Long-term Effects Of Interventions Research Articles

Mitigating the Adverse Effects of Night Shifts: A Review of Strategies for Enhancing Health Outcomes in Shift Workers

Introduction and PurposeShift work, essential for continuous operation in industries like healthcare, transportation, and security, disrupts circadian rhythms and adversely affects health. This review consolidates findings on the multifaceted impacts of night shift work, emphasizing interventions to mitigate these effects and improve worker health and well-being. Brief Description of the State of KnowledgeNight shift work disrupts circadian rhythms, leading to cognitive decline, sleep disorders, mental health risks, cardiovascular issues, metabolic disturbances, and cancer susceptibility. Effective interventions include limiting shift lengths and frequency, incorporating rest breaks and napping, aligning meal times with circadian rhythms, using melatonin supplementation and light therapy to improve sleep quality, engaging in regular aerobic exercise, and employing stress management techniques. Summary Implementing proposed interventions can mitigate the adverse health effects of night shift work, enhancing worker well-being, efficiency, and job satisfaction. Tailoring strategies to different age groups optimizes effectiveness, with structured approaches beneficial for older workers and flexible options suitable for younger workers. Further research should explore long-term intervention effects and develop personalized strategies for diverse populations. This review provides comprehensive guidelines for managing the health impacts of night shift work, supporting improved patient safety, reduced accidents, and enhanced work performance across various industries.

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

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

Maintaining the impact of action-oriented entrepreneurship training: the role of error mastery orientation for training transfer in an active learning setting

ABSTRACT Action-oriented entrepreneurship training can boost entrepreneurship, but positive short-term effects often decay over time. Based on training transfer theory, we argue that error mastery orientation is a personal characteristic that affects the maintenance of training outcomes over time in the transfer context of entrepreneurship. We implemented an action-oriented entrepreneurship training at a university in Uganda and collected data from training participants before (NT0 = 175) and after the training programme (NT1 = 164) as well as at a 1-year follow-up measurement (NT2 = 52). Growth curve models showed that the participants experienced an increase in entrepreneurial action and new venture creation over time. Furthermore, error mastery orientation influenced the maintenance of entrepreneurial action and new venture creation over time. The study contributes to theories of entrepreneurship training and training transfer by demonstrating that error mastery orientation is a boundary condition of the long-term effectiveness of active learning interventions, such as action-oriented entrepreneurship training.

Exploring the impact of social identity and team dynamics on mental health help-seeking behavior among collegiate athletes: a qualitative study

This study explores the influence of social identity and team dynamics on the mental health help-seeking behaviors of collegiate athletes. The research aims to understand how factors such as gender, ethnicity, and social status shape athletes' attitudes and actions regarding mental health assistance. Method: Using a mixed-method approach that included focus group discussions (FGDs) and in-depth interviews, data were collected from 30 athletes representing various sports disciplines, ensuring balanced representation in terms of gender, ethnicity, and social status.Result: Thematic analysis revealed significant themes: male athletes faced substantial stigma in seeking mental health assistance, viewing it as a sign of weakness, while female athletes were more open and supported by a culture of emotional expression. Minority athletes encountered additional barriers due to cultural stigma and a lack of culturally competent services, whereas majority athletes had better access to mental health resources. High-status athletes experienced pressure to maintain their image, leading to reluctance in seeking help, while low-status athletes faced challenges in accessing resources despite their willingness to seek help. Positive team dynamics, characterized by support and open communication, facilitated help-seeking behavior, while negative dynamics, such as bullying and lack of trust, created barriers. Conclusion: The study highlights the need for targeted interventions that address specific needs based on gender, ethnicity, and social status, promote mental health literacy, and foster supportive team environments. Future research should focus on the long-term effects of stigma-reduction interventions, culturally tailored mental health services, and the impact of team dynamics over time. These findings provide valuable insights for developing effective mental health support systems for collegiate athletes. Keywords: Cultural Competency, Ethnicity, Health Literacy, Social Identification, Athletes, Bullying

Cardiac disease-induced trauma and stress-related disorders.

