Impact Of Intervention Research Articles

Association of Coronary Microvascular Rarefaction and Myocardial Fibrosis With Coronary Artery Disease.

To evaluate, in a cohort study, whether coronary microvasculature and myocardial structure differ between people with and without coronary artery disease (CAD). We performed histological analysis of left ventricle free wall obtained at autopsy from 25 men and 23 women with ≥1 coronary artery with ≥75% area stenosis, and 25 men and 25 women without (no or minimal) CAD, matched for sex and age, who died suddenly from noncardiac causes. Decedents with myocardial infarction or other cardiac abnormality were excluded. Decedents with and without CAD had similar height and weight. Heart weight of decedents with CAD was higher than that of decedents without CAD (mean, 391 versus 364 g; mean difference, 27 g [95% CI, 0.3-54.0], P=0.048). Decedents with CAD had lower arteriole density (mean, 1.4 per mm2 versus 1.8 per mm2; mean difference, -0.4 per mm2 [95% CI, -0.6 to -0.2], P=0.0001), lower capillary length density (mean, 3164 versus 3701 mm/mm3; mean difference, -537 [95% CI, -787 to -286], P<0.0001), and higher total myocardial fibrosis (mean, 7.5% versus 5.7%; mean difference, 1.7% [95% CI, 1.0-2.5], P<0.0001), than decedents without CAD. CAD was associated with coronary microvascular rarefaction and increased myocardial fibrosis. The association of CAD with coronary microvascular rarefaction and increased myocardial fibrosis may contribute to the increased risks of death, myocardial infarction and heart failure that accompany CAD, and may attenuate the impact of percutaneous coronary intervention on cardiovascular risk in people with stable angina.

Interventions for Preventing Tobacco Uptake among Adolescents within School Setting in South-East Asia region: A Systematic Review

Abstract Background Tobacco users disproportionately reside in lower-and-middle income countries, with many people beginning consumption of tobacco in adolescence. Countries employ interventions in schools as a means of providing health education thereby creating mass awareness among them. However, research has mostly restricted to developed nations. Objective To examine the impact of interventions implemented in preventing tobacco uptake among adolescents in school setting in South-East Asia region. Method The protocol was registered prospectively on PROSPERO (CRD42022337341). Systematic search was conducted on 6 databases: PubMed, Embase, Scopus, CINAHL, ProQuest and Web of Science. Randomized Control Trials (RCT) and Cluster RCT conducted in school set-up in South-East Asia among adolescents below 18 years’ age were included. Articles between timeline 2002–2022 were considered. Results From a total of 963 articles, total of 13 studies were included. Four were RCT, while nine were Cluster RCT. Most of the studies were targeted at change in prevalence, followed change in knowledge and attitude towards tobacco and impact on susceptibility to use tobacco. Nine studies had interventions based on Health Promoting School Framework, three were Peer-led Interventions and one was Counsellor-centred Intervention. Risk of Bias assessment revealed eight studies had low risk of bias, two had some concerns while three were high risk studies. Conclusion Interventions that focus on building a holistic environment and go beyond the usual classroom environment have primarily been implemented and found to be effective in this region. There is a need for strong, high-quality RCT studies with standardised evaluation techniques to combat tobacco use among adolescents.

