Participant Satisfaction Research Articles

Out-BREAK!: An IDWeek 2023 Escape Room to Break Out of the Educational Mold.

An escape room is a cooperative game that has been adapted into medical education and major academic conferences. We describe the design, development, and implementation of an educational ID-themed escape room activity entitled "Out-BREAK!" at an international conference, IDWeek 2023. An anonymous survey was conducted to collect demographic data, assess participant satisfaction with the escape room puzzles, and gauge participant interest in game-based learning. Thirty escape room sessions were held over 3 days and included 201 participants. Escape room survey respondents (n = 132) were younger and more likely to be trainees compared with in-person IDWeek attendants. Among 131 responses, all respondents enjoyed the experience and would recommend the escape room activity to friends. Survey respondents enjoyed the puzzle solving (93%), medical content (92%), and team building (79%) components. Only 35% of the respondents had ever previously participated in game-based learning; 95% thought the escape room was a valuable teaching method. Among the 72 survey respondents involved in medical education, almost all (90%) said they were interested in incorporating escape rooms into medical education. The Out-BREAK! escape room at IDWeek 2023 was successfully implemented and well received. Despite only a third of participants having prior experience with game-based learning, almost all respondents perceived the escape room to be an effective teaching method.

A randomised controlled implementation study integrating patient self-screening with a remote central monitoring system to screen community-dwellers aged 75 years and older for atrial fibrillation.

Diagnosis of atrial fibrillation (AF) provides opportunities to reduce stroke risk. This study aimed to compare AF diagnosis rates, participant satisfaction and feasibility of an electrocardiogram (ECG) self-screening virtual care system with usual care. This randomised controlled implementation study involving community-dwelling people aged ≥75 years was conducted from May 2021 to June 2023. Participants were given a handheld single-lead ECG device and trained to self-record ECGs once daily on weekdays for 12 months. The control group received usual care with their general practitioners in the first 6 months and participated in the subsequent 6 months. AF diagnosis and participant satisfaction were assessed at 6 months. 200 participants (mean age 79.0±3.4 years; 54.0% female; 72.5% urban). AF was diagnosed in 10/97 (10.3%) intervention participants and 2/100 (2.0%) in the control group (Odds Ratio 5.6, 95% CI 1.4-37.3, p=0.03). In the intervention, 80% of AF cases were diagnosed within 3 months. 91/93 (97.9%) intervention participants and 55/93 (59.1%) control-waitlisted participants (p<0.001) were satisfied with AF screening. Of the expected 20 days per month, the overall monthly median number of days participants self-recorded ECGs was 20 (interquartile range 17-22). Participants were confident using the device (93%), reported it was easy to use (98%) and found screening efficient (96%). Patient-led AF self-screening using single-lead ECG devices with a remote central monitoring system was feasible, acceptable, and effective in diagnosing AF among older people. This screening model could be adapted for implementation, interfacing with integrated care models within existing health systems.

Evaluation of local people's perceptions, satisfaction, and support for tourism regarding the Şanlıurfa culture route festival

This study aims to determine the participants' perceptions, satisfaction, and support for tourism regarding the Şanlıurfa Culture Route Festival. The participants' perceptions of the festival's social, individual, economic, and touristic benefits significantly influence their satisfaction levels. Among these, perceived economic and personal benefits impact festival satisfaction the most. Furthermore, participants' satisfaction with the festival substantially affects their support for tourism development. Accordingly, the positive perception of the benefits associated with the festival influences satisfaction levels, and high satisfaction levels directly impact tourism development support in the destination. Analysing the averages of the responses given by participants to the scales, it is found that the festival helps alleviate daily stress, contributes to the promotion of the region, provides social interaction opportunities for local people, increases the business volume of local enterprises and that the events organised during the festival are sufficient. Additionally, it has been observed that participants intend to attend the Culture Route Festival again and strongly support tourism development.

Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise.

This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury. Pilot randomized clinical trial. Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences. The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status. This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.

Cognitive Performance is Associated With 1-Year Participation and Life Satisfaction Outcomes: A Traumatic Brain Injury Model Systems Study.

