Training Package Research Articles

Diagnostic Performance of Artificial Intelligence in Chest Radiographs Referred from the Emergency Department

Background: The increasing integration of AI in chest X-ray evaluation holds promise for enhancing diagnostic accuracy and optimizing clinical workflows. However, understanding its performance in real-world clinical settings is essential. Objectives: In this study, we evaluated the sensitivity (Se) and specificity (Sp) of an AI-based software (Arterys MICA v29.4.0) alongside a radiology resident in interpreting chest X-rays referred from the emergency department (ED), using a senior radiologist’s assessment as the gold standard (GS). We assessed the concordance between the AI system and the resident, noted the frequency of doubtful cases for each category, identified how many were considered positive by the GS, and assessed variables that AI was not trained to detect. Methods: We conducted a retrospective observational study analyzing chest X-rays from a sample of 784 patients referred from the ED at our hospital. The AI system was trained to detect five categorical variables—pulmonary nodule, pulmonary opacity, pleural effusion, pneumothorax, and fracture—and assign each a confidence label (“positive”, “doubtful”, or “negative”). Results: Sensitivity in detecting fractures and pneumothorax was high (100%) for both AI and the resident, moderate for pulmonary opacity (AI = 76%, resident = 71%), and acceptable for pleural effusion (AI = 60%, resident = 67%), with negative predictive values (NPV) above 95% and areas under the curve (AUC) exceeding 0.8. The resident showed moderate sensitivity (75%) for pulmonary nodules, while AI’s sensitivity was low (33%). AI assigned a “doubtful” label to some diagnoses, most of which were deemed negative by the GS; the resident expressed doubt less frequently. The Kappa coefficient between the resident and AI was fair (0.3) across most categories, except for pleural effusion, where concordance was moderate (0.5). Our study highlighted additional findings not detected by AI, including 16% prevalence of mediastinal abnormalities, 20% surgical materials, and 20% other pulmonary findings. Conclusions: Although AI demonstrated utility in identifying most primary findings—except for pulmonary nodules—its high NPV suggests it may be valuable for screening. Further training of the AI software and broadening its scope to identify additional findings could enhance its detection capabilities and increase its applicability in clinical practice.

Evaluation of an Educator Mental Health Literacy Online Training Package

ABSTRACTEducators and school staff are critical to recognizing and supporting students' mental health, but frequently do not have the training to confidently bring mental health literacy into the classroom or assist students who experience distress. Moreover, few free, easily accessible trainings are available for this audience. Classroom Well‐being Information and Strategies for Educators (Classroom WISE) is a free, K‐12 mental health literacy training package that includes a self‐paced online course, video library, and resource collection. Using pre‐ and postcourse anonymous surveys from over 2000 educators, school mental health professionals, and school staff who completed Classroom WISE, this study found high levels of satisfaction, significant increases in mental health literacy knowledge, high perceived importance of mastering skills to promote student well‐being, and increased preparedness to implement mental health‐related strategies. Participants reported intentions to bring mental health literacy into the classroom, and identified barriers and facilitators to using Classroom WISE that leaders can respond to or employ when moving to implement Classroom WISE across a school or district. School district or school‐wide use of Classroom WISE can assist in building a safe and supportive school environment and help students in need to access mental health services.

Protocol for a mixed methods process evaluation for a randomised controlled trial to improve shared decision-making about, and uptake of, osteoporosis medicines: the iFraP study