The Effect of Memory Training on Cognitive Function: A Systematic Review

Memory is related to the processes that allow us to record, store and then retrieve experiences and information. Memory as an information processor is analogized by psychologists and neurologists as a computer. The recording process, called encoding, is the process of obtaining information conveyed to the system by translating it into neural code which is processed in the brain.The goal of the research titled is to systematically evaluate and synthesize existing studies to determine the impact of memory training interventions on various aspects of cognitive function. This includes assessing how memory training may enhance skills such as attention, processing speed, working memory, and overall cognitive performance. By identifying patterns, strengths, and limitations in the current literature, the study aims to provide insights into the effectiveness of memory training programs and guide future research and practical applications in cognitive enhancement.Method: Articles used in systematic reviews are typically sourced from various academic databases such as PubMed, PsycINFO, Scopus, and Google Scholar. These include studies published in peer-reviewed journals. The keywords used for searching may include phrases like "memory training," "cognitive function," "cognitive enhancement," "working memory," and other related terms. This combination of keywords helps filter relevant articles. For instance, in this review, there might be 150 articles identified through the initial search. After a selection process based on inclusion and exclusion criteria, approximately 30 articles are chosen for further analysis. The articles included in the systematic review are examined systematically, following the PRISMA 2020 guidelines: Study Identification,Study Selection,Data Extraction,Analysis and Synthesis Analyzing the results from the selected studies and compiling conclusions based on the available evidence.Results: The findings from these five literature studies cumulatively imply that activities involving the Al-Quran, such as listening, reading, or memorizing, have a positive impact on various aspects of physical and mental health, cognitive function, and brain responses. The implications of these results may stimulate further research in the field of cognitive interventions, as well as provide a more in-depth look at the role of memorization in the development of cognitive abilities at critical developmental stages.Conclusion: From the five studies reviewed, it can be concluded that memory training interventions, especially in the context of memorizing the Qur'an, contribute positively to the improvement of cognitive function in various age groups, including children, adolescents, adults, and the elderly. The implications of these findings give impetus to further research in the field of cognitive intervention, focusing on memorization strategies, as well as providing deeper insight into the role of memorization in the development of cognitive abilities at critical stages of life.

The spatial-temporal variations and influencing factors of COVID-19 case fatality rate: a worldwide study in 30 countries from February 2021 to May 2022.

To evaluate the variations in COVID-19 case fatality rates (CFRs) across different regions and waves, and the impact of public health interventions, social and economic characteristics, and demographic factors on COVID-19 CFRs, we collected data from 30 countries with the highest incidence rate in three waves. We summarized the CFRs of different countries and continents in each wave through meta-analysis. Spearman's correlation and multiple linear regression were employed to estimate the correlation between influencing factors and reduction rates of CFRs. Significant differences in CFRs were observed among different regions during the three waves (P<0.001). An association was found between the changes in fully vaccinated rates (r s =0.41), population density (r s =0.43), the proportion of individuals over 65years old (r s =0.43), and the reduction rates of case fatality rate. Compared to Wave 1, the reduction rates in Wave 2 were associated with population density (β=0.19, 95%CI: 0.05-0.33) and smoking rates (β=-4.66, 95%CI: -8.98 - -0.33), while in Wave 3 it was associated with booster vaccine rates (β=0.60, 95%CI: 0.11-1.09) and hospital beds per thousand people (β=4.15, 95%CI: 1.41-6.89). These findings suggest that the COVID-19 CFRs varied across different countries and waves, and promoting booster vaccinations, increasing hospital bed capacity, and implementing tobacco control measures can help reduce CFRs.

Utilizing the CFIR framework for mapping the facilitators and barriers of implementing teachers led school mental health programs - a scoping review.

Ample evidence has been generated regarding the effectiveness of school-based mental health interventions as part of the continuum of care for children and capacity building of teachers to deal with the emotional and behavioral challenges of students. The increasing trend of utilization of teachers as the natural support system of children and the huge financial impact of public health interventions highlights the need to review all available evidence regarding multilevel factors that facilitate or pose a challenge to the provision of School Mental Health Programs (SMHP) using teachers as providers. The current review aims to map extracted evidence under the Consolidated Framework for Implementation Research (CFIR) domains to support future implementation research on school-based mental health services. The scoping review included experimental, qualitative studies, and systematic reviews involving teacher-led mental health programs conducted in the school setting to improve the socio-emotional well-being of children and adolescents irrespective of time and geographical limitations. All (published and unpublished) evidence in English from Pubmed, Cochrane database of systematic reviews and clinical trials, Scopus, and Science Direct was searched using keywords and Boolean combinations and extracted using study designs, place of study, year of publication, sample size, and target population. A qualitative analysis of implementation facilitators and barriers cited by the studies was carried out and mapped on CFIR. This review identified barriers and facilitators of implementation across school-based mental health Programs in 29 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation, and the characteristics of individuals involved in implementation. These included the availability of structural characteristics, positive school culture, organizational readiness, committed leadership, and beliefs of the providers. Findings highlight the need for early assessment of contextual factors acting as barriers and facilitators and careful execution following realistic planning and stakeholders' engagement to ensure the success of SMHP.