To determine, in persons with traumatic brain injury (TBI), the association between cognitive change after inpatient rehabilitation discharge and 1-year participation and life satisfaction outcomes. Secondary analysis of prospectively collected TBI Model Systems (TBIMS) data. Inpatient rehabilitation and community. 499 individuals with TBI requiring inpatient rehabilitation who completed the Brief Test of Adult Cognition by Telephone (BTACT) at inpatient rehabilitation discharge (ie, baseline) and 1-year postinjury. Participation Assessment with Recombined Tools-Objective (PART-O) and Satisfaction with Life Scale (SWLS). Of 2,840 TBIMS participants with baseline BTACT, 499met inclusion criteria (mean [standard deviation] age=45 [19] years; 72% male). Change in BTACT executive function (EF) was not associated with 1-year participation (PART-O; β=0.087, 95% CI [-0.004, 0.178], P =.061) when it was the sole model predictor. Change in BTACT episodic memory (EM) was associated with 1-year participation (β=0.096, [0.007, 0.184], P =.035), but not after adjusting for demographic, clinical, and functional status covariates (β=0.067, 95% CI [-0.010, 0.145], P =.089). Change in BTACT EF was not associated with life satisfaction total scores (SWLS) when it was the sole model predictor (β=0.091, 95% CI [-0.001, 0.182], P =.0503). Change in BTACT EM was associated with 1-year life satisfaction before (β=0.114, 95% CI [0.025, 0.202], P =.012) and after adjusting for covariates (β=0.103, [0.014, 0.191], P =.023). In secondary analyses, change in BTACT EF was associated with PART-O Social Relations and Out and About subdomains before (Social Relations: β=0.127, 95% CI [0.036, 0.217], P =.006; Out and About: β=0.141, 95% CI [0.051, 0.232], P =.002) and after (Social Relations: β=0.168, 95% CI [0.072, 0.265], P <.002; Out and About: β=0.156, 95% CI [0.061, 0.252], P <.002) adjusting for functional status and further adjusting for covariates (Social Relations: β=0.127, 95% CI [0.040, 0.214], P =.004; Out and About: β=0.136, 95% CI [0.043, 0.229], P =.004). However, only the models adjusting for functional status remained significant after multiple comparison correction (ie, Bonferroni-adjusted alpha level=0.002). EF gains during the first year after TBI were related to 1-year social and community participation. Gains in EM were associated with 1-year life satisfaction. These results highlight the potential benefit of cognitive rehabilitation after inpatient rehabilitation discharge and the need for interventions targeting specific cognitive functions that may contribute to participation and life satisfaction after TBI.

Abstract B054: Using Libraries to Educate About Cancer Finances (LEAF): A pilot study of an educational webinar intervention to address information needs for community individuals affected by cancer

Abstract Introduction. Financial toxicity affects 30-70% of cancer patients. There is limited data on interventions to address practical and financial information needs that could mitigate financial toxicity for community individuals affected by cancer. Our objective was to test feasibility of a pilot educational webinar intervention and assess patient reported outcomes, knowledge, and satisfaction. Methods. An educational webinar intervention was advertised by Los Angeles Public Library and delivered by community organization Triage Cancer. Four live webinars focused on Understanding Health Insurance, Decisions About Work, Getting Organized, and Being Prepared. Attendees who self-identified as cancer patients, survivors, or caregivers were recruited to participate. Electronic surveys assessed baseline demographics and patient reported outcome measures including Health Insurance Literacy Measure (range 9-36, higher scores indicate higher literacy), PROMIS Self-Efficacy (range 10-50, higher scores indicate higher self- efficacy), InCharge Financial Distress/Well-Being (range 1-10, higher scores indicate better financial well-being), and knowledge questions (20 total) at baseline and 3 months. After each session, the Client Satisfaction Questionnaire for Internet-based interventions (range 0-32, higher scores indicate greater satisfaction) and knowledge questions were assessed (5 per session). Results. There were 18 total attendees with 8-11 attendees per session. Of 8 consented participants, 71% were female, 58% were &amp;gt;50 years old, and all were insured. Participants were diverse (29% Asian, 29% White, and 14% Indigenous). Seven participants completed the baseline survey and were eligible for analysis. Participants attended an average of 2.3 sessions (range 1-4). At baseline, average health insurance literacy was 24.5, self-efficacy was 42.4, financial distress/well-being was 5.8, and overall knowledge score was 71%. Among 4 participants who completed the 3-month survey, average health insurance literacy improved by 28%, self-efficacy worsened by 14%, financial distress/well-being improved by 34%, and overall knowledge scores improved by 2%. After each webinar, average session knowledge increased after Getting Organized (n=4, +21%), Understanding Health Insurance (n=2, +17%), and Being Prepared (n=5, +12%) and was unchanged after Decisions about Work (n=5). There was moderate/high satisfaction with CSQ-I scores ranging from 20-29 for the four sessions. Conclusion. These results demonstrate the feasibility and participant satisfaction of a small pilot educational webinar intervention about practical and financial topics delivered in partnership with a public library system and community organization. Preliminary findings suggest the potential to improve certain outcomes (i.e., health insurance literacy, financial distress/well- being, and knowledge) with the intervention. Future efforts are focused on increasing dissemination through structured self-study of recorded webinars and reaching those with lower baseline health literacy or technological comfort. Citation Format: Margaret Liang, Shu-Fan Chen, Monica Bryant, Joanna Doran, Madeleine Ildefonso, Caroline Zakarian, Patricia Thompson. Using Libraries to Educate About Cancer Finances (LEAF): A pilot study of an educational webinar intervention to address information needs for community individuals affected by cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B054.

