Background:Cancer inequities among vulnerable populations in rural areas remain a public health challenge in Canada. Rural populations are defined as vulnerable due to geographic isolation, limited access to specialized oncology care, and socioeconomic barriers such as transportation and financial toxicity. Professional navigation offers a potential solution to bridge these gaps, yet there is a lack of evidence on the barriers to and facilitators of its adoption in breast cancer survivorship. Objective:The objective of this study is to evaluate the effectiveness of a cancer navigation intervention using professional navigators compared to the standard of care (medical care) in improving the quality of life and functional outcomes of newly diagnosed survivors of breast cancer in interior British Columbia. Methods:A single-center, parallel-group, open-cohort randomized controlled trial is being conducted over 3 years. Ethics approval was obtained for the study. Participants who provide informed consent are randomized into 2 groups: the intervention group receives the cancer navigation intervention and the control group receives the standard of care (the usual medical care offered by health care practitioners). The baseline study time point spanned January to March 2025, the first follow-up spanned April to June 2025 at 3 months after enrollment, and the second follow-up spanned July to September 2025 at the end of 6 months after enrollment. The cancer navigation intervention comprises direct psychosocial and educational webinars, coordinated telephone support services, and community-based cancer care resources. Professional navigators are qualified registered nurses who facilitate information and connect participants with available supportive resources, services, and programs. The main outcomes are financial distress, quality of life, and satisfaction with navigation and interpersonal relationships. The Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy, Functional Assessment of Cancer Therapy-Breast, Breast Cancer Navigation Survey, Participant Satisfaction With Navigation Scale, Satisfaction With Interpersonal Relationships Survey, and Breast Cancer Navigation Interview are used in the study. Steps are being taken to ensure the trustworthiness of the qualitative data. With a 5% level of significance (2 tailed) and 90% power, the sample size was calculated as 108. Results:Data collection took place from January 2 to September 30, 2025. A total of 164 participants were recruited. Conclusions:This study aims to demonstrate effectiveness and satisfaction with professional navigation and knowledge translation for future implementation of a cancer navigation intervention in British Columbia.

BACKGROUND:The effectiveness of exercise and education in individuals with ankle osteoarthritis (OA) has not been investigated, and their perspectives on these interventions remain underexplored. OBJECTIVE:To understand the experiences of individuals with ankle OA on participating in a feasibility trial comparing general advice and education plus exercise and their views on such interventions. DESIGN:Descriptive qualitative study. METHODS:We invited adults with ankle OA who participated in a feasibility trial for an interview. Data were transcribed, de-identified and analysed using Reflexive Thematic Analysis. RESULTS:We interviewed twenty-two participants (age range 45-84 years, 14 females) and identified three themes: 1) The trial team made the trial a great experience, with some room for improvement (e.g., online weekly diaries, access to assessment results); 2) Both general advice and education plus exercise interventions can have a meaningful impact on participants' lives. For some who received general advice, the physiotherapy assessment and the advice received were catalysts for change, while exercise was expected and enjoyable for those who received education plus exercise. However, some thought the general advice and education did not add to their existing knowledge; 3) Lack of discipline and 'life' aspects (e.g., being a student, getting sick) can hinder participation. CONCLUSION:Participants in a feasibility study comparing general advice and education plus exercise had a positive experience with the trial processes, research team, physiotherapists and exercise program. However, perspectives on general advice and education varied, and they had suggestions for improvement that should be considered in future ankle OA trials.