This review aims to present an updated overview of cardiac disease-induced trauma and stress-related disorders such as acute stress disorder (ASD), adjustment disorder (AjD), and posttraumatic stress disorder (PTSD). First, the prevalence of these disorders, their diagnostic criteria, and their differences from other trauma-related disorders are described. Special challenges in diagnosis and treatment are identified, with various screening tools being evaluated for symptom assessment. Additionally, the risk factors studied so far for the development of symptoms of cardiac-induced posttraumatic stress disorder and the bidirectional relationship between posttraumatic stress disorder and cardiovascular diseases are summarized. Various therapeutic interventions, including pharmacological approaches, are also discussed. Finally, various areas for future research are outlined. Experiencing acardiovascular disease, particularly alife-threatening cardiac event, can potentially lead to stress-related disorders such as ASD, AjD, and cardiac disease-induced PTSD (CDI-PTSD). If left untreated, these disorders are associated with aworsening cardiac prognosis and higher mortality rates. Approaching treatment through atrauma-focused lens may be beneficial for managing CDI-PTSD and stress-related disorders. Future research should explore treatment options for both the patients and the caregivers as well as investigate the long-term effects of trauma-focused interventions on physical and mental health outcomes.

The effectiveness of positive psychological interventions for patients with cancer: A systematic review and meta-analysis.

To evaluate the effectiveness of positive psychological interventions on quality of life, positive psychological outcomes and negative psychological outcomes in patients with cancer. Patients with cancer often suffer from various psychological problems and have a poor quality of life. Positive psychological interventions have been increasingly applied to patients with cancer, but the results of these studies have not been synthesized. A systematic review and meta-analysis of randomized controlled trials according to PRISMA. Six English databases and four Chinese databases were searched from the inception to December 2022. Two reviewers independently assessed the risk of bias using the Cochrane Risk of Bias tool. RevMan was used for meta-analysis. Twenty-nine randomized controlled trials examined the effects of positive psychological interventions including meaning therapy, dignity therapy, positive psychotherapy, mindfulness- based intervention, life review, expressive writing intervention, acceptance and commitment psychotherapy, attention and interpretation therapy, compassion training and spiritual therapy on patients with cancer. Positive psychological interventions significantly improved the quality of life, enhanced positive psychological outcomes including well-being, meaning of life, self-esteem, optimism, resilience and self-efficacy and alleviated negative psychological outcomes including depression, anxiety and hopelessness. However, the heterogeneity of some outcomes was rather high, due to the wide diversity of the interventions included. Positive psychological interventions have potentially positive effects on improving quality of life, enhancing positive psychological outcomes and alleviating negative psychological outcomes in patients with cancer. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of positive psychological interventions. As feasible psychological interventions, healthcare professionals can consider applying appropriate positive psychological interventions according to the condition of cancer patients. No patient or public contribution.

A 16-month follow-up after a youth-led social marketing intervention to encourage healthy lifestyles in children (aged 9 at baseline and 11 at follow-up) from disadvantaged neighbourhoods: the European Youth Tackling Obesity-Kids project

ObjectivesThe objective of this study was to assess the influence of the European Youth Tackling Obesity-Kids (EYTO-Kids) 10-month intervention, based on social marketing and peer-led methodologies, at 16 month of its ending. Study designChildren (aged 9 at baseline and 11 at the follow-up) from disadvantaged neighbourhoods who participated in the 10-month EYTO-Kids parallel-cluster randomised controlled intervention study in Reus (Spain) were included. The number of participants was 252 (retention rate: 67.2%) in the intervention group (7 schools) and 226 (retention rate: 69.1%) in the control one (8 schools). Primary (physical activity and fruit consumption) and secondary (screen time; and vegetables, fast food, and sugary drink consumption) outcomes were assessed. ResultsAt follow-up, consumption of ≥1 fruit per day increased in girls (odds ratio [OR] (95% confidence interval [CI]) = 2.28 (1.2; 4.2), P = 0.012) and all children (OR (95%CI) = 2.28 (1.0; 2.6), P = 0.044) in the intervention group vs. the control one. Physical activity ≥6 h/week similarly increased in both groups. ConclusionAt long-term effectiveness of a 10-month intervention on improving fruit consumption in children was observed. Therefore, peer-led and social marketing methodologies enhance healthy lifestyles by conveying children towards healthy choices.