Do Personalized Nutrition Interventions Improve Dietary Intake and Risk Factors in Adults With Elevated Cardiovascular Disease Risk Factors? A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Dietary modifications can improve cardiovascular disease (CVD) risk factors. Personalized nutrition (PN) refers to individualized nutrition care based on genetic, phenotypic, medical, behavioral, and/or lifestyle characteristics. PN may be beneficial in improving CVD risk factors, including diet. However, this has not been reviewed previously. The aim was to evaluate the effectiveness of PN interventions on CVD risk factors and diet in adults at elevated CVD risk. Six databases were searched for randomized controlled trials published between 2000 and 2023 that tested the impact of PN interventions on CVD risk factors in people at elevated risk. Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria checklist. Data synthesis of eligible articles included participant characteristics, intervention details, and change in primary CVD risk factor outcomes, including blood pressure (BP), plasma lipids, and CVD risk score, and secondary risk factors, including anthropometric outcomes and diet quality. Random-effects meta-analyses were conducted to explore weighted mean differences (WMDs) in change or final mean values for studies with comparable data (studies with dietary counseling interventions) for outcomes including BP, blood lipids, and anthropometric measurements. Of 7676 identified articles, 16 articles representing 15 studies met the inclusion criteria. Studies included between 40 and 563 participants and reported outcomes for CVD risk factors, including hyperlipidemia (n = 5), elevated BP (n = 3), overweight/obesity (n = 1), and multiple risk factors (n = 6). Risk of bias was low. Results suggested potential benefit of PN on systolic BP (WMD: -1.91; 95% CI: -3.51, -0.31 mmHg) and diastolic BP (WMD: -1.49; 95% CI: -2.39, -0.58 mmHg) and dietary intake in individuals at high CVD risk. Results were inconsistent for plasma lipid and anthropometric outcomes. Results were promising for PN interventions that used dietary counseling on CVD risk factors in at-risk individuals. However, further evidence for other personalization methods is required, including improving methodological quality and longer study duration in future PN interventions. OpenScience Framework (https://doi.org/10.17605/OSF.IO/SHVWP).

Impact National Strategic Program Transportation Sector On Export Performance In Indonesia

The study aims to identify the impact of transport infrastructure development policies on Indonesian export performance. The case on this study is the National Strategic Program (PSN) of the transport sector, which has begun to implemented in stages over time and between different locations since 2017. The study also compares the impact of policy between regions on Java Island and regions outside Java Island. By using the Callaway and Sant'Anna Difference-in-differences (CSDID) method, the study analysed the impact of policy interventions on the PSN province (province in which there is a PSN transport sector) compared to the Non PSN Province (Province in which there is no PSN Transport sector). The results of the study found that after the intervention of policy and the availability of international ports, the Province of PSN has a 33,9% higher export performance than the Non-PSN Province. The research also found that policy interventions had a significant impact partially in the region outside of Java. The research also found that policy interventions only partially had a significant impact in the region outside of Java, because the existence of policy intervention and the availability of international ports, the PSN Province outside Java Island had an export performance of 59,5% higher than the Non-PSN Province

The Impact of a Creativity Camp Intervention on Depression and Well-Being in Adolescents.

Depression is a serious public health problem that often emerges during adolescence. Many adolescents do not respond to standard treatments, necessitating the development of novel interventions. We conducted a preliminary study to assess the impact of a novel creative arts intervention on depression and well-being in adolescents. In this quasi-experimental study, 69 adolescents 12-17years completed an 8-day "Creativity Camp" intervention encompassing multiple creative activities. Self-report questionnaires to measure depression, anxiety, and well-being were administered at five time points to allow examination of change across multiple temporal segments: the 2 weeks before the intervention, the 2 weeks during the intervention, the 2 weeks after the intervention, and the 6months after the intervention. Adolescents were assigned to one of two groups to compare changes observed during the 2 week before-intervention period (Group A) to the changes observed during the intervention period (pre-post intervention) (Group B). According to both parent and child reports, pre-to-post-intervention, mean adolescent depressive symptoms significantly decreased, and these changes were sustained 2 weeks after the intervention and (according to parents) at the 6-month follow-up. There was preliminary evidence for improved well-being at post-intervention. Comparison of Group A's changes during the before-intervention period to Group B's changes pre-post intervention was significant for parent-reported depression. Preliminary evidence suggests that the Creativity Camp intervention may positively impact adolescent depression and well-being. This evidence highlights the importance of investigating and implementing treatment approaches focusing on creative arts for adolescents with depression.