Objective:Conduct a scoping review to identify radiographic measures of patellofemoral joint (PFJ) alignment and bony morphology reported in literature published during a representative period (2014-2018), and describe their reported measurement properties. Design:Eight electronic databases were searched using keywords relating to "patellofemoral" and "radiograph". Identified records were screened for eligibility by two independent assessors. English-language studies published in the years 2014-2018 were included if they reported: (i) acquiring PFJ radiographs; (ii) method of radiograph acquisition; and (iii) descriptions of radiographic PFJ alignment and bony morphology measures. Non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years were excluded. For studies that reported measurement properties (reliability, validity, responsiveness), quality appraisal was performed by two independent assessors using the COSMIN Risk of Bias tool. Descriptive data were reported. Results:Of 18,678 records identified, 336 articles met our criteria . Ninety-one unique radiographic alignment and morphology measures were described. Most prevalent were measures of patellar height (222, 66.1 %), patellar alignment (142, 42.3 %), and patellar inclination (121, 36 %). Reliability data were reported by 83 (24.7 %) of the studies. Conclusions:During the selected period, 91 different radiographic measures of PFJ alignment and morphology were reported, with multiple methods used to obtain similar measures, and limited data on reliability and validity. These findings make it difficult to recommend specific measures for clinical and research use. Further studies are needed to determine the measurement properties of radiographic PFJ alignment and morphology measures, and to establish consensus-based recommendations for priority measures and acquisition methods for specific PFJ conditions.

The personality disorders are said to be at the vanguard in the shift to a dimensional model of classification, as exemplified in the Alternative Model of Personality (AMPD) presented in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for emerging models and in the 11th edition of the International Classification of Diseases (ICD-11). Considered herein are some limitations and challenges. For the DSM-5 AMPD trait model, these include problematic placements, inadequate coverage, perceived complexity, and lack of cutoff points. For the DSM-5 AMPD Level of Personality Functioning (LPF), they include the complexity, the questionable presumption that the LPF defines the core of personality disorder, the presumption that the LPF identifies what is unique to the personality disorders, and the premise that the LPF is distinct from the maladaptive traits. Limitations and challenges of the ICD-11 model are the absence of lower-order facet scales and the fact that only the level of severity is required. This review suggests that the trait of depressivity belongs with negative affectivity and suspicion belongs within antagonism, that maladaptive traits from all 10 poles of the five domains should be provided, and that cutoff points based on social-occupational impairment and/or distress should be provided. The review summarizes research that questions whether the LPF represents the core of personality disorder, identifies what is unique to the personality disorders, and is distinct from maladaptive traits. Finally, the review suggests that the ICD-11 should require the assessment of the traits and include facet scales.

BackgroundAnkle dorsiflexion range of motion plays a pivotal biomechanical role within the lower limb with implications both in rehabilitation, injury risk reduction and athletic performance. However, clinicians often lack practical guidance on diagnosing and differentiating the various joints or structures that have been shown to have a role in ankle dorsiflexion range of motion restriction.Clinical questionTo move beyond the “one size fits all approach” paradigm in musculoskeletal rehabilitation, we propose addressing the 2 following questions: (1) How can clinician utilize the weight-bearing lunge test findings to develop a clinical-decision making system for ankle dorsiflexion range of motion assessment? and (2) How can this system guide individualized interventions to restore ankle dorsiflexion range of motion specific to each athlete's needs?.SolutionsWe outline a 3-step framework for improving ankle dorsiflexion range of motion restriction: (1) having a quantitative and qualitative assessment using the weight-bearing lunge test to identify joint or structure involvement, (2) having confirmatory diagnostic testing to pinpoint mobility restrictions of the joint or structures involved, and (3) proposing targeted interventions based on individual findings, ensuring a personalized rehabilitation approach rather than a generalized global protocol.Clinical applicationThis rehabilitation practice commentary addresses a notable gap in the existing literature on clinical choices regarding ankle dorsiflexion restriction treatment. By integrating this individual clinical decision-making system, clinicians can enhance rehabilitation and performance optimization beyond standard treatment methods.