Impact and learner perspectives of a spaced-education platform to assess hand hygiene auditor competency.

To ensure whether spaced education, which increases long-term knowledge retention, could be integrated into auditor competency assessment. Quality improvement project. Academic, freestanding children's hospital. Hand hygiene (HH) auditors. We enrolled trained HH auditors in an online spaced-education platform to assess mastery of knowledge, delivering 46 unique questions at spaced intervals followed by rationale; we retired questions after 3 correct answers. An e-mailed 10-item survey gauged participant satisfaction with the program. The Wilcoxon signed-rank test was used to compare change in median knowledge score from first to final attempt. A total of 12,120 questions were attempted by 126 auditors, and 49 (39%) completed the entire course. Median knowledge score increased significantly by 10.5 percentage points (IQR 4-15) between first and final attempts (P < 0.001). Thirty auditors (27%) responded to the survey. The majority agreed the number and complexity of questions were appropriate (57% and 67%, respectively). Eighty-seven percent reported the platform easy to navigate, and 77% agreed adequate time was provided for completion. Free-text suggestions included delivering fewer questions at a narrower spacing interval over a shorter time frame because of competing work demands. Auditor knowledge of HH indications and technique is critical to ensuring data validity. A spaced-education competency program improved HH auditor knowledge in the short term. Completion rate was low, and some participants expressed a desire for fewer questions over a shorter time frame. This study offers insight into ways to optimize spaced education as a potential tool for HH competency assessment.

Safety and Efficacy of an Injectable Solution Enriched With Sodium Hyaluronate, Amino Acids, and Peptides in Relation to Superficial Facial Connective Tissues (Dermis and Retinacular Cutis).

Skin aging research often focuses on the dermis, overlooking the significance of the retinacular cutis (RC) in aging. This study aimed to investigate the efficacy, safety, and effect of an injectable solution containing hyaluronic acid, amino acids, and peptides, on facial sagging and laxity by targeting the RC. This single-center observational study recruited 28 female volunteers aged 25-65 years. The participants received four monthly injections of the studied solution. Objective measures included skin hydration, elasticity, color, thickness, collagen density evaluated via DermaLab Combo and high-resolution ultrasound imaging. Subjective measures included participant satisfaction evaluated using the Global Aesthetic Improvement Scale (GAIS). Adverse effects were monitored throughout the study period. Significant improvements were observed in skin hydration, elasticity, and collagen density after treatment. Hydration increased by 25.9% at T1 (30 days after last session), sustaining a 15.9% increase at T2 (120 days after last session). Elasticity improved by 29.2% at T1 and 20.7% at T2. Collagen density increased by 20.27% at T1 and 16.71% at T2. Self-reported GAIS scores showed consistent increases. Adverse effects were minimal and included only transient ecchymosis and mild pain. Injections of the solution had a substantial hydrating effect, enhanced elasticity, and increased collagen density in the RC and dermis. Results persisted at the 120-day follow-up, indicating sustained benefits. Hence, this injectable solution may offer a safe and effective non-invasive treatment option for improving skin laxity and sagging, targeting the RC and other deep connective tissue such as retaining ligaments.

