Search results for: intervention development

Authors: Christian Andrä, Pauline Hähner, Sebastian Ludyga

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Introduction: In the recent past, discussions on the importance of physical activity for child development have contributed to a growing interest in executive functions, which refer to cognitive processes. By controlling, modulating and coordinating sub-processes, they make it possible to achieve superior goals. Major components include working memory, inhibition and cognitive flexibility. While executive functions can be trained easily in school children, there are still research deficits regarding the trainability during preschool age. Methodology: This quasi-experimental study with pre- and post-design analyzes 23 children [age: 5.0 (mean value) ± 0.7 (standard deviation)] from four different sports groups. The intervention group was made up of 13 children (IG: 4.9 ± 0.6), while the control group consisted of ten children (CG: 5.1 ± 0.9). Between pre-test and post-test, children from the intervention group participated special games that train executive functions (i.e., changing rules of the game, introduction of new stimuli in familiar games) for ten units of their weekly sports program. The sports program of the control group was not modified. A computer-based version of the Eriksen Flanker Task was employed in order to analyze the participants’ inhibition ability. In two rounds, the participants had to respond 50 times and as fast as possible to a certain target (direction of sight of a fish; the target was always placed in a central position between five fish). Congruent (all fish have the same direction of sight) and incongruent (central fish faces opposite direction) stimuli were used. Relevant parameters were response time and accuracy. The main objective was to investigate whether children from the intervention group show more improvement in the two parameters than the children from the control group. Major findings: The intervention group revealed significant improvements in congruent response time (pre: 1.34 s, post: 1.12 s, p<.01), while the control group did not show any statistically relevant difference (pre: 1.31 s, post: 1.24 s). Likewise, the comparison of incongruent response times indicates a comparable result (IG: pre: 1.44 s, post: 1.25 s, p<.05 vs. CG: pre: 1.38 s, post: 1.38 s). In terms of accuracy for congruent stimuli, the intervention group showed significant improvements (pre: 90.1 %, post: 95.9 %, p<.01). In contrast, no significant improvement was found for the control group (pre: 88.8 %, post: 92.9 %). Vice versa, the intervention group did not display any significant results for incongruent stimuli (pre: 74.9 %, post: 83.5 %), while the control group revealed a significant difference (pre: 68.9 %, post: 80.3 %, p<.01). The analysis of three out of four criteria demonstrates that children who took part in a special sports program improved more than children who did not. The contrary results for the last criterion could be caused by the control group’s low results from the pre-test. Conclusion: The findings illustrate that inhibition can be trained as early as in preschool age. The combination of familiar games with increased requirements for attention and control processes appears to be particularly suitable.

Keywords: executive functions, flanker task, inhibition, preschool children

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Authors: Faith Samkange, Juliet Chipumuro, Henry Wanyama

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Business development and entrepreneurship constitute a major part of economic and human development for many countries within the Southern Africa Development Communities (SADC). While a marked increase in entrepreneurship activity has been registered, more than 70% of these business enterprises are still failing particularly in their conceptual years. One of the major reasons for this failure is that project process trends have tended to be fragmented and linear in approach while focusing primarily on isolated articulation of development aspects such as marketing, operations, accounting and human resources management with limited integration. Given the complexity of environmental, economic and human development issues in the SADC region, a multi-disciplinary, transformative, systematic and coordinated approach towards entrepreneurship development may be a more useful approach. This paper develops a proposed conceptual framework for an innovative and sustainable food production and food consumption Agritech entrepreneurship project in the Eastern Cape Province of South Africa based on a systematic review of existing literature. A thematic analysis of the literature reviewed is applied to develop this theoretical contribution to knowledge. The conceptual framework will be tested in a research driven intervention project designed to improve the quality of life for marginalized indigenous African communities by addressing poverty alleviation, unemployment and gender inequality as stipulated in the global sustainable development goals by the United Nations in 2018.