The Impact of Rwanda's Education on Fertility

Purpose: This study examines the relationship between education and fertility in Rwanda. The main objective of this study is to identify the impact of fertility on population growth in Rwanda Design/Methodology/Approach: This research used the secondary data from the National Institute of Statistics of Rwanda (NISR) reported as the Demographic Health Survey (DHS) dataset spanning 2010, 2015, and 2020 from the National Institute of Statistics of Rwanda(NISR). Utilising stratified random sampling, as implemented in the DHS datasets, provides a robust and representative sample for investigating the impact of growth phases on body weight and morphometrics across different age groups in Rwanda. The Logistic regression model was used to assess the effect of education on fertility in Rwanda. Findings: Findings reveal that households with children are significantly more likely to attend school, and non-poor households exhibit higher attendance rates compared to those categorized as poor. Disparities in fertility rates between women with no education and those with higher education underscore the influence of education, with substantial reductions observed over the years. Contraceptive use displays differential patterns across education levels, with higher education correlating with increased usage. Median age of first birth rises with education level, indicating a shift towards later childbirth. The odds ratio (OR) of 0.842, implies that with each unit increase in education attainment, there's a decrease in the odds of experiencing the outcome variable, which presumably pertains to having children. Sex and marital status have minimal influence, with odds ratios of 1.078 and 1.06 respectively. Age shows negligible impact with an odds ratio of 1.01. Conversely, the wealth category strongly predicts having children, with higher-wealth individuals having 3.552 times higher odds. The Research Limitation: Research is limited by the absence of current DHS dataset Practical Implication: Understanding these dynamics can inform the development of more effective family planning strategies tailored to specific socio-cultural contexts, ultimately contributing to improved reproductive health outcomes. Social Implication: Fertility rates exhibit a negative association with education, emphasising the importance of education in demographic transitions Originality/ value: The unique contribution of this problem lies in its call for a context-specific examination of the relationship between education and fertility in Rwanda, incorporating socio-economic factors, as well as the need for longitudinal studies to capture the long-term effects of educational interventions on fertility behaviours.

The Effectiveness of Virtual Reality-Based Training on Cognitive, Social, and Physical Functioning in High-Functioning Older Adults (CoSoPhy FX): 2-Arm, Parallel-Group Randomized Controlled Trial.

Virtual reality (VR) has emerged as a promising technology for enhancing the health care of older individuals, particularly in the domains of cognition, physical activity, and social engagement. However, existing VR products and services have limited availability and affordability; hence, there is a need for a scientifically validated and personalized VR service to be used by older adults in their homes, which can improve their overall physical, cognitive, and social well-being. The main purpose of the CoSoPhy FX (Cognitive, Social, and Physical Effects) study was to analyze the effects of a VR-based digital therapeutics app on the cognitive, social, and physical performance abilities of healthy (high-functioning) older adults. This paper presents the study protocol and the results from the recruitment phase. A group of 188 healthy older adults aged 65-85 years, recruited at the Medical University of Lodz, Poland, were randomly allocated to the experimental group (VR dual-task training program) or to the control group (using a VR headset app showing nature videos). A total of 3 cognitive exercises were performed in various 360° nature environments delivered via a VR head-mounted display; the participants listened to their preferred music genre. Each patient received 3 sessions of 12 minutes per week for 12 weeks, totaling a minimum of 36 sessions per participant. Attention and working memory (Central Nervous System Vital Signs computerized cognitive battery) were used as primary outcomes, while other cognitive domains in the Central Nervous System Vital Signs battery, quality of life (World Health Organization-5 Well-Being Index), health-related quality of life (EQ-5D-5L), and anxiety (General Anxiety Disorder 7-item questionnaire) were the secondary outcomes. The group-by-time interaction was determined using linear mixed models with participants' individual slopes. In total, 122 (39%) of the initial 310 participants failed to meet the inclusion criteria, resulting in a recruitment rate of 61% (188/310). Among the participants, 68 successfully completed the intervention and 62 completed the control treatment. The data are currently being analyzed, and we plan to publish the results by the end of September 2024. VR interventions have significant potential among healthy older individuals. VR can address various aspects of well-being by stimulating cognitive functions, promoting physical activity, and facilitating social interaction. However, challenges such as physical discomfort, technology acceptance, safety concerns, and cost must be considered when implementing them for older adults. Further research is needed to determine the long-term effects of VR-based interventions, optimal intervention designs, and the specific populations that would benefit most. ClinicalTrials.gov NCT05369897; https://clinicaltrials.gov/study/NCT05369897. DERR1-10.2196/53261.