Penyuluhan dan Sosialisasi Guna Meningkatkan Kesadaran Bahaya NAPZA bagi Remaja Desa Sumbersari

Abuse of Narcotics, Psychotropics and Addictive Substances (Drugs) among the younger generation is a crucial issue that threatens the future of the nation. This abuse has a significant negative impact on the mental and physical development of the younger generation. Therefore, prevention efforts through education, routine counseling and positive activities in the community are very important. The socialization program on the dangers of drugs was carried out at the Sumbersari Village Hall, Ngampel District, Kendal Regency. The targets for this activity are teenagers from Sumbersari Village. This activity is carried out using the ABCD method which includes identifying community strengths, asset mapping, community economic analysis, creating relationships and activity priorities, as well as monitoring and evaluation. The results of counseling regarding the abuse of narcotics, psychotropic substances and other addictive substances in Sumbersari village show significant benefits for the younger generation. Participants' responses emphasized the importance of the understanding provided. The suitability of participants' expectations with the reality of the activity can be seen from the appreciation for the presence of food and similarities with socialization at school. Participants' understanding also increased thanks to the material presented in an interesting way. Comfort during activities is an important factor in maintaining participant concentration. However, participant satisfaction was affected by schedule discrepancies.

Retrospective study on the outcomes and satisfaction with endometrial ablation by bipolar energy (NovaSure®) for the treatment of heavy menstrual bleeding.

To determine the effectiveness, safety, and participant satisfaction with endometrial ablation by bipolar energy (NovaSure®) in the treatment of heavy menstrual bleeding (HMB), and to investigate factors associated with poorer outcomes. Multicenter retrospective observational study based on medical record review of the outcomes related to endometrial ablation by the bipolar-energy technique procedure to treat HMB in the setting of three university teaching hospitals in Spain. A total of 333 women were included in the study. Most bipolar-energy ablations were successful (85.12%; n = 269 out of 316), with amenorrhea the most frequent outcome (39.6%, n = 131 out of 316). The majority of participants had no complications (95.5%; n = 317 out of 332), and of those who did, only 2.1% were related to the technique. No further treatment was required for HMB in 82.8% of women (n = 274 out of 331), and surgery was avoided in 91.8%; only 5.9% of women underwent ablation-related hysterectomy. In women with previous transverse cesarean sections (CS), 91.0% avoided subsequent surgical treatment. Eighty-six percent of women (n = 221 out of 257) were satisfied with the procedure. Bipolar-energy ablation is very effective and safe for the treatment of HMB and yielded a high rate of participant satisfaction in our setting. The presence of comorbidities or previous CSmay slightly reduce the effectiveness of the method, while performing concomitant surgery (mainly curettage) increases the rate of complications. Notably, despite the known increased risk of hysterectomy, most participants with previous CSs who underwent ablation avoided major surgery.

A brief descriptive analysis of a pilot study of peer support training and supervision for Texas firefighters

Background Peer support has been shown to reduce the incidence and severity of mental health disorders among firefighters. This pilot project had two aims: (1) to assess training satisfaction and knowledge, self-efficacy, and skills development of Texas firefighters participating in the International Association of Fire Fighters (IAFF) Peer Support Training, and (2) to determine if newly trained peer support specialists would use monthly phone supervision. Methods The study included 14 Texas firefighters who enrolled in the IAFF Peer Support Training. Pre- and post-tests were administered to evaluate training satisfaction, skills development, self-efficacy, and behavioral health knowledge of participants. Use of phone supervision over 6 months following the training was also recorded. Results Overall, participants reported high satisfaction with the training provided. While self-efficacy regarding detection of mental health issues and therapeutic empathy skills significantly improved following the training, participants did not show a significant improvement in knowledge regarding mental health. Attendance of participants to supervision calls was less than expected, although 71% attended at least one supervision call. Conclusions This project was successful in increasing firefighters’ self-efficacy and therapeutic empathy skills, and participants were highly satisfied with the training. However, further research on follow-up supervision of peer support trainees is needed.

