Myokine Secretion following an Aerobic Exercise Intervention in Individuals with Type 2 Diabetes with or without Exercise Resistance.

Type 2 diabetes (T2D) is characterized by muscle metabolic dysfunction that exercise can minimize, but some patients do not respond to an exercise intervention. Myokine secretion is intrinsically altered in patients with T2D, but the role of myokines in exercise resistance in this patient population has never been studied. We sought to determine if changes in myokine secretion were linked to the response to an exercise intervention in patients with T2D. The participants followed a 10-week aerobic exercise training intervention, and patients with T2D were grouped based on muscle mitochondrial function improvement (responders versus non-responders). We measured myokines in serum and cell-culture medium of myotubes derived from participants pre- and post-intervention and in response to an in vitro model of muscle contraction. We also quantified the expression of genes related to inflammation in the myotubes pre- and post-intervention. No significant differences were detected depending on T2D status or response to exercise in the biological markers measured, with the exception of modest differences in expression patterns for certain myokines (IL-1ß, IL-8, IL-10, and IL-15). Further investigation into the molecular mechanisms involving myokines may explain exercise resistance with T2D; however, the role in metabolic adaptations to exercise in T2D requires further investigation.

Training to use smart tablets to access reliable online health information in older adults' post-pandemic: A focused pilot intervention study.

BACKGROUND: Older adults are becoming more accepting and interested in using digital technologies, but difficulties and barriers remain for accessing reliable health-related information. The purpose of this focused pilot intervention study was to: (1) understand older adults' firsthand experiences and challenges while using smart tablets post-COVID-19 pandemic, and (2) gather suggestions for age-appropriate training materials, preference of training materials, and resources to access reliable online health information. METHODS: A focused pilot intervention study that involved training older adults to use smart tablets followed by focus group of a convenience sample of 13 older adults (65-85 years old; 91.6% female) on their experiences of using smart tablets. RESULTS: Thematic analysis revealed three themes: tablets are convenient to access online information and older adults reported technical, security concerns, emotional and cognitive challenges regarding use of smart tablets. Older adults also requested one-on-one support, assistance, and topic specific learning for future training sessions. CONCLUSIONS: Future studies should focus on providing detailed, clear instructions at an acceptable pace for older adults.

Study protocol for a randomized controlled trial investigating the effect of online interpretation bias intervention on stress reactivity in the children of parents with depression: the CoCo study.

BACKGROUND: Current preventive interventions for the children of parents with depression demonstrate modest effects on depression incidence. This may be because existing interventions tend to comprise general psychotherapeutic tools, rather than targeting the specific mechanisms underlying familial transmission. Improved theoretical models of familial transmission could enhance the development of targeted interventions. Although existing models assume that cognitive and biological vulnerability factors influence one another, the precise mechanisms are unknown. This project is the first to experimentally test whether negative interpretation bias has an impact on cortisol response in children of parents with depression. This study protocol reports a randomised controlled trial of an interpretation bias intervention which aims to shift participants' interpretation bias in a more positive direction and thereby alter their stress response. METHODS: Children aged 10-14 years who have i) one parent with a current or previous depression diagnosis, with at least one episode occurring during the child's lifetime and ii) do not have a current or previous psychiatric diagnosis themselves, will be assigned to one of two conditions: an interpretation bias intervention (n = 50) or a structurally similar placebo intervention (n = 50). The interpretation bias intervention consists of a short lab-based cognitive reappraisal of interpretations training, a four-week app-based Cognitive Bias Modification of Interpretations intervention and interpretation bias specific if-then plans. Interpretation bias will be assessed before and after the intervention using the Scrambled Sentences Task. The effect of the intervention on participants' stress response will be assessed by salivary cortisol collected at five different time points: from immediately before until 45 min after administering the Trier Social Stressor Test for Children. Stress reactivity will be measured via baseline to peak cortisol and stress recovery will be measured via the 45 min cortisol marker. We hypothesise that children who participate in the interpretation bias intervention will display a positive shift in interpretation bias and this, in turn, will alter their stress response. Children who receive the placebo intervention are expected to show a smaller positive shift in interpretation bias and stress reactivity. DISCUSSION: The findings of the present study will contribute to models of familial depression transmission as well as informing preventive interventions. If training a more positive interpretation bias subsequently alters participants' stress response, then incorporating such tools may increase the efficacy of existing preventive interventions. TRIAL REGISTRATION: Deutsches Register Klinischer Studien DRKS00028842. Registered August 19, 2022.

