Effect of fertility health awareness strategies on fertility knowledge and childbearing in young married couples (FertStart): study protocol for an effectiveness-implementation hybrid type I multicentre three-arm parallel group open-label randomised clinical trial

IntroductionBirth rates have been declining in many advanced societies including Singapore. We designed two interventions with vastly different resource requirements, which include fertility education, personalised fertility information and a behavioural change component targeting modifiable psychological constructs to modify fertility awareness and childbearing intentions. We aim to evaluate the effect of these two interventions on knowledge, attitudes and practice around childbearing compared with a control group among young married couples in Singapore and understand the implementation factors in the setting of an effectiveness-implementation hybrid type 1 three-arm randomised trial.Methods and analysisWe will randomise 1200 young married couples to no intervention (control), Fertility Health Screening group (FHS) or Fertility Awareness Tools (FAT) in a 7:5:5 ratio. Couples in FHS will undergo an anti-Mullerian hormone test and semen analysis, a doctor’s consultation to explain the results and standardised reproductive counselling by a trained nurse. Couples in FAT will watch a standardised video, complete an adapted fertility status awareness (FertiSTAT) tool and receive an educational brochure. The attitudes, fertility knowledge and efforts to achieve pregnancy of all couples will be assessed at baseline and 6 months post-randomisation. Birth statistics will be tracked using administrative records at 2 and 3 years. The primary outcome is the change in the woman’s self-reported intended age at first birth between baseline and 6 months post-randomisation. In addition, implementation outcomes and cost-effectiveness of the two interventions will be assessed.Ethics and disseminationThis study has been reviewed and approved by the Centralized Institutional Review Board of SingHealth (2019/2095). Study results will be reported to the study funder and there are plans to disseminate them in scientific conferences and publications, where authorship will be determined by the International Committee of Medical Journal Editors guidelines.Trial registration numberNCT04647136; ClinicalTrails.gov Identifier.

Effectiveness and scalability of an electronic patient-reported outcome measure and decision support tool for family-centred and participation-focused early intervention: PROSPECT hybrid type 1 trial protocol

IntroductionEarly intervention (EI) endorses family-centred and participation-focused services, but there remain insufficient options for systematically enacting this service approach. The Young Children’s Participation and Environment Measure electronic patient-reported outcome (YC-PEM e-PRO) is an evidence-based measure for caregivers that enables family-centred services in EI. The Parent-Reported Outcomes for Strengthening Partnership within the Early Intervention Care Team (PROSPECT) is a community-based pragmatic trial examining the effectiveness of implementing the YC-PEM e-PRO measure and decision support tool as an option for use within routine EI care, on service quality and child outcomes (aim 1). Following trial completion, we will characterise stakeholder perspectives of facilitators and barriers to its implementation across multiple EI programmes (aim 2).Methods and analysisThis study employs a hybrid type 1 effectiveness-implementation study design. For aim 1, we aim to enrol 223 caregivers of children with or at risk for developmental disabilities or delays aged 0–3 years old that have accessed EI services for three or more months from one EI programme in the Denver Metro catchment of Colorado. Participants will be invited to enrol for 12 months, beginning at the time of their child’s annual evaluation of progress. Participants will be randomised using a cluster-randomised design at the EI service coordinator level. Both groups will complete baseline testing and follow-up assessment at 1, 6 and 12 months. A generalised linear mixed model will be fitted for each outcome of interest, with group, time and their interactions as primary fixed effects, and adjusting for child age and condition severity as secondary fixed effects. For aim 2, we will conduct focus groups with EI stakeholders (families in the intervention group, service coordinators and other service providers in the EI programme, and programme leadership) which will be analysed thematically to explain aim 1 results and identify supports and remaining barriers to its broader implementation in multiple EI programmes.Ethics and disseminationThis study has been approved by the institutional review boards at the University of Illinois at Chicago (2020-0555) and University of Colorado (20-2380). An active dissemination plan will ensure that findings have maximum reach for research and practice.Trial registration numberNCT04562038.

Ultra High-Frequency Electric Installation with a Hybrid-Type Working Chamber

Ultra-high frequency (UHF) electric installations, using the energy of UHF electromagnetic oscillations, can perform thermal UHF modification of dielectric materials and products. As a result, its properties and parameters change in an object processed in a UHF electromagnetic field faster and more uniformly than when the heat is transferred to a heated dielectric by thermal conductivity, convection, thermal radiation. The exact change in the properties and parameters of polymers of living and inanimate nature, uniform in volume and significantly in a shorter time spent in a UHF electromagnetic field, can be obtained in UHF electrical installations, and practically without heating the object as a result of the so-called non-thermal UHF modification. The paper proposes the design and design of a UHF electric installation with a hybrid-type working chamber. Such a working chamber makes it possible to simultaneously carry out non-thermal UHF modification of a polymer and thermal UHF modification of a dielectric in one installation. A UHF electric installation with a hybrid-type working chamber is cheaper. It takes up less space than two separate installations producing the same products with the same productivity.

Hybrids of Solanum corymbiflorum and S. diploconos (Solanaceae) – a hope for new commercial varieties of edible fruits

Solanum diploconos (Mart.) Bohs („guava tamarillo”) and Solanum corymbiflorum (Sendtn.) Bohs („hardy tamarillo”) are wild relatives to subtropical, orchard, small tree – Solanum betaceum Cav. (called simply „tamarillo”). Both these species create edible fruits, but they have not been cultivated widely so far as fruit trees. However, each one of these species has valuable features. Solanum corymbiflorum is quite hardy to frost, deciduous and early blooming both in fenological year time as well as in its lifespan but has untasty fruits. Solanum diploconos has quite good tasting fruits and it is pest and disease resistant. This work has been an attempt to connect their best features in hybrids to create new, potentially commercial cultivars to grow as fruit plants. Three types of hybrids were created: F1 hybrid type – Solanum corymbiflorum × Solanum diploconos, BC1 backrossing type - (Solanum corymbiflorum × Solanum diploconos) × Solanum corymbiflorum and the second BC1 backcrossing type – (Solanum corymbiflorum × Solanum diploconos) × Solanum diploconos. Out of the numerous variable individuals within each type, we selected three very valuable from an agronomic point of view cultivars (Solanum 'Lynn', 'Pinczow Springs' and 'Iwona'). The work with crossing and selecting the next cultivars will be continued.