Long guidewire peripheral intravenous catheters in emergency departments for management of difficult intravenous access: A multicenter, pragmatic, randomized controlled trial.

A quarter of patients who present to emergency departments (EDs) have difficult intravenous access (DIVA), making it challenging for clinicians to successfully place a peripheral intravenous catheter (PIVC). Some literature suggests that guidewire PIVC improves first-insertion success rate. The aim was to determine the clinical and cost-effectiveness of a novel long PIVC (5.8 cm) with a retractable coiled guidewire (GW-PIVC) for patients with DIVA, compared with standard care PIVCs. A pragmatic randomized controlled trial was conducted in two Australian EDs. Eligible participants were adults assessed as meeting DIVA criteria. Participants were randomized (1:1 ratio; stratified by hospital) to either GW-PIVC (long) or standard care group (short or long PIVC). The use of ultrasound was discretionary in the standard care group and was recommended in the GW-PIVC group due to the pragmatic design that was primarily testing the GW-PIVC rather than the ultrasound use. Primary outcome was first-insertion success and secondary outcomes included all-cause device failure, patient and staff satisfaction, and cost-effectiveness. The analysis was intention to treat. A total of 446 participants were randomized and 409 received PIVCs. The use of GW-PIVC, compared with standard PIVC, had a lower first-insertion success rate (68% vs. 77%, odds ratio [OR] 0.65, 95% confidence interval [CI] 0.43-0.99, p < 0.05). There was no difference in PIVC failure (134.0 per 1000 catheter days [GW-PIVC] vs. 111.8 [standard PIVC] per 1000 catheter days, hazard ratio 1.18, 95% CI 0.72-1.95). Both participant (8/10 vs. 9/10, median difference [MD] -1.00, 95% CI -1.37 to -0.63) and clinician (8/10 vs. 10/10, MD -2.00, 95% CI -2.37 to -1.63) satisfaction was lower with GW-PIVCs compared with standard PIVCs. More nurses inserted standard PIVCs than GW-PIVCs (56.9% vs. 36.5%) and had less confidence in their ultrasound skills (28.0% vs. 46.6% self-claimed as advanced/expert users). The cost per participant of GW-PIVC insertions was 2.46 times greater than standard PIVC insertions ($AU80.24 vs. $AU32.57). GW-PIVCs had significantly lower first-insertion success and non-significantly higher all-cause catheter failure. Additional training and device design familiar to clinicians are vital factors to enhance the likelihood of successful future implementation of GW-PIVCs.

Private Mediation as a Means of Achieving Public Goals

The development and strengthening of private mediation significantly determine the possibilities of overcoming the challenges in the process of the institutionalization of mediation. Establishes an effective system of dispute resolution at the state level. The legal or practical regulation of the abovementioned should be considered a prerequisite for implementing the interests of the subjects of law and forming legal awareness. In addition, the perfect functioning of the justice system, which should ensure the implementation of the legal interests of the subjects of law, is an expression of public and private interests. The well-being and satisfaction of the civil turnover participants are significantly determined by the existence of flexible dispute resolution systems and mechanisms, the correct implementation of which creates guarantees for the stability of civil turnover. In addition, it’s in the public interest that the chain of the means of dispute resolution should be flexible and diverse and allow the interested parties to choose an acceptable method in each case. Regardless of its importance, providing fast and affordable forms of dispute resolution remains a challenge. In addition, it’s important to strengthen cooperation between the public and private sectors in this process, which will be considered an innovation in Georgia. Accordingly, following legislative changes, it is important to raise public awareness, improve legal culture, and strengthen the court’s role in implementing state policy regarding dispute resolution.