Effectiveness of combined robotics and virtual reality on lower limb functional ability in stroke survivors: A systematic review of randomized controlled trials.

Lower limb impairments are common consequences of stroke. Robotics and virtual reality (VR) play crucial roles in improving lower limb function post-stroke. This review aims to assess the effects of combined robot and VR interventions on lower limb functional ability poststroke and to provide recommendations for future studies in the rehabilitation field. PubMed, SCOPUS, CINAHL, MEDLINE, EMBASE, and Web of Science were searched from inception to March 1, 2024. Randomized controlled trials (RCTs) involving patients with a stroke, administering combined robot and VR compared with passive (i.e., rest) or active (any intervention), and including at least one outcome evaluating lower limb function (i.e., balance, gait, mobility, muscle tone, muscle strength, range of motion) or activities of daily living were selected. The Cochrane Collaboration tool was employed to evaluate the risk of bias in the included studies. Nine studies met the eligibility criteria. In total, 364 stroke survivors (Mean age 55.62 years) were involved in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," "moderate quality" (n=3), and "low quality" (n=1). There are mixed findings on the effects of combined robot and VR on lower limb functional ability in stroke survivors. The evidence for the effects of combined robot and VR on lower limb functional ability post-stroke is promising. Further trials with long-term follow-up are strongly warranted to understand the immediate and long-term effect of combined robot and VR intervention on various lower limb impairments and to define the optimal treatment protocols.

Nutritional Care for Adults in Nursing Homes: A Scoping Review.

The need for improved nutrition in older adults requiring care has been acknowledged, but, to the best of our knowledge, there is a lack of systematic review and integration of nutritional care studies with older adults in nursing homes. This scoping review aimed to examine the scope and nature of nutritional care research for older adults in nursing homes and to identify research gaps, following the guidelines of the Joanna Briggs Institute. We found varied nutritional care for older adults living in nursing homes, including individualized sessions, such as nutrition counseling, the addition of foods and preparations for increased nutritional intake, and the maintenance of an eating environment, such as feeding assistance and calling. The nutritional care identified in this scoping review also included studies that have improved the nutritional status of older adults in nursing homes by implementing educational programs for care staff. For future research on effective nutritional care for older adults in nursing homes, we suggest evaluating both short- and long-term intervention effects with an adequate sample size.

Examining the long-term effectiveness of a culinary nutrition education intervention on children's dietary practices and variety

Examining the long-term effectiveness of a culinary nutrition education intervention on children's dietary practices and variety

