Effectiveness Of Interventions Research Articles

Advances in the multidisciplinary surgical approach to primary spinal sarcomas: insights from a retrospective case series on outcomes and survival

IntroductionThe management of spinal sarcomas is complex, given their widespread involvement and high recurrence rates. Despite consensus on the need for a multidisciplinary approach with surgery at its core, there is a lack of definitive guidelines for clinical decision-making. This study examines a case series of primary spinal sarcomas, focusing on the surgical strategies, clinical results, and survival data to inform and guide therapeutic practices.MethodsWe conducted a retrospective analysis of patients who underwent surgical resection for primary spinal sarcomas between 2005 and 2022. The study focused on gathering data on patient demographics, surgical details, postoperative complications, overall hospital stay, and mortality within 90 days post-surgery.ResultsThe study included 14 patients with a primary diagnosis of spinal sarcoma, with an average age of 48.6 ± 12.6 years. Chondrosarcoma emerged as the most common tumor type, representing 57.1% of cases, followed by Ewing sarcoma at 35.7%, and synovial sarcoma at 7.1%. Patients with chondrosarcoma were treated with en-bloc resection, while the patient with synovial sarcoma underwent intra-lesional excision and those with Ewing sarcoma received decompression and tumor debulking. Postoperative assessments revealed significant improvements in neurological conditions. Notably, functional status as measured by the Karnofski Performance Index (KPI), improved substantially post-surgery (from 61.4 to 80.0%) The mean follow-up was 34.9 ± 9.2 months. During this time period one patient experienced fatal bleeding after en-bloc resection complications involving the vena cava. None of the patient needed further surgery.ConclusionsOur 16-year study offers vital insights into managing primary spinal sarcomas, showcasing the effectiveness of surgical intervention, particularly en-bloc resection. Despite their rarity and complexity, our multidisciplinary treatment approach yields improved outcomes and highlights the potential for refined surgical strategies to become standardized care in this challenging domain.

Topography and soil variables drive the plant community distribution pattern and species richness in the Arjo-Diga forest in western Ethiopia.

Understanding plant community characteristics, distributions, and environmental relationships is crucial for sustainable forest management. Thus, this study examined the relationships between plant community composition and topographic and soil variables within the Arjo-Diga forest. Vegetation data were collected from 72 nested plots (30 × 30 m2 and 2 × 2 m2) systematically laid along nine transects spaced 300 to 700 m apart. Environmental variables, including soil properties and anthropogenic disturbance, were recorded within each main plot. Agglomerative hierarchical cluster analysis and canonical correspondence analysis (CCA) using R software were employed to identify distinct plant community types and examine their relationships with environmental factors. The Shannon‒Wiener diversity index was calculated to quantify and compare species diversity among the identified community types. The analysis revealed five distinct plant community types: 1: Maesa lanceolata-Ehretia cymosa, 2: Trichilia dregeana-Flacourtia indica, 3: Acacia abyssinica-Millettia ferruginea, 4: Combretum collinum-Croton macrostachyus, and 5: Terminalia macroptera-Piliostigma thonningii. The CCA results highlighted the significant influence (p < 0.05) of altitude, CEC, TN, and disturbance on species distribution and plant community formation. The findings indicate that variation in plant communities is closely associated with altitude, TN, and CEC, as well as with disturbance factors such as human interventions, with elevation being the most influential factor. Based on these findings, it is recommended that conservation plans consider the effects of human interventions to address the challenges in conserving forests in the future. Additionally, further research efforts should focus on mitigating disturbance factors and understanding the environmental variables that affect forests to improve their protection.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention.

In patients with liver failure (LF), the high rate of secondary infections, which are associated with poor prognosis, highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs. To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions. This retrospective study included 64 patients with LF, including 32 with and 32 without secondary infections. A questionnaire was used to collect data on age; laboratory parameters, including total and direct bilirubin, prothrombin time, blood ammonia, and other biochemical parameters; invasive procedures; and complications. Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care, whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes. The infection rate, which was not associated with age or complications, was significantly associated with biochemical parameters and invasive procedures (P < 0.05). The infection rate was 61.6% in patients who had undergone invasive procedures and 32.1% in those who had not undergone invasive procedures during the hospital stay. The infection rate was also significantly associated with the type of LF (P < 0.05), with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF. The nursing satisfaction rate was 58.3% in the uninfected group and 91.7% in the infected group, indicating significantly higher satisfaction in the infected group (P < 0.05). In patients with LF, the rate of secondary infections was high and associated with biochemical parameters and type of LF. Comprehensive nursing intervention can improve patient satisfaction.