A relational coordination training intervention to improve job satisfaction and intent to stay in the intensive care unit: A pilot study.

BACKGROUND: Relational coordination (RC) explores the coordination of work between and among professionals in a workgroup. RC is associated with higher job satisfaction and retention; however, researchers have not tested RC training interventions to improve job satisfaction and retention. PURPOSE: To explore changes in job satisfaction and intent to stay among health care professionals following a virtual RC training intervention. METHODS: We conducted a pilot, parallel group randomized controlled trial in four intensive care units. Data collection occurred via survey. Difference-in-difference regression models were used to analyze the job satisfaction and intent to stay outcomes. DISCUSSION: The RC training intervention did not influence job satisfaction or intent to stay. Participants with baccalaureate degrees and African American/Black participants reported lower intent to stay. CONCLUSION: The results from this pilot study are a critical first step in testing the efficacy of an RC training intervention to improve staff outcomes in a larger powered study.

Experiences of a mental health promotion, prevention, and early-intervention training program targeted to school nurses in the United Arab Emirates.

AIM: To report participants' and facilitators' experiences of mental health promotion, prevention, and early-intervention training program targeted at school nurses in the United Arab Emirates (UAE). BACKGROUND: The UAE school healthcare service is staffed by full-time nurses and part-time doctors and linked to primary healthcare centers. This service supports children's physical and mental well-being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored. METHODS: We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early-intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research. RESULTS: Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style. CONCLUSION: A well-structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential. IMPLICATIONS FOR NURSING PRACTICE, RESEARCH, AND POLICY: School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff.

Effect of a training intervention for finding the missed cases of tuberculosis amongst patent medicine vendors in Delta State, Nigeria.

Context: The undiagnosed and untreated tuberculosis (TB) cases underpin the experience of accelerating deaths. Everyone should be engaged in managing TB patients to revert the current trend. Aims: In this context, we assessed the outcome of an education intervention on the knowledge of TB and referral practice of presumptive TB cases to directly observed therapy strategy amongst patent medicine vendors (PMVs). Settings and Design: The study was quasi-experimental, conducted amongst 647 PMVs in Delta State, Nigeria. Methods: A structured questionnaire was administered to obtain baseline data on knowledge of TB. An educational intervention on knowledge of TB was then given. A post-intervention assessment of TB knowledge was subsequently conducted using the same questionnaire. The exact number of referrals of presumptive TB cases by PMVs and the number that tested positive amongst the referred presumptive TB cases, 3 months before and after the training were obtained from the state TB database. Statistical Analysis Used: SPSS v. 26 was used for data analysis. Results: The pre-training knowledge average score was 15.45 ± 6.45, while the post-training average score was 19.44 ± 7.03 (P < 0.001). The pre-training average number of presumptive cases referred was 146 ± 124.7, and the post-training was 205.67 ± 255.4, P = 0.41. The pre-training average number of cases that turned out positive was 9.5 ± 6.3, and the post-training was 13.5 ± 11.3, P = 0.42. Conclusion: There was a significant improvement in PMVs' knowledge of TB post-intervention. However, while an increase in the number of cases referred and positives detected was observed, this was not significant. Periodic training and updates to PMVs in keeping with current trends and best practices in TB management are recommended.