Alternating posture between sitting and standing with sit-stand desks may improve lower back pain (LBP). This study explored the effectiveness, acceptability and adherence of two sit-stand desk recommendations on LBP (measured via App) and secondary health and work outcomes. Fifty-six desk-based workers with LBP (age = 37.7 [SD = 10.0] years, 75 % women) were randomised to either a fixed ratio (30 min sitting:15 min standing); or a personalised ratio (self-selected or pre-emptive to discomfort). After 3 months, fixed ratio participants experienced reduced worst (-1.33 points/10) and average LBP (-0.83 points/10); personalised ratio participants experienced reduced worst LBP only (-0.69 points/10). Fixed ratio participants improved in their job-related stress, concentration and presenteeism; whereas, personalised ratio participants reduced their sitting time. Both recommendations were acceptable, while adherence was higher in the fixed ratio group. In conclusion, a 30:15 sit-stand ratio was acceptable and effective at improving LBP in the short term compared to a personalised ratio.

Background: Literature reporting positive outcomes from the Good Life with osteoArthritis in Denmark (GLA:D (R)) program in Australia mainly involves patients attending private physiotherapy services. Objective: Evaluate the feasibility of implementing GLA:D (R) in Australian public hospitals. Design: Implementation study in three metropolitan tertiary public hospitals over six months. Method: Patients aged >= 18 years with knee or hip joint -related problems deemed appropriate for non -surgical care were invited to participate in GLA:D (R). Feasibility was evaluated using RE -AIM framework components (Implementation, Effectiveness, Maintenance) using service -level metrics, patient -level data, and program fidelity assessment. Findings of qualitative interviews with service providers are presented in Part 2. Results: Implementation : 70 patients (69 with knee osteoarthritis) participated (13 cohorts). 55 (79%) patients attended both education sessions, and 49 patients (70%) attended 10 -12 exercises sessions. Fidelity was met based on environmental, therapist, participant- and program -related criteria. Effectiveness: At 3 months, patients reported lower average pain (visual analogue scale [0 -100 mm]: effect size -0.56, 95% CI -0.88 to -0.23) and disability (HOOS/KOOS-12 [100-0]: 0.67, 0.28 to 1.05), and improved quality of life (EQ-5D overall score: 0.46, 0.11 to 0.80). No adverse events were reported. All patients who completed 3 -month assessment (n = 52) would recommend GLA:D (R). Maintenance: All participating services elected to continue delivering GLA:D (R) beyond the study. Conclusions: Implementing GLA:D (R) in Australian public hospitals is feasible, safe, and acceptable to patients with knee osteoarthritis. Public hospital patients with knee osteoarthritis reported improvements in pain, disability, and quality of life similar to previous GLA:D (R) cohorts.

Background: Previous literature has reported the successful implementation of the Good Life with osteoArthritis in Denmark (GLA:D (R)) program into predominantly private practice settings. There may be unique challenges present within the public hospital setting that influence GLA:D (R) implementation in public health. Objective: Explore the attitudes and experiences of service providers directly involved in implementing GLA:D (R) in Australian public tertiary hospitals. Design: Qualitative descriptive study design. Method: Service providers (n = 14) from three participating hospitals took part in semi-structured focus groups at the completion of the 6-month implementation period. Inductive thematic analysis was employed to identify primary domains across all facilities. Results: Four broad domains were identified. Factors that influenced uptake included GLA:D (R) being a recognisable, evidence-based product requiring minimal development or adaptation. The fidelity of the GLA:D (R) Australia program was challenged by referral of patients with multiple/complex medical comorbidities, and patient preference to complete registry data via paper rather than online. Several operational considerations are required when delivering GLA:D (R) in a public hospital setting, including adequate numbers of GLA:D (R)-trained staff, additional screening requirements, obtaining appropriate clinical space, and persisting patient barriers to attending the service. GLA:D (R) provided benefits beyond improvement in pain and function, including social interactivity, high attendance and promotion of long-term self-management, while also maximising service efficiencies. Conclusions: Implementing GLA:D (R) in Australian public hospitals was supported by service providers. Specific operational and administrative factors, including staff training, patient complexity, and registry requirements should be considered when attempting to embed and sustain GLA:D (R) in large Australian public tertiary hospitals.