Keywords: innovative entrepreneurship, sustainability, food production and consumption, marginalised communities, poverty alleviation

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Authors: E. H. Walsh, J. McMahon, M. P. Herring

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Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

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Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz

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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Keywords: watching comedy movie, humor, pain, anxiety, nursing, care

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Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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Authors: Maggie Mosher, Adam Carreon, Sean Smith

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A systematic literature review was conducted to explore the evidence base on the use of augmented reality (AR), virtual reality (VR), mixed reality (MR), and extended reality (XR) to present social skill instruction to school-age students with autism spectrum disorder (ASD). Specifically, the systematic review focus was on a. the participants and intervention agents using AR, VR, MR, and XR for social skill acquisition b. the social skills taught through these mediums and c. the social validity measures (i.e., goals, procedures, and outcomes) reported in these studies. Forty-one articles met the inclusion criteria. Researchers in six studies taught social skills to students through AR, in 27 studies through non-immersive VR, and in 10 studies through immersive VR. No studies used MR or XR. The primary targeted social skills were relationship skills, emotion recognition, social awareness, cooperation, and executive functioning. An intervention to improve many social skills was implemented by 73% of researchers, 17% taught a single skill, and 10% did not clearly state the targeted skill. The intervention was considered effective in 26 of the 41 studies (63%), not effective in four studies (10%), and 11 studies (27%) reported mixed results. No researchers reported information for all 17 social validity indicators. The social validity indicators reported by researchers ranged from two to 14. Social validity measures on the feelings toward and use of the technology were provided in 22 studies (54%). Findings indicated both AR and VR are promising platforms for providing social skill instruction to students with ASD. Studies utilizing this technology show a number of social validity indicators. However, the limited information provided on the various interventions, participant characteristics, and validity measures, offers insufficient evidence of the impact of these technologies in teaching social skills to students with ASD. Future research should develop a protocol for training treatment agents to assess the role of different variables (i.e., whether agents are customizing content, monitoring student learning, using intervention specific vocabulary in their day to day instruction). Sustainability may be increased by providing training in the technology to both treatment agents and participants. Providing scripts of instruction occurring within the intervention would provide the needed information to determine the primary method of teaching within the intervention. These variables play a role in maintenance and generalization of the social skills. Understanding the type of feedback provided would help researchers determine if students were able to feel rewarded for progressing through the scenarios or if students require rewarding aspects within the intervention (i.e., badges, trophies). AR has the potential to generalize instruction and VR has the potential for providing a practice environment for performance deficits. Combining these two technologies into a mixed reality intervention may provide a more cohesive and effective intervention.

Keywords: autism, augmented reality, social and emotional learning, social skills, virtual reality

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Authors: B. A. N. Madubashini, S. Anojan, S. Thurka, N. M. C. J. Nawasinghe, G. A. S. Milanga, W. M. I. S. Weerakoon, I. D. N. Ihalahewage

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Evidence-based health promotional approaches are known to be successful ways of reducing tobacco consumption in a rural village. Hence tobacco prevention is essential in improving lives of people, and community-based approaches are considered as effective. This community-based health promotion intervention implemented to reduce high consumption of tobacco in a rural area in Sri Lanka. This intervention was conducted in a rural village of Sri Lanka. In the beginning, facilitation discussions conducted with community members to identify determinants leading to tobacco consumption among villagers. Intervention was planed based on those determinants. Community actions through small active groups to demote smoking were generated. Children groups displayed cigarette buds collected around common places such as temple to community gatherings including funeral welfare society elaborating the cost and the money spent on cigarettes. A till (expenditure box) was introduced, and smokers in family were encouraged to put money on a cigarette to it when they decide to smoke instead. This way they could monitor potential savings if quit. Children groups introduced a tool 'Engalanthe puthata (for overseas son)' to shops. Shop owners agreed to add a pebble to a box whenever they sell a cigarette. The money spent on cigarettes in that shop was calculated regularly, and that was considered as money sent to tobacco company overseas, so to the son of the company owner. This was useful to encourage quitting and to stop selling cigarette in the shops. All four shops in the community volunteered to stop selling cigarettes. Eleven percent of users quitted smoking and 37% users reduced smoking. Child empowerment was high, and 60% of children had shown their disapproval on smoking publicly at least once. Similar community-based health promotion intervention can be used to generate community actions leading to reduction of tobacco consumption.

Keywords: cigarette, community, empowerment, health promotion, intervention

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Authors: M. Wisnu Pamungkas, Patrianef Darwis

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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.

Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty

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Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

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This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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Authors: Yiqi Sun, Zhiyuan Zhang, Chenkun Ma

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Regeneration of outmoded urban forms and restorative environments are now recognized as major assets towards achieving sustainable development. Shanghai, like many Chinese cities, is now shifting from an agitated industrial past to more livable development schemes. Therefore, a sustainable approach to Shanghai development consists in turning industrial heritage into places with high potential for improving citizen’s daily life as regard to the three pillars of sustainability, namely: environment, economy, and society. As such, this study focuses on the Corniche in Xuhui West Bund district; a former industrial area converted into recreational public spaces in Xuhui West Bund. This area was the birthplace of the aviation industry of China, and many of the industrial features were preserved. Unused areas have been transformed into exhibition halls and green spaces, integrating some of the original industrial, architectural forms. Our case study investigates the effects of this approach associating urban regeneration with restorative design, as well as its impact on the surrounding neighborhood. Information extracted from visitors’ answers to a questionnaire survey; on-site systematic observation, counts, and measurements allowed us to assess the sustainability of this intervention in terms of accessibility, functionality, cultural and restorative qualities. In general, we found that cycling is not highly encouraged by the current design and level of connectivity, while visitors widely acknowledge the enhancement of cultural heritage resulting from the intervention. Moreover, recreational and restorative areas were found to have a very positive effect on local communities. Indeed, such an approach can provide valuable insights on how future interventions in Chinese major cities could take full advantage of existing assets in creating a more environmental, more livable, and culturally richer city.

Keywords: architectural heritage conservation, cultural urban identity, sustainability assessment, restorative environment, urban regeneration

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Authors: Ke Guek Nee, Wong Siew Fan, Nigel V. Marsh

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Excessive use of the Internet has become a cause for concern in many countries, including Malaysia. Such behaviour is reported to be more prevalent amongst young adults who are reported to be spending large amount of time on the Internet. The present study has three objectives. First one is designing a manual-based Cognitive Behavioural Therapy (CBT) programme to reduce problematic Internet use among young adults in Malaysia. Second one is examining the effectiveness of a manual-based CBT programme at the pilot study stage. Thirdly, the programme focuses on reducing the level of stress and anxiety in problematic Internet users. We adopted CBT with single subject experimental design method. A total of six participants completed the entire program. They were asked to report their daily Internet use and software was installed on their devices to record actual use. The data collection involved three time frame measurements: T1 (baseline), T2 (immediately during the last session of the intervention sessions), and T3 (follow-up). Three scales were used to measure the effectiveness of the program: Depression, Anxiety, Stress Scales (DASS), Social Interaction Anxiety Scale (SIAS), and Problematic Internet Use Questionnaire (PIUQ). The results revealed that the intervention programme has significantly improved two dimensions of problematic Internet use which were obsession and control disorder. The participants’ mental health also showed a deduction in means scores for depression, anxiety and stress with depression showing the greatest improvement after the intervention programme. The participants’ social anxiety showed a slight deduction in means scores. We concluded that the intervention programme designed was effective. However, its limitations need to be addressed in future research.

Keywords: excessive internet use, cognitive behavioral thearapy (CBT), psychological well-being, young adults

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Authors: Vilma Deltuvaitė

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Comparisons of financial development across countries are central to answering many of the questions on factors leading to economic development. For this reason this study analyzes the implications of financial system’s development on country’s economic development. The aim of the article: to analyze the impact of financial system’s development on economic development. The following research methods were used: systemic, logical and comparative analysis of scientific literature, analysis of statistical data, time series model (Autoregressive Distributed Lag (ARDL) Model). The empirical results suggest about positive short and long term effect of stock market development on GDP per capita.

Keywords: banking sector, economic development, financial system’s development, stock market, private bond market