“Leaving no one behind”: digital empathy and inclusive media literacy education for young adults on the autism spectrum

The paper advocates for the necessity of inclusive media literacy education (MLE) and equal opportunities for young adults with autism spectrum disorder (ASD), which is in alignment with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) 2008 and the Sustainable Development Goal 4 Quality Education (SDG, 2030). It underscores the commitment to ‘leaving no one behind’, a core tenet of the SDGs, by focusing on developing digital empathy and inclusive MLE for young adults with ASD in the digital age. The study aims to empower young adults with ASD in Chennai, India, with media literacy and digital empathy through a one-day hands-on workshop and to assess the impact of this educational intervention on their understanding and application of media literacy in their daily lives. The paper employs a mixed-method approach that integrates experimental-qualitative research and the data is analysed using ‘qualitative reflexive’ thematic analysis. The study’s findings demonstrate significant improvements in the participants’ abilities to discern fake news, learn digital empathy and cybersecurity by engaging responsibly with digital media, and include MLE in their academic curriculum. The paper suggests that such educational interventions can enhance digital empathy and media literacy among young adults with ASD.

Mitigating overuse of antinuclear antibody (ANA) testing through educational intervention: a study in internal medicine and neurology departments.

Overuse of antinuclear antibody (ANA) tests leads to increased costs, false positives, and unnecessary treatments. This study evaluated ANA overuse in internal medicine and neurology departments and assessed the impact of an educational intervention. This quality improvement educational intervention study examined ANA test overuse in five internal medicine departments and one neurology department at a university-affiliated medical center. The educational intervention included a session focusing on ANA testing appropriateness. Outcome measures comprised the ANA/new patient ratio (APR) and the percentage of positive ANA test results. Outcomes were compared between the pre- and post-intervention periods (both 6months). The intervention took place in December 2021. The APR decreased from 43% in the pre-educational intervention period to 27% in the post-intervention period in the neurology department (odds ratio [OR] 0.49, confidence interval [95% CI] 0.37-0.63, P < 0.0001) and from 2.6% to 2.2% in the internal medicine departments (OR 0.89, 95% CI 0.73-1.10, P = 0.28). The percentage of positive ANA tests increased from 43% pre-intervention to 53% in the post-intervention period (OR 1.49, 95% CI 0.90-2.46, P = 0.12) in the neurology department and from 48% to 59% (OR 1.56, 95% CI 0.99-2.44, P = 0.0543) in the internal medicine departments. A simple educational intervention reduced unnecessary ANA testing in the neurology department but not in internal medicine departments, improving patient selection and potential cost savings. The results underscore the importance of targeted education to promote evidence-based behavior among healthcare professionals. Further research with longer follow-up is needed to assess the sustainability of these improvements.

Technological Interventions to Implement Prevention and Health Promotion in Cardiovascular Patients.

Background/Objectives: The aim of the narrative review is to identify information on the impact of technological interventions (such as telehealth and mobile health) on the health promotion of cardiac patients from diverse populations. Methods: The online databases of PubMed and the Cochrane Library were searched for articles in the English language regarding technological interventions for health promotion in cardiac patients. In addition, a methodological quality control process was conducted. Exclusion was based on first reading the abstract, and then the full manuscript was scanned to confirm that the content was not related to cardiac patients and technological interventions. Results: In all, 11 studies were included in this review after quality control analysis. The sample size reported in these studies ranged from 12 to 1424 subjects. In eight studies mobile phones, smartphones, and apps were used as mHealth interventions with tracking and texting components; two studies used videoconferencing as a digital intervention program, while three studies focused on using physical activity trackers. Conclusions: This review highlights the positive aspects of patient satisfaction with the technological interventions including, but not limited to, accessibility to health care providers, sense of security, and well-being. The digital divide becomes apparent in the articles reviewed, as individuals with limited eHealth literacy and lack of technological knowledge are not motivated or able participate in these interventions. Finding methods to overcome these barriers is important and can be solved to some extent by providing the technology and technical support.

