Long-term Effects Of Interventions Research Articles

The effectiveness of using artificial intelligence in improving academic skills of school-aged students with mild intellectual disabilities in Saudi Arabia

What This Study AddsTeaching academic skills to students with intellectual disabilities can be a challenge for educators. This study explored the role of AI in the field of special education and provided a novel framework for educational integration of children with mild ID. Interestingly, it demonstrated that using AI-driven interventions could significantly improve academic skills and lead to better learning outcomes. This is crucial, as the holistic approach associated with the "whole child" model of education is prevalent due to the challenges students with ID face in social interactions typically involved in academic socialization. BackgroundIntellectual disabilities (ID) are neurodevelopmental disorders that hinder learning, communication, and daily functioning. It negatively impacts learning of academic skills such as match and reading skills. Artificial intelligence (AI) may offer opportunities for these students to improve their academic performance. AimsTo investigate the effectiveness of using AI in improving academic skills in a sample of seventy boys aged 9–12 with mild ID. They were enrolled into special education programs integrated into public schools in the Jeddah region of Saudi Arabia. MethodsParticipants were randomly assigned to an experimental and control group. The experimental group received ten 60-minute sessions twice weekly during five weeks, utilizing AI to personalize their academic skills activities. The control group received the educational program without the AI. All participants completed the Woodcock-Johnson IV-achievement test at pre-intervention, post-intervention, and one-month follow-up. ResultsThe experimental group demonstrated significant and sustained improvements in academic performance across all measured domains compared to the control group, with effect sizes ranging from moderate (η² = 0.685) to large (η² = 0.921), underscoring the efficacy of the intervention at post-intervention. Conclusions and ImplicationsThis study sheds light on the promise of applying AI tools in special education to respond to distinctive needs experienced by students with mild ID. Future studies should investigate the long-term effects of such interventions and their broader applications across diverse educational contexts for inclusive learning.

School-age growth and development following infant feeding and/or water, sanitation, and hygiene interventions in rural Zimbabwe: long-term follow-up of a cluster-randomised trial

Few trials have explored long-term effects of interventions designed to reduce child stunting. We evaluated school-age outcomes in rural Zimbabwean children who received cluster-randomised water, sanitation and hygiene (WASH) and/or infant and young child feeding (IYCF) interventions from pregnancy up to 18 months of age. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial enrolled pregnant women from two rural Zimbabwean districts (Chirumanzu and Shurugwi) between 2012 and 2015, and cluster-randomised them using a 2×2 factorial design to standard-of-care, WASH, IYCF, or combined WASH & IYCF, with a co-primary outcome of height-for-age Z-score and haemoglobin at 18 months (clinicaltrials.govNCT01824940). Children who were HIV-unexposed, age 7 years, and still living in Shurugwi district were eligible for this follow-up study (registered at PACTR 202201828512110) and measured between 1st April 2021 and 30th September 2022. The primary outcome at 7 years was cognitive function using the Kaufman Assessment Battery for Children (KABC-II). Secondary outcomes were executive function, literacy and numeracy, fine motor skills, socioemotional function, handgrip strength, broad jump distance, shuttle-run test distance, anthropometry, lean mass index, and skinfold thicknesses. Study nurses conducting assessments were blinded to intervention arm. Analysis followed a pre-registered statistical analysis plan. Intention-to-treat analyses using generalized estimating equations were used to assess the long-term effects of WASH and IYCF on each outcome, leveraging the factorial trial design. A pre-specified subgroup analysis by child sex was also performed. Among 3989 HIV-negative women, 3676 children were assessed at age 18 months; of these, 1002 (510 female) were assessed at mean (SD) age 7.3 (0.2) years. There was no effect of IYCF or WASH on the KABC-II score or secondary cognitive outcomes, except a small improvement in socioemotional function in WASH arms (-0.98 points, 95% CI-1.73,-0.22, p=0.01). Children in IYCF arms had higher handgrip strength (0.28Kg, 95% CI 0.02, 0.53, p=0.03); however, in the pre-specified subgroup analysis, improved handgrip strength was seen only in boys (0.53Kg, 95% CI 0.19, 0.87 p=0.002). There were no significant effects of either intervention on other outcomes. Early-life IYCF and WASH led to few functional benefits by school-age. Interventions that are more comprehensive, delivered for longer, and include nurturing care should be considered to improve long-term cognitive and physical function. Wellcome [220671/Z/20/Z, 108065/Z/15/Z]; NIH [R61HD103101]; Thrasher [15250]; and IMMANA [3.02].

Impact of complete revascularization on long-term clinical outcomes in patients with multi-vessel disease, including chronic total occlusion.

To compare the long-term prognostic effect of complete percutaneous coronary intervention (PCI) on cardiovascular events in chronic total occlusion (CTO) patients with the multi-vessel disease (MVD) compared with medical therapy (MT). We enrolled 441 patients with CTO and MVD who underwent PCI. The study population was divided into the CTO-PCI (n = 231) and the CTO-MT (n = 210) groups. Active PCI for non-CTO lesions was permitted in both groups. The primary endpoint was defined as the composite of all-cause death or myocardial infarction (MI). The primary endpoint occurred more frequently in the CTO-MT group (13.5%) than in the CTO-PCI group (4.7%; P = 0.002). However, the target vessel revascularization (TVR), as a secondary endpoint, occurred more in the CTO-PCI group (16.3% vs. 5.5%, P = 0.001). After propensity score matching (PSM) analysis, the primary endpoint was higher in the CTO-MT group (12.6%) than in the PCI group (2.3%): all-cause death (8.4% vs. 2.3%, P = 0.042) and MI (4.3% vs. 0.0%, P = 0.023). Moreover, TVR of the CTO lesions occurred more frequently in the CTO-PCI group (18.1% vs. 6.8%, P = 0.009). Significant improvement in the left ventricular ejection fraction (LVEF) was observed in both groups. According to the results of the subgroup analysis, CTO-PCI may be more effective in patients with diabetes, preserved LVEF (> 50%), and well-developed collateral vessels (> grade II). In this study, complete revascularization in CTO with MVD reduced the incidence of all-cause death, MI, and a composite of both over a 5year follow-up compared to medical treatment for CTO lesions.