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Authors: Terrell Strayhorn

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The lack of diversity in science, technology, engineering, and mathematics (STEM) fields is a persistent and concerning issue. One contributing factor to the underrepresentation of minority groups in STEM fields is a lack of sense of belonging, which can lead to lower levels of academic engagement, motivation, and achievement. In particular, Black students have been shown to experience lower levels of sense of belonging in STEM compared to their white peers. This study aimed to explore the effects of a psychological intervention on Black students' sense of belonging in physics and math courses at historically Black colleges and universities (HBCUs) and predominantly white institutions (PWIs). The study used a randomized controlled trial design and included 305 Black undergraduate students enrolled in physics or math courses at HBCUs and PWIs in the United States. Participants were randomly assigned to either an intervention group or a control group. The intervention consisted of a brief psychological, video-based intervention designed to enhance sense of belonging, which was delivered in a single session. The control group received no intervention. The primary outcome measure was sense of belonging in physics and math courses, as assessed by a validated self-report measure. Other outcomes included academic engagement, motivation, and achievement as measured by physics and math (course) grades. Preliminary results show that the intervention has a significant positive effect on Black students' sense of belonging in physics and math courses, with a moderate effect size. The intervention also had a significant positive effect on academic engagement and motivation, but not on academic achievement. Importantly, the effects of the intervention were larger for Black students enrolled at PWIs compared to those enrolled at HBCUs. Findings, at present, suggest that a brief psychological web-based intervention can enhance Black students' sense of belonging in physics and math courses, and that the effects may be particularly strong for Black students enrolled at PWIs, although they are not negligible for Black students at HBCUs. This is an important finding given the persistent underrepresentation of Black students in STEM fields, the growing number of Black students at PWIs, and the potential for enhancing sense of belonging to improve academic outcomes and increase diversity in these fields. The study has several limitations, including a relatively small sample size and a lack of long-term follow-up. Future research could explore the generalizability of these findings to other minority groups and other STEM fields, as well as the potential for longer-term interventions to sustain and enhance the effects observed in this study. Overall, this study highlights the potential for psychological interventions to enhance sense of belonging and improve academic outcomes for Black students in STEM courses, and underscores the importance of addressing sense of belonging as a key factor in promoting diversity and equity in STEM fields.

Keywords: sense of belonging, achievement, racial equity, postsecondary education, intervention

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Authors: Kailash Ghimire, Manoj Thapa

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This study focuses on early identification of deficiencies in pre-required areas of students who are enrolled in College Algebra and Calculus I classes. The students were given pre-diagnostic tests on the first day of the class before they are provided with the syllabus. The tests consist of prerequisite, uniform and advanced content outlined by the University System of Georgia (USG). The results show that 48% of students in College Algebra are lacking prerequisite skills while 52% of Calculus I students are lacking prerequisite skills but, interestingly these students are prior exposed to uniform content and advanced content. The study is still in progress and this paper contains the outcome from Fall 2017 and Spring 2018. In this paper, early intervention used in these classes: two days vs three days meeting a week and students’ self-assessment using exam wrappers and their effectiveness on students’ learning will also be discussed. A result of this study shows that there is an improvement on Drop, Fail and Withdraw (DFW) rates by 7%-10% compared to those in previous semesters.

Keywords: student at risk, diagnostic tests, identification, intervention, normalization gain, validity of tests

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Authors: Esra Orum Cattik

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This study evaluated the effects of using video modeling procedures on the iPad to teach play skills to children with autism spectrum disorders. A male student with autism spectrum disorders participated in this study. A multiple baseline-across-skills single-subject design was used to evaluate the effects of using video modeling procedures on the iPad. During baseline, no prompts were presented to participants. In the intervention phase, the teacher gave video model on iPad to the first skill and asked play with toys for him. When the first play skill completed the second play skill began intervention. This procedure continued till all three play skill completed intervention. Finally, the participant learned all three play skills to use video modeling presented on the iPad. Based upon findings of this study, suggestions have been made to future researches.

Keywords: autism spectrum disorders, play, play skills, video modeling, single subject design

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Authors: Louise Penzenstadler, Tiphaine Robet, Radu Iuga, Daniele Zullino

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Context: The outpatient clinic of the psychiatric addiction service of Geneva University Hospital has been providing support to individuals affected by various narcotics for 30 years. However, the increasing consumption of crack cocaine in Geneva has presented a new challenge for the healthcare system. Research Aim: The aim of this research is to evaluate the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder. Methodology: The research utilizes a combination of quantitative and qualitative retrospective data analysis to evaluate the effectiveness of the outreach intervention. Findings: The data collected from October 2023 to December 2023 show that the outreach program successfully made 1,071 contacts with drug users and led to 15 new requests for care and enrollment in treatment. Patients expressed high satisfaction with the intervention, citing easy and rapid access to treatment and social support. Theoretical Importance: This research contributes to the understanding of the challenges and specific needs of a complex group of drug users who face severe health problems. It highlights the importance of outreach interventions in establishing trust, connecting users with care, and facilitating medication-assisted treatment for opioid addiction. Data Collection: Data was collected through the outreach program's interactions with drug users, including street outreach interventions and presence at locations frequented by users. Patient satisfaction surveys were also utilized. Analysis Procedures: The collected data was analyzed using both quantitative and qualitative methods. The quantitative analysis involved examining the number of contacts made, new requests for care, and treatment enrollment. The qualitative analysis focused on patient satisfaction and their perceptions of the intervention. Questions Addressed: The research addresses the following questions: What is the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder? How effective is the outreach program in connecting drug users with care and initiating medication-assisted treatment? Conclusion: The outreach program has proven to be an effective intervention in establishing trust with crack users, connecting them with care, and initiating medication-assisted treatment for opioid addiction. It has also highlighted the importance of addressing the specific challenges faced by this group of drug users.