OBJECTIVES:To develop an internationally agreed-upon core domain set for ankle osteoarthritis (OA). METHODS:In a three-part Delphi process, a group of multidisciplinary health professionals with expertise in ankle OA and people with ankle OA responded to online questionnaires. The questionnaires proposed a list of 29 candidate domains derived from a systematic review of ankle OA research, and interviews with people with ankle OA and health professionals. Consensus was defined a priori as ≥70% agreement in people with ankle OA and health professionals whether a domain should or should not be included in a core domain set. An online consensus meeting was held to discuss and resolve undecided candidate domains. RESULTS:A total of 100 people (75 health professionals and 25 people with ankle OA) from 18 countries (4 continents) participated in this study. Five domains reached consensus for inclusion in a core domain set for ankle OA - pain severity, health-related quality of life, function, disability and ankle range of motion. Twenty-one candidate domains reached agreement not to be included in the core domain set, and three domains remained undecided (ankle instability, physical capacity, and mental health). CONCLUSION:This international consensus study, which included people with ankle OA and health professionals, has established a core domain set for ankle OA with five domains that should be measured and reported in all ankle OA trials - pain severity, health-related quality of life, function, disability and ankle range of motion. This core domain set will guide the reporting of outcomes in clinical trials on ankle OA. Future research should determine which outcome measurement instruments should be used to measure each of the core domains.

Introduction:: Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and without POP, at rest and with elevated IAP, and to compare the change in measures from the supine to standing position between groups. Methods:: Thirty premenopausal vaginally parous women with (n=15) and without (n=15) POP were included. Transperineal ultrasound was used to assess pelvic floor morphometry (bladder neck [BN], rectal ampulla [RA], levator plate angle [LPA], anorectal angle [ARA], levator anteroposterior distance [LAP], and levator hiatal area [LHA]) in supine and standing, at rest and bearing down. Measures were compared between positions (supine and standing) and groups (women with and without POP). Results:: At rest, BN and RA were lower and LPA was smaller in standing than supine for all participants (all p<0.04), and LHA and LAP distance were greater in standing than supine for women with POP (p<0.001). In standing rest, BN and RA were lower and LHA was greater in women with than without POP (p<0.001). There were no differences between women with and without POP in these measures in supine (all p>0.23). ARA was greater in women with POP than without POP in both positions at rest (p=0.002). During bearing down, BN and RA were lower, ARA and LPA were smaller, and LHA and LAP distance were larger in standing than in supine for all participants (all p<0.023). In bearing down in both positions, BN and RA were lower and ARA and LHA were greater in women with than without POP (all p=0.013). Conclusion:: Our findings indicate lower pelvic floor support in women with POP compared to women without POP that is evident during bearing down in supine, and at rest and during bearing down in standing. These findings underscore the utility of transperineal ultrasound to assess pelvic floor morphometry in standing to guide management of women with POP.

OBJECTIVES:Explore healthcare professionals' perspectives on the main problems that their patients with ankle osteoarthritis experience and to propose health-related domains. METHODS:A qualitative study using semi-structured interviews was conducted with an international multidisciplinary group of healthcare professionals identified as ankle experts. Eligibility criteria were aged ≥18 years, and a certified healthcare professional with ≥ 5-year experience post-qualification in working with ankle osteoarthritis and/or chronic ankle pain. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS:Twenty-one healthcare professionals (20 males; mean (range) age 49 (34-72) years) from four professions (orthopaedic surgeons (n = 9), athletic trainers (n = 5), physiotherapists (n = 4) and podiatrists (n = 3)) were interviewed. Four main themes were identified: 1) people with ankle osteoarthritis have difficulty with weight-bearing activities; 2) symptoms of pain and stiffness predominate, alongside swelling, instability, weakness and poor balance; 3) chronic pain in ankle osteoarthritis has psychosocial consequences; and 4) the loss of activities of daily living and independence compromises quality of life. We proposed 15 health-related domains that emerge from the interview data. CONCLUSION:Healthcare professionals recognise that ankle osteoarthritis patients have difficulty in physical, sporting, and occupational weight-bearing activities, and they live with persistent ankle pain, stiffness and other symptoms that have physical and psychosocial consequences. The health-related domains derived from interviews with expert healthcare professionals will contribute to the development of a core domain set for ankle osteoarthritis.