Background High quality shared decision-making (SDM) conversations involve people with or at risk of osteoporosis and clinicians working together to decide, where appropriate, which evidence-based medicines best fit the person’s life, beliefs, and values. The improving uptake of Fracture Prevention drug treatments (iFraP) intervention comprises a computerised Decision Support Tool (DST), clinician training package and information resources, designed for use in UK Fracture Liaison Service (FLS) consultations. The iFraP intervention will be tested in a pragmatic, parallel-group, individual randomised controlled trial in patients referred to four FLSs in England. This mixed methods process evaluation aims to assess which components of iFraP were delivered and how (fidelity), whether iFraP results in a change in osteoporosis drug treatment initiation rates and how, and how context affects implementation of iFraP and outcomes. Methods We will collect quantitative data using (1) Case Report Forms completed by FLS clinicians; (2) self-reported questionnaires completed by patient participants; and (3) DST analytic data. We will collect qualitative data using (1) semi-structured interviews with patients who receive the iFraP intervention in their FLS appointment, FLS clinicians delivering iFraP appointments, and primary care clinicians that have consulted with a patient following their iFraP FLS appointment; and (2) FLS consultation recordings. A triangulation protocol will be used to integrate the quantitative and qualitative findings to generate novel insights about the intervention under evaluation. Discussion The process evaluation, alongside the trial, will help to understand what elements of the iFraP intervention were delivered and how, the mechanisms of impact and how context affected implementation and outcomes, and intervention acceptability. Mixed methods interpretation will lead to further insights about the implementation of SDM and DSTs in-practice. Trial registration ISRCTN: 10606407, 21/11/2022 https://doi.org/10.1186/ISRCTN10606407

Esports Training, Periodization, and Software—A Scoping Review

Electronic sports (esports) and research on this emerging field are interdisciplinary in nature. By extension, it is essential to understand how to standardize and structure training with the help of existing tools, developed over years of research in sports sciences and informatics. Our goal for this work is to review the available literature in esports research, focusing on sports sciences (training, periodization, planning, and career stages) and software (training tools, visualization, analytics, and feedback systems). To verify the existing sources, we applied the framework of a scoping review to address the search from multiple scientific databases with further local processing. We conclude that the current research on esports has mainly focused on describing and modeling performance metrics that span over multiple fragmented research areas (psychology, nutrition, informatics). However, these building blocks have not been assembled into a well-functioning theory of performance in esports by, e.g., providing exercise regimes or methods of periodization for esports.

Design, Implementation, and Evaluation of a Training Package for Violence Prevention in Adolescents: Its Effect on Self-control and Social Skills

Background: Adolescence is a period marked by significant changes, during which individuals face major emotional, cognitive, and behavioral challenges. Violence remains a significant global concern, and factors such as self-control and social skills play a crucial role in reducing and managing adolescent violence. Objectives: This study aimed to design, implement, and evaluate a training package for violence prevention (TPVP) in adolescents and assess its impact on self-control and social skills among students in Isfahan. Methods: This study was conducted on sixty 13 - 15-year-old female students in Isfahan, Iran, during the 2022 - 2023 academic year. First, the TPVP was developed after reviewing relevant theories and existing training packages, then it was evaluated by a panel of faculty members from the Department of Social Medicine, psychiatrists, and clinical psychologists. The students were randomly divided into two groups: (1) an intervention group, and (2) a control group, with 30 students in each group. The intervention group received the TPVP and attended five training sessions. To assess social skills and self-control, the Inderbitzen and Foster Social Skills Questionnaire and the Tangney Self-control Questionnaire were administered to both groups before and three months after the intervention. Results: Sixty female students aged 13 - 15 participated in this study. The mean self-control score in the intervention group was significantly higher than in the control group after the intervention (46.33 ± 6.488 vs. 40.44 ± 7.307, P = 0.002). Prior to the training, there was no significant difference in social skills scores between the two groups. However, following the intervention, the mean social skills score in the intervention group was significantly higher than in the control group (118.38.726 vs. 102.913.468, P < 0.0001). Conclusion: The violence prevention training package was effective in improving self-control and social skills among students. The study demonstrated that the implementation of a structured TPVP can enhance both self-control and social skills in adolescents.

Enhancing palliative care for oncology patients: The effect of educational intervention on nurses competency and Attitude

Background: Cancer is the second leading cause of death so the need for palliative care has increased to enhance patient’s quality of life and alleviate suffering. Nurses level of competency and attitude about palliative care are important factors affecting quality of care applied for patients. Aim: Assess and evaluate the nurses' competency and attitude regarding palliative care of cancers patients. Design: Pre -experimental (one group pre/posttest) design. Sample: A convenient sample of all available nurses (120). Setting: The study was carried out in Aswan Oncology Institute. Tools: Tool I: A structured interview questionnaire for nurses to assess nurse’s knowledge regarding palliative care, tool II: Nurses' observational checklist to assess nurses’ practices related to palliative care and tool III: Nurses' attitude toward palliative care. Results: The total score of nurses' knowledges had improved from 51.8% to 75.9% pre/post the intervention, concerning nurses’ total practices ,39.3% of the studied nurses had competent level of practice pre the intervention which improved to (82.1%) post intervention. Hundred percent of the studied nurses had negative attitude pre-palliative care intervention, while post 43.8% had negative attitude. Conclusion: Palliative care training package had significant improvement in nurses' attitude and competencies. Recommendations: Continuous in-service training program should be conducted periodically in order to update nurses' knowledge and improve their competencies levels regarding palliative cares.

Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals

ObjectivesResearch has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the ‘Mental Health Interventions for Children with Epilepsy’ (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.MethodsThe MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.ResultsTherapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.ConclusionsThe overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.

Blood pressure management protocol based on transtheoretical model effectiveness on self- care: A systematic review

Background: Hypertension is a prevalent medical condition associated with cardiovascular and kidney diseases, leading to premature death and disability. Despite medication use, hypertension continues to rise due to unhealthy lifestyles. Self-care strategies play crucial roles in effectively treating hypertension. We aimed to evaluate the effectiveness of interventions based on the transtheoretical model (TTM) in improving self-care, self-efficacy, and health-related quality of life (HRQOL) in hypertensive adults. Methods: A comprehensive search was performed in multiple databases using appropriate search strategies. Two independent reviewers screened articles, and assessed their adherence to the inclusion and exclusion criteria. The risk of bias in randomized controlled trials was assessed by the Cochrane Collaboration tool and quasi-experimental studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies. Results: The review included 24 studies with a total of 6553 participants. Most interventions aimed to encourage a healthier lifestyle and improve diet and physical activity. The message was delivered through various methods such as slide/tape messages, individual education/counseling sessions, telephone-delivered interventions, and multimedia training software based on the TTM. Control groups received physician visits or attended lifestyle lectures but did not receive specific behavior change programs like the intervention groups. Conclusion: Our results indicated that the TTM and stage of change model can be an appropriate framework for delivering educational messages to patients.

Content and design of respectful maternity care training packages for health workers in sub-Saharan Africa: Scoping review.

Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear. To explore the content and design of RMC training packages for health workers in sub-Saharan Africa. MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022. There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results. Key data, including training content and methods used, were extracted and summarized. Thirty-two citations from 26 studies/programs were identified (24 journal papers, 5 manuals/guides, 2 reports and 1 PhD thesis), with 27 citations from 22 studies informing the review findings. About half of all conducted studies were from East Africa. The most common topics in RMC trainings were communication, privacy and confidentiality, and human resources. Most trainings were multicomponent and appear to be largely in-service training. Health workers providing direct care to women, compared with non-clinical staff such as receptionists and cleaners, were the only recipients of training in most studies (81.8%). Two broad categories of training methods/tools were identified: workshop-based and action-based. Over 90% of the studies assessed impact of the training, with a majority focused on impacts on maternal health and care; however, half of the latter studies did not appear to have feedback mechanisms in place for implementing change. The content and design of RMC training in sub-Saharan Africa are multifaceted, suggesting the complexity of implementing/promoting RMC. Some progress has been made; however, missed opportunities in training remain with respect to study populations, training topics, cadres, and feedback mechanisms.

Using Peer Assessment Leveraging Large Language Models in Software Engineering Education

This paper explores the integration of generative AI and large language models into the realm of software engineering education and training, with a specific focus on the transformation of traditional peer assessment methodologies. The motivation stems from the growing demand for innovative educational techniques that can effectively engage and empower learners in mastering Software Engineering principles. The proposed approach involves presenting students with modeling exercises solved by ChatGPT, prompting them to critically evaluate and provide constructive feedback on the generated solutions. By engaging students in a dialogue with the AI model, we aim to foster a dynamic learning environment where learners can articulate their considerations and insights, thereby enhancing their comprehension of software engineering principles, critical thinking and self evaluation skills. Preliminary results from pilot implementations indicate promising outcomes, suggesting that this approach not only enhances the quality of peer feedback but also contributes to a more interactive and engaging educational experience.