Challenges of Providing Transitional Care and Empowerment for Individuals with Intellectual Disabilities (ID): A Qualitative Study of Families’ Experiences through Guardian Interviews

This study aimed to explore the challenges and strategies associated with transitional care for individuals with intellectual disabilities (ID) through interviews with 12 guardians. The research identified key issues including system fragmentation, the inadequacy of tailored services, and the critical role of informal support networks. Findings reveal that guardians experience significant difficulties navigating a fragmented care system and face challenges in accessing services that meet their loved ones' specific needs. Despite these obstacles, guardians employ proactive strategies, such as developing personalized care plans and fostering independence and self-advocacy, to manage the transition effectively. The study emphasizes the need for integrated care models and tailored support services, as well as support for guardians in care planning. It also highlights the importance of strengthening informal support networks. Limitations include the small sample size and reliance on self-reported data, which may impact the generalizability of the findings. Future research should explore broader populations and conduct longitudinal studies to assess the long-term effectiveness of transitional care interventions. Overall, this study has provided valuable insights for improving transitional care programs and supports the development of more coordinated, responsive, and personalized care strategies for individuals with ID.

NEUROSCIENCE AND LATE LITERACY: NEW INSIGHTS FOR PEDAGOGICAL PRACTICES

This research investigated the intersection between neuroscience and late literacy, focusing on how neuroscientific advances can inform and improve pedagogical practices in this context. The central problem analyzed was how neuroscience knowledge can be applied to improve literacy processes in young people and adults. The overall objective was to examine the contributions of neuroscience to the development of effective strategies for late literacy, considering the neurological specificities of this population. The methodology used was a systematic literature review, with a qualitative approach, analyzing recent publications in cognitive neuroscience, youth and adult education, and literacy methodologies. The results indicated that understanding the neural mechanisms involved in learning to read and write in adults can support more efficient pedagogical practices. Insights on neural plasticity, phonological processing, and memory strategies specific to late learners stood out. The research highlighted the importance of multisensory and contextualized approaches, considering the previous experiences of the students. The final considerations pointed to the need for greater integration between neuroscience and education in the training of literacy teachers, as well as the development of methodologies adapted to the neurocognitive particularities of young people and adults in the process of learning to read and write. Longitudinal studies were recommended to evaluate the long-term effectiveness of neuroscience-based interventions in late literacy.

A Systematic Review of the Long-term Efficacy of Physical Activity Interventions in Reducing Risk Factors for Obesity in Adults

Background: Regular physical activity (PA) provides numerous health advantages, including lowering mortality rates and preventing obesity. Despite well-established guidelines advising 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic PA weekly, sedentary lifestyles remain prevalent, especially in industrialised nations. This systematic review examines the long-term effectiveness (12-24 months) of PA interventions aimed at reducing obesity risk among adults, with a particular focus on identifying strategies that promote sustained adherence. Methods: A comprehensive literature search was performed using multiple databases, including Cochrane Library, PubMed, and Embase, focusing on studies published between January 2004 and January 2024. The inclusion criteria focused on randomised controlled trials and similar designs targeting healthy adults, with interventions promoting sustained PA. Primary outcomes assessed were long-term PA adherence, reductions in obesity rates, and improvements in physical and metabolic health. Results: Twenty-one studies met the inclusion criteria, covering a range of intervention strategies. Most interventions featured structured PA programmes, often with personalised components and ongoing support. Several high-quality studies demonstrated long-term PA adherence, increased weekly energy expenditure, and improvements in fitness. However, adherence rates varied, with participants meeting recommended PA levels ranging from 4.6% to 81%. The meta-analysis showed a small to moderate positive effect of PA interventions on outcomes like PA levels and weight loss, with an effect size of 0.37 (CI: 0.25-0.50). Discussion: The results highlight the need for tailored, culturally sensitive interventions, particularly for vulnerable populations. Long-term PA adherence is stronger in older adults than middle-aged ones, but the sustainability of these effects remains unclear, warranting further research

Long-term effectiveness of SBIRT by outreach visits on subsequent alcohol treatment utilization among inpatients from general hospital: a 36-months follow-up

Aim To investigate the long-term effect of Screening, Brief Intervention, and Referral to Treatment (SBIRT) on alcohol treatment utilization among general hospital inpatients. Methods This 36-month follow-up of a randomized controlled trial included general hospital inpatients who were screened using the Alcohol Use Disorder Identification Test (AUDIT). Patients with an AUDIT score of 8+ were included. Patients were randomized to either SBIRT (Relay) or treatment as-usual (TAU). Outcome was attendance at a specialized outpatient treatment institution or prescription of pharmacological alcohol treatment in general practice. Using the Danish Civil Registration System, patients were followed in the Danish National Patient Registry, Danish National Alcohol Treatment Register, and the Danish National Prescription Registry. Data was collected up to 36 months after discharge. Results The study population consisted of 258 patients in the Relay group and 303 patients in the TAU group. In the Relay group, 36 (14.0%) patients received treatment versus 23 (7.6%) in the TAU group. Patients in the Relay group had higher odds for