Intervention Studies Research Articles

A nutrition intervention study’s effect to hematology profiles on elderly group in social retirement home

The increase in the elderly brings consequences, including a higher risk of disease. Inappropriate nutritional intake is also known as one of the risk factors related to the elderly's non-communicable diseases, and nutritional intervention is essential to improve the elderly nutritional status and quality of life. It was an interventional study with a before-after one-group approach. The study was conducted for three months (October-December 2021) in three social retirement homes. The intervention given was supplementation with additional protein sources and snacks each day. The biochemistry profiles were taken 2 times: before and after three months of intervention, comprised of HbA1c, lipid, transferrin, creatinine, and blood pressure level. The data will be analyzed for its normality before being processed with paired t-test or Wilcoxon signed rank based on the normality results. The analysis results show that there are significantly lower transferrin levels (p=0.040), an increase in cholesterol level (p=0.000), and low-density lipoprotein (LDL) level increased from 114.05±32.03 to 125.94±31.41 (p=0.000). There is also a remarkable decrease in hemoglobin (p=0.005) and high-density lipoprotein (HDL) levels. Conversely, there are an increase in HbA1C (p=0.007) and triglyceride level (p=0.005). There is no significant difference in creatinine level. We conclude that nutrition interventions have a significant effect on elderly blood profiles. However, to achieve an improvement, the study should consider physical activity and other variables that might be altering the results.

Single organ metastatic sites in non-small cell lung cancer: Patient characteristics, treatment patterns and outcomes from a large retrospective Canadian cohort

BackgroundThere is a paucity of information about the characteristics, treatment patterns, and outcomes of non-small cell lung cancer (NSCLC) patients with single organ metastasis (SOM). MethodsThis retrospective cohort study includes all patients with a diagnosis of stage IV NSCLC diagnosed from 2014 to 2016 and treated at Princess Margaret Cancer Centre. We compared baseline characteristics and patterns of metastatic sites between patients with SOM versus multiple (M)OM. Additionally, we identified treatment modalities and outcomes for patients with SOM. Cox multivariable models (MVA) were utilized to evaluate differences in overall survival (OS) between the SOM and MOM cohorts. ResultsOf 893 pts analyzed, 457 (51 %) had SOM, while 436 (49 %) had MOM at initial diagnosis. Demographics were comparable between the two groups. Brain was the most common site of metastasis for SOM patients. When compared to the MOM group, the SOM group had lower percentages of liver and adrenal metastases. Amongst SOM patients, 54 % received single modality treatment, and 20 % did not receive any treatment for their SOM. In MVA, patients with liver (HR 2.4), bone (HR 1.8), and pleural (HR 1.7) metastasis as their SOM site had the worst outcomes, with median OS of 6.8 months, 12.1 months, and 13.0 months respectively. Patients with SOM had a significantly improved median OS compared to those with MOM (15.9 months vs. 10.6 months; HR 0.56, 95 % CI 0.47–0.66, p < 0.001). ConclusionIn NSCLC patients who presented with SOM, survival correlated with the initial organ involved and was better overall compared to patients with MOM. SOM NSCLC may benefit from specific management strategies and SOM patients could be considered as a specific subgroup for survival analyses in observational and non-randomized interventional studies. In clinical trials, SOM can be considered as a stratification factor in the future.

Foveal Changes after Uneventful Phacoemulsification Surgery for Senile Nuclear Cataract

Objective: To describe foveal thickness and foveal anatomical changes after uneventful phacoemulsification surgery. Design: Interventional case control study. Participants: Both eyes of healthy phakic patients presenting to the American University of Beirut Medical Center Eye clinic for phaco-emulsification surgery in one eye (the study eye). The fellow eye served as control. Methods: OCT images of the macula were taken pre-operatively, then on a weekly basis for 12 weeks post-operatively. Outcomes: post op foveal thickness and morphological changes. Results: From the originally recruited 66 patients, 52 patients (104 eyes) completed the study. A transient increase in foveal thickness was observed in 36/52 (69%) eyes mostly between weeks 4 and7 post operatively. Twenty-seven eyes developed anatomic changes including: microcysts in 15 eyes (55%), regular cysts in 6 eyes (22%), and epiretinal membranes in 6 eyes (11.5%). Changes appeared as early as 1 week post operatively, and lasted on the average 4 weeks. Conclusion: Uncomplicated cataract surgery can lead to transient thickening of the macula as well as morphological changes.