Keywords: crack addiction, outreach treatment, peer intervention, polydrug use

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Authors: Osman Ali, Jeanne Kriek

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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.

Keywords: problem-solving, self-directed, critical thinking, intervention

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Authors: Hayfa Almutary, Noof Eid Al Shammari

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Aim: The management of depression in patients undergoing hemodialysis remains challenging. The aim of this study was to evaluate the effectiveness of a breathing training program on quality of life and depression among patients on hemodialysis. Design: A one-group pretest-posttest quasi-experimental design was used. Methods: Data were collected from hemodialysis units at three dialysis centers. Initial baseline data were collected, and a breathing training program was implemented. The breathing training program included three types of breathing exercises. The impact of the intervention on outcomes was measured using both the Kidney Disease Quality of Life Short Version and the Beck Depression Inventory-Second Edition from the same participants. The participants were asked to perform the breathing training program three times a day for 30 days. Results: The mean age of the patients was 52.1 (SD:15.0), with nearly two-thirds of them being male (63.4%). Participants who were undergoing hemodialysis for 1–4 years constituted the largest number of the sample (46.3%), and 17.1% of participants had visited a psychiatric clinic 1-3 times. The results show that the breathing training program improved overall quality of life and reduced symptoms and problems. In addition, a significant decrease in the overall depression score was observed after implementing the intervention. Conclusions: The breathing training program is a non-pharmacological intervention that has proven visible effectiveness in hemodialysis. This study demonstrated that using breathing exercises reduced depression levels and improved quality of life. The integration of this intervention in dialysis units to manage psychological issues will offer a simple, safe, easy, and inexpensive intervention. Future research should compare the effectiveness of various breathing exercises in hemodialysis patients using longitudinal studies. Impact: As a safety precaution, nurses should initially use non-pharmacological interventions, such as a breathing training program, to treat depression in those undergoing hemodialysis.

Keywords: breathing training program, depression, exercise, quality of life, hemodialysis

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Authors: Yi-Ying Lin, Su-Guo, Chia-Hao, Ming-Szu Hong

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Objectives: Smoking is a common addictive behavior in teenagers. Long-term smoking is hazardous to health, causes family and social expenditure, and is an important topic that should not be overlooked by academia or the government. The aims of this study are to examine the effectiveness of these courses in terms of teenagers’ knowledge and attitudes towards the hazards of smoking and the effectiveness of their self-efficacy in rejecting smoking. Methods: This study adopted a pre-test post-test design and selected 7th, 8th, 10th, and 11th graders from two junior high schools. Total of 1073 valid questionnaires were collected. The self-completed questionnaire included background information, smoking status of relatives staying with the subject, attitudes of parents towards child smoking, knowledge and attitudes towards smoking, and anti-smoking self-efficacy. Results and clinical applications: Subjects in the experimental group underwent course interventions, which are 'smoking prevention courses,' in the semester. After course intervention, it was found that the intervention showed significant efficacy in terms of knowledge and self-efficacy in rejecting smoking in senior high school students but no efficacy in junior high school. We recommend that this course can be used in normal senior high schools. With regards to junior high schools, smoking prevention courses should be designed to be gamified, or combined with activities with both anti-smoking messages and entertainment at the same time, so that knowledge, attitudes, and self-efficacy can be subconsciously cultivated.

Keywords: adolescent students, smoking knowledge, attitudes, anti-smoking self-efficiency, smoking prevention intervention

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Authors: Nneka U. Igboeli, Maxwell O. Adibe

