Long-term Effects Of Interventions Research Articles

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 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.

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.

Long-term effects of a preventive intervention on multiple components of adolescents' emotional insecurity.

A gap in research on family interventions is the understanding of long-term effects on hypothesized mechanisms of effect regarding children's processes of responding to family stressors. This study assessed the long-term effects of an intervention designed to improve interparental and family conflict resolution on adolescents' emotional insecurity about interparental conflict. Emotional insecurity about interparental conflict has long been linked with adolescents' risk for adjustment problems. These findings have motivated the development of several family-based preventive interventions, one of which is the focus of this study. A community sample of 225 adolescents and their parents participated in an RCT-based study of an intervention designed to reduce adolescent's emotional insecurity about interparental conflict. The intervention's effect on patterns of change in adolescents', mothers', and fathers' reports of the three components of adolescents' emotional insecurity (emotional reactivity, behavioral dysregulation, and cognitive representations) from posttest through the 3-year follow-up were examined using multilevel modeling. Results suggested that the intervention predicted immediate (pre to posttest) and long-term linear decreases in emotional reactivity, as well as long-term quadratic change in behavioral dysregulation. These findings support the beneficial effects of a brief intervention on multiple components of emotional security. The results also underscore the importance of considering the potential of long-term (including nonlinear) patterns of change that may occur as a function of family-based interventions, as well as that the impact of family-based interventions may vary as a function of reporter and component of emotional insecurity.

Long-Term Effect of a Tablet-Based Cognitive Behavioral Group Intervention on Step Count, Fatigue, Self-Efficacy, and Quality of Life in Older Adults With Arthritis: A Pilot Study.

To evaluate the long-term effect of a tablet-based, cognitive-behavioral group intervention (Tab-G) to improve daily walking for older adults with arthritis. Using an experimental pretest/posttest repeated measure design, long-term effects on step count, fatigue, self-efficacy, and quality of life (QOL) were investigated. Results of repeated measures analysis of variance showed significant improvement in step counts (F[1, 37] = 4.18, p = 0.048), fatigue (F[1, 36] = 9.971, p = 0.003), self-efficacy (F[1,28] = 4.645, p = 0.04), and QOL (F[1, 29] = 6.147, p = 0.019) in the Tab-G group compared to the control group. There were significant time effects across four time points (baseline and Weeks 4, 8, and 10) in fatigue (F[3, 108] = 5.43, p = 0.002), self-efficacy (F[3, 84] = 5.433, p = 0.002), and QOL (F[3, 87] = 3.673, p = 0.015), but not in step counts (F[3, 111] = 0.611, p = 0.609). Findings demonstrate positive long-term effects on fatigue in older adults with arthritis. [Journal of Gerontological Nursing, 50(5), 35-42.].

Comparison of Long-Term Outcomes of Surgical Treatment of Human Papillomavirus-Dependent Neoplastic Lesions in Patients With Chronic Immunosuppression After Allogenic Organ Transplantation and Patients With Primary or Acquired Immunodeficiency—A One-Center Experience

Immunodeficiency predisposes to severe manifestations of human papillomavirus (HPV) infection, including extensive, recalcitrant anogenital lesions and their progression towards carcinomas. This holds for primary and acquired immunodeficiencies, and post-transplant immunosuppressive therapy. About 50% to 90% of patients receiving chronic immunosuppression after allogenic transplantation develop HPV-associated lesions within 4 to 5 years, comprising 10% to 15% of patients presenting with (pre)cancerous HPV-dependent anogenital lesions. Immunodeficiency is one of the highest risk factors associated with severe clinical manifestations of HPV-associated cancers. The primary objective of this work is to compare the long-term therapeutic effectiveness of surgical intervention for HPV-dependent lesions in transplant recipients undergoing chronic immunosuppression and patients burdened with primary or acquired immunodeficiencies. Two groups of 30 patients (selected for most extensive presentations of HPV-dependent neoplastic anogenital lesions), who underwent surgical treatment of these lesions were followed up for 3 to 5 years. The first group comprised patients who qualified and underwent kidney or liver transplantation (10 for a rare disease indication) and are under chronic immunosuppressive regimens. The second group comprised patients burdened by primary or acquired immunodeficiency (15 each). The recurrence rate in the follow-up period was the primary compared parameter. The recurrence rate was higher in the second group, amounting to >15%. For the first group a <5% recurrence rate was observed for recipients without rare disease indications, compared to <15% for recipients with such indications. The importance of rapid surgical intervention and the need for postoperative monitoring for recurrence is highlighted. Chronic immunosuppression demonstrates high relative safety and efficacy in terms of HPV-dependent anogenital lesion recurrence.

Imagining a better world: assessing the immediate and delayed effects of imagined contact on attitudes toward refugees in elementary school.

Preparing host-society children for contact with refugees coming into their classes poses a new and important challenge for countries with little prior experience in integration. Imagined contact is a prejudice-reduction intervention that can be particularly useful in this context. However, its long-term effects and potential age-related variations in its efficacy among primary school children remain understudied. This study investigated the short-term and long-term effects of an imagined contact school intervention on the change in attitudes and contact intentions of 1,544 children aged 7-15. Of these, 827 participated in a four-session-long intervention delivered by their teachers within their regular classes, while 717 served as a comparison group. Short-term effects were assessed approximately one week after the last intervention session, with long-term effects evaluated around two and a half months later. Our findings indicate that the imagined contact intervention instigates positive changes in intergroup attitudes and contact intentions in both the short term and long term, but only for the children in the lower grades of primary school. While the durability of these effects among younger participants holds promise for future use of imagined contact in schools, we also scrutinize potential developmental and methodological explanations of the absence of expected intervention effects among older children.

Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication—a sub-study of the VIPVIZA RCT

BackgroundPeople with intermediate CVD risk constitute most of the population. Within this group, the proportion of events is lower compared to the high-risk group, but they contribute with the largest absolute number of events. Atherosclerosis is a dynamic process and progression can be slowed or even reversed with medication and lifestyle changes, but adherence to prescribed treatment is crucial.AimTo investigate the long-term effects of interventions with pictorial risk communication of cardiovascular (CVD) risk on average adherence in a group of statin users. Compare response in adherence over time between men and women after intervention.MethodsParticipants on active statin treatment were followed up to 5 years after being randomly assigned to an intervention program aimed at raising CVD risk awareness among participants and their physicians. Merging prescribed medication databases with VIPVIZA study to study adherence over time. A moving average adherence was used to compare groups.ResultsGenerally, the average adherence to statins among the 512 participants was high. Men had a higher average adherence over time, while women had a sharper increase in adherence in conjuncture with the intervention program.ConclusionsBoth men and women were receptive to pictorial information regarding CVD risk, but the intervention effect was more pronounced in women. Sex differences are important when considering risk communication strategies. Periodically repeating the intervention was beneficial for maintaining the intervention effect over time.Trial registrationThe VIPVIZA study is registered with ClinicalTrials.gov, May 8, 2013, number NCT01849575.