Key mental health differences in conflict-related sexual violence and how sex, severity, and early intervention impact on improvement: a retrospective observational study

BackgroundConflict-related sexual violence (CRSV) is a significant health and human rights issue in humanitarian contexts, but there is a need of further research on differences between sexes in terms of severity of symptoms and improvement. Consequently, we explored the differences in severity and outcomes among male and female survivors of CRSV who received mental health and psychosocial support (MHPSS) in an armed conflict setting.MethodsWe retrospectively analysed medical records from 3442 CRSV survivors in a MHPSS programme in Borno State, Nigeria, between 2018 and 2019. Patient characteristics, severity (measured with Clinical Global Impression of Severity Scale [CGI-S scale]), and improvement (measured with Clinical Global Impression of improvement [CGI-I] scale) were assessed by an attending counsellor. We assessed predictors for severity and improvement using a multivariable logistic regression analysis and time to improvement by sex using Kaplan Meier (K–M) curves and Cox regression.ResultsWe included 3442 patients who had at least one CRSV event in this study (2955 [85.9%] female, 486 [14.1%] male, one unknown). The most prevalent categories of symptoms were depression (49.9%; n = 1716), post-traumatic (25.6%; n = 879), and anxiety (20.3%; n = 697) symptoms. Most patients had mild (59.0%; n = 1869/3170) or moderate (36.4%; n = 1153/3170) symptoms at baseline, with 4.7% having severe symptoms (n = 148/3170). The logistic regression analysis (n = 1106), showed male patients had a 59% higher odds of severe symptoms at baseline than female patients (aOR 1.59; 95% CI 1.04–2.45). Among males, those older than 55 years had three times higher odds of presenting severe symptoms than younger patients (aOR 3.65; 95% CI 1.43–9.34). Women aged 36–55 years were more likely to present improvement than younger female patients (aOR 1.32; 95% CI 1.11–1.58). For both sexes, prompt attention after a CRSV event (≤ 3 days) positively predicted improvement (aOR 13.9; 95% CI 1.48–130 males, aOR 2.11; 95% CI 1.22–3.64 females) compared to late attention. Time to improvement did not differ between sexes, with an average of at least three consultations needed to achieve improvement.ConclusionsOur study suggests that psychological attention of survivors within the first 72 h should be a priority. MHPSS programmes addressing CRSV should be inclusive to all patients, and gender-neutral approaches to ensure access, safety, confidentiality, and non-discrimination for all survivors should be developed.

Long lasting insecticidal nets (LLINs) intervention impact on use, misuse and challenges in malaria and lymphatic filariasis transmission