Strengthening Business Mindset in Facing Digitalization for the People of Gapan, Philippines

This community service program aims to increase understanding and digitalization skills among business people in Gapan. This program includes various main activities such as seminars, practical skills training, as well as assistance and mentoring sessions. Participants gain insight into the importance of digitalization, skills in using business software, data management, digital marketing, and e-commerce. Mentoring and mentoring help participants apply knowledge in their business context, overcome practical challenges, and develop an adaptive and innovative mindset. The program results show an increase in participants' awareness, knowledge and skills regarding digitalization. Evaluation through participant satisfaction surveys and training observations indicated a high level of satisfaction and a need for more practical sessions and more intensive mentoring. Overall, this program has succeeded in preparing the people of Gapan to face the digital era and increasing their business competitiveness. Important findings include increased access to technology, knowledge about e-commerce, use of data for business decisions, as well as changes in attitudes and mindsets that are more adaptive and innovative. This program makes a positive contribution to increasing competitiveness and local economic growth

3D printed versus milled stabilization splints for the management of bruxism and temporomandibular disorders: study protocol for a randomized prospective single-blinded crossover trial

BackgroundNowadays, stabilization splints for the management of bruxism and temporomandibular disorders (TMD) can be produced utilizing a digital workflow comprising a digital impression of the teeth, digital splint design, and computer-aided manufacturing of the splints. The latter is usually a milling process, however, more recently 3D printing gained popularity due to its better cost and time efficiency. It remains unknown whether 3D printed stabilization splints are inferior to milled splints regarding clinical outcomes.MethodsThis clinical trial assesses the non-inferiority of 3D printed occlusal splints compared to milled occlusal splints in a monocentric prospective randomized single-blinded crossover trial with two cohorts. One cohort includes 20 participants with bruxism, the other 20 participants with pain-related TMD, i.e., myalgia, myofascial pain, or arthralgia of the jaw muscles/the temporomandibular joint(s) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Michigan-type stabilization splints are fabricated in a digital workflow by milling or 3D printing using CE-marked materials within their intended purpose. The participants wear a milled and a 3D printed splint in a randomized order for 3 months each, with follow-up visits after 2 weeks and 3 months. Investigated outcome parameters are oral health-related quality of life (OHRQoL) evaluated by the Oral Health Impact Profile (OHIP-G14), participant satisfaction as rated on a visual analog scale, therapeutic efficacy, and technical result of the splints. In this context, therapeutic efficacy means antagonist wear and—in the TMD group—reduction of pain/disability assessed by the Graded Chronic Pain Scale (GCPS v2.0) and clinical assessment following the DC/TMD standard, while technical outcome measures splint fit, wear and fracture rate.DiscussionThe trial will provide important information on the clinical outcome of 3D printed stabilization splints in comparison to milled splints and will, therefore, enable an evidence-based decision in favor of or against a manufacturing process. This, in turn, will guarantee for a maximum of the patient’s OHRQoL during splint therapy, therapeutic efficacy, and longevity of the splints.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00033904. Registered on March 15, 2024.

Impact of a social media-delivered distance learning program on mhGAP training among primary care providers in Jalisco, Mexico

BackgroundThe World Health Organization’s (WHO) Mental Health Gap Action Programme (mhGAP) aims to provide evidence-based guidelines for the management of mental, neurological, and substance use disorders in non-specialized healthcare settings. However, implementing these guidelines remains a challenge due to various factors, including limited training opportunities for primary care providers. This study con the effectiveness of a social media-delivered distance education program on the mhGAP intervention guide, to overcome barriers of technology access and digital literacy, providing a familiar and accessible platform for primary care providers in Jalisco.MethodsA quasi-experimental study with a pre-test/post-test design was conducted. Primary care providers from Jalisco were invited to participate in a distance education program on the mhGAP intervention guide. The program consisted of online modules, webinars, and discussion forums facilitated by mental health experts. Knowledge assessments were conducted before and after the intervention using a standardized questionnaire. Participant satisfaction and perceived utility were also evaluated through surveys and focus group discussions.ResultsA total of 1,096 primary care providers completed the program. The mean knowledge score significantly improved from 58.2% (SD = 12.8%) in the pre-test to 81.4% (SD = 9.6%) in the post-test (p < 0.001), with a large effect size (Cohen’s d = 2.04). Subgroup analyses revealed consistent knowledge gains across different demographic and professional characteristics. Participant satisfaction was high, with 92% rating the program’s overall quality as “good” or “excellent.” Qualitative findings highlighted the benefits of accessibility, flexibility, interactivity, and practical applicability of the distance education approach.ConclusionsThe social media-delivered distance education program on the mhGAP intervention guide effectively improved the knowledge of primary care providers in Jalisco, Mexico. Participants reported high levels of satisfaction and perceived utility. This study demonstrates the potential of distance education strategies to disseminate evidence-based guidelines and enhance mental health service delivery in primary care settings, particularly in resource-limited areas.