Assessing vaccine hesitancy and vaccine literacy in the European prison population: a multicenter repeated cross-sectional study

Abstract The study aimed to quantify vaccine hesitancy and vaccine literacy in prison populations and assess their correlation prior and after the implementation of training and information activities targeting PLP. A repeated cross-sectional observational study was conducted in 13 prisons of 4 European countries prior and after the implementation of a co-developed training package. The study sample included 847 people living in prison in the baseline round. The second round is currently ongoing. Through a structured questionnaire vaccine hesitancy, vaccine literacy, general health literacy, previous vaccine refusal history and socio-demographic characteristics of participants were assessed. Exploratory factor analysis was used to extract three independent components of vaccine hesitancy. Logistic regression was applied to assess the association between previous vaccine refusal and vaccine hesitancy; multiple linear regression was applied to assess the association between vaccine hesitancy and vaccine literacy and general health literacy. All analyses were adjusted for socio-demographic variables. In the baseline round, we identified three independent components of vaccine hesitancy explaining 49% of the total variance: Mistrust (proportion of the variance explained, 27%), Concern (14%) and Conspiracy (8%). All the components were associated with previous vaccine refusal (p-value <0.001) and presented very good internal consistency. Young participants presented the highest levels of vaccine hesitancy; migrants had the lower levels of Mistrust and the higher level of Concern; all three factors were lower among participants with the highest degree of academic education. Mistrust and Concern were inversely associated with vaccine literacy while all three subscales were associated with general health literacy (all p-values <0.001).

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

An ACNAP survey assessing the cardiology multidisciplinary learning needs to support lipid management

Abstract Background/ Introduction: Reducing LDL cholesterol is a high priority in cardiovascular care but requires knowledge and skills to deliver effectively. Nurses and allied professionals (NAPs) can play a major role in supporting lipid optimisation. Most NAPs will work together with patients prescribed lipid lowering therapies, and some may be more closely involved in initiation and monitoring. The Association of Cardiovascular Nursing and Allied Professionals (ACNAP) wanted to gauge the level of understanding, confidence and learning needs of cardiology professionals to better implement European Society of Cardiology (ESC) lipid lowering guidelines. Purpose The aim of the project was to highlight gaps in knowledge to better inform needs for training and educational programmes developed by ACNAP. Methods A 29 question electronic survey was developed by expert consensus, exploring previous experience, clinical knowledge, and perceptions of learning needs. It was launched at the EuroHeartCare conference in June 2023, on social media, and members of the ESC were emailed inviting participation. Results 123 people responded. 29.5% of the respondents were physicians and 70.5% NAPs. Most respondents were involved in lipid optimisation of some description with only 7.0% of respondents having no direct involvement in their patient cohort. A higher percentage of respondents responded "totally agree" when asked it they knew what cholesterol targets to aim for in secondary prevention, compared to primary prevention (61% v 41.5%). 94% of respondents felt comfortable when to initiate statins and and 82% ezetimibe. This reduced to 45% for inclisiran and 40% for bempedoic acid. Similarly, the majority felt comfortable counselling a patient newly initiated on statins or ezetimibe, but significantly fewer the newer lipid lowering therapies. Experience and understanding of familial hypercholesterolaemia (FH) was also explored. Only half the respondents would be comfortable in identifying and diagnosing FH and a further 25% unsure. A large percentage (37%) were unaware of the Simon Broome criteria or the Dutch Lipid Criteria Network (49%). When considering learning needs, 71% of NAP respondents needed extra support to help make lipid lowering decisions. This rises to 84% and 74% when looking at nurses and pharmacists separately, respectively. Nearly 76% would prefer any learning to be delivered online, with interactive online training packages being the most popular method. Conclusions The three main gaps identified by NAPs were: management in primary prevention (initiation and targets), the newer innovative medicines (bempedoic acid, inclisiran and PCSK9 monoclonal antibodies) and FH. Interestingly, these are the same gaps highlighted by physician responders. These findings can help guide ACNAP and ESC in the development of educational programmes with the aim to improve better lipid management overall.