Social Objectives of Microfinance Institutions and Evaluating its Implementation: A Systematic Review

This research explores the social goals of Microfinance Institutions (MFIs), emphasizing their role in empowering underserved groups, including women, rural populations, and micro-entrepreneurs through financial services. Despite their noble intentions, the commercialization of MFIs, influenced by large banking entities, has shifted the focus towards profitability, potentially undermining their mission to alleviate poverty. A systematic literature review conducted from 2010 to 2020 discloses mixed results regarding the relationship between financial sustainability and outreach depth for microfinance institutions (MFIs). The study explores such as balancing financial sustainability and social outreach, mission drift, regulatory hurdles, and governance shortcomings. It underscores the necessity for collaborative regulation, financial literacy, and enhanced governance to maintain the sustainability and efficacy of microfinance efforts. The study highlights the need for MFIs to balance financial sustainability with their social missions, advocating for enhanced governance, regulatory cooperation, and financial literacy to optimize their impact on poverty alleviation and economic inclusion. Academically, it calls for continued research into the trade-offs between profitability and social outreach, and the effectiveness of innovative microfinance interventions.

Angiogenic Effects of Aerobic Training and Royal Jelly Consumption with Emphasis on the Role of miR-126 and miR-210 in the Aortic Artery of Ovariectomized Diabetic Rats

Background: Cardiovascular complications in postmenopausal diabetic women are significantly higher than in their healthy peers. Although the beneficial effects of exercise interventions and consumption of foods rich in antioxidants on angiogenesis have been established, the synergistic effects of exercise training and royal jelly (RJ) consumption on angiogenesis in ovariectomized diabetic patients are still not well understood. Objectives: This study investigated the angiogenic effects of aerobic training (AT) and royal jelly (RJ) consumption, with an emphasis on the role of miR-126 and miR-210 in the aortic artery of ovariectomized diabetic (OVXD) rats. Methods: Thirty female OVXD rats were divided into five groups: OVXD control, Sham (Sh), RJ, AT, and AT + RJ. Additionally, six healthy rats were selected as the healthy control group (HC) to evaluate the effects of modeling on variables. Groups 4 and 5 underwent aerobic training for eight weeks, five sessions per week, with an intensity of 55 - 75% of VO2max. Groups 3 and 5 received 100 mg/kg/day of RJ. A one-way ANOVA test was used to analyze VEGF, eNOS, miR-126, and miR-210 (α = 0.05). Results: Vascular endothelial growth factor, eNOS, and miR-210 levels in the AT, RJ, and AT + RJ groups were higher than in the OVXD group (P ≤ 0.05). Although miR-126 levels in the RJ and AT + RJ groups were higher than in the OVXD group (P ≤ 0.05), the effects of AT and RJ separately on increasing VEGF and eNOS were more favorable than the combined effect of AT + RJ. Conclusions: While both AT and RJ supplementation individually increase markers of vascular angiogenesis, the simultaneous effects of these two interventions seem to moderate this mechanism.

Single-Cell Fluidic Force Spectroscopy Reveals Dynamic Mechanical Fingerprints of Malignancy in Breast Cancer.

The interplay between cancer cell physical characteristics and metastatic potential highlights the significance of cancer cell mechanobiology. Using fluidic-based single-cell force spectroscopy (SCFS), quartz crystal microbalance with dissipation (QCM-D), and a model of cells with a spectrum of metastatic potential, we track the progression of biomechanics across the metastatic states by measuring cell-substrate and cell-to-cell adhesion forces, cell spring constant, cell height, and cell viscoelasticity. Compared to highly metastatic cells, cells in the lower spectrum of metastatic ability are found to be systematically stiffer, less viscoelastic, and larger. These mechanical transformations in cells within a cluster correlate with cells' metastatic potential but are significantly absent in single cells. Additionally, the response to chemotherapy is found to be highly dependent on cell viscoelastic properties in terms of both response time and magnitude. Shifts in cell softness and elasticity might serve as mechanoadaptive mechanisms during cancer cell metastasis, contributing to our understanding of metastasis and the effectiveness of potential therapeutic interventions.