Comparing the outcomes of in-vitro fertilization in patients receiving vaginal, subcutaneous, and intramuscular progesterone for luteal phase support: a three-armed randomized controlled trial

BackgroundThe optimal approach to luteal-phase support in infertility treatment remains a subject of debate. This study was conducted to investigate the clinical outcomes, side effects, and patient satisfaction associated with vaginal, subcutaneous, and intramuscular progesterone administration in infertile women undergoing Frozen Embryo Transfer (FET).MethodsThis three-armed randomized clinical trial assigned infertile patients eligible for FET to three progesterone treatment groups: vaginal suppositories (400 mg twice daily; n = 100), subcutaneous injections (25 mg daily; n = 102), and intramuscular injections (50 mg daily; n = 108). The primary outcomes were chemical and clinical pregnancy rates per embryo transfer cycle, with chemical pregnancy defined as beta-human chorionic gonadotropin levels > 50 IU/mL two weeks post-transfer and clinical pregnancy confirmed by ultrasound four weeks later. Exploratory outcomes included progesterone-related adverse effects and participant satisfaction, assessed via a Likert-scale survey 12 weeks post-transfer. Statistical analyses included Chi-square tests for categorical data, one-way analysis of variances, and Kruskal–Wallis tests for continuous data.ResultsThe intramuscular progesterone group had significantly higher chemical pregnancy rates compared to the vaginal and subcutaneous groups (41.7% vs. 26.0% and 27.5%, respectively; p = 0.026). Although the clinical pregnancy rate was also higher in the intramuscular group (32.4%) compared to the vaginal (23.0%) and subcutaneous groups (21.6%), this difference was not statistically significant (p = 0.148). Additionally, patient satisfaction was greater with vaginal and subcutaneous applications than with intramuscular injections (p < 0.001), likely due to a significantly higher incidence of side effects, such as pain and edema at the injection site, in the intramuscular group (p < 0.001).ConclusionsWe found that intramuscular progesterone resulted in higher chemical pregnancy rates than vaginal or subcutaneous routes, but this did not translate into higher clinical pregnancy rates. Despite its effectiveness, intramuscular administration was associated with more adverse effects and lower patient satisfaction. Future research should explore optimizing progesterone regimens to balance efficacy and patient comfort.Trial registrationThe trial protocol was registered on December 6, 2020, in the Iranian Registry of Clinical Trials (IRCT), a primary registry in the World Health Organization (WHO) Registry Network, under the registration number IRCT20141217020351N12.

Targeted precision cryotherapy for acne vulgaris.

Acne vulgaris poses a significant dermatological challenge, necessitating alternative treatments due to limitations and side effects associated with current therapies. This pilot clinical trial investigated the feasibility and efficacy of precision cryotherapy for acne vulgaris. A total of 20 volunteers underwent targeted precision cryotherapy using a carbon dioxide-based device. Treatment outcomes were assessed using various parameters, including Investigator Global Assessment (IGA) score, acne lesion count, erythema index (EI), global evaluation score, and participant satisfaction. Safety monitoring included adverse event reporting and physical examination. Precision cryotherapy demonstrated a significant reduction (90.25%) in the acne lesion count by week 4, with clinical improvement indicated by IGA score reduction (p<0.001). The EI showed notable improvements at weeks 1, 2, and 4. The global evaluation score demonstrated a 75%-100% clinical improvement at Visit 4. Participants reported high satisfaction (6.75±0.79) with the procedure. No adverse event or discomfort was reported. Precision cryotherapy effectively improved acne lesions, which was safe and satisfactory for participants. These findings suggest its potential as an alternative therapeutic modality, especially for populations with limited treatment options. Further research is needed to validate the results and explore underlying mechanisms.