Approaches for delivery of refractive and optical care services in community and primary care settings.

Uncorrected refractive error is a leading cause of vision impairment which, in most cases, can be managed with the appropriate spectacle correction. In 2021, the World Health Assembly endorsed a global target of a 40-percentage-point increase in effective coverage of refractive error by 2030. To achieve this global target, equitable access to refractive and optical services within community and primary care settings needs to be strengthened. This review will inform the development of technical guidance to support improvements in the testing and correction of refractive error among World Health Organization (WHO) member states. To determine the range of approaches for delivery of refractive and optical care services in community and primary care settings, and the methods employed for their evaluation. We searched CENTRAL, MEDLINE, Embase and Global Health databases, grey literature, and annual reports and websites of relevant organizations involved in eye-care delivery from January 2002 to November 2022 to identify approaches for refractive and optical service delivery. We included observational and interventional studies, reviews, and reports from relevant organizations related to delivering refractive services and optical services for preschool and school-aged children and adults in community and primary care settings published between January 2002 and November 2022. We searched for studies and reports published within the last 20 years because vision impairment due to uncorrected refractive error has only recently become a public health and eye health priority, therefore we did not expect to find much relevant literature until after 2002. Two review authors screened titles, abstracts and full texts, and extracted data. We resolved any discrepancies through discussion. We synthesized data, and presented results as tables, figures, and case studies. This project was led by the World Health Organization (WHO) Vision and Eye Care Programme. We identified 175 studies from searches of databases and grey literature, 146 records from company reports, and 81 records from website searches of relevant organizations that matched our inclusion criteria. Delivery approaches for refractive and optical services in community care included school-based, pharmacy, and outreach models, whereas primary care approaches comprised vision centre, health centre, and a combination of vision or health centre and door-to-door delivery. In community care, school-based and outreach approaches were predominant, while in primary care, a vision-centre approach was mainly used. In the WHO African region, the school-based and outreach approaches were mainly reported while, in the Americas, the outreach approach was mostly used. Very few approaches for service delivery were reported in the WHO Eastern Mediterranean region. Prominent gaps exist in the evaluation of the approaches, and few studies attempted to evaluate the approaches for delivery of refractive and optical care services. We comprehensively describe a range of approaches for delivery of refractive and optical services in community and primary care. Further evaluation of their effectiveness will better inform the application of these service-delivery approaches. The study outcomes will help guide WHO member states in strengthening refractive and optical services at community and primary care levels. This scoping review was supported by the Vision and Eye care Programme, World Health Organization and ATscale Global Partnership. The protocol of this scoping review was published in the Open Source Framework.

Evaluating Sex-specific Differences in Abdominal Fat Volume and Proton Density Fat Fraction on MRI Scans Using Automated nnU-Net-based Segmentation.

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Sex-specific abdominal organ volume and proton density fat fraction (PDFF) in people with obesity during a weight loss intervention was assessed using automated multiorgan segmentation of quantitative water-fat MRI. An nnU-Net architecture was employed for automatic segmentation of abdominal organs, including visceral (VAT) and subcutaneous adipose tissue (SAT), liver, psoas and erector spinae muscle, based on quantitative chemical shiftencoded MRI and using ground truth labels generated from participants of the Lifestyle Intervention (LION) study. Each organ's volume and fat content were examined in 127 participants (73 female, 54 male; body mass index, 30-39.9 kg/m2) and in 81 participants (54 female, 32 male) of these after an 8-week formula-based low-calorie diet. Dice scores ranging from 0.91 to 0.97 were achieved for the automatic segmentation. PDFF was found to be lower in VAT compared with SAT in both male and female participants. Before intervention, females exhibited higher PDFF in SAT (90.6% versus 89.7%, P < .001) and lower PDFF in liver (8.6% versus 13.3%, P < .001) and VAT (76.4% versus 81.3%, P < .001) compared with males. This relation persists after intervention. As a response to caloric restriction, male participants lost significantly more VAT volume (1.76 L versus 0.91 L, P < .001) and showed a higher decrease in SAT PDFF (2.7% versus 1.5%, P < .001) than female participants. Automated body composition analysis on quantitative water-fat MRI data provides new insights for understanding sex-specific metabolic response to caloric restriction and weight loss in people with obesity. Published under a CC BY 4.0 license.