A digital positive psychology intervention for college student mental health and health behaviors

Purpose The purpose of this study is to evaluate the impact of a 10-week positive psychology course on college student stress, anxiety, self-compassion, resilience and health behaviors. Design/methodology/approach This study implemented a 10-week positive psychology program that included ten one-week modules. Each module consisted of a reading on a given positive psychology topic, a guided learning slideshow, a video to reinforce topical understanding and individual reflection or application exercises. Participants completed pre and postintervention measures, including the perceived stress scale, generalized anxiety disorder-7, self-compassion scale, brief resilience scale and wellness behavior inventory. Findings A total of 48 students consented to participate in the study, of which 35 completed the 10-week positive psychology online intervention as well as the pre and postsurveys (27.1% attrition rate). There were no statistically significant differences between pre and postresponses for any of the outcome scales. However, there was a trend toward a decrease in perceived stress and generalized anxiety, as well as a trend toward an increase in self-compassion and health behaviors from pre to posttest. Research limitations/implications The main limitation of this study was design and sample size. Although it was a pilot study, future research should consider a randomized control trial, including pre and postevaluation and blind comparison group. Finally, this intervention was only implemented in the online, asynchronous format. Future research might consider comparing face-to-face, asynchronous online and synchronous online modalities. Practical implications Future implementation should include a more rigorous design, such as a comparison group with randomization as well as a larger sample size. Social implications Given the previous effectiveness of positive psychological interventions on health behaviors, continued research may use direct measures of health behavior engagement throughout the intervention (Biber and Ellis, 2019). This study provides other researchers and practitioners with a model for utilization with middle, high and university students. Originality/value This study used open-access content that was free of charge to students to promote positive mental health and health behavior change.

Propelling Nurse-Led Structured Intervention to Enhance Self-Care among Patients with Chronic Heart Failure (PROACT-HF): A Cluster Randomized Controlled Trial Study Protocol.

Heart Failure (HF) is a common chronic disease that has a high readmission rate and is associated with worsening symptoms and major financial impacts. Disease management implemented during or after an HF hospitalization has been shown to reduce hospitalization and mortality rates. Particularly for outpatients, it is necessary to provide self-care interventions. Structured nurse-led support such as timely follow-ups, including phone calls, is beneficial for improving self-care assessments. Evidence for nurse-led support has been investigated but is less than conclusive. The aim of this study is to compare the effectiveness of a nurse-led structured intervention for outpatients with chronic HF against the usual medical care in terms of self-care behaviors and occurrence of symptom exacerbation or rehospitalization. This is a cluster-randomized controlled trial. A total of 40 facilities with certified HF nurses will be allocated to two-arm clusters at a 1:1 ratio, randomly to the intervention or usual care arms. A total of 210 participants will be assigned from the hospital. Participants will be adults aged 18 years or older diagnosed with chronic HF who are classified as Stage C according to the ACCF/AHA Heart Failure staging system. In the intervention group, patients will receive structured nursing support. This begins with weekly support, including phone calls, for the first month, then transitions to monthly support thereafter. The aim is to ensure the stability of their living conditions, promote medication adherence, and encourage self-management. In the control group, patients will receive the usual care. Primary outcomes will assess the improvement or continuation of self-care behavior as measured by changes in EHFScBS (European Heart Failure Self-Care Behavior Scale) scores. Secondary outcomes include occurrence of readmission within 30 days, 3 months, 6 months, and 1 year after discharge, duration of home care until readmission, and blood levels of BNP and NT-proBNP.

Effectiveness of early rehabilitation interventions in patients with traumatic brain injury using a large database.