Randomized, controlled, within-patient, single-blinded pilot study to evaluate the efficacy of 12-weeks of endermotherapy with adult burn survivors

BackgroundVacuum massage, or endermotherapy, is applied to scar tissue with the primary therapeutic goal of promoting structural or physiological changes. These changes are intended to enhance pliability, enabling the skin to possess the strength and elasticity required for normal mobility. The advantage of vacuum massage compared to therapist-generated manual massage is that it provides a standardized dosage using rollers and suction valves to mobilize the tissue. However, research documenting and supporting its impact on post-burn hypertrophic scar is lacking. Thus, this study was designed to objectively characterize the changes in scar elasticity, erythema, melanin, thickness, and transepidermal water loss immediately after a vacuum massage session and after a 12-week course of treatment compared to intra-individual matched control scars. MethodsWe conducted a prospective, randomized, controlled, within-patient, single-blinded clinical trial, initially designed as a fully-powered study but limited to a pilot study due to COVID-19 restrictions. Nineteen burn survivors consented to participate and 16 completed the study. Two homogeneous, intra-individual scars were randomized to usual care control or vacuum massage therapy plus usual care. Vacuum massage interventions were provided by a certified massage therapist three times per week for 12 weeks. Scar characteristics were evaluated every four weeks immediately before and after mechanical massage treatment. The evaluations included measurements of elasticity (Cutometer), erythema and melanin (Mexameter), transepidermal water loss (TEWL) (Tewameter), and thickness (high-frequency ultrasound). Linear mixed-model analyses were performed to test for immediate and long-term treatment effects. ResultsThe ANOVA analyses revealed a non-significant time:treatment interaction for elasticity, erythema, melanin, thickness, or TEWL. There was a significant increase in elasticity and erythema and a decrease in TEWL in both the control and treatment sites over time with consistent standard care. However, there was no statistically significant immediate or long-term treatment effect for any of the skin characteristics. Nonetheless, the mean participant satisfaction was 4/5 (SD = 1.5) and the mean participant perception of effectiveness was 8/10 (SD = 1.9). ConclusionsThis pilot study did not find a treatment benefit of vacuum massage therapy for elasticity, erythema, melanin, thickness or TEWL, but it did find an improvement with time in elasticity, erythema and TEWL. Despite the lack of objective improvement of the treated scar site, participants were satisfied with the results and believed vacuum massage was very effective. Further high-quality research is required to better inform clinicians patient education and treatment decisions for this costly, burdensome treatment approach that has high participant satisfaction.

P37: Building Resilience in Geriatric Health Today (BRIGHT)

Objectives: With a rapidly aging population in Singapore, late-life depression and anxiety become increasingly relevant as they impact on quality of life, disability and healthcare costs. BRIGHT initiative begins as a group coaching programme with the aim to empower at risk elderly to self-manage physical and mental health ailments. This poster aims to present the latest findings and updates from BRIGHT as we embark on to the next phase, BRIGHT Train the Trainers (BRIGHT T3) programme to ensure long term sustainability of theseinterventions.Methods: BRIGHT consists of three two-hour workshops facilitated by a multidisciplinary team (MDT) comprising psychiatrists, psychologists, and medical social workers. Two virtual runs were conducted over zoom while five physical runs were conducted on site at the local senior activity centres. Scales of GDS, GAI, HCS and SF 12 were administered pre and post intervention to capture 1) reduction in depressive and anxiety symptoms, 2) quality of life, 3) improvement in health confidence, and 4) participant satisfaction.This intervention is supplemented by a mobile wellness application nested within Singhealth Healthbuddy application, providing seniors access to an application with self-monitoring, inbuilt reward systems to reinforce positive behaviours and self-help mental health resources.BRIGHT T3 programme aims to promote mental wellness and create sustainable impact by establishing a self- sustaining model through peers, volunteers and grassroot leaders who will continue to deliver the programme in their respective communities. Eligible trainers identified will be pre-screened by the BRIGHT team and a baseline assessment of mental health literacy will be administered. The comprehensive training regimen comprises of training modules in didactic and experiential format which will be led by the BRIGHT MDT. As trainees gain competence, they will progress to leading sessions under close supervision.Results: Average participant satisfaction was 85% with positive verbal reviews from community partners as well. GDS, GAI, HCS, and SF 12 PCS scores improved by an average of 1.8, 1.7, 1.6 and 1.8 respectively. On the other hand, SF-12 MCS scores decreased by an average of 1.8.Conclusions: By focusing on a train-the-trainer model, the programme ensures long-term sustainability of these interventions.