The Role of Stigma and Resilience in Healthcare Engagement Among Transgender Latinas in the U.S. South: Baseline Findings from the ChiCAS Study.

Research demonstrates that stigma and resilience influence transgender peoples' healthcare use. Less is known about transgender Latinas in the U.S. South who face multilevel barriers to healthcare access. We used baseline data from the ChiCAS intervention study. Using logistic regression, we examined how stigma (perceived discrimination related to gender identity, race/ethnicity, sexual behavior and perceived documentation status and internalized transphobia), and resilience (ethnic group pride and social support) are associated with two healthcare outcomes (use of routine medical care and medically supervised gender-affirming hormones). We also explored barriers to accessing both types of care. After removing 13 participants with missing data, our sample size was 131 transgender Latinas in the U.S. South. Most participants (74.8%, n = 98) received routine medical care in the past year and 57.3% (n = 75) had ever received medically supervised gender-affirming hormones. Reports of discrimination were highest for gender identity and documentation status. Race/ethnicity-based discrimination was positively associated with accessing routine medical care in the past year (OR = 1.94, p = 0.048). Having more social support was positively associated with care (routine care: OR = 3.48, p = 0.002 and gender-affirming hormones: OR = 2.33, p = 0.003). The most commonly reported barriers to accessing both types of care included cost, insurance, and not knowing where to go. Findings highlight the importance of social support for healthcare use among transgender Latinas. Social support may be especially important when considering the unique experiences of discrimination faced by transgender Latinas in the U.S. South.

Evaluation of the Cancer Awareness Measure in Adolescents in Turkiye: A Methodological Study.

Purpose: Cancer awareness can help reduce the associated morbidity and mortality. There is no scale for the assessment of general cancer awareness in Turkiye. This study aimed to evaluate the cultural relevance and psychometric properties of the cancer awareness measure (CAM) for use in adolescents in the Turkish population. Methods: This methodological study included 400 students attending seven high schools in western Turkiye, recruited by convenience sampling. The CAM was translated into Turkish and assessed for content validity by expert panel opinion and content validity index (CVI). The Turkish CAM was administered online, and its reliability was assessed using Cronbach's alpha coefficients, item-total and item-subscale correlation coefficients, and test-retest analysis. Results: The Turkish CAM had excellent content validity (scale CVI = 0.99). Cronbach's alpha for the entire scale was 0.72, and item-subscale correlation coefficients were 0.33-.75 (p < 0.001). Test-retest reliability was good, with an intraclass correlation coefficient of 0.83 for the entire scale (p < 0.001). The students' mean score on the Turkish CAM was 45.60 ± 7.23 (on a scale of 11-77), indicating moderate cancer awareness. Conclusion: The Turkish CAM is a valid and reliable measure that can be used to assess cancer awareness in adolescents in Turkiye. Interventional studies should be performed to measure and increase cancer awareness and promote cancer prevention among young people.

Capability to identify and manage critical conditions: effects of an interprofessional training intervention

BackgroundThe burden of critical illness is a global issue. Healthcare systems often fail to provide essential emergency and critical care for deteriorating patients, and the optimal strategy for ensuring safe care is not fully known. This study aimed to explore the capability to identify and manage critical conditions and to evaluate how an interprofessional training intervention that included theory as well as high-fidelity simulation (proACT) in the short and long term affected the capability.MethodsA questionnaire study was performed. A cross-sectional survey of all in-hospital nurses and physicians in a Swedish region (n538) and a longitudinal cohort of participants entering the proACT course during a six-month period (n99) were included. Descriptive and comparative statistics were generated. Additionally, qualitative content analysis was performed for free text answers.ResultsThe findings demonstrated that the intervention improved the individual healthcare professionals’ competence with a sustained effect over time. The coverage of proACT trained staff increased from 13.2% to 26.5%, but no correlation was observed with workplace conditions that support safe care. Collaboration and workplace climate were perceived to be mainly positive, but for safer care, an overall need for improved competence and staffing was emphasized.ConclusionsThe present study confirms previously identified issues and the need for improvements in the care of critically ill patients in general hospital wards. It supports the notion that a training intervention, such as proACT, can increase the capability to identify and manage patients with critical conditions. All healthcare professions increased the competence. Hence, more effort is needed to enable staff of all professions to participate in such training. Studies of interventions cover higher number of trained staff in the setting are warranted to clarify whether the training can also improve workplace conditions that support safe care of deteriorating and critically ill patients.