Rehabilitation is important for patients with moderate-to-severe traumatic brain injury (TBI). However, the timing of early rehabilitation initiation is ambiguous, and its safety and effectiveness are unknown. To examine the effectiveness and safety of early rehabilitation in patients with moderate-to-severe TBI using propensity score analysis and a large database. Retrospective cohort study. A large medical database (JMDC database) of tertiary care facilities was used to compare outcomes of early and delayed rehabilitation. Patients aged between 20 and 90 years who were diagnosed with TBI were admitted to acute care hospitals. Inclusion criteria were patients undergoing rehabilitation within 7 days of admission with a Glasgow Coma Scale score of 3 to 12 on admission. This study included 3074 patients with moderate-to-severe TBI. Patients were classified into an early rehabilitation group (within 2 days of admission) or a delayed rehabilitation group (3 to 7 days postadmission), depending on when rehabilitation started after TBI. Rehabilitation was defined as any type or intensity of intervention provided by a physical, occupational, and/or speech/language therapist. Interventions were not controlled. The primary outcome was Barthel Index (BI) efficiency (BI gain/length of stay). Secondary outcomes included BI gain (discharge BI - admission BI), incidence of aspiration pneumonia complications during hospitalization, discharge to home, mortality, and length of stay. After applying inverse probability weighting with propensity scores, the total was 6152 patients. 3074 (50.0%) patients received early rehabilitation. The early rehabilitation group showed no difference in inpatient mortality (p = .438), improved BI efficiency (β = 0.86, p < .001), and shorter length of stay (β = -5.00, p = .018). Early rehabilitation in patients with moderate-to-severe TBI is associated with more efficient functional improvement and reduced hospital stays without an increase in inpatient mortality.

Child and Family Outcomes and Experiences Related to Family-Centered Care Interventions for Hospitalized Pediatric Patients: A Systematic Review.

Family-centered care (FCC) is the recommended model for pediatric inpatient care. Our overall aim was to conduct a narrative synthesis of the contemporary published research on the effectiveness of FCC interventions for pediatric inpatients. Our specific objective was to critique studies of inpatient pediatric FCC interventions that evaluated child or parent outcomes. We searched five databases (Pubmed, CINAHL, Embase, PsychInfo, and Web of Science) for peer-reviewed research published from 1 January 2017 to 6 February 2024. Independent reviewers evaluated each study based on pre-specified inclusion and exclusion criteria, then extracted and narratively synthesized the data. We found 16 studies of 15 interventions conducted in six countries. The studies were quantitative (n = 11), qualitative (n = 3), and mixed methods (n = 2), with most designs being of low to moderate quality based on a modified Mixed-Methods Appraisal Tool. Interventions included family-centered rounds, parent-focused health information technology, education, patient navigation, parent-peer support, partnership, and parent participation in caregiving. Most studies found significant improvements in parents' well-being, knowledge, and participation, as well as decreased stress and anxiety with the FCC interventions compared to usual care. One study found no differences in child outcomes (infant feeding, length of stay) between usual care and a parent-participation intervention. Although FCC interventions led to many improved outcomes for parents, there were few well-designed comparison studies using validated tools and well-defined interventions. Higher quality research is needed to promote greater uptake and sustainability of FCC interventions globally.

Transforming Brown Practices into Green Jobs: Training Intervention and Green Job Motivation of Agripreneuship Trainees