Myths and misconception of COVID-19 among hospital sanitary workers in Pakistan: Efficacy of a training program intervention.

OBJECTIVE: Hospital sanitary workers are among the prime source to disseminate information at a massive level, however they received least attention during the pandemic COVID-19. The study was designed to investigate the prevailing myths and misconceptions of the coronavirus pandemic among the sanitary workers of health care system. Further, a systematic training program is devised and tested to demystify the false myths with discerning truth and awareness-raising in hospital sanitary workers. METHOD: A pre-post face-to-face intervention design was opted and the intervention was conducted at five locations by the project team. The intervention consisted a 3 days training program to target myths and misconceptions of hospital sanitary workers. The study was completed in 8 months starting from August, 2019 to March, 2020. Participants were recruited from local hospitals having a specialized indoor COVID treatment facility. The sample consisted of 82 participants (n = 25, 30.09% females) with age ranging from 18 to 60 years (M ± SD = 37.41 ± 10.09). FINDINGS: The results indicated that 86.4% of the participants never heard the name of the coronavirus before the pandemic in Pakistan. A majority of the participants (> 50%) believed on a very alarming but unrealistic rate of mortality i.e., 30-60%. The pre-testing showed a high prevalence of myths in all four domains (i.e., popular treatments = 24.44, conspiracy myths = 7.93, home remedies = 16.46, and COVID-reliance = 7.82). The pre and post comparison of individual myths showed significant improvement on 24 of the 26 myths with a decline ranging from 0.18 to 1.63. Overall, the intervention significantly decreased scores on all four domains of coronavirus myths. CONCLUSION: The training intervention appeared to effectively reduce myths and misconceptions of sanitary staff workers and is advised to be included as a standard training program for sanitary workers of health care system.

Use of motivational techniques to enhance unpaid caregiver engagement in a tailored skills training intervention.

OBJECTIVES: The Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES) evaluated a skills training program to support family caregivers of cognitively or functionally impaired persons. HI-FIVES demonstrated sustained improvements in caregivers' and patients' experiences of VA care. The aim of this distinct, secondary qualitative study was to explore the potential processes related to the individual tailored skills-based telephone training underpinning HI-FIVES intervention effects. We explored topics caregivers selected, characteristics of action items created, patterns of action or inaction, and barriers to action item completion across topics. METHODS: Qualitative data was analysed from 118 dyads randomized into the HI-FIVES intervention which included three weekly facilitated training calls covering five education topics and action items developed by caregivers for each topic. Qualitative analysis of text responses to questions from the training calls was used. RESULTS: Three of the top four most selected topics were caregiver-oriented and caregivers created an action item most often for self-care topics. Caregiver-oriented topics also had the highest action item completion rates. The majority of action items created met SMART guidelines for goal setting and simple structure. With regard to barriers to action item completion, caregivers commonly reported still contemplating/pending. CONCLUSION: Our findings identify motivational interviewing as an effective technique to identify critical intervention content and address barriers to achieving caregiving goals. We suggest that caregivers felt more empowered to create and complete an action item when they had more control over completing the action item, such as in topics related to their own self-care.

The better sleep better well-being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study.

The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well-being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8 hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence-based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.

Implementation science: Scaling a training intervention to include IUDs and implants in contraceptive services in primary care.