Effectiveness of test-and-treat model with direct-acting antiviral for hepatitis C virus infection in migrants: a prospective interventional study in Italy.

Migrants, mainly undocumented and low-income refugees, are at high risk of hepatitis C virus (HCV) infection, but are a difficult-to-reach and to-treat population. The aim of the study was to evaluate the effectiveness of a test and treat model with direct-acting antiviral for HCV infection in these migrants coming from low-income and living in southern Italy. A prospective, multicenter, collaborative study based on a four-phase-program (educational counseling, screening, linkage-to-care and treatment) was designed in southern Italy; the study started in June 2018, was stopped in February 2020 because of the outbreak of SARS-CoV2 infection in Italy and was resumed in February 2021 until November 2021. After educational counseling on infectious diseases that are transmitted through blood or sexually pseudonymized HCV screening was offered to all undocumented migrants and low-income refugees observed at one of the 1st level clinical centers. The HCV-RNA-positive subjects were referred to one of the 3rd level units of Infectious Diseases (ID) and treated with a 12-week course of sofosbuvir-velpatasvir and observed for 12 weeks after the end of direct antiviral agents (DAA) treatment. For the descriptive analysis, the categorical variables were reported as absolute numbers and relative frequencies. Continuous variables were summarized as mean and standard deviation (SD) if normally distributed, or as a median and interquartile range (IQR) if not normally distributed. We used Pearson chi-square or Fisher's exact test for categorical variables and Student's t test or Mann-Whitney test for continuous variables. A P value < 0.05 was considered to be statistically significant. Analyses were performed with SPSS 21.0. Of the 3501migrants observed in the study period, 3417 (97.6%) agreed to be screened; 185 (4.7%) were anti-HCV-positive and, of these, 53 (28.6%) were HCV-RNA-positive. Of these 53 subjects, 48 (90.5%) were referred to an ID unit and started DAA treatment. The HCV-RNA-positive-subjects were older [median 36 years (IQR: 32-21) vs 27.19 (IQR: 30.5-19.25); P = 0.001], and less frequently males [35 (66.03 %) vs 119 (90.1%), P < 0 .0001] than seronegative participants. They more frequently came from Eastern Europe (70.8%) stayed longer in Italy [months of stay in Italy, mean ± SD: 51.02±52.84 vs 25.7 ± 42.65, P = 0.001], and had more years of schooling [years of schooling, mean ± SD: 9.61±2.81 vs 7.10 ± 4, P = 0.0001]. HCV-RNA-positive-subjects less frequently reported piercing, tattoos and tribal scars as risk factors (23.6%). Of these 48 HCV RNA positive subjects who started DAA, 47 (97.9%) showed a sustained virological response and one dropped-out in follow-up after DAA treatment. No subject had any adverse event. This model of HCV screening and linkage to care seems effective to eliminate HCV infectionin a difficult-to-reach and to-treat population, such as undocumented migrants and low-income refugees. The participation of cultural mediators in the study made possible a better interaction between migrants and physicians, as is evident from the large number of subjects enrolled. Eliminating HCV among migrants will have a long-term positive impact from a public health and healthcare perspective by reducing the number of individuals who potentially develop HCV-related complications such as liver cirrhosis and hepatocellular carcinoma and reducing the circulation of HCV in the regions that host them which often, as in the case of Italy, are low endemic for HCV infection.

The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review.

Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.

Impact of Intergenerational Shokuiku (Food and Nutrition Education) Programs on Alleviating Loneliness in Japanese Communities across Ages

As loneliness is a risk factor for mental and physical health problems in various age groups, this study aimed to explore the impact of the intergenerational Shokuiku (food and nutrition education) program (IGSP) on loneliness in a Japanese community. This single-arm intervention study conducted between 2022 and 2023 included children (n = 21), guardians (n = 16), university students (n = 3), and older adults (n = 6). The IGSP was a one-day program that included participants making and eating their own bread, butter, and sorbet. Loneliness was measured using the Five-item Loneliness Scale for Children (Five-LSC; Japanese) and the three-item UCLA Loneliness Scale (Japanese; for adults) with other direct questions. Social capital, including civic participation, social cohesion, and reciprocity, was assessed using a self-administered questionnaire. The Five-LSC score significantly decreased post-intervention (p = 0.04). There was a significant increase in adults who reported not feeling lonely (p = 0.001). However, the UCLA Loneliness Scale scores did not show any significant changes. A positive change in social cohesion, including community contribution (p = 0.001) and attachment (p = 0.002), was observed among adults. This study suggests that IGSPs have a positive impact on loneliness in children and a partly positive one in adults. These findings emphasize the potential of intergenerational programs to reduce loneliness in communities.