Long-Term Engagement of Patients With Advanced Cancer

The long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown. To evaluate the association of a long-term intervention of a lay health worker-led advance care planning intervention among patients with advanced stages of cancer with overall survival and end-of-life health care use and costs. This follow-up study of the EPAC randomized clinical trial conducted between August 2013 and February 2015 used data from 9.4 years after the first patient was enrolled with a data cut-off date of February 1, 2023. Overall, 213 participants with stage 3 or 4 or recurrent cancer in the US Veterans Affairs Palo Alto Health Care System were included. A 6-month lay health worker-led education and support intervention to assist patients with establishing their end-of-life preferences vs usual care. The outcomes of interest were overall survival, risk of death, restricted mean survival time, and palliative care, hospice, and acute care use in the final 30 days before death for participants who died. Among 213 participants randomized and included in the intention-to-treat analysis, the mean (SD) age was 69.3 (9.1) years; 211 (99.1%) were male, 2 (0.90%) were female. There were no demographic or clinical characteristic imbalances at enrollment. As of February 1, 2023, 188 had died. The intervention group had a 25% reduction in risk of death (hazard ratio, 0.75; 95% CI, 0.56-0.98); more palliative care (44 [50.0%] vs 35 [35.0%]) and hospice use (64 [72.7%] vs 53 [53.0%]); and lower emergency department use (20 [22.7%] vs 47 [47.0%]), hospitalizations (17 [19.3%] vs 46 [46.0%]), and median (IQR) total health care costs (median [IQR], $1637 [$383-$9026] vs $18 520 [$4790-$50 729]) than control group participants. The effects of the lay health worker-led intervention remain durable, with nearly complete follow-up, supporting integration into routine cancer care. ClinicalTrials.gov Identifier: NCT02966509.

Toward Sustainable Diets-Interventions and Perceptions Among Adolescents: A Scoping Review.

Adolescence is an important life stage during which shifts toward more healthy and sustainable diets can be promoted. Adolescents have increasing influence over their food choices, informed by their developing personal knowledge and values, affecting long-term dietary behaviors into adulthood. The recent literature regarding adolescents' (1) perceptions of environmentally sustainable diets and (2) interventions to support adolescents to eat sustainably was reviewed in this study. We reviewed published literature that focused on adolescent participants and their perceptions of, or interventions to support, sustainable dietary habits. Five electronic databases were searched to include studies published since 2012 that met the inclusion criteria, including reporting of participants aged between 11 and 18 years, reporting on adolescents' perceptions of sustainable diets or interventions implemented to improve the sustainability of adolescents' diets, and framed in the context of sustainability. Data were extracted, including study and participant characteristics, methodology, and results in relation to each of the 2 research focus areas. Twenty-eight articles were included in the review. Findings suggest that adolescents' understanding of what constitutes sustainable eating is poor. Adolescents who had previously received education regarding sustainable diets valued nature and health, or were from a rural or indigenous community, were more likely to value environmentally sustainable-food choices. Interventions which target adolescents' understanding of and aspiration to make sustainable-food choices appears to improve their attitudes toward sustainable food, whereas interventions to increase the availability of sustainable foods improved the environmental sustainability of adolescents' dietary intake. Multicomponent, tailored, and community-based interventions were most effective; however, the long-term effect of these interventions remains unclear. More research is needed in low- and middle-income countries, with consideration of adolescents' level of autonomy in food choice in local food environments and the long-term effectiveness of interventions. Systematic Review Registration: Open Science Framework identifier osf.io/h3jz6.

Parental barriers to implementing family-centred care in a neonatal intensive care unit in Islamic Republic of Iran.

Studies have shown short-term and long-term positive effects of family-centred care interventions on neonatal and maternal health, and developmental outcomes in neonatal intensive care units. However, some challenges and barriers limit implementation of family-centred care. To investigate parental barriers to implementing family-centred care in a neonatal intensive care unit in Islamic Republic of Iran. A conventional content analysis was conducted at a neonatal intensive care unit in Tehran, Islamic Republic of Iran from 2020 to 2021. Twenty semi-structured interviews and 9 field notes were conducted. The interview data were analysed using the Graneheim and Lundman method and the demographic data were analysed using SPSS version 21. Two themes emerged from the data analysis. The first theme was "inefficiency of playing the parental role", with 2 main categories of "face unpleasant feelings" and "inappropriate presence and participation". The second theme was "ineffective involvement of parents in the care", with 3 main categories of "lack of effective communication with personnel", "interference of parents in the treatment process", and "given insufficient information by parents". Parental barriers to the provision of family-centred care featured prominently in the study. Therefore, to improve neonatal and family health, there is a need for involvement, coordination and effective communication between the medical teams and parents to create a supportive and friendly environment in neonatal intensive care units.