BackgroundLower limb osteoarthritis (OA) is a leading cause of disability and can affect an individual's ability to work.ObjectivesTo explore Australian physiotherapists’ use of work-related interventions in managing patients with lower limb OA, and identify current management practices.MethodsPhysiotherapists with at least two years of experience treating patients with lower limb OA were invited to complete an online survey to understand how physiotherapists manage patients with lower limb OA, specifically regarding interventions related to work.ResultsA total of 132 physiotherapists completed the survey. In free text responses, only 1.5% and 2.3% of physiotherapists nominated work-related items in their key components of treatment or educational topics discussed with patients with lower limb OA, respectively. From a range of work-related activities presented, over half of physiotherapists indicated they regularly/always provided education about the benefits of remaining in work (63.5%) and advice on managing symptoms at work (57.4%). Less than 10% of physiotherapists regularly/always used a validated scale to identify barriers for work (9.6%), discussed absences from work (9.6%), conducted a workplace assessment (4.4%), and discussed submitting workers’ compensation claims (2.6%). Exercise and patient education were the most frequently nominated physiotherapy treatments in free text (96.2% and 86.3%, respectively) and fixed response (99.2% and 93.9%, respectively) questions.ConclusionMany physiotherapists do not address work-related activities in their management of patients with lower limb OA. In light of work-related challenges commonly experienced by individuals with lower limb OA, this is an important aspect of management of this condition.

Although neuromuscular injury prevention programs decrease injuries, implementation is challenging. Netball Australia developed the Netball KNEE program – a netball-specific warm-up program designed for netball coaches, players and support staff to enhance movement efficiency and prevent injury. It contains exercises for warm-up/footwork, strength, balance/landing and agility. This study aimed to explore the Reach, perceived Effectiveness, Adoption, Implementation and intended Maintenance of the Netball KNEE program in community netball. Community netball coaches ( n = 257) from 52 community netball clubs completed an online survey on their familiarity with the KNEE program (Reach), satisfaction and perceived effectiveness (Effectiveness), use of the program in training (Adoption), use of specific program components and provision of feedback (Implementation) and intended future use of the program (Maintenance). 66.5% of coaches who responded to the survey were familiar with the KNEE program (Reach), and 43.0% of coaches reported using the program weekly (Adoption). Most coaches who were familiar with the program were satisfied with it (87.2%) and perceived it to be effective in reducing injuries (77.0%) (perceived Effectiveness). Only 58.7% of the 155 of coaches who adopted the program reported using all activity categories (warm up/footwork, strength, balance/landing and agility) (Implementation). Warm up/footwork activities were reported to be used most commonly (by 99.4% of coaches). Reported provision of feedback on program key principles (e.g., take off, landing, deceleration, changing direction) was variable (54.2%–97.4%) (Implementation). Study findings suggest the need for strategies to improve the reach, adoption and implementation of the KNEE program in community netball.