Effect of GLP-1RA Treatment on Adhesion Molecules and Monocyte Chemoattractant Protein-1 in Diabetic Patients with Atherosclerosis

Cardiovascular disease (CVD) remains a prominent cause of global mortality, primarily driven by atherosclerosis. Diabetes mellitus, as a modifiable risk factor, significantly contributes to atherogenesis. Monocyte recruitment to the intima is a critical step in atherosclerotic plaque formation, involving chemokines and adhesion molecules such as selectins, ICAM-1, and MCP-1. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are a promising group of drugs for reducing cardiovascular risk in diabetic patients, prompting investigation into their mechanisms of action. This interventional study enrolled 50 diabetes patients with atherosclerotic plaque, administering GLP-1RA for 180 days. Serum concentrations of MCP-1, ICAM-1, and L-selectin were measured before and after treatment. Anthropometric and biochemical parameters were also assessed. GLP-1RA treatment resulted in significant improvements in anthropometric parameters, glycemic control, blood pressure, and biochemical markers of liver steatosis. Biomarker laboratory analysis revealed higher baseline levels of MCP-1, ICAM-1, and L-selectin in diabetic patients with atherosclerotic plaque compared to healthy controls. Following treatment, MCP-1 and L-selectin levels decreased significantly (p &lt; 0.001), while ICAM-1 levels increased (p &lt; 0.001). GLP-1RA treatment in diabetic patients with atherosclerotic plaque leads to favorable changes in serum molecule levels associated with monocyte recruitment to the endothelium. The observed reduction in MCP-1 and L-selectin suggests a potential mechanism underlying GLP-1RA-mediated cardiovascular risk reduction. Further research is warranted to elucidate the precise mechanisms and clinical implications of these findings in diabetic patients with atherosclerosis.

Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults-The BEER-HIIT Study.

High-intensity interval training (HIIT) is a time-efficient strategy to improve fitness and performance. Whereas the multiple and negative effects of high intake of alcohol have been widely studied, the effect of moderate alcohol doses after exercise is not clear, and it is currently under debate. For that, a total of 80 young healthy adults are studied and allocated into 5 groups, each including 16 participants. Four groups follow a HIIT program, while the fifth group is a control non-training group. The training groups will be randomized according to the characteristics of the ingested beverage (alcohol beer, beer 0.0%, sparkling water, or ethanol). The effects of HIIT on several aspects of physical performance and mental health in young healthy adults are evaluated, also the concomitant effect of daily and moderate alcohol consumption. The novelty of this study lies in the continuous measurement of the psychological parameters associated with carrying out a highly demanding training program in conjunction with alcohol consumption in moderate quantities, reflecting real-life conditions.

Changes in vessel density patterns assessed with OCTA in patients with diabetic macular edema treated with anti-VEGF therapy.

To determine the presence of sectoral changes in vessel density (VD) patterns induced by vascular endothelial growth factor inhibitors (anti-VEGF) in patients with diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Prospective, interventional study. A total of 43 patients (63 eyes) were initially enrolled in the study. We performed swept source (SS) OCT and sectorial OCTA measurement to determine parafoveal VD at baseline and after six months of anti-VEGF treatment. In the locations with statistically significant differences in VD between baseline and month 6, we performed univariate and multivariate analyses to determine which, if any, of the baseline variables were associated with the observed changes. A total of 34 patients (48 eyes) were included in the final analysis. Mean VD decreased from baseline to month 6 (from 45.2 (± 3.5) to 44.6 (± 3.2) % in the SCP and from 50 (± 3.3) to 49 (± 3.9) % in the DCP). The only significant changes in VD were observed in the nasal sector of the deep capillary plexus, with a decrease of 2.9% (p = 0.001). On univariate and multivariate analyses, the only variable significantly associated with changes in VD in the nasal sector after 6months of treatment was baseline VD in the same sector. Anti-VEGF therapy has a small impact on VD values over time. These variations observed after treatment seems to be related to changes over areas of vascular anomalies and displaced vessels adjacent to cystic areas, with no significant changes over ischemic areas. No correlation was observed between this trend and other clinical baseline features.