Effect of Paraprofessional AAC Training Package on Staff and Student Communication

Effect of Paraprofessional AAC Training Package on Staff and Student Communication

To be or not to be? The question of equitable healthcare

Purpose The purpose of this commentary is to appraise and critically evaluate sexual minorities' mental health provision according to individual and systemic barriers to mental health care. It addresses the issue of health inequity by first exploring the background narrative that informs health inequalities and then moving forward in creating a health equity framework. Design/methodology/approach From the focus point of mad studies and queer theory. Findings In this critical commentary, the work alongside others will be viewed and discussed in terms of addressing individual and systemic barriers to mental health care. Furthermore, how this has been significantly influenced by the colonisation of mental health with its polarising language and increased marginalisation will be discussed. Practical implications Progress world view (PWV) will help sexual minorities receive the care needed. Social implications Through the decolonisation of mental health, there will be a new understanding that helps us achieve health equity by using a gay worldview lens called the PWV (Broadway-Horner, 2024). Originality/value In closing, recommendations for future research alongside policy implications for service restructuring implementation of a decolonising health service. This will include a national training package to increase self-efficacy levels. It brings together a cohesive understanding of the PWV within a larger body of work on sexual minorities and mental health.

Clinical study on the intervention effect of digital therapy on children with attention deficit hyperactivity disorder (ADHD)

To evaluate the efficacy and safety of digital therapy for children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD). From January to March 2023, 52 children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD) from Wuhan Children’s Hospital, Hubei Province, China were selected for intervention using the “MindPro1” attention training software developed by Jiangsu Ruinao Qizhi Medical Technology Co., Ltd. Before the intervention, the children were in a stable treatment state, and no modifications were made to the original treatment plan during the MindPro1 intervention. Subjects with severe mental illness or other conditions that may affect the implementation and evaluation of disease treatment were excluded. Subjects completed the planned 4-week intervention, and changes in attention-related variables were assessed using the Test of Attention Variables (TOVA) and the parent version of the 18-item SNAP-IV scale (Swanson, Nolan, and Pelham, version IV scale) before and after the intervention. After 4 weeks of intervention, the lower limit of the 95% confidence interval of the response rate of the 18-item SNAP-IV-Parent scale, which was ≥ 30% improvement from baseline, was higher than 27.5% (better than similar products on the market); the SNAP-IV parent score improved (P < 0.001), with statistical significance; the TOVA-ACS score improved (P < 0.05), with statistical significance. The acceptance rate of parents of children was 100%, and the average compliance rate was 95%. There were 4 cases (7.69%) of adverse reactions that may be related to the device in this trial, which recovered spontaneously within 2 days of discontinuation, and no serious adverse events occurred. After 4 weeks of treatment with ADHD auxiliary treatment software, the objective attention assessment data and attention function assessment scale were significantly improved. Parents had a high acceptance of the software, the average compliance rate of participants was high, and the incidence of related adverse events was low and mild.

Recruitment and retention of new doctors in remote and Aboriginal medical services through the Remote Vocational Training Scheme's Targeted Recruitment Strategy: a focus group study.

To explore the results of a targeted recruitment strategy designed to attract and retain new doctors in remote and Aboriginal medical services where they can access Remote Vocational Training Scheme (RVTS) training and support to qualify as general practitioners. Two 2-hour purposeful online focus groups on the RVTS' Targeted Recruitment Strategy. Five participants and nine stakeholders with knowledge and experience of the strategy. Data were transcribed and deductively and inductively coded for themes including insights from separate project reference and stakeholder advisory groups. Perspectives of the strategy. The overarching theme was that the strategy is useful for attracting and retaining new general practitioners in areas of high need and is potentially scalable. Since 2018, 20 new doctors were recruited via the Targeted Recruitment Strategy and six of them completed the RVTS program. The strategy could better differentiate target locations because increasing communities are experiencing major general practice workforce shortages. The package of employment and training could also be more clearly defined for participants, nationally marketed and collaboratively implemented. Further, more site accreditation and ongoing risk and quality review is needed, along with intense early supports for participants who are new to both the community and general practice work. The Targeted Recruitment Strategy is still maturing but the early results suggest it is a unique and proactive model for attracting and improving access to general practitioners in places with high needs. It could be strengthened through formal agreements between communities and agencies, ensuring coordinated implementation, clarifying roles and responsibilities, and developing clear pathways for risk and quality management.

