participants completed the survey, with neonatologists comprising the majority (45%). Nearly half of the participants (48%) reported prior experience with POC-LU. The most prevalent indications for POC-LU use were diagnosis of pleural effusion (90%), pneumothorax (87%), and respiratory distress syndrome (76%). Participants identified the primary barrier to POC-LU adoption as the lack of trained providers available for both training and clinical integration. Notably, most respondents (87%) expressed keen interest in learning neonatal POC-LU. A subgroup analysis based on the responses collected from NICU-directors of 12 institutions yielded results consistent with those of the overall participant pool. Conclusion: This survey underscores the perceived importance of POC-LU among NICU healthcare providers. A Canadian consensus is required to facilitate the development of widespread training programs as well as standardized clinical practice guideline for its implementation. What is Known: • In recent years, point-of-care lung ultrasound (POC-LU) has emerged as an important tool in neonatology, revolutionizing the assessment and management of critically ill infants. However, its adoption in Canadian Neonatal Intensive Care Units remains limited. What is New: • Most Canadian healthcare providers showed high level of interest in learning POC-LU techniques. Additionally, POC-LU was perceived as a useful tool for diagnosis and guiding intervention in various neonatal respiratory diseases. Nonetheless, the lack of expertise emerged as the primary barrier to its adoption and practice across different groups of participants regardless of their clinical experience level.

Biased choice and incentive salience: Implications for addiction.

Before we can make any choice, we must gather information from the environment about what our options are. This information-gathering process is critically mediated by attention, and our attention is, in turn, shaped by our previous experiences with-and learning about-stimuli and their consequences. In this review, we highlight studies demonstrating a rapid and automatic influence of reward learning on attentional capture and argue that these findings provide a human analog of sign-tracking behavior observed in nonhuman animals-wherein signals of reward gain incentive salience and become attractive targets for attention (and overt behavior) in their own right. We then consider the implications of this idea for understanding the drivers of cue-controlled behavior, with focus on addiction as a case in which choices with regard to reward-related stimuli can become injurious to health. We argue that motivated behavior in general-and addiction in particular-can be understood within a "biased competition" framework: Different options and outcomes compete for attentional priority as a function of top-down goals, bottom-up salience, and prior experience, and the winner of this competition becomes the target for subsequent outcome-directed and flexible behavior. Finally, we outline the implications of the biased-competition framework for cognitive, behavioral, and socioeconomic interventions for addiction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

#1600 The effect of integrated real-time hemodialysis surveillance on staff workload and time efficacy—a multicenter prospective study

Abstract Background and Aims For many years, dialysis data have been manually registered and transferred to the patients’ electronic health records by dialysis staff. However, manual documentation can be associated with poor data completeness, delayed recognition of inadequate dialysis prescriptions, and high staff workload. We studied the effect of introducing a new integrated, digitalized haemodialysis surveillance system, the Treatment Guidance System (TGS), on staff workload and time saving in clinics from a large multi-national dialysis provider. To measure the effect of introducing the new TGS system on staff workload and time saving. Method This was a prospective, observational multicenter study conducted between November 2021 and January 2023 in five countries: Saudi Arabia, Spain, Portugal, UK, and Kazakhstan. Inclusion criteria were clinics with adequate digital infrastructure, introducing the TGS. Only staff without prior experience with TGS were included in this study. Staff workload was determined using the NASA Task Load Index (TLS) at three timepoints: 1: two weeks prior to introduction of the TGS, 2: one month after introduction of the TGS, and 3: three months after introduction of the TGS. Time saving was determined by observation of the time used for dialysis data documentation by an independent person at timepoints 1 and 3. Differences in staff workload were determined by Friedman's two-way analysis of variance by ranks with Bonferroni correction for multiple tests, while time saving was determined by Wilcox signed rank test. Results In total, 223 participants from 20 clinics were included in the study, 56% were female, age distribution was 32.1% &amp;lt;30 years, 58.8% 30-49 years, and 9.1% ≥50 years, and dialysis experience was 17.5% ≤2 years, 27.9% 2-5 years, 33.3% 5-10 years, and 21.2% &amp;gt;10 years. The staff adaptability to the introduction of TGS at their workplace and the workload perception improved significantly over all domains of the NASA TLS (Table 1). While most domains improved by approximately 50%, median physical demand improved by more than 60% (Table 1). There was some variation of the observed time used for documentation between different countries, however, the observed time decreased in all countries from median (25-75%) 9:35 (5:36-14:41) minutes at timepoint 1 to 5:22 (2:05-9:22) minutes at timepoint 3 (p &amp;lt; 0.001). The largest saving was noted in the United Kingdom (14:06 (11:01-18:25) to 5:17 (4:56-5:45) minutes), while the smallest saving was noted in Kazakhstan, where only 3 individuals were observed (3:37 to 3:08). Conclusion Introduction of the novel, digitalized, integrated real-time dialysis documentation system TGS greatly reduced staff workload and time spent with documentation of dialysis treatments. Digitalization and automation of haemodialysis treatment has the potential to improve dialysis treatment, which will be further elucidated by the analysis of data quality and completeness in the current study.

Preference for novel biomedical HIV pre-exposure prophylaxis methods among adolescent girls and young women in Kampala, Uganda: a mixed methods study

BackgroundNovel HIV pre-exposure prophylaxis (PrEP) methods including a potential future HIV vaccine, will increase prevention options for adolescent girls and young women (AGYW) at high risk of HIV infection in Eastern and Southern Africa, yet data on AGYW’s preferences for various PrEP methods is limited. We investigated preferences for five biomedical PrEP methods (oral, injectable, vaginal ring, implant, HIV vaccine) among 14–24-years-old AGYW in Kampala, Uganda.MethodsFrom January to December 2019, we conducted a mixed methods study including 265 high-risk AGYW. After receiving two education sessions on the five PrEP methods, participants were asked about their “most preferred PrEP method.” Multinomial logistic regression (oral PrEP as reference category) was used to determine participant characteristics associated with method preference. Results are presented as adjusted relative risk ratios (aRRR) with 95% confidence intervals (CI). In-depth interviews were conducted with 20 selected participants to examine reasons influencing PrEP preferences and suggestions for method improvements. Transcripts were analyzed thematically.ResultsParticipants preferred methods were: HIV vaccine (34.7%), oral PrEP (25.7%), injectable PrEP (24.9%), PrEP implant (13.6%), and vaginal ring (1.1%). Preference for injectable PrEP increased with every year of age (aRRR 1.22; 95% CI 1.04–1.44) and among participants with chlamydia or gonorrhoea (aRRR 2.53; 95% CI 1.08–5.90), while it was lower among participants having sexual partner(s) living with HIV or of unknown HIV status (aRRR 0.30; 95% CI 0.10–0.91). Preference for PrEP implants also increased with age (aRRR 1.42; 95% CI 1.14–1.77) and was strong among participants having ≥10 sexual partners in the past 3 months (aRRR 3.14; 95% CI 1.16–8.55), while it was lower among those with sexual partner(s) living with HIV or of unknown HIV status (aRRR 0.25; 95% CI 0.07–0.92). PrEP method preference was influenced by product attributes and prior experiences with similar product forms commonly used in health care.ConclusionAGYW have varied preferences for biomedical PrEP method and those with higher sexual behavioral risk prefer long-acting methods. As we anticipate more available PrEP options, oral PrEP use should be supported among AGYW, especially for those with sexual partners living with HIV or of unknown HIV status.