SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials

High quality protocols facilitate proper planning, conduct, reporting, and external review of randomised trials, yet their completeness varies and key elements are often not considered. To strengthen good reporting of trial protocols, the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 statement has been updated to incorporate new evidence and emerging perspectives. This SPIRIT 2025 explanation and elaboration document provides users with exemplars of reporting in contemporary trial protocols, contextual elaboration, more detailed guidance on reporting, references to key empirical studies, an expanded checklist, and a link to a website for further information. The document is intended to be used in conjunction with the SPIRIT 2025 statement and serves as a resource for researchers planning a trial and for others interested in trial protocols

Effectiveness of coronary heart disease peer support interventions: a systematic review and meta-analysis

Aims: To investigate the effect of peer support interventions on psychosocial outcomes, self-management behaviours and readmissions among people with coronary heart disease (CHD). The second aim was to characterise the peer support strategies being tested including the intervention initiation, method, dose, timing, format and content, and the characteristics and training of the peers providing the intervention.Methods and Results: Systematic review and meta-analysis (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, PubMed [non-MEDLINE], Web of Science, and Cochrane Central Register) and risk of bias appraisal was conducted on the above outcomes according to the PRISMA checklist and Cochrane Collaboration guidelines. Meta-analysis was undertaken in RevMan5.4 using the inverse variance method and random effects model. Intervention components and outcomes unsuitable for meta-analysis were narratively synthesised. Sixteen randomised controlled trials (n=2013) were included. Peer support had no effect on anxiety (SMD -0.73, 95%CI -1.57,0.10), depression (SMD -0.09, 95%CI -0.25,0.06), health-related quality of life (SMD -0.38, 95%CI -1.84,1.08), or perceived social support (SMD -0.05, 95%CI -0.31,0.21). However, peer support interventions significantly improved self-management behaviours (SMD 1.49, 95%CI 0.66,2.32) and self-efficacy up to 6 months (SMD 0.57, 95%CI 0.37,0.77), and reduced readmissions (RR 0.25, 95%CI 0.10,0.60). Self-efficacy remained higher in those receiving peer support at 6-12 months post-intervention (SMD 0.67, 95%CI 0.29,1.05). Peer support interventions varied widely, but common strategies included in person (56%), group based (31%) experience sharing (44%). Although subgroup analysis was not possible, narrative synthesis indicated that in-person strategies and peer support that was commenced during admission were the most effective for improving outcomes.Conclusion: Peer support interventions for people with CHD may be used to improve self-management and self-efficacy, and reduce readmission risk, but anxiety, depression, HRQoL and social support did not reach statistical significance when meta-analysed. In-person, group based and experience sharing were the most common peer support categories, and strategies that were in-person and initiated during admission demonstrated the most consistent improvements across outcomes. REGISTRATION: PROSPERO [CRD42024514564]

Patient outcomes and surgical strategies in revision cervical arthroplasty following M6-C™ disc-related osteolysis

PURPOSE: Periprosthetic osteolysis from the M6-C™ Artificial Cervical Disc (Orthofix, Lewisville, Texas) has become a significant issue, sometimes requiring revision spine surgery (RSS). This study evaluates patient-reported outcome measures (PROMs) and revision strategies for managing device-related wear and osteolysis.METHODS: PROMs, including the Visual Analogue Scale (VAS) for neck/arm pain and the Neck Disability Index (NDI), were analyzed at pre-index surgery (T1), pre-RSS (T2), and final follow-up (T3). Osteolysis severity was graded radiographically. A control group who underwent primary M6-C cervical total disc replacement (CTDR) without RSS was included for comparison.RESULTS:Of 53 patients with M6-C CTDR, 19 (35.9%) required RSS due to osteolysis. Osteolysis grades included Grade 1 (4 patients), Grade 2 (7 patients), Grade 3 (3 patients), and Grade 4 (5 patients). Revision strategies included removal and anterior fusion, requiring vertebrectomy for Grade 4 cases; revisions to a different CTDR prosthesis were reserved for Grades 1-3. The RSS group showed significant VAS neck pain improvement at T3 (mean = 36.2 points, p < 0.001), exceeding the minimum clinically important difference (MCID). However, VAS arm pain and NDI did not meet MCID thresholds. The control group showed clinically significant improvements across all PROMs. At T2, the RSS group had a higher disability (NDI, p = 0.027) than the controls.CONCLUSION: Revision surgery for M6-C osteolysis improves neck pain, not arm pain or disability. Early detection and tailored revision strategies are crucial to optimize patient outcomes and mitigate osteolysis-related disability

Crisis planning intentions among hotel managers: what have we learned from the COVID-19 pandemic?

This study investigates the motivational factors which influence future crisis planning intentions, by utilising the Theory of Planned Behaviour (TPB) as the underlying theoretical framework. This research focuses on understanding the attitudes, subjective norms, and perceived behavioural control of hotel managers’ intentions regarding future crisis planning. To enhance the TPB model, the study incorporates two additional variables: perceived risk and past behaviour, thereby addressing previous calls to extend the TPB model. Employing a qualitative methodology, semi-structured interviews (n = 21) were conducted with hotel managers who worked at government-appointed quarantine hotels in Australia during the COVID-19 pandemic. Thematic analysis was conducted using Leximancer, an artificial intelligence (AI) data text mining software to explore the verbatim content via text mining, thematic analysis. This research provides critical insights into the determinants of crisis planning intentions among hotel managers, contributing to the theoretical and practical understanding of crisis preparedness in the hospitality industry