To assess the effectiveness and misuse status of Long Lasting Insecticidal Nets (LLINs), intervention, a study was conducted in areas of malaria and lymphatic filariasis endemicity from November 2021 to August 2022. A preliminary survey preceded a cross-sectional survey of the misuse of LLINs. Considering the outcome of the former, 57 households misusing LLINs were reported. Thirty (30) cohorts each from LLIN misusing and LLIN non misusing households served as permanent cohorts for mosquito collections (60 rooms in 60 households in 3 sentinel villages). The study also investigated the status of LLIN usage and non usage. Mosquitoes caught with Aspirators and Pyrethrum Knockdown (PKD) techniques were identified using standard morphological keys. Among those who used LLIN, 68.42% used it for other purposes than vector control while 31.58% didn’t utilize it for mosquito control. About 59.65% didn’t know the effect of using it for purposes other than malaria/LF control while 40.35% were familiar. Of 8,180 endophilic mosquitoes caught and assessed for parity, infection/infectivity status, 60.07% (4,914/8,180) and 39.93% (3,266/8,180) represented LLIN misusing and LLIN non-misusing catches respectively. Overall, insignificantly higher catches were made in LLIN misusing cohorts than LLIN non misusing cohorts (63.54% versus 36.45%, 58.89% versus 41.11%, 58.86% versus 41.18%) for 2015, 2016 and 2017 respectively. Specifically, malaria/LF vector densities showed that Anopheles gambiae s.l. (82.53% versus 74.04%) was the highest followed by An. funestus s.l. (10.15% versus 12.19%) and Culex quinquefasciatus (6.82% versus 3.83%) while other species were rarely present. The physiological, infection (0.28% versus 0.49%) and infectivity (0.00% versus 0.00%) statuses with Wuchereria bancrofti were insignificant between the cohorts (p&gt;0.05). None of the Anopheles assessed for Plasmodium sporozoite were positive for both cohorts. The percentage level of LLIN household use was 43.33% while 41.03% slept under LLIN daily, 58.97% slept sometimes. Obstacles to LLIN use included hot/heat (56.86%), dislike (21.57%), lack of protection (11.86%) and ineffectiveness (9.80%). The role of significant misuse of LLIN was highlighted by the study. The results indicated the intensity of filariasis transmission by transmitting vectors was higher than that of malaria and re-emphasis the need to promote positive attitude towards the use of LLIN for control of the two diseases.

Impact of a 6-month sit-stand desk-based intervention on regional musculoskeletal discomfort and overall post-work fatigue in office workers: a cluster randomised controlled trial

Evaluate the impact of a 6-month sit-stand desk (SSD) intervention on office workers’ regional musculoskeletal discomfort (MD) and overall post-work fatigue (PWF) compared to a control group. A two-arm (1:1) clustered randomised controlled trial including 38 participants (aged 24–60 years, 77% women) assigned to intervention or control groups. The intervention, spanning 6 months, involved psychoeducation, motivational prompts, and SSD. The control group maintained standard working conditions. MD was assessed using the Nordic Musculoskeletal Questionnaire, and PWF with the Need for Recovery Scale. ANCOVA was employed to compare groups, adjusting for covariates, with 5% significance. The intervention group reduced overall MD (p = 0.018) and PWF (p = 0.013), while the control group showed no changes. However, no time*group interactions were found (p > 0.05). A 6-month SSD intervention alleviated office workers’ MD and PWF, suggesting benefits from increasing standing time by at least 30 minutes/day. Future investigations must explore individual heterogeneity in response to SSD. Trial registration https://doi.org/10.17605/OSF.IO/JHGPW.

Improving struggling medical and nursing students’ subjective vitality, school engagement and academic performance through a peer mentorship intervention programme: an intervention protocol

BackgroundThe undergraduate medical training programme is demanding and rigorous. This underlines the importance of a peer mentorship strategy to improve the well-being, self-determination, school connectedness, and performance of struggling medical and nursing students. This study is aimed at identifying struggling medical and nursing students using two cumulative continuous assessment test (CAT) scores, assess their subjective vitality and school engagement and evaluate the impact of the peer mentorship intervention on them.MethodsThe study will adopt a mixed-methods approach and will be conducted in the medical colleges of Nnamdi Azikiwe University, Awka, Nigeria, and the University of Rwanda. Three instruments will be used: The subjective Vitality Scale (SVS), the University Student Engagement Inventory (USEI), and the academic records of the students before and after the commencement of the intervention programme. The consenting least-performing medical and nursing students identified by their low CAT scores (below 45%) in basic medical sciences will be selected for study in each institution. The outcome measures will include students’ CAT scores, subjective vitality, and school engagement scores. The data will be analysed both quantitatively and qualitatively. Thematic content analysis will be adopted in the analysis of the responses generated from the focus group discussion. The mean ± standard deviation or median and interquartile range statistic will be adopted for the quantitative data.DiscussionGiven the paucity of data on struggling medical and nursing students in Nigeria and Rwanda, this research was designed to help in exploring evidence-based interventions to improve and prevent poor subjective well-being of struggling students. The study is expected to fill these knowledge gaps. Trial registration: Pan African Clinical Trial registry, PACTR202405546896613, registration date: 27th May, 2024. This proposal has been supported by grant 1R25TW011217 from the US National Institutes of Health (NIH)/Fogarty International Center (FIC) which also includes co-funds from the U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC) and the President’s Emergency Plan for AIDS Relief (PEPFAR) to the African Forum for Research and Education in Health (AFREhealth). The Grant Principal Investigators are Profs. Nelson K.Sewankambo (contact PI), Prisca Adejumo, Jean Bisimwa Nachega, Fatima Suleman.