Introduction: Advice for women with pelvic organ prolapse (POP) often includes lying down to decrease the effects of gravity on the pelvic floor. The aim of this study was to compare pelvic floor morphometry before and after 30 min of supine lying in women with symptomatic POP. Methods: Pelvic floor morphometry was assessed in vaginally parous, premenopausal women with symptomatic POP >= stage 1. The modified Pelvic Organ Prolapse Quantification system was used in supine to assess points Ba (anterior vaginal wall), Bp (posterior vaginal wall), and C (cervix). Transperineal ultrasound imaging was used in supine and standing to assess the following measures at rest and bearing down: bladder neck position, bladder position, rectal ampulla position, levator plate angle, anorectal angle, levator anteroposterior distance, and levator hiatal area. Measures taken before and after 30 min of supine lying were compared. Results: Twenty-one women (median (range) age: 39 (29-50) years) with varied stages of POP (33% stage 1, 57% stage 2, and 10% stage 3) were included. Most measures of pelvic floor morphometry were unchanged after 30 min of supine lying compared to before lying. Participants had greater resting levator hiatal area in supine and levator anteroposterior distance at rest and bearing down in supine after lying down (p <= 0.001), suggesting reduced pelvic floor muscle activity. Conclusion: Findings suggest that a 30-min period of supine lying does not improve support of the pelvic organs.

BACKGROUND:Although footwear can improve pain and function in individuals with knee osteoarthritis (OA), perspectives about footwear in this population have not been explored. OBJECTIVES:This qualitative study explored preferences, attitudes and beliefs about footwear in adults with knee OA. METHODS:Twenty individuals with a clinical diagnosis of knee OA (aged 45-79 years, 65% women) participated in semi-structured interviews about factors which influence footwear selection, the effect of footwear on knee symptoms, and footwear modifications. Data were analysed thematically. RESULTS:Four themes, with sub-themes, were identified: i) there are specific footwear characteristics people look for, with comfort as their top priority; ii) shoe appearance is important; iii) footwear can aggravate or ease symptoms; and iv) people with knee OA find footwear in a variety of ways. Participants related built-in arch support, a cushioned insole and low/no heel, without addition of foot orthoses, to comfort, and were willing to pay more for comfort and quality. Appearance was also a consideration, and participants indicated they would tolerate short periods of symptom aggravation for aesthetic shoes. Participants felt that footwear choice affected their knee symptoms and risk of slipping/twisting. Participants reported that their footwear choices were determined through trial-and-error, and sometimes on advice from health professionals or shoe store salespersons. CONCLUSIONS:There are specific footwear features important to individuals with knee OA. Knowledge of these features can be used by health professionals to inform footwear discussions with knee OA patients and serve as considerations when developing footwear targeted for this population.

Objective:Conduct a scoping review to describe the use and application of different radiographic classification approaches to grade patellofemoral osteoarthritis (PFOA) in literature published during a representative period (2014-2018), and describe reported measurement properties of these grading criteria. Design:The scoping review was conducted in accordance with PRISMA-ScR guidelines. Eight electronic databases were searched using keywords relating to "patellofemoral" and "radiograph". Two independent assessors screened each record for eligibility. English-language studies published in the years 2014 to 2018 were included if they acquired patellofemoral joint (PFJ) radiographs, described the method of radiograph acquisition, and reported grading PFOA. We excluded non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years. Studies that reported measurement properties underwent quality appraisal using the COSMIN Risk of Bias Tool. Descriptive statistics were reported. Results:Of 18,678 records identified, 177 articles were selected. Twenty-six classification approaches to grade radiographic PFOA were reported, with Kellgren-Lawrence (KL) (n = 70, 40 %), OsteoArthritis Research Society International (OARSI) (n = 26, 15 %), and Iwano (n = 25, 14 %) most prevalent. Axial projections (n = 81, 46 %) were most commonly used to grade PFOA, followed by lateral (n = 31, 18 %) and frontal (n = 16, 9 %) projections. KL was most frequently used across settings, disciplines, and regions. Reliability data was reported by 32 (18 %) studies. Conclusions:Multiple radiographic OA classification approaches were used to grade PFOA during the representative period, although few are specific to the PFJ. We recommend that a reliable and valid PFOA radiographic grading approach be developed using standardized PFJ radiograph acquisition techniques.