Business model innovation and its impact on the diffusion of innovation in construction business organizations

The evolving business landscape, driven by digitalization and environmental, social, and governance (ESG) considerations, requires a systems approach to construction business. The discussion around digitalization as a key driver of innovation and a catalyst for change has been crucial, prompting construction organizations to adapt their business models. Due to the dynamic nature of the construction industry, construction organizations often encounter challenges in embracing new technologies and updating their business models to meet changing market demands. Consequently, business model innovation often takes a backseat. This chapter delves into how innovation, particularly driven by public sector clients, can influence business model innovations in construction organizations, drawing insights from an extensive literature review and the Hong Kong Housing Authority case. The findings suggest that construction organizations may be more inclined to adopt new technologies, implement systems, and explore business model innovations when public policies are in place to support such initiatives

30 Years of contribution and future directions in tourism, hospitality, and events research: A Quo Vadis perspective from the Journal of Hospitality and Tourism Management

The Journal of Hospitality and Tourism Management (JHTM) recently celebrated its 30th anniversary, a significant milestone reflecting its enduring contribution to research in tourism, hospitality, and events. As part of the celebrations, the senior editorial board of JHTM has prepared this perspective paper, one of several initiatives marking this occasion. The paper critically examines research published in JHTM, focusing on seven key topics: Events & Festivals; Experience Design and Management; Destination Marketing & Management; Service Management; Information & Communication Technologies (ICT); Sociocultural Impacts of Tourism; and Climate Change & Environmental Concerns

Determinants of Physical Activity 10 Months Following a Supervised Exercise Program in People With Type 2 Diabetes

AIMS: Supervised exercise provides numerous health benefits for people with type 2 diabetes mellitus (T2D); however, long-term adherence is poor. We aimed to identify (1) factors associated with total physical activity (PA) participation 10 months following supervised exercise and (2) barriers to and enablers of self-directed exercise.METHODS: Fifty-seven adults with type 2 diabetes mellitus (age: 60.4 [8.6] y, 23% women, glycated hemoglobin [HbA1c]: 8.7% [1.9%], PA: 68.1 [142.3] min·wk-1) were allocated to low-volume combined aerobic and resistance high-intensity interval training (78 min·wk-1) or combined moderate intensity continuous training (210 min·wk-1). Participants completed 8 weeks of supervised training, then 10 months of self-directed exercise (12 mo total). Sociodemographic, medical, psychological, and health determinants of total PA at 12 months were identified using correlation and multiple regression analyses. Barriers and enablers were derived from individual participant interviews.RESULTS: At 12 months, average weighted total PA was 209.4 (174.3) minutes per week. Only allocation to combined aerobic and resistance high-intensity interval training was an independent predictor of total PA at 12 months (β = 0.477, P = .027). Enablers of self-directed exercise included flexible exercise schedule and social support. Barriers were limited access to specialized equipment and competing time demands.CONCLUSIONS:This study highlights factors to consider when designing long-term exercise support for people with type 2 diabetes mellitus

Dietitians’ practices and perspectives of the delivery of nutritional care to cancer survivors in the primary care setting

Purpose:The number of people living longer after a cancer diagnosis is increasing. Guidelines for cancer survivorship recommend a healthy diet and maintaining a healthy weight post-treatment. While cancer survivors often express the need for professional support for nutrition management, few report seeing a dietitian. This study aimed to explore primary care dietitians’ experiences, practices, and perspectives in providing nutritional care to cancer survivors in Australia.Methods:This qualitative study used in-depth, semi-structured interviews with primary care dietitians working in private practice and community care. Interviews were recorded and transcribed. A qualitative descriptive methodological approach integrated with a working analytical framework was utilized for coding and data analysis.Results:Twenty-four dietitians working in primary care participated. Four themes and 13 sub-themes were identified: (1) diversity in dietetic practice and cancer-related care interactions; (2) accessing referral pathways and funding sources in a complex healthcare system; (3) the application of nutrition education, and upskilling in cancer care; (4) client barriers and dietitians' challenges and factors influencing confidence in cancer care.Conclusion:Dietitians in this study highlighted the need for clear referral pathways to primary care particularly as a continuation of cancer-related care following the acute setting. There is a need for tailored support for dietitians supporting people diagnosed with cancer in the primary care setting, including opportunities to upskill in cancer care

What a real review into the QPS should look like

With yet another review to be held into the Queensland Police Service, the public needs to know what the parameters will be, writes Terry Goldsworthy

Does emotional inhibition affect public perceptions of not-in-my-backyard infrastructures? A case study of waste-to-energy incineration facilities

NIMBY (Not-In-My-Backyard) phenomena are widespread social issues in energy project development that fundamentally stem from public risk perceptions and emotional reactions to sensitive facilities. Emotions are critical factors that shape public cognition and attitudes, playing a pivotal role in both the emergence and resolution of NIMBY conflicts. This study uses waste-to-energy (WTE) facilities as a case to explore the impact of emotion inhibition strategies on public cognition and attitudes through behavioral survey experiments. A comparative analysis of positive and negative emotion inhibition was conducted with 240 participants, and the results of the study demonstrate that emotional inhibition can substantially alter public perceptions, with varying impacts depending on whether positive or negative emotions are inhibited and on the group size. Insights are provided into the role of emotions in shaping public perceptions during group discussions, supporting governmental efforts to anticipate and manage energy facility construction conflicts, mitigate negative outcomes from emotional arousal, and promote the sustainable development of WTE incineration facilities.</p