The Role of NGOs in Health Capacity Building for Organizational Staff and Volunteers in Myanmar

The role of non-governmental organizations (NGOs) in health capacity building for trained community volunteers in Myanmar, a Least Developed Country (LDC) is significantly noteworthy. The study highlights the training programs and initiatives conducted by NGOs in areas such as sexual and reproductive health and rights (SRHR) and Gender-Based Violence (GBV) prevention, addressing critical needs in family planning, maternal health, GBV prevention, and the prevention of TB, HIV/AIDS, and other infectious diseases. The training programs and packages are designed to equip healthcare providers and community volunteers with fundamental skills, thereby enabling them to effectively address the health issues facing by the community especially among the vulnerable population. The study also points to the effective use of participatory learning methods by NGOs, such as interactive workshops, role-plays, case studies, and group discussions, which actively engage participants and promote an environment conducive to collective learning and knowledge sharing. Furthermore, through FGD, it was found that NGO interventions contribute to positive changes in health behaviors, such as increased awareness of preventive measures and adoption of healthier lifestyles.

A person-centred consultation intervention to improve shared decision-making about, and uptake of, osteoporosis medicines (iFraP): a pragmatic, parallel-group, individual randomised controlled trial protocol

Background Good quality shared decision-making (SDM) conversations involve people with, or at risk of osteoporosis and clinicians collaborating to decide, where appropriate, which evidence-based medicines best fit the person’s life, beliefs, and values. We developed the improving uptake of Fracture Prevention drug treatments (iFraP) intervention comprising a computerised Decision Support Tool (DST), clinician training package and information resources, for use in UK Fracture Liaison Service consultations. Two primary objectives to determine (1) the effect of the iFraP intervention on patient-reported ease in decision-making about osteoporosis medicines, and (2) cost-effectiveness of iFraP intervention compared to usual NHS care. Secondary objectives are to determine the iFraP intervention effect on patient reported outcome and experience measures, clinical effectiveness (osteoporosis medicine adherence), and to explore intervention acceptability, mechanisms, and processes underlying observed effects, and intervention implementation. Methods The iFraP trial is a pragmatic, parallel-group, individual randomised controlled trial in patients referred to a Fracture Liaison Service, with nested mixed methods process evaluation and health economic analysis. Participants aged ≥50 years (n=380) are randomised (1:1 ratio) to one of two arms: (1) iFraP intervention (iFraP-i) or (2) comparator usual NHS care (iFraP-u) and are followed up at 2-weeks and 3-months. The primary outcome is ease of decision-making assessed 2 weeks after the consultation using the Decisional Conflict Scale (DCS). The primary objectives will be addressed by comparing the mean DCS score in each trial arm (using analysis of covariance) for patients given an osteoporosis medicine recommendation, alongside a within-trial cost-effectiveness and value of information (VoI) analysis. Process evaluation data collection includes consultation recordings, semi-structured interviews, and DST analytics. Discussion The iFraP trial will answer important questions about the effectiveness of the new ‘iFraP’ osteoporosis DST, coupled with clinician training, on SDM and informed initiation of osteoporosis medicines. Trial registration ISRCTN 10606407, 21/11/2022 https://doi.org/10.1186/ISRCTN10606407

Analysis of virtual simulation training teaching problems of intellectual property law based on real working situations

This article aims to take AI intelligent training software and real business drills of intellectual property as the training mode to carry out intellectual property-related training in fields such as data intellectual property creation, application, management, transformation, and education, and truly achieve the educational goal of integrating science, education and industry. First, innovate the intellectual property training platform. Through AI question-and-answer led by digital human images, introduce front-line practical experts in the field of intellectual property into the virtual simulation training teaching process, build a training scene for the entire chain protection of intellectual property and real working situations, and improve the practical effect of training and cultivating intellectual property talents. Second, deepen the social service system of intellectual property. Project team members guide students and trainees to actively participate in patent navigation, patent group projects, pilot projects, intellectual property protection projects, etc., exercise and promote the continuous improvement of the social service capabilities of various intellectual property talents. At the end of the article, it is proposed that while intellectual property law teaching adapts to the development needs of the digital age, it should take the construction and teaching application of a virtual simulation experiment platform in real work situations as the core, respond to the practical needs of social practice work, and improve students' ability to adapt to society. The organic integration of AI technology, digital human technology and practical training teaching of intellectual property law has certain reference significance for the realization of the metaverse vision.