OBJECTIVE:The Netball KNEE Program is an injury prevention program (IPP) developed by Netball Australia. It is promoted to coaches, but implementation is limited. This study explored community netball coaches' perspectives on factors that influence IPP implementation, and ideas on how it could be improved.METHODS:Twenty-four coaches from 16 netball clubs participated in semi-structured interviews that asked about their beliefs about injury prevention, use of and confidence in delivering IPP, barriers and facilitators to implementation, and suggestions to ease IPP implementation. Interviews were analysed using inductive thematic analysis.RESULTS:Two themes were identified - Factors that influence IPP implementation (4 sub-themes), and Suggestions to improve IPP implementation (2 sub-themes). Coaches thought early development of injury prevention habits was important. Life roles, coaching experience and engagement with development courses influenced IPP delivery. Coaches expressed concerns about Netball KNEE program length and complexity and lack of implementation support. They suggested the need for a short simple IPP and engagement with health/exercise professionals for implementation.CONCLUSIONS:This study engaged with stakeholders to identify barriers that need to be addressed to improve IPP implementation in netball. Coaches desired a short simple standardised IPP, and training from physiotherapists or exercise professionals on implementation.

Pain and disability associated with lower limb osteoarthritis (OA) may contribute to difficulties at work. This study aimed to understand the perspectives of workers with lower limb OA on difficulties, concerns, and coping strategies used at work. Twenty-two individuals with lower limb OA who were working in paid employment participated in semi-structured interviews. Data were qualitatively analyzed using an inductive thematic approach. Codes were identified and refined through review of interview transcripts and discussion with the research team. Six themes were identified in relation to experiences working with lower limb OA. Themes were as follows: weight-bearing physical demands are challenging; lower limb OA can affect work performance; emotional consequences of pain; concerns about work in the future; positive experiences of supportive colleagues and managers; and minimal effects on sedentary work. Three themes were identified relating to strategies to manage at work: adjustments at work help manage pain and avoid exacerbations; regular strategies to manage pain; and healthcare professionals are consulted, but usually not specifically for work. Workers with lower limb OA experience physical and emotional difficulties at work that can impact work performance. Workers are concerned about longevity and job security and use a range of strategies to manage symptoms and remain at work. Employers, employees, and healthcare professionals may need to work together to create workplace accommodations to help workers with lower limb OA confidently remain in work.

Borderline personality disorder (BPD) is a heterogeneous condition that is particularly associated with three broad personality dimensions: neuroticism (i.e., high negative affectivity), agreeableness (i.e., low antagonism), and conscientiousness (i.e., low disinhibition). The purpose of the present study was to explore whether treatment with BPD Compass, a novel personality-based intervention for BPD, results in greater reductions in BPD symptoms, neuroticism, agreeableness, and conscientiousness compared to a waitlist control (WLC) condition. We also aimed to characterize within-treatment effects for participants assigned to the BPD Compass condition and evaluate patients' satisfaction with treatment. Participants (N = 51; Mage = 28.38; 83.3% female; 93.8% White; 54.2% sexual minority) meeting DSM-5 criteria for BPD were enrolled in a randomized controlled trial to evaluate the efficacy of BPD Compass. Patients were randomly assigned to receive 18 sessions of BPD Compass or complete an 18-week waiting period. BPD Compass led to larger reductions in BPD symptoms (assessor-rated [β = -0.47] and self-reported [β = -0.62]) and neuroticism (β = -0.37), but not agreeableness (β = 0.08) or conscientiousness (β = 0.10), compared to the WLC condition. Within the BPD Compass condition, pre- to posttreatment improvements in BPD symptoms, neuroticism, and conscientiousness were significant and large in magnitude (Hedges' gs: -1.38 to -1.08). Patients were highly satisfied with BPD Compass and generally perceived it to be an appropriate length. Thus, BPD Compass may be an accessible and useful complement to more specialty or intensive treatments for BPD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).