The effect of replacing sedentary behavior with different intensities of physical activity on depression and anxiety in Chinese university students: an isotemporal substitution model

BackgroundPrevious research has suggested that engaging in regular physical activity (PA) can help to reduce symptoms of depression and anxiety in university students. However, there is a lack of evidence regarding the impact of reducing sedentary behavior (SB) and increasing light-intensity PA (LPA) on these symptoms. This study aims to address this gap by using isotemporal substitution (IS) models to explore how substituting SB with LPA or moderate-to-vigorous PA (MVPA) affects depression and anxiety symptoms among university students.MethodsThe study recruited 318 university students with a mean age of 21.13 years. Accelerometers were used to objectively measure the time spent on SB, LPA, and MVPA, while depression and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Self-rating Anxiety Scale (SAS). IS models using multivariable linear regression were employed to estimate the associations between different behaviors and depression and anxiety symptoms when 30 min of one behavior was substituted with another.ResultsIn the single-activity model, less SB (β = 0.321, 95% CI: 0.089, 1.297) and more MVPA (β = −0.142, 95% CI: −1.496, − 0.071) were found to be significantly and negatively associated with depression scores, while less SB (β = 0.343, 95% CI: 0.057, 1.014), LPA (β = 0.132, 95% CI: 0.049, 1.023), and more MVPA (β = −0.077, 95% CI: −1.446, − 0.052) were significantly and negatively correlated with anxiety scores. The IS analysis revealed that substituting 30 min of SB with LPA (β = −0.202, 95% CI: −1.371, − 0.146) or MVPA (β = −0.308, 95% CI: −0.970, − 0.073) was associated with improvements in depressive symptoms. Substituting 30 min of SB with MVPA (β = −0.147, 95% CI: −1.863, − 0.034) was associated with reduced anxiety symptoms.ConclusionReplacing 30 min of SB with MVPA may alleviate depression and anxiety symptoms in university students. Further research is needed to explore the long-term effects of PA interventions on the mental health disorders of this population.

Recurrence of sleep apnea in children after intracapsular coblation tonsillectomy: A comprehensive exploration of tonsil regrowth

ObjectivesSleep apnea is a prevalent issue in children, associated with significant morbidities such as cardiovascular and neurocognitive disorders. There is increasing interest in intra-capsular tonsillectomy by coblation (ICTC) as a method to address obstructive sleep apnea (OSA) in children. However, the literature remains controversial regarding the most effective intra-capsular tonsillectomy (ICT) technique with the least morbidity. Our current research extends a previous study that established the effectiveness and safety of ICTC, demonstrating rapid post-surgical recovery with minimal analgesic needs. This new investigation specifically focuses on long-term follow-up. Our aim is to assess tonsil regrowth and the risk of recurrence of OSA symptoms at a mean follow-up of 6.1 years post-surgery. By presenting the results of this extended study, our goal is to gain a better understanding of the long-term effectiveness of this surgical intervention in treating OSA in children. Thus, considering the initial benefits, we will also explore potential long-term implications. Materials and methodsThis research follows up on children from our previous study who underwent ICTC, with or without adenoidectomy, for OSA resulting from tonsillar hypertrophy at a tertiary-level university hospital between March 2016 and March 2018. They were followed up for an average of 6.1 years postoperatively. Symptom recurrence is assessed by comparing preoperative OSA-18 questionnaire results with those obtained at the 6.1-year mark. Tonsil regrowth is evaluated by comparing preoperative Brodsky scores with those obtained at 6.1 years. ResultsThe mean total score of OSA-18 significantly decreased from 79.41 (SD = 14.95) before ICTC to 25.47 (SD = 8.92) at 6.1 years postoperatively (p < 0.001, mean difference = 53.94, 95 % CI [50.32, 57.56]). Similarly, the mean Brodsky score dropped from 2.95 (SD = 0.51) before ICTC to 1.04 (SD = 0.24) 6.1 years postoperatively (p < 0.001, mean difference = 1.92, 95 % CI [1.80, 2.04]). The overall regrowth rate was 2.35 % (n = 2), with a revision surgery rate of 1.18 % (n = 1). ConclusionICTC exhibits minimal risk of tonsil regrowth and maintains long-term efficacy in preventing the recurrence of OSA symptoms. Therefore, it justifies broader utilization in addressing OSA symptoms arising from tonsillar hypertrophy in children.