Building capacity for contraceptive services in primary care settings, including for intrauterine devices (IUDs) and implants, can help to broaden contraceptive access across the US. Following a randomized trial in family planning clinics, we brought a provider training intervention to other clinical settings including primary care in all regions. This implementation science study evaluates a national scale-up of a contraceptive training intervention to varied practice settings from 2013 to 2019 among 3216 clinic staff serving an estimated 1.6 million annual contraceptive patients. We measured providers' knowledge and clinical practice changes regarding IUDs and implants using survey data. We estimated the overall intervention effect, and its relative effectiveness in primary care settings, with generalized estimating equations for clustered data. Patient-centered counseling improved, along with comfort with method provision and removal. Provider knowledge increased (p < 0.001), as did evidence-based counseling for IUDs (aOR 3.3 95% CI 2.8-3.9) and implants (aOR 3.5, 95% CI 3.0-4.1), and clinician competency in copper and levonorgestrel IUDs (aORs 1.8-2.6 95% CIs 1.5-3.2) and implants (aOR 2.4 95% CI 2.0-2.9). While proficiency was lower initially in primary care, gains were significant and at times greater than in Planned Parenthood health clinics. This intervention was effectively scaled, including in primary care settings with limited prior experience with these methods. Recent changes to Title X family planning funding rules exclude several large family planning providers, shifting greater responsibility to primary care and other settings. Scaling effective contraceptive interventions is one way to ensure capacity to offer patients full contraceptive services.

Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia.

BACKGROUND: In low- and middle-income countries, chest radiographs are most frequently interpreted by non-radiologist clinicians. OBJECTIVE: We examined the reliability of chest radiograph interpretations performed by non-radiologist clinicians in Botswana and conducted an educational intervention aimed at improving chest radiograph interpretation accuracy among non-radiologist clinicians. MATERIALS AND METHODS: We recruited non-radiologist clinicians at a referral hospital in Gaborone, Botswana, to interpret de-identified chest radiographs for children with clinical pneumonia. We compared their interpretations with those of two board-certified pediatric radiologists in the United States. We evaluated associations between level of medical training and the accuracy of chest radiograph findings between groups, using logistic regression and kappa statistics. We then developed an in-person training intervention led by a pediatric radiologist. We asked participants to interpret 20 radiographs before and immediately after the intervention, and we compared their responses to those of the facilitating radiologist. For both objectives, our primary outcome was the identification of primary endpoint pneumonia, defined by the World Health Organization as presence of endpoint consolidation or endpoint effusion. RESULTS: Twenty-two clinicians interpreted chest radiographs in the primary objective; there were no significant associations between level of training and correct identification of endpoint pneumonia; concordance between respondents and radiologists was moderate (κ=0.43). After the training intervention, participants improved agreement with the facilitating radiologist for endpoint pneumonia from fair to moderate (κ=0.34 to κ=0.49). CONCLUSION: Non-radiologist clinicians in Botswana do not consistently identify key chest radiographic findings of pneumonia. A targeted training intervention might improve non-radiologist clinicians' ability to interpret chest radiographs.

A training intervention for home care nurses in cross-cultural communication: An evaluation study of changes in attitudes, knowledge and behaviour.

AIMS: To assess whether a training intervention in cross-cultural communication can positively impact attitudes, knowledge and behaviour and to investigate possible dependencies between these components. DESIGN: (Controlled) longitudinal multimethod evaluation. METHODS: A training based on theoretical considerations and informed by semi-standardized interviews with home care nurses was developed and evaluated. Participants rated their cross-cultural attitudes, knowledge and behaviour and answered case vignettes assessing their knowledge before and after this training. Shift observations assessed behaviourial aspects at t1 and t2. Data were collected between June 2016-March 2017 and between April 2017-November 2017. Analyses of variance and multiple linear regression models were employed. RESULTS: The training showed promising tendencies with cross-cultural attitudes, knowledge and behaviour with diverging results for initially quite high self-reports showing positive but mostly not significant developments and objective assessments mostly showing significant positive changes. There were significant associations between self-reported cross-cultural behaviour at t1 and objective cross-cultural knowledge at t2, whereas self-rated and objectively assessed knowledge showed no significant associations. Shift observations showed significant positive developments in participants' communication behaviour. CONCLUSION: Our study shows the importance of using different methods and targeting different outcomes areas to rate impacts of (cross-cultural) training interventions. Future studies should consider challenging conditions in home care nursing affecting the success of interventions and investigate mechanisms of skill acquisition in nursing. IMPACT: This is one of very few studies using multi-method approach to evaluate a cross-cultural competency intervention and simultaneously assess cross-cultural attitudes, knowledge and behaviour including possible dependencies between these aspects.