Purpose: Within the backdrop of labor market uncertainty for young people and environmental externalities, the study tested the effect of training intervention on green collar job motivation of agripreneuship trainees in a green growth project in Mezam, North West Cameroon. Focus was on training, attitude and social pressure as determinants of green job motivation off agripreneurs. Materials and Methods: The study adopted a quantitative survey design with the goal of data on green collar job training and motivation and a sample of 125 participants (71 females; 54 males) was recruited from a training intervention initiative from Mezam, North West Cameroon. An instrument with internal reliability consistency (α=0.74) was used to gather information. The information was entered into SPSS version 27, and correlation and hierarchical regression were used as test statistics. Findings: According to the results, it was reported as a significant predictor of green job motivation, p &lt; 0.05. In the second model capacity building and attitude significantly determined green job motivation p &lt; 0.05. While the third model (capacity enhancement, attitude, social pressure) was significant, p &lt; 0.05, social pressure as a separate dimension failed to determine green job motivation, p &gt; 0.05, of agripreneurs trainees. From the results of the study it was reported that training factors were capable of predicting green job motivation and the need for transforming brown occupations was also recognised within green growth venture. Implications to Theory, Practice and Policy: Green economic activities have undergone evolution with demands for new skills and training should be recognized as a sustainable measure of green collar job behaviours. Considering the position of green growth models in developing green collar mindset, it asserts that greener occupations are capable of catalysing wealth creation, environmental justice and sustainable and should be promoted. Therefore, advocates of green employment should draw from policy strategies and enrich training programmes to be more responsive to changing environmental, suggesting transformation from brown to green through green mindset building. While the paper contributes to scarce body of knowledge in green jobs, implications for policy and practice have been presented with areas for future research

The interdependence between hospital choice and waiting time — with a case study in urban China

Hospital choice models often employ random utility theory and include waiting time as a choice determinant. When applied to evaluate health system improvement interventions, these models disregard that hospital choice in turn is a determinant of waiting time. We present a novel, general model capturing the endogeneous relationship between waiting time and hospital choice, including the choice to opt out, and characterize the unique equilibrium solution of the resulting convex problem. We apply the general model in a case study on the urban Chinese health system, specifying that patient choice follows a multinomial logit (MNL) model and waiting times are determined by M/M/1 queues. The results reveal that analyses which solely rely on MNL models overestimate the effectiveness of present policy interventions and that this effectiveness is limited. We explore alternative, more effective, improvement interventions.

Biomolecular therapies for chronic discogenic low back pain: A narrative review.

Chronic low back pain caused by intervertebral disc (IVD) degeneration, also termed chronic discogenic low back pain (CD-LBP), is one of the most prevalent musculoskeletal diseases. Degenerative processes in the IVD, such as inflammation and extra-cellular matrix breakdown, result in neurotrophin release. Local elevated neurotrophin levels will stimulate sprouting and innervation of sensory neurons. Furthermore, sprouted sensory nerves that are directly connected to adjacent dorsal root ganglia have shown to increase microglia activation, contributing to the maintenance and chronification of pain. Current pain treatments have shown to be insufficient or inadequate for long-term usage. Furthermore, most therapeutic approaches aimed to target the underlying pathogenesis of disc degeneration focus on repair and regeneration and neglect chronic pain. How biomolecular therapies influence the degenerative IVD environment, pain signaling cascades, and innervation and excitability of the sensory neurons often remains unclear. This review addresses the relatively underexplored area of chronic pain treatment for CD-LBP and summarizes effects of therapies aimed for CD-LBP with special emphasis on chronic pain. Approaches based on blocking pro-inflammatory mediators or neurotrophin activity have been shown to hamper neuronal ingrowth into the disc. Furthermore, the tissue regenerative and neuro inhibitory properties of extracellular matrix components or transplanted mesenchymal stem cells are potentially interesting biomolecular approaches to not only block IVD degeneration but also impede pain sensitization. At present, most biomolecular therapies are based on acute IVD degeneration models and thus do not reflect the real clinical chronic pain situation in CD-LBP patients. Future studies should aim at investigating the effects of therapeutic interventions applied in chronic degenerated discs containing established sensory nerve ingrowth. The in-depth understanding of the ramifications from biomolecular therapies on pain (chronification) pathways and pain relief in CD-LBP could help narrow the gap between the pre-clinical bench and clinical bedside for novel CD-LBP therapeutics and optimize pain treatment.

Work-related stress is associated with low work ability, but not with poor self-rated health: A cross-sectional study in primary healthcare.

People seeking care at primary healthcare centres may be exposed to work-related stress, increasing the risk of future sick leave. Thus, it is important to identify work-related stress, and to explore how stress relates to work ability and health. To investigate the association between work-related stress and a) work ability, and b) self-rated health, among working women and men seeking care for physical or mental health complaints. This cross-sectional study analyzed baseline data (n = 232) from a randomized controlled trial investigating the effects of a brief intervention to prevent sick leave. Data regarding work-related stress, work ability and self-rated health were analyzed using binary logistic regression models. In models adjusted for age, gender and education, high work-related stress measured by the Work Stress Questionnaire was significantly associated with low work ability. The highest odds ratio (OR 3.27, 95% CI 1.66-6.42) was found between the domain "interference between work and leisure time" and work ability, suggesting a more than three times higher odds for low work ability when perceiving that work interferes with leisure time. No significant association was found between work-related stress and self-rated health. Health professionals should explore patients' work-related stress when they seek care for physical or mental complaints in primary healthcare. Patients' perceived balance between work and leisure time seems particularly important to address. Increased awareness might facilitate timely, relevant strategies to reduce stress and promote work ability.

The association between health literacy and self-care of hypertension among older adults in five regions in Jordan

Purpose This study aims to determine the relationship between health literacy and the self-care of hypertension in older adults in five regions in Jordan. Design/methodology/approach A cross-sectional study was conducted with 1,100 older adult patients with hypertension who had follow-ups in cardiac clinics of the five biggest hospitals in five regions of Jordan. The research instruments included a Health Literacy Questionnaire (CHEWQ) and the self-care of hypertension inventory. Findings The average health literacy score was 8.52 ± 1.6, indicating inadequate health literacy, while their self-care of hypertension score was 42.33 ± 10.9, indicating low self-care. Inadequate health literacy and factors such as marital status, education level, income and overall health status were linked to poor self-care of hypertension (p &lt; 0.05). Practical implications This study suggests that there is a need to assess the effectiveness of various health literacy interventions, such as educational programs and customized communication strategies, in enhancing self-care behaviors across diverse populations, particularly among the elderly. Originality/value The study findings highlight the need for nursing interventions aimed at improving health literacy to enhance the ability of older adults in Jordan to manage their hypertension.

Effectiveness of preventive intervention programmes aiming to improve oral health in children who have undergone caries-related dental extractions: a rapid review.

To determine the effectiveness of preventive interventions in children who have undergone caries-related dental extractions. Rapid review across five databases (CENTRAL, Ovid Medline, Embase, Web of Science and Scopus). Quality was assessed using the Risk of Bias 2 tool. Five studies were included, all randomised controlled trials involving pre-and/or post-extractions activity. Three studies involved oral health education (computer game, motivational interviewing, visual aids), one delivered clinical prevention (fissure sealants), and one an enhanced prevention programme combining additional health education and a clinical intervention (fluoride varnish). Retention was mixed (55%-80% in the intervention groups). Of the three studies measuring caries, all reported less caries development in the test group. However, only a study involving a dental nurse-delivered structured conversation, informed by motivational interviewing, showed an improvement in oral health. Two studies reporting on plaque and gingival bleeding had conflicting results. A study reporting on subsequent dental attendance did not demonstrate a clear improvement. Few published studies have explored prevention-based interventions in high caries-risk children requiring dental extractions. Whilst evidence of clinical benefit of preventive interventions in this population is limited, the potential use of contemporary behaviour change techniques appears promising. There is an urgent need for more high-quality longer-term trials using contemporary methodologies.

Changing epidemiology and antimicrobial resistance of bacteria causing bacteremia in Taiwan: 2002-2020.

AMR surveillance not only enables the identification of regional variations but also supports the development of coordinated efforts to combat AMR on a global scale. The TSAR has been a biennial, government-endorsed, multicenter study focusing on pathogens isolated from inpatients and outpatients in Taiwan hospitals since 1998. Our report presents an 18-year comprehensive analysis on blood isolates in the 2002-2020 TSAR program. The study highlights an alarming increase in the proportion of E. faecium causing bacteremia accompanied by elevated vancomycin resistance. It is worth noting that this trend differs from the observations in the United States and China. Understanding the composition of bacteria causing bacteremia, along with their prevalence of antimicrobial resistance, holds significant importance in establishing healthcare and research priorities. Additionally, this knowledge serves as a critical factor in evaluating the effectiveness of preventive interventions.

Effects of a Brief Self-Compassion Online Intervention on Complex Posttraumatic Stress Symptoms Among Chinese University Students With Trauma History: A Pilot Randomized Controlled Trial

Purpose: The present study aimed to investigate the efficacy of a brief 10-day online self-compassion intervention, lasting around 25 min per day, in reducing complex posttraumatic stress disorder (CPTSD) symptoms among university students with trauma history. Method: We adopted a 2 (intervention group vs. control group) × 3 (pre-test vs. post-test vs. one-month follow-up) randomized controlled trial (RCT) design. Results: Seventy-seven participants completed the study; repeated measures analysis of variance revealed a reduction in total CPTSD scores post-intervention. There was medium effect size of the intervention on disturbances in self-organization symptoms. Network analysis of CPTSD symptom changes and intervention conditions showed that changes in avoidance of external trauma cues, worthlessness, emotion dysregulation, feelings of isolation, and nightmare symptoms were directly associated with the intervention condition. Conclusions: The pilot RCT suggests the feasibility and potential effectiveness of the online self-compassion intervention for CPTSD symptoms among university students.

Long-Term Effects of a Multi-Component Community-Level Intervention to Reduce Single Vehicle Nighttime Crashes: Follow up Findings from a 24-Community Randomized Trial.

This follow up study examines whether a multi-component, high-visibility alcohol enforcement intervention implemented in 12 California cities had long-term effects on alcohol-related motor vehicle crashes beyond the time period of the original study. Previous results indicated a significant reduction in single vehicle nighttime (SVN) crashes among 15 to 30-year-olds in intervention cities relative to controls (Saltz et al., 2021). A randomized trial was conducted with 24 randomly chosen California cities from 2012 to 2017 to evaluate a multi-component intervention to reduce excessive drinking and driving while impaired among adolescents and young adults. Twelve of the cities were randomly assigned to the intervention condition and implemented high-visibility alcohol enforcement operations and other components from April 2013 to March 2016. Multi-level negative binomial regression analyses were conducted with motor vehicle crash data from 2010 to 2021 to examine whether single vehicle nighttime (SVN) crashes among 15 to 30-year-olds decreased in intervention cities relative to controls after the multi-component intervention was implemented. Analyses controlled for community sociodemographic characteristics, the overall time trend, the COVID pandemic, and pre-intervention levels of SVN crashes and adjusted for correlation of repeated observations within cities over time. Regression analyses indicated a significantly lower level of monthly SVN crashes among 15-to-30-year-olds in intervention cities during post-intervention months through 2021 relative to control cities [Event Rate Ratio (95%CI) = 0.88 (0.79, 0.98), p<.05] when controlling for community sociodemographic characteristics, the overall time trend, COVID, and pre-intervention levels of SVN crashes. Study findings suggest that a multi-component, high-visibility alcohol enforcement intervention can have long-term effects on alcohol-related motor vehicle crashes and related injuries and fatalities among adolescent and young adult drivers.

Reported snakebite mortality and state compensation payments in Madhya Pradesh, India, from 2020 to 2022.

India experiences the highest snakebite burden globally, with 58 000 predicted deaths annually. The central Indian state of Madhya Pradesh is thought to have a substantial snakebite burden and provides compensation to families who can demonstrate by postmortem and hospital treatment reports that their relatives have died due to snakebite. This study represents the first report on the frequency of distribution of compensation for snakebite deaths in Madhya Pradesh. Statewide snakebite death compensation data from 2020-2021 and 2021-2022, provided by the Madhya Pradesh health authorities, were analysed alongside interviews with 15 families that described the events that ultimately led to their compensation claims. Compensation was paid to a total of 5728 families, with a total value equating to 22 912 Lakhs (approximately US${\$}$27.94 million). Families described commonly recognised snakebite risk factors and behaviours in the events that resulted in their relatives' deaths. The snakebite burden in Madhya Pradesh is significant, both in terms of mortality and economic expenditure of the state. Sustained investment in preventative interventions, as well as monitoring of the rate of compensation payouts due to snakebite death as a measure of intervention effectiveness, should be considered to substantially reduce snakebite incidence and mortality.