Music-Based Therapy for the Treatment of Perioperative Anxiety and Pain-A Randomized, Prospective Clinical Trial.

Background: Music-based intervention has been advocated as a nonpharmacologic approach for the perioperative control of pain and anxiety in surgical patients. However, its impact on patients with preoperative anxiety has not been clearly established. Our study aimed to examine the impact of music-based intervention administered before, during, and after surgery on postoperative opioid consumption and pain levels, as well as preoperative anxiety, depression, and pain catastrophizing. We hypothesized that, compared to a control group, music-based intervention would be effective in reducing opioid requirements and mood disorders. Methods: This study was a single-center, prospective, single-blinded, randomized controlled trial. Inclusion criteria isame-day or observation surgery. Exclusion criteria included American Society of Anesthesiologists physical status IV, use of spinal anesthesia, PROMIS Anxiety T-scores ≤ 57.4 and ≥74.1, preoperative chronic opioid use, transgender surgery, and history of drug or alcohol abuse. Music-based intervention was developed by a certified music therapist. Each patient was randomized to receive standard of care (SC) or SC plus music-based intervention before, during, and after surgery. The primary end point was postoperative oral morphine equivalents (OMEs) over 5 days following surgery using the area under the curve (AUC)Secondary end points were PROMIS Anxiety, PROMIS Depression scores Pain Catastrophizing Scale scores, postoperative nausea and vomiting, time of hospital discharge, and patient satisfaction (0 = totally unsatisfied to 10 = completely satisfied). Results: A total of 75 patients were randomized to a music-based intervention (n = 33) or control (n = 42) group. Patients in the music-based intervention group consumed 56.7% less opioids than those in the control group (AUC was 2.8 in the music-based intervention group vs. 6.4 in the control group, absolute standardized mean difference (aSMD) = 0.34 (-0.17, 0.85)). No difference in pain scores was recorded between groups. Music-based intervention also reduced anxiety on postoperative day (POD)2 (aSMD = 0.38 (-0.16, 0.91)), depression on POD2 (aSMD = 0.31 (-0.23, 0.84)) and POD4 (aSMD = 0.24 (-0.29, 0.77)), and pain catastrophizing on POD1 (aSMD = 0.24 (-0.3, 0.77)). Conclusions: Our data support the use of music-based intervention to reduce postoperative opioid requirements. Music-based intervention may also reduce anxiety, depression, and pain catastrophizing.

Health Management of Remote Workers Using Tele-Exercise During The COVID-19 Pandemic in Japan

Health management is increasingly recognized as a vital business resource aimed at enhancing employee well-being. The COVID-19 pandemic has significantly influenced lifestyle habits, underscoring the need for effective health management strategies tailored to thechanging work environment. This study aims to explore the impact of tele-exercise interventions on remote workers group (G1). Itcompares the effects of tele-exercise with those of traditional face-to-face exercise group (G2). Over three months, G1 engaged in a 30-minute weekly exercise program tailored for remote execution, while G2 participated in traditional, in-person sessions. The analysis includedANOVA to assess the differences over time between G1 and G2, Correlation Analysis to examine the relationships among the measuredvariables within each group, and Correspondence Analysis to explore the association patterns between the groups' responses and thevariables of interest. The ANOVA revealed a significant difference in Daily Stress (DS) levels between G1 and G2, with G1 showing higherDS levels. Correlation analysis indicated a strong negative relationship between Body Mass Index (BMI) and Sleep Quality (SQ) in G1, and astrong positive relationship between DS and Satisfaction of Life (SL). Correspondence Analysis showed that that G1 was encompassed in ajob and life satisfaction area, and G2 was encompassed in a sleep and stress for weight control area. This study concluded that both groupsinitially experienced weight gains and increased sleep duration due to remote work. Daily Stress was found to be significantly higher in G1than in G2, possibly due to the isolation of tele-exercise. Correlation analyses highlighted the influence of time on relationship between BMIand SQ, and DS and SL. The study emphasizes stress management and good sleep quality in remote work, with exercise interventionspromoting well-being and productivity.