The effect of social anxiety on teenagers’ internet addiction: the mediating role of loneliness and coping styles

Background & AimThere is a lack of understanding of how social anxiety may affect Internet addiction among adolescents. Based on several theories, the purpose of this study was to investigate the multiple mediating roles of loneliness and coping styles in the association between social anxiety and Internet addiction in Chinese adolescents.MethodsThis study used the Social Anxiety Scale, Internet Addiction Test, Loneliness Scale, and Simple Coping Style Questionnaire to investigate 1188 students in two junior high schools and senior high schools in Henan Province, China. We adopted Pearson’s correlation analysis and the PROCESS Macro Model 81 in regression analysis to explore the relationships among social anxiety, loneliness, coping styles, and Internet addiction.ResultsWe found that social anxiety not only directly affects teenagers' Internet addiction, but also affects teenagers' Internet addiction through loneliness and coping styles.ConclusionsThese results emphasize the importance of improving social anxiety to reduce Internet addiction among adolescents. At the same time, it also emphasizes the need to reduce adolescents' loneliness and cultivating positive coping styles. In addition, this study has certain theoretical significance for teenagers' mental health and intervention studies on Internet addiction.

Estimating Clostridioides difficile infection-associated readmission rates: A systematic review and meta-analysis.

The economic burden of Clostridioides difficile infection (CDI) is considerable and mostly associated with a high frequency of hospitalizations. Numerous publications have demonstrated that CDI is associated with a higher risk of hospital readmission, but not always a specific rate or attributable to disease recurrence. In this systematic review, we describe the incidence of 30-day CDI-associated readmission rates and the effect of active interventions. Three search engines were utilized for the literature search, and a total of 9 studies were included in this review. Hospital readmission proportions from interventional and observational studies were analyzed through meta-analysis with random effects. Two thousand five hundred and twenty-one articles were identified. After screening full-text articles, 9 eligible articles published between 2002 and 2023 met the inclusion criteria. In total, 132,862 CDI patients were evaluated. Thirty-day CDI-associated readmissions were defined as either an ICD9/10 code indicating CDI admission with a prior admission within the past 30 days (n = 4) or a medical chart evaluation of signs and symptoms consistent with CDI (diarrhea) along with a positive diagnostic test (n = 5) with a prior hospitalization for CDI within the past 30 days. Meta-analysis of observational studies estimated 30-day CDI readmissions were 6% (95% CI, 5%-7%). Three studies evaluated the effect of active interventions to reduce CDI-associated 30-day readmission rates. Two of 3 interventions reduced the likelihood of CDI-associated 30-day readmissions. This systematic review identified a 6% rate of 30-day CDI-associated hospital readmission. Antimicrobial stewardship efforts and the use of specific therapeutics were shown to reduce these rates.

Proof of concept of an experimental prototype for the prevention of parastomal hernia.

The aim of this study was to analyse the complications and problems associated with the use of an experimental prototype designed for the prevention of parastomal hernia (PSH), one of the most frequent complications in ostomates. A single-centre, non-comparative, proof-of-concept interventional pilot study of an experimental prototype designed to be used in conjunction with an abdominal compression binder to prevent PSH was conducted. The "Ostomy Fixation Device for Hernia Prevention" (patent P201531826) is a semi-rigid ostomy protector, to be used in conjunction with a compression binder. It is designed to adapt to the dimensions of standard ostomy bags from different brands and serves to transmit, in a localised manner, the support coming from the compression binder in the peristomal area without putting pressure on the collection bag. The main outcome measures were efficacy, safety, and patient-users' opinion/perception. Ten patients were studied for 12 months. Mean age was 61 years (± 11.59), 70% (7) were male, 80% (8) ostomised for colorectal cancer, 90% (9) underwent planned surgery and 80% (8) had a colostomy. the incidence of HPE was 10% (1). no participant experienced pain, discomfort, itching, stinging, leakage, pouch detachment, allergy to components, or injury to the stoma or peristomal skin due to rubbing or pressure. 90% (n = 9) were considered "very satisfied" or "satisfied" with the device. An innovative device designed in collaboration between healthcare professionals and end-users has been shown to be safe and effective in reducing PSH in the group of ostomates studied.