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Iron and folate supplementation in pregnancy are important interventions that prevent maternal anaemia and fetal anomaly. Thus, daily oral doses of iron and folic acid are recommended throughout pregnancy as part of antenatal care. However, low adherence has been a major drawback leading to low effectiveness of these programs. The effect of mobile text message reminders to pregnant women to take their routine medications on adherence was evaluated in this study. The first 100 women who consented to the study were recruited and randomized to either receive a text message reminder on adherence to routine medications or not. Adherence was assessed using the 8-item Modified Morisky Adherence Scale (8-MMAS). The folders of successfully recruited women were tagged with the a study number assigned to each of them. The womens’ phone numbers were collected and these were used to send text messages reminders on adhering to routine drugs only to women in the intervention group. The text messages were sent three times per week for a period of four weeks with an adherence reassessment at the one month follow-up antenatal visit for recruited women. At one month follow-up, the lost to follow-up were 6 (16%) women for the intervention group and 17 (34%) for the control group. The across group mean difference in adherence score was 0.07 (-0.96 – 1.10) at baseline and 0.3 (-0.31 – 0.92) after intervention, both insignificant at p > 0.05. The within group change were increases of 0.58 (0.00 – 1.16) (p = 0.05) from baseline for the intervention group and a 0.35 (-0.51 – 1.20) (p = 0.395) for the control group. Non-significant increase in adherence scores were recorded for both groups. However, the increase in adherence scores of women in the intervention group was greater and may be potentially transformed into more positive results if the study period is increased with possibly reduced study drop-outs shows great promise for more positive results.

Keywords: adherence, mobile phone, pregnant women, reminders

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Authors: Regina Bowler

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Rationale & Aims: Complementary interventions such as mindfulness-meditation, gratitude, and self-affirmation are often used by therapists to treat stress. Many studies have been conducted using these interventions either individually or adjunctively with regard to stress. However, there has been little work comparing these interventions to investigate which of them is the most effective in treating stress. This study aims to compare these interventions and to determine which of them has the strongest perceived and physiological impact on stress. Participants: 120 law students preparing to take the bar exam: 3 experimental groups of 30 individuals, 1 control group of 30 individuals. Methods: One day prior to administering the interventions, baseline salivary cortisol samples will be taken, and the participants will complete the perceived stress scale (Cohen et al., 1983). Thirty days prior to the bar exam, each experimental group will be given an intervention to practice. Interventions will be practiced once in the morning after waking and once at night at bedtime. In group one, each participant will do a recorded three-minute mindfulness meditation. In group two, each participant will practice gratitude by writing down three things he/she/they are grateful for. In group three, each participant will practice affirmation by writing three sentences affirming his/her/their core values. The control group will not have an intervention to practice. Starting experimental day 1, upon waking and prior to practicing the intervention, the participants will take a salivary cortisol sample. Then they will practice their given intervention. Every night, before going to bed, the participants will practice their given intervention for a second time. The participants will practice their interventions and take salivary cortisol samples for 28 days. After each seven-day period (days 7, 14, 21, 28), the participants will fill out a brief questionnaire about the effects their intervention has on their stress, daily life, and relationships with themselves and others. On day 29, the participants will take a final salivary cortisol sample and will fill out the Perceived Stress Scale (Cohen et al., 1983). Applications of findings: Findings from this study would inform therapists of best practices when working with clients with stress. Moreover, therapists will gain knowledge of how individuals perceive these interventions and their impact on stress, daily life, somatic symptoms, and relationships with self and others. Thus, therapists will be able to administer these interventions with more precision to the stress-related contexts and issues their clients bring.

Keywords: stress, mindfulness-meditation, gratitude, affirmations, complementary interventions

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Authors: Natasha Yasmin Felles, Gerard Riley

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Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

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Authors: James Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: yoga, mental health, incarceration, wellness

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Authors: Jade V. Rushby, Tony Loughland, Tracy L. Durksen, Hoa Nguyen, Robert M. Klassen