Targeting cognitive function: Development of a cognitive training intervention for diabetes.

AIM: The aim of this project was to develop and demonstrate the feasibility of a comprehensive cognitive training intervention to build self-efficacy for implementation of cognitive strategies in people with diabetes. BACKGROUND: People with diabetes are at greater risk than the general population for developing cognitive dysfunction. Some attention has been paid to the effect of cognitive impairments on diabetes self-management, but even when cognitive problems have been identified, few interventions have been tailored for those with diabetes. METHODS: The intervention combines in-person classes and home-based online computer training. Development, in 2017, included (a) adaptation of prior established, tested interventions; (b) interviews with stakeholders; and (c) integration of course content. RESULTS: Information provided by the stakeholders was used to modify an existing intervention to meet the needs of people with diabetes so that feasibility testing could occur. Despite initial difficulty with recruitment, the intervention was found to be feasible, and nineteen participants found it to be acceptable. CONCLUSION: This comprehensive cognitive training intervention targeting type 2 diabetes and cognitive dysfunction demonstrates that existing interventions can be adapted for use with people with diabetes.

Moderate-intensity aerobic exercise improves physical fitness in bethlem myopathy.

INTRODUCTION: Bethlem myopathy is caused by dysfunctional collagen VI assembly, leading to varying degrees of hyperlaxity, contractures and muscle weakness. Previous studies demonstrate that cardiovascular training is safe and beneficial in patients with myopathies. However, exercise exacerbates the dystrophic phenotype in collagen VI-knockout mice. METHODS: Six men with Bethlem myopathy were included (4 training; 2 controls). After training, 2 patients detrained. Patients performed 10 weeks of home-based, moderate-intensity exercise monitored by a pulse-watch. The primary outcome was change in peak oxygen uptake (VO2peak ). Secondary outcomes were performances in functional tests. RESULTS: VO2peak improved in the training group (16%, P = 0.017). Detraining led to regression of VO2peak toward baseline values (-8%; P = 0.03). No change was seen in the control group (-7%; P = 0.47). Performance in functional tests did not change significantly. Creatine kinase values were stable during the study. CONCLUSIONS: Moderate-intensity exercise seems to safely improve oxidative function in patients with Bethlem myopathy. Muscle Nerve 60: 183-188, 2019.

Effects of a long-term home-based exercise training programme using minimal equipment vs. usual care in COPD patients: a study protocol for two multicentre randomised controlled trials (HOMEX-1 and HOMEX-2 trials).

BACKGROUND: Exercise training is an important component of pulmonary rehabilitation (PR) programmes in chronic obstructive pulmonary disease (COPD), but the great majority of COPD patients who would benefit from PR never follow such programmes or fail to maintain exercise training after PR completion. Against this background, we developed an exercise training programme that requires minimal equipment and can be implemented long-term in the patient's home-setting. The aims of the HOMEX-1 and HOMEX-2 trials are to assess the effectiveness of this home-based exercise training programme in two groups of COPD patients over the course of one year: patients who have completed PR (HOMEX-1 trial) and patients who did not enrol in existing PR programmes within the last two years (HOMEX-2 trial). METHODS: HOMEX-1 and HOMEX-2 are multicentre, parallel group, randomised controlled trials. For both trials each, it is planned to include 120 study participants with a diagnosis of COPD. Participants will be randomised with a 1:1 ratio into the intervention group or the control group (usual care/no intervention). The intervention consists of minimal-equipment exercise training elements with progressive level of intensity, conducted by the participant during six days per week and instructed and coached by a trained health care professional during three home visits and regular telephone calls during one year. Primary outcome is change in dyspnoea (domain of Chronic Respiratory Questionnaire) from baseline to 12-months follow-up. Secondary outcomes are change in dyspnoea over the course of the year (assessed at 3, 6 and 12 month) and change in functional exercise capacity, physical activity, health-related quality of life, health status, exacerbations and symptoms from baseline to 12 months follow-up. In addition, explanatory, safety and cost-effectiveness outcomes will be assessed. We will conduct intention-to-treat analyses separately per trial and per protocol analyses as sensitivity analyses. DISCUSSION: The HOMEX-1 and HOMEX-2 trials assess a novel intervention that provides an innovative way of making exercise training as accessible as possible for COPD patients. If the intervention proves to be effective long-term, it will fill the gap of providing an easily accessible and feasible intervention so that more COPD patients can follow an exercise programme. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: HOMEX-1 NCT03461887 (registration date: March 12, 2018; retrospectively registered); HOMEX-2 NCT03654092 (registration date: August 31, 2018).

Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial.

BACKGROUND: US unintended pregnancy rates remain high, and contraceptive providers are not universally trained to offer intrauterine devices and implants to women who wish to use these methods. OBJECTIVE: We sought to measure the impact of a provider training intervention on integration of intrauterine devices and implants into contraceptive care. STUDY DESIGN: We measured the impact of a continuing medical education-accredited provider training intervention on provider attitudes, knowledge, and practices in a cluster randomized trial in 40 US health centers from 2011 through 2013. Twenty clinics were randomly assigned to the intervention arm; 20 offered routine care. Clinic staff participated in baseline and 1-year surveys assessing intrauterine device and implant knowledge, attitudes, and practices. We used a difference-in-differences approach to compare changes that occurred in the intervention sites to changes in the control sites 1 year later. Prespecified outcome measures included: knowledge of patient eligibility for intrauterine devices and implants; attitudes about method safety; and counseling practices. We used multivariable regression with generalized estimating equations to account for clustering by clinic to examine intervention effects on provider outcomes 1 year later. RESULTS: Overall, we surveyed 576 clinic staff (314 intervention, 262 control) at baseline and/or 1-year follow-up. The change in proportion of providers who believed that the intrauterine device was safe was greater in intervention (60% at baseline to 76% at follow-up) than control sites (66% at both times) (adjusted odds ratio, 2.48; 95% confidence interval, 1.13-5.4). Likewise, for the implant, the proportion increased from 57-77% in intervention, compared to 61-65% in control sites (adjusted odds ratio, 2.57; 95% confidence interval, 1.44-4.59). The proportion of providers who believed they were experienced to counsel on intrauterine devices also increased in intervention (53-67%) and remained the same in control sites (60%) (adjusted odds ratio, 1.89; 95% confidence interval, 1.04-3.44), and for the implant increased more in intervention (41-62%) compared to control sites (48-50%) (adjusted odds ratio, 2.30; 95% confidence interval, 1.28-4.12). Knowledge scores of patient eligibility for intrauterine devices increased at intervention sites (from 0.77-0.86) 6% more over time compared to control sites (from 0.78-0.80) (adjusted coefficient, 0.058; 95% confidence interval, 0.003-0.113). Knowledge scores of eligibility for intrauterine device and implant use with common medical conditions increased 15% more in intervention (0.65-0.79) compared to control sites (0.67-0.66) (adjusted coefficient, 0.15; 95% confidence interval, 0.09-0.21). Routine discussion of intrauterine devices and implants by providers in intervention sites increased significantly, 71-87%, compared to in control sites, 76-82% (adjusted odds ratio, 1.97; 95% confidence interval, 1.02-3.80). CONCLUSION: Professional guidelines encourage intrauterine device and implant competency for all contraceptive care providers. Integrating these methods into routine care is important for access. This replicable training intervention translating evidence into care had a sustained impact on provider attitudes, knowledge, and counseling practices, demonstrating significant changes in clinical care a full year after the training intervention.

Developing and assessing the acceptability of an epilepsy first aid training intervention for patients who visit UK emergency departments: A multi-method study of patients and professionals.

Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures. Currently, no such intervention is available for PWE attending the ED. A collaborative approach (patients, carers, health professionals) was adopted to develop a patient-focused, self-management intervention. An existing group-based seizure management course, offered by the Epilepsy Society, was adapted. Collaborative feedback was sought via a base-line document review, one-to-one semi-structured interviews, and focus group discussions. The applied framework provided a systematic approach from development through to implementation. Participant feedback overall was extremely positive. People with epilepsy who visit the ED reported a positive view of epilepsy seizure first aid training and associated educational materials. Their feedback was then used to develop the optimized intervention presented here. Strengths and perceived barriers to successful implementation and participation, as well as the practical and psychosocial benefits, were identified. We describe the developed intervention together with the process followed. This description, while being project-specific, provides a useful template to assist in the development of interventions more generally. Ongoing evaluation will determine the effects of the training intervention on participants' behavior.

Validation of an active shape model-based semi-automated segmentation algorithm for the analysis of thigh muscle and adipose tissue cross-sectional areas.

OBJECTIVE: To validate a semi-automated method for thigh muscle and adipose tissue cross-sectional area (CSA) segmentation from MRI. MATERIALS AND METHODS: An active shape model (ASM) was trained using 113 MRI CSAs from the Osteoarthritis Initiative (OAI) and combined with an active contour model and thresholding-based post-processing steps. This method was applied to 20 other MRIs from the OAI and to baseline and follow-up MRIs from a 12-week lower-limb strengthening or endurance training intervention (n = 35 females). The agreement of semi-automated vs. previous manual segmentation was assessed using the Dice similarity coefficient and Bland-Altman analyses. Longitudinal changes observed in the training intervention were compared between semi-automated and manual segmentations. RESULTS: High agreement was observed between manual and semi-automated segmentations for subcutaneous fat, quadriceps and hamstring CSAs. With strength training, both the semi-automated and manual segmentation method detected a significant reduction in adipose tissue CSA and a significant gain in quadriceps, hamstring and adductor CSAs. With endurance training, a significant reduction in adipose tissue CSAs was observed with both methods. CONCLUSION: The semi-automated approach showed high agreement with manual segmentation of thigh muscle and adipose tissue CSAs and showed longitudinal training effects similar to that observed using manual segmentation.

Far transfer to language and math of a short software-based gaming intervention.

Executive functions (EF) in children can be trained, but it remains unknown whether training-related benefits elicit far transfer to real-life situations. Here, we investigate whether a set of computerized games might yield near and far transfer on an experimental and an active control group of low-SES otherwise typically developing 6-y-olds in a 3-mo pretest-training-posttest design that was ecologically deployed (at school). The intervention elicits transfer to some (but not all) facets of executive function. These changes cascade to real-world measures of school performance. The intervention equalizes academic outcomes across children who regularly attend school and those who do not because of social and familiar circumstances.

Does training with 3D videos improve decision-making in team invasion sports?

We examined the effectiveness of video-based decision training in national youth handball teams. Extending previous research, we tested in Study 1 whether a three-dimensional (3D) video training group would outperform a two-dimensional (2D) group. In Study 2, a 3D training group was compared to a control group and a group trained with a traditional tactic board. In both studies, training duration was 6 weeks. Performance was measured in a pre- to post-retention design. The tests consisted of a decision-making task measuring quality of decisions (first and best option) and decision time (time for first and best option). The results of Study 1 showed learning effects and revealed that the 3D video group made faster first-option choices than the 2D group, but differences in the quality of options were not pronounced. The results of Study 2 revealed learning effects for both training groups compared to the control group, and faster choices in the 3D group compared to both other groups. Together, the results show that 3D video training is the most useful tool for improving choices in handball, but only in reference to decision time and not decision quality. We discuss the usefulness of a 3D video tool for training of decision-making skills outside the laboratory or gym.