EARLY SUCCESSFUL PRIMARY PERCUTANEOUS CORONARY INTERVENTION ON LEFT VENTRICULAR EJECTION FRACTION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Early intervention in patients with ST-elevation myocardial infarction (STEMI) is crucial for preserving left ventricular function and improving patient outcomes. Primary percutaneous coronary intervention (PPCI) has become the standard of care, and the timing of intervention significantly influences recovery and long-term prognosis. Objective: This study aimed to evaluate the impact of early successful primary percutaneous coronary intervention (PPCI) on left ventricular ejection fraction (LVEF) in patients presenting with STEMI. Methods: A prospective cohort study was conducted on 116 STEMI patients undergoing PPCI at a tertiary care hospital. The patients were categorized into two cohorts: early presenters (n=67) who received PPCI within 6 hours of symptom onset and late presenters (n=49) who received PPCI after 6 hours. Baseline characteristics, procedural outcomes, Thrombolysis in Myocardial Infarction (TIMI) flow grades, and LVEF measurements were assessed at presentation and two months post-PPCI using transthoracic echocardiography. The primary outcome was the change in LVEF from baseline to follow-up, and the secondary outcome was the distribution of TIMI flow grades achieved during PPCI. Statistical analysis was performed using appropriate tests to compare outcomes between the two groups. Results: Early presenters demonstrated significantly better outcomes compared to late presenters. At presentation, the mean LVEF in the early group was higher (45.67 ± 1.73%) compared to the late group (36.94 ± 1.25%) (p = 0.0001). At the two-month follow-up, the LVEF improved significantly in both groups, with early presenters achieving an LVEF of 56.24 ± 1.73%, which was notably higher than the LVEF of late presenters (45.12 ± 1.42%) (p = 0.0001). In terms of coronary reperfusion, 62.7% of early presenters achieved TIMI grade 3 flow compared to 26.5% of late presenters (p = 0.0001), indicating better coronary artery perfusion in the early intervention group. Conclusion: Early successful PPCI in STEMI patients is associated with superior recovery of left ventricular function and improved coronary reperfusion compared to delayed intervention. Patients who received PPCI within 6 hours of symptom onset demonstrated significantly higher LVEF at follow-up and achieved better TIMI flow grades, highlighting the critical importance of minimizing treatment delays in STEMI management.

Leveraging value-based health principles to improve translation and impact of digital psychological interventions for people with chronic pain.

Leveraging value-based health principles to improve translation and impact of digital psychological interventions for people with chronic pain.

Investigating the impact of an AI-based play activities intervention on the quality of life of school-aged children with ADHD

BackgroundAttention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that not only impacts children's behavior, learning, and social interactions but also their quality of life. Advances in artificial intelligence (AI) may provide new opportunities to improve the ADHD symptoms and quality of life of children with ADHD, especially through customized play activities that address their specific needs. AimsThis study examined the impact of AI-based play activities on the quality of life of 61 Saudi children aged between 8 and 12 years who had an ADHD diagnosis. MethodsAI-based play activities intervention consisted of twelve 45-minute sessions, delivered to the experimental group over four weeks (three sessions per week). The control group did not receive any intervention. Children and parents completed the Pediatric Quality of Life Inventory (PedsQL) at pre-test, post-test and follow-up. Results and outcomesThe experimental group exhibited significant improvements in all dimensions and total scores of PedsQL, with moderate to large effect sizes. These improvements were not observed in the control group. The beneficial effects of the AI-based play activities were maintained at the 7-weeks follow-up. ConclusionsAI-based play interventions may enhance quality of life for children with ADHD, with sustained improvements observed after 7-weeks. Incorporating such interventions into educational and therapeutic settings could improve behavioral, social, and cognitive ADHD symptoms. Future research should explore broader applications and long-term effects of AI-based play activities interventions.