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This paper reports a study investigating the development and implementation of an online multi-session ‘scenario-based learning’ (SBL) program administered to preservice teachers in Australia. The transition from initial teacher education to the teaching profession can present numerous cognitive and psychological challenges for early career teachers. Therefore, the identification of additional supports, such as scenario-based learning, that can supplement existing teacher education programs may help preservice teachers to feel more confident and prepared for the realities and complexities of teaching. Scenario-based learning is grounded in situated learning theory which holds that learning is most powerful when it is embedded within its authentic context. SBL exposes participants to complex and realistic workplace situations in a supportive environment and has been used extensively to help prepare students in other professions, such as legal and medical education. However, comparatively limited attention has been paid to investigating the effects of SBL in teacher education. In the present study, the SBL intervention provided participants with the opportunity to virtually engage with school-based scenarios, reflect on how they might respond to a series of plausible response options, and receive real-time feedback from experienced educators. The development process involved several stages, including collaboration with experienced educators to determine the scenario content based on ‘critical incidents’ they had encountered during their teaching careers, the establishment of the scoring key, the development of the expert feedback, and an extensive review process to refine the program content. The 4-part SBL program focused on areas that can be challenging in the beginning stages of a teaching career, including managing student behaviour and workload, differentiating the curriculum, and building relationships with colleagues, parents, and the community. Results from prior studies implemented by the research group using a similar 4-part format have shown a statistically significant increase in preservice teachers’ self-efficacy and classroom readiness from the pre-test to the final post-test. In the current research, professional teaching identity - incorporating self-efficacy, motivation, self-image, satisfaction, and commitment to teaching - was measured over six weeks at multiple time points: before, during, and after the 4-part scenario-based learning program. Analyses included latent growth curve modelling to assess the trajectory of change in the outcome variables throughout the intervention. The paper outlines (1) the theoretical underpinnings of SBL, (2) the development of the SBL program and methodology, and (3) the results from the study, including the impact of the SBL program on aspects of participating preservice teachers’ professional identity. The study shows how SBL interventions can be implemented alongside the initial teacher education curriculum to help prepare preservice teachers for the transition from student to teacher.

Keywords: classroom simulations, e-learning, initial teacher education, preservice teachers, professional learning, professional teaching identity, scenario-based learning, teacher development

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Authors: James Beauchemin

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Research indicates that college students are experiencing mental health challenges of greater severity, and an increased number of students are seeking help. Contributing to the compromised wellness of the college student population are the prevalence of unhealthy lifestyle habits and behaviors such as alcohol consumption, tobacco use, dietary concerns, risky sexual behaviors, and lack of physical activity. Alternative approaches are needed for this population that emphasize prevention and holistic lifestyle change that mitigate mental health and wellness challenges and alleviate strain on campus resources. This presentation will introduce a Solution-Focused Wellness (SFW) intervention model and examine wellness domains solution-focused strategies to promote personal well-being, and provide supporting research from multiple studies that illustrate intervention effectiveness with a collegiate population. Given the subjective and personal nature of wellness, a therapeutic approach that provides the opportunity for individuals to conceptualize and operationalize wellness themselves is critical to facilitating lasting wellness-based change. Solution-Focused Brief Therapy (SFBT) is a strength-based modality defined by its emphasis on constructing solutions rather than focusing on problems and the assumption that clients have the resources and capacity to change. SFBT has demonstrated effectiveness as a brief therapeutic intervention with the college population in groups and related to health and wellness. By integrating SFBT strategies with personal wellness, a brief intervention was developed to support college students in establishing lifestyles trends consistent with their conceptualizations of wellness. Research supports the effectiveness of a SFW model in improving college student wellness in both face-to-face and web-based formats. Outcomes of controlled and longitudinal studies will be presented, demonstrating significant improvements in perceptions of stress, life satisfaction, happiness, mental health, well-being, and resilience. Overall, there is compelling evidence that utilization of a Solution-Focused Brief Therapy approach with college students can help to improve personal wellness and establish healthy lifestyle trends, providing an effective prevention-focused strategy for college counseling centers and wellness centers to employ. Primary research objectives include: 1)establish an evidence-based approach to facilitating wellness pro motion among the college student population, 2) examine the effectiveness of a Solution-Focused Wellness (SFW) intervention model in decreasing stress, improving personal wellness, mental health, life satisfaction, and resiliency,3) investigate intervention impacts over time (e.g. 6-week post-intervention), and 4) demonstrate SFW intervention utility in wellness promotion and associated outcomes when compared with no-treatment control, and alternative intervention approaches.