Assessment of Nurses’ Knowledge, Attitude and Practice Regarding Physical Restraint: A Scoping Review

The use of physical restraints (PR) in healthcare settings, especially in psychiatric units, is a controversial topic. The attitude, knowledge, and practices of nurses towards PR can influence its application, which raises concerns about the balance between patient safety and individual rights. With mental disorders being a leading cause of disability globally, understanding the complexities surrounding PR use becomes paramount. A comprehensive literature review was conducted using multiple databases, including PubMed, Medline, CINAHL, PsycINFO, ProQuest, The Cochrane Library, the Saudi Digital Library, and Google Scholar. The search spanned literature published up to December 2022, focusing on studies that explored the relationship between nurses’ knowledge, attitudes, and practices regarding PR in psychiatric settings. Inclusion and exclusion criteria were applied to filter out relevant studies. From 220 records initially retrieved, 12 articles were identified for the final review. The reviewed studies highlighted a moderate knowledge and attitude among nurses concerning PR. Many nurses were found to be uncertain about the reasons for PR application and its alternatives. Educational interventions were emphasized in several studies as beneficial in improving nurses’ knowledge, attitudes, and practices. However, inconsistencies were observed regarding the impact of these interventions on nurses’ attitudes. Experience, higher education, and continuous training sessions were found to be correlated with better knowledge and more favourable attitudes towards PR. This review emphasizes the critical need for consistent training and education for nurses regarding PR, given the profound implications for patient care and safety. While educational interventions show promise in enhancing knowledge and practice, their impact on attitudes remains contested. Future research should consider the gaps identified in this review, including the exploration of alternatives to PR, larger sample sizes and longitudinal studies to understand the long-term effects of interventions.

Long-term sustained effects of the Look AHEAD lifestyle intervention on body composition among adults with type 2 diabetes.

The objective of the study was to test whether there are sustained effects of the Look AHEAD intensive lifestyle intervention (ILI), versus diabetes support and education (DSE), on weight and body composition 12 to 16 years after randomization. Participants were a subset of enrollees in the Look AHEAD dual-energy x-ray absorptiometry substudy who completed the final visit, composed of men (DSE = 99; ILI = 94) and women (DSE = 134; ILI = 135) with type 2 diabetes and mean (SD) age 57.2 (6.4) years and BMI 34.9 (5.1) kg/m2 at randomization. Dual-energy x-ray absorptiometry measured total and regional fat and lean masses at randomization, at Years 1, 4, and 8, and at the final visit. Linear mixed-effects regressions were applied with adjustment for group, clinic, sex, age, race/ethnicity, and baseline body composition. Weight and most body compartments were reduced by 2% to 8% (and BMI 4%) in ILI versus DSE in men but not women. ILI-induced loss of lean tissue did not show a lower percent lean mass versus DSE at 16 years after randomization. ILI-related changes in weight, fat, and lean mass were detectable 12 to 16 years after randomization in men but, for unknown reasons, not in women. There was no evidence that the intervention led to a disproportionate loss of lean mass by the end of the study.

Long-term effects of early-life education intervention on children’s outcomes: Evidence from school consolidation in rural China

Government commitment to early-life education intervention has contributed to human capital accumulation and economic growth in developing countries. Using data from the China Family Panel Studies, we investigate the effects of the primary school consolidation program on children’s cognitive development and behavioral performance. Using a cohort difference-in-differences model, we find that rural children who experienced school consolidation performed better in cognitive tests and had higher levels of openness of the Big Five personality traits, but lower levels of extraversion. Further analysis suggests that early-life education intervention generates long-term effects. Those who experienced school consolidation had higher educational attainment, better occupational fit, and more consistent independent learning, but difficulties in interpersonal interaction. Our findings imply that early-life education intervention should pay more attention to the cultivation of socio-emotional abilities.