Cardiac myosin inhibitor, CK-586, minimally reduces systolic function and ameliorates obstruction in feline hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) remains the most common cardiomyopathy in humans and cats with few preclinical pharmacologic interventional studies. Small-molecule sarcomere inhibitors are promising novel therapeutics for the management of obstructive HCM (oHCM) patients and have shown efficacy in left ventricular outflow tract obstruction (LVOTO) relief. The objective of this study was to explore the 6-, 24-, and 48-hour (h) pharmacodynamic effects of the cardiac myosin inhibitor, CK-586, in six purpose-bred cats with naturally occurring oHCM. A blinded, randomized, five-treatment group, crossover preclinical trial was conducted to assess the pharmacodynamic effects of CK-586 in this oHCM model. Dose assessments and select echocardiographic variables were assessed five times over a 48-h period. Treatment with oral CK-586 safely ameliorated LVOTO in oHCM cats. CK-586 treatment dose-dependently eliminated obstruction (reduced LVOTOmaxPG), increased measures of systolic chamber size (LVIDs Sx), and decreased select measures of heart function (LV FS% and LV EF%) in the absence of impact on heart rate. At all tested doses, a single oral CK-586 dose resulted in improved or resolved LVOTO with well-tolerated, dose-dependent, reductions in LV systolic function. The results from this study pave the way for the potential use of CK-586 in both the veterinary and human clinical setting.

Opportunistic smoking cessation interventions for people accessing financial support settings: A scoping review.

The aim of this work was to systematically scope the evidence on opportunistic tobacco smoking cessation interventions for people accessing financial support settings. We searched MEDLINE, Embase, PsycINFO and the Cochrane Tobacco Addiction Group specialized register to 21 March 2023. We duplicate screened 20% of titles/abstracts and all full texts. We included primary studies investigating smoking cessation interventions delivered opportunistically to people who smoked tobacco, within settings offering support for problems caused by financial hardship, for example homeless support services, social housingand food banks. Data were charted by one reviewer, checked by anotherand narratively synthesized. We included 25 studies conducted in a range of financial support settings using qualitative (e.g. interviews and focus groups) and quantitative (e.g. randomized controlled trials, surveys and single arm intervention studies) methodologies. Evidence on the acceptability and feasibility of opportunistic smoking cessation advice was investigated among both clients and providers. Approximately 90% of service providers supported such interventions; however, lack of resources, staff training and a belief that tobacco smoking reduced illicit substance use were perceived barriers. Clients welcomed being asked about smoking and offered assistance to quit and expressed interest in interventions including the provision of nicotine replacement therapy, e-cigarettes and incentives to quit smoking. Six studies investigated the comparative effectiveness of opportunistic smoking cessation interventions on quitting success, with five comparing more to less intensive interventions, with mixed results. Most studies investigating opportunistic smoking cessation interventions in financial support settings have not measured their effectiveness. Where they have,settings, populations, interventions and findings have varied. There is more evidence investigating acceptability, with promising results.

Eating Behaviours and Dietary Intake in Children and Adolescents: A Systematic Review.

This systematic review aimed to examine existing evidence related to associations between eating behaviours and dietary intake in children and adolescents, with a focus on the Children Eating Behaviour Questionnaire (CEBQ) and the Dutch Eating Behaviour Questionnaire (DEBQ) as assessment tools. We conducted a systematic review following PRISMA guidelines. We included observational and interventional studies published in English, Spanish, or Portuguese, that evaluated the association between eating behaviours and food and beverage intake. Thirteen studies from nine countries met the inclusion criteria, with sample sizes ranging from 62 to 4,914 individuals aged 2 to 16 years-old. Ten studies used the CEBQ, and three used the DEBQ. Our retrieved studies showed that children and adolescents engaging in food approach behaviours tend to consume foods rich in sugar and fats. However, we observed a higher consumption of fruits and vegetables. On the other hand, children and adolescents with lower engagement to food avoidant behaviours, generally exhibited a lower overall food consumption, except for snacks, which they consumed at a higher rate. This systematic review suggests that eating behaviours play an important role in shaping dietary intake. Nevertheless, due to the heterogeneity related to eating behaviours and diet intake, it highlights the need for further research to understand these complex relationships to develop effective interventions for promoting healthy eating habits in children and adolescents.