Keywords: wellness, college students, solution-focused, prevention

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Authors: Tianyue Wan

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Lost space is the space that has not been used for a long time and is in decline, proposed by Roger Trancik. And in his book Finding Lost Space: Theories of Urban Design, the concept of lost space is defined as those anti-traditional spaces that are unpleasant, need to be redesigned, and have no benefit to the environment and users. They have no defined boundaries and do not connect the various landscape elements in a coherent way. With the rapid development of urbanization in China, the blind areas of urban renewal have become a chaotic lost space that is incompatible with the rapid development of urbanization. Therefore, lost space needs to be reconstructed urgently under the background of infill development and reduction planning in China. The formation of lost space is also an invisible division of social hierarchy. This paper tries to break down the social class division and the estrangement between people through the regeneration of lost space. Ultimately, it will enhance vitality, rebuild a sense of belonging, and create a continuous open public space for local people. Based on the concept of lost space and energy field, this paper clarifies the significance of the energy field in the lost space renovation. Then it introduces the energy field into lost space by using the magnetic field in physics as a prototype. The construction of the energy field is support by space theory, spatial morphology analysis theory, public communication theory, urban diversity theory and city image theory. Taking Wuhan’s Lingjiao Park of China as an example, this paper chooses the lost space on the west side of the park as the research object. According to the current situation of this site, the energy intervention strategies are proposed from four aspects: natural ecology, space rights, intangible cultural heritage and infrastructure configuration. And six specific lost space renewal methods are used in this work, including “riveting”, “breakthrough”, “radiation”, “inheritance”, “connection” and “intersection”. After the renovation, space will be re-introduced into the active crow. The integration of activities and space creates a sense of place, improve the walking experience, restores the vitality of the space, and provides a reference for the reconstruction of lost space in the city.

Keywords: dynamic vitality intervention, lost space, space vitality, sense of place

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Authors: Edidiong Ekefre

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The Nigerian civil war was one of the foremost postcolonial conflicts in West Africa that attracted a serious humanitarian problem due to an unprecedented refugee crisis that affected the Biafran region. Due to its geographical location, the Nigerian government used blockades and starvation as a weapon of war against the Biafran. Faced with strong opposition from the Nigerian government, most humanitarian organizations withdrew their support from Biafra, whose death toll was rapidly growing daily due to starvation, malnutrition, and chronic ailment. Thus, the Catholic Church, a major Christian denomination in Biafra, had to see it as its religious obligation to support the humanitarian needs of the Biafrans. Thus, applying oral history methods with archival research, this paper examines the humanitarian activities of the Catholic Church in the Nigerian civil war. It contends that the Catholic Church was a key player in the humanitarian aspect of the Nigerian civil war. The paper concludes that faith-based humanitarian intervention in the Biafran refugee crisis was essential for the survival of the Biafran war-stricken women and children.

Keywords: refugee crisis, humanitarian intervention, Caritas International, blockades, airlifts, starvation

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Authors: R. S. Mehta, G. N. Mandal

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Hepatitis-B is the major infectious disease of mankind. In Nepal it is reported that more than 4.3% of Nepalese population at any time in their life has been infected with Hepatitis-B virus (HBV). The objective of this study was to evaluate the effectiveness of planned educational programme regarding knowledge and practice of hepatitis-B among the nurses working at medical units of BPKIHS. Pre-experimental research design was used to conduct the study among the nurses working in medical units of BPKIHS. Total 40 nurses were included in the pre-test and 34 in the post-test. The education intervention was arranged on 24th May 2012 from 2:15 pm to 4:45 pm i.e. two and half hours. After two weeks of education intervention post-test was conducted. Most of the participants (60%) were of the age group of 18-22 years, Hindu (82.5%), and unmarried (65%). After education intervention there is significant differences in knowledge on the components of Hepatitis-B at 0.05 level of significance. There is no difference in the attitude components after post-test except the component patient contaminated with Hepatitis-B must be called as the last patient (p=0.035). It can conclude that hepatitis-B educational program improved knowledge and practice among the nurses.

Keywords: educational program, Hepatitis-B, pre-experimental design, medical units

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Authors: Junior George Martin

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The purpose of this study was to explore college instructors’ integration of technology in their content area curriculum. The instructors indicated that they were in need of additional training to successfully integrate technology in their subject areas. The findings point to the implementation of a proposed the Technological, Pedagogical, and Content Knowledge (TPACK) model professional development workshop to satisfactorily address the weaknesses of the instructors in technology integration. The professional development workshop is proposed as a rational solution to adequately address the instructors’ inability to the successful integration of technology in their subject area in an effort to improve their pedagogy. The intense workshop would last for 5 days and will be designed to provide instructors with training in areas such as a use of technology applications and tools, and using modern methodologies to improve technology integration. Exposing the instructors to the specific areas identified will address the weaknesses they demonstrated during the study. Professional development is deemed the most appropriate intervention based on the opportunities it provides the instructors to access hands-on training to overcome their weaknesses. The purpose of the TPACK professional development workshop will be to improve the competence of the instructors so that they are adequately prepared to integrate technology successfully in their curricula. At the end of the period training, the instructors are expected to adopt strategies that will have a positive impact on the learning experiences of the students.

Keywords: higher education, modern technology tools, professional development, technology integration

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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