Impact of pharmacist-led digital interventions on asthma outcomes: A systematic review.

Impact of a play-based intervention on creativity and cognitive flexibility measures in primary education students in Antofagasta (Chile).

Nursing and interdisciplinary interventions to support people with advanced cancer at the end of life in emergency departments: A systematic review.

P17. Impact of concomitant mitral valve intervention on late survival in elderly patients with ischemic mitral regurgitation undergoing surgical revascularization

Effects of insecticides and awareness on the dynamics of a delayed malaria model: A real-data calibration.

Impact of school-led total sanitation intervention on hygiene and sanitation knowledge and practices among caregivers in Kenya: A quasi-experimental study

The impact of a self-affirmation intervention on the mental and social health, and academic performance of minoritized students in STEM.

Despite extensive research on criminal group disruption, little is known about how alternative efficiency/security configurations within drug trafficking organizations (DTOs) shape resilience under sustained law enforcement pressure. DTOs face a core trade-off: efficiency—achieved through coordination and information sharing—increases exposure, while security—based on compartmentalization and trust—constrains flexibility and scale. Although widely theorized, this trade-off has rarely been examined as alternative strategic profiles subjected to comparable enforcement conditions. We address three unresolved propositions about the efficiency/security trade-off in DTOs: whether different efficiency/security orientations within drug trafficking yield different resilience outcomes, whether security-oriented configurations should be expected to be more resilient, and how enforcement intensity and timing condition resilience. We build on MADTOR—an empirically grounded agent-based model calibrated on data from a major Italian investigation—to simulate DTO operations and multi-actor law enforcement interventions over five years. The model compares how secure, efficient, and intermediate DTOs respond to disruptions of varying intensity via survival, membership, and revenues. Results show that resilience varies across enforcement regimes: efficient DTOs perform better under lower-intensity disruption, whereas secure DTOs gain a survival advantage as arrest intensity increases and interventions are delayed through reduced exposure. These findings provide theory-driven insights that alternative strategic profiles within a shared activity domain produce distinct resilience trajectories and challenge portrayals of DTOs as uniformly profit-oriented enterprises. The study demonstrates how strategic configurations interact with enforcement intensity and timing to shape resilience outcomes, and offers a transparent simulation framework to evaluate the long-term impact of alternative interventions. • The efficiency/security trade-off shapes drug trafficking organization (DTO) resilience under enforcement. • Efficiency boosts survival without enforcement, but increases exposure under pressure. • Under repeated interventions, secure DTOs outlive efficient ones. • Intervention timing and frequency strongly condition DTO survival.

The sport education model (SEM) is one of the most extensively studied curriculum models in physical education. The five core social–emotional learning (SEL) competencies are fundamental to students’ holistic development. The current systematic review with meta-analysis sought to map the connections between empirical research evidence on the SEM and the five competencies of SEL, as well as to investigate the effects of SEM-based interventions on SEL-related learning outcomes. A total of 45 studies met the inclusion criteria. A systematic review highlighted the impact of SEM-based interventions in enhancing five social–emotional competencies. A significant overall effect ( g = 1.18, 95% confidence interval [0.55, 1.80]); z = 3.69, p < .001) was detected. Moderate to large effects on each SEL competency were identified. School level, lesson duration, type of sport, and experimental design could potentially moderate the influence of SEM-based interventions. SEM-based curricula are effective in improving SEL competencies.

Periodontitis is a multifactorial inflammatory disease that has been associated with several systemic inflammatory conditions. Periodontal inflammation indices are quantitative tools used to estimate the inflammatory burden of periodontitis and its potential systemic relevance. The aim of this review was to summarise and critically evaluate the current evidence on periodontal inflammation indices as connecting factors between periodontitis and systemic inflammatory diseases, and to assess their responsiveness to periodontal and systemic therapy. This narrative review included intervention studies investigating patients with both periodontitis and systemic inflammatory diseases by monitoring the inflammatory status using a periodontal inflammation index. Relevant studies were identified through systematic searches across major electronic databases. The available evidence is limited and methodologically heterogeneous. Most studies focused on periodontal-inflamed-surface-area (PISA). Intervention studies using PISA have been reported in relation to diabetes mellitus, cardiovascular disease, rheumatoid arthritis, and chronic kidney disease. Several studies indicate that reductions in periodontal inflammatory burden following periodontal or systemic therapy may be accompanied by improvements in selected systemic inflammatory or disease-related parameters. However, these findings are inconsistent and often limited by small sample sizes, short follow-up periods, and inadequate control of confounding factors. While periodontal inflammation indices provide a biologically plausible framework for quantifying inflammatory burden, the bidirectional relationship between periodontal and systemic inflammation, as well as the long-term impact of therapeutic interventions, remains incompletely understood. Periodontal inflammation indices may support the assessment of periodontitis as a contributor to systemic inflammatory burden. Although high-quality evidence is limited, periodontal therapy may represent a non-pharmacological adjunct in the management of certain systemic inflammatory diseases. Consequently, it may be worthwhile for various medical disciplines, researchers, and professional organisations to engage in comprehensive discourse and issue official statements concerning periodontal therapy as a primary and secondary prevention for systemic diseases.

Impact of mobilization intervention on recovery outcomes after pediatric appendectomy.

RF26. Impact of Unplanned Coronary Interventions on Morbidity and Mortality in Aortic Root Replacement: A 20-Year, Multicenter Retrospective Study

Smartphone apps facilitate the dissemination of resources to help people with bipolar disorder (BD) implement self-management strategies. However, current apps do not address all treatment outcomes valued by people with BD, nor are they designed with scalability in mind. This study evaluated the feasibility and preliminary efficacy of an alpha version of the co-designed PolarUs app, a self-guided intervention developed to support quality of life (QoL) self-monitoring and self-management in BD. North American residents with a confirmed diagnosis of BD used the iOS PolarUs app for 12 weeks. To assess feasibility, adherence rates were assessed, operationalized by completion of weekly in-app Brief Quality of Life in BD (QoL.BD) scores. Linear mixed modeling was used to test the hypothesis that QoL (primary outcome) would improve over the intervention period and explore secondary outcomes (i.e., mood symptoms, self-efficacy, subjective recovery, self-compassion). Hierarchical cluster analysis was used to investigate associations between app adherence and primary outcomes. In 170 participants (70% women, mean age 39 years SD = 12.1) there was a steady decline in app adherence over the intervention period, with 37% of participants completing their final weekly assessment. However, significant improvements were observed overall for QoL, mood symptoms, and self-compassion. Four distinct app adherence clusters were observed, displaying varying relationships with baseline QoL and trajectories of QoL improvement. Preliminary adherence and efficacy data for the PolarUs app are positive and demonstrate how the inclusion of lived experience perspectives in app development supports intervention acceptability and impact.

This systematic review aimed to capture the most recent evidence on interventions for students with reading difficulties in Grades 4-12 and to assess moderating effects of study, intervention, and sample characteristics. Peer-reviewed articles and reports published between 2011-2023 (in English) were eligible if they described a school-based intervention addressing and assessing one or more reading skill(s), targeted Grade 4-12 students with or at risk of reading difficulties, and included a control or comparison group ( k =106; n =156,981). Correlated and Hierarchical Effects meta-analyses with robust variance estimation yielded an aggregate effect of g = 0.212 on reading outcomes, with a Moderate to High level in quality of evidence. Subgroup and moderator analyses indicated that the impact of intervention varied by reading outcome, with the strongest effects shown for vocabulary. These analyses showed the effectiveness of interventions focused on comprehension, vocabulary, word study, or multiple components for older students who experience reading difficulties, across all grade levels and classroom settings, and when delivered by classroom teachers or researchers. Such interventions are particularly potent for students with learning disabilities and those from a language background other than English, and results hold true regardless of students’ socioeconomic status. Results published more recently and in academic journals tended to show stronger effects overall, as did briefer interventions (<15 hours), and interventions assessed using bespoke researcher-developed measures. Findings offer an up-to-date source of evidence on reading interventions for older students and provide impetus for further research in this critical area. • Reading interventions for students in Grades 4-12 yield a positive aggregate effect • Interventions focused on comprehension or vocabulary produced larger effects • Teacher-delivered interventions yielded stronger effects for vocabulary outcomes • GRADE assessment indicated a Moderate to High level of evidence

Nature-based social prescribing (NBSP) is gaining traction as an approach to support health and wellbeing (HWB). Yet the role of Connection to Nature (CTN) within NBSP remains poorly understood. This scoping review examined how CTN is conceptualised, measured and integrated into NBSP interventions and its impact on HWB outcomes. Following PRISMAScR guidelines, we searched four databases (APA PsycInfo, CINAHL, EMBASE and MEDLINE) for studies published between 2016 and 2025, identifying 21 eligible papers. Studies were grouped into four categories: review papers; gardening and horticulture; green care; and structured nature engagement and educational interventions. Across intervention types, CTN was consistently associated with improvements in mood, stress regulation, confidence, social connectedness, and overall wellbeing. CTN appeared malleable and responsive to meaningful or reflective nature engagement, suggesting it may function as a pathway linking nature contact to HWB. Findings indicate that intentionally incorporating CTN into NBSP design, practitioner training, and evaluation may enhance intervention impact and promote equitable access to nature based wellbeing benefits. CTN was rarely defined consistently or measured using validated tools and was often inferred qualitatively rather than assessed directly. This variability limits understanding of CTN's unique contribution relative to other NBSP mechanisms such as social connection, physical activity, and immersive sensory experiences. To advance the field, future research should adopt clearer CTN definitions, use conceptually aligned measures, distinguish between state and trait CTN, and employ longitudinal or mixed methods designs. Embedding CTN within NBSP policy and practice offers potential to strengthen both individual wellbeing and broader public and environmental health goals.

There is a paucity of real-world evidence on the impact of early treatment as well as polytherapy use on advanced motor milestone achievement in children with spinal muscular atrophy (SMA) with ≤ 2 survival motor neuron 2 gene (SMN2) copies. The objective of this study is to evaluate predictors of motor milestone change in children with ≤ 2 SMN2 copies, focusing on the timing of treatment initiation and the impact of treatment decisions. This study employed a mixed longitudinal and repeated cross-sectional design. Data were drawn from the Cure SMA Community Update Survey, collected between 2020 and 2024. The study included 228 children with ≤ 2 SMN2 copies, each contributing at least one survey response, resulting in 414 total observations collected over the study period, with data provided by caregivers who reported residence in the USA. The primary outcome was maximum motor milestone achievement, evaluated using a mixed-effects ordinal hierarchical regression model to account for individual variability and repeated measures. Treatment before 3 weeks of age increased the odds of greater motor milestone achievement by 13.4-fold compared to treatment after 4months (p = 0.001). SMA prenatal or newborn screening facilitated earlier treatment and reduced disparities in motor milestone achievement across income levels. Polytherapy was linked to 2.4-fold higher odds of reaching higher-level motor milestones compared to monotherapy (p = 0.01). Early treatment initiation improved motor outcomes in children with ≤ 2 SMN2 copies. The findings support the importance of screening newborn screening as part of an effective strategy for optimizing motor development, as well as support the importance of further investigation into the relationship between the increasing proportion of polytherapy use and motor function development.

Early-life sun exposure accounts for a substantial portion of lifetime UV damage, with much of lifetime risk acquired before age 20 years. Despite clear pediatric and dermatology guidelines, many parents remain unsure of what optimal sun protection means, highlighting the need for accessible education and intervention. In our study, parents expressed strong interest in learning how to protect their newborns but lacked clear, actionable guidance. A brief, targeted educational session significantly improved parental attitudes toward sun safety and increased their intention to adopt recommended photoprotective behaviors.

ABSTRACT Health-care professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their knowledge, detection, and management of clients with dementia. To synthesize and aggregate the educational intervention studies that aimed to improve knowledge and practices for detection and management of clients with dementia among HPs. A comprehensive search of literature was conducted for the articles published between 2000 and 2025. Articles involving educational interventions among health-care professionals’ knowledge and practices of dementia detection and management. Citation searching and reference list screening yielded additional studies. Including 29 articles, the results showed that practical skills play a critical role in bridging theoretical knowledge and clinical application. Interventions that were delivered via peer educators, i.e. educated GPs or nurses, were particularly effective because they valued the unique challenges of the clinical environment. The most effective materials targeted both knowledge and emotional barriers, focusing on building confidence in communication, managing difficult behaviors, and connecting patients with relevant resources. The evidence clearly indicates that only integrative, interactive, and skills-based educational approaches lead to sustained improvements in dementia detection and management. Passive, one-time, or theory-only programs without adequate support demonstrated limited effectiveness. Overall, multimodal, practice-oriented programs combining peer-led workshops, hands-on screening training, and case-based learning addressing real-world communication and management challenges are most effective for dementia care skills. PROSPERO Registration: CRD420251171533

Despite the implementation of control policies, smoking prevalence remains high in Eastern Mediterranean Region (EMR), and the impact of tobacco control efforts on cancer prevention is unclear. We assessed the potential impact of key policy interventions on tobacco-related cancer incidence in EMR countries from 2025 to 2050. We conducted a modeling study using a country-level historical data to project tobacco smoking prevalence in EMR countries under four scenarios: (i) full implementation of the MPOWER (Monitor, Protection, Offer, Warn, Enforce, and Raise) policy package, (ii) a 10-unit increase in the cigarette affordability index (Higher values of the affordability index indicate that cigarettes are less affordable) (iii) maximized literacy rates (100% adult literacy), and (iv) combined implementation of all three policies. For each scenario, we estimated the Population Attributable Fraction (PAF) of tobacco smoking for 13 cancer types causally linked to tobacco use. The number of preventable cancer cases was calculated using the difference in PAFs between the current and alternative scenarios, referred to as the Potential Impact Fraction (PIF). An estimated 14.3 million tobacco-related cancer cases will occur in the EMR between 2025 and 2050, with over 3 million attributable to current smoking prevalence (PAF = 21.3%; [95% CI: 18.4, 24.6]). Combined implementation of all assessed policies could prevent 442,292 cases (95% CI: 226,987, 660,045) (3.1% of all projected cases; [95% CI: 1.6, 4.6]). The greatest impact was observed in low HDI (Human Development Index) countries, where up to 291,425 (95% CI: 198,186, 388,546) cases could be averted. Maximizing literacy showed the highest preventive potential in low (n = 224,463; [95% CI: 149,521, 307,386]) and medium HDI (n = 84,569; [95% CI: [2,801, 177,317]) countries, while full implementation of MPOWER had the greatest effect in high HDI countries (n = 11,890; [95% CI: 8,397, 15,378]). As our main limitation, we assumed a causal relationship between previously implemented policies and concurrent changes, while other potential causes of these changes have not been considered in the current study. Strengthening tobacco control policies particularly improving literacy in low HDI countries may potentially contribute to reductions in future cancer burden in EMR.

Purpose The aim is to examine the dynamics of intellectual capital in public higher education institutions in Bogotá (Colombia) through a sensitivity analysis that simulates the impact of interventions in human, structural, relational capital and innovation and entrepreneurship. Design/methodology/approach The study developed a synthetic intellectual capital index based on the Intellectus model. This was adapted and updated for the Colombian context. The index was then applied to a sample of public higher education institutions, which, collectively, account for 20% of higher education enrolment. After refining the initial 344 indicators, a final set of 140 was obtained. A sensitivity analysis was then conducted using the principal component analysis (PCA) function in RStudio. The simulations analyse the effect of percentage interventions, compared to the results for each type of capital. Findings After refining 344 initial indicators, a reduced version of 140 indicators was obtained. Sensitivity analysis was then applied to this reduced version using the PCA function within R Studio software. The simulations analyse the effect of percentage interventions, compared to the results for each type of capital. Research limitations/implications Future research should explore the development of indicators that effectively capture the entrepreneurial potential of universities. This need is particularly evident in the limited representation of social-relational capital (8.5%) and entrepreneurship and innovation (9%) within current research proposals. These areas offer significant opportunities to cultivate stronger university relations with organisations and society, thereby promoting knowledge transfer as a vital “third mission.” Furthermore, robust indicators can facilitate the measurement of intervention impacts, contributing to the system’s modernisation and update through enhanced competitiveness and productivity. Practical implications Measuring intellectual capital enables guidelines for its management and investment. Institutions should manage and invest in relationships, expand coverage and access through knowledge transfer and enhance outcomes in entrepreneurship and innovation to ensure renewal and modernisation. Originality/value This work, based on quantitative data, examines the effects of knowledge management interventions on the accumulation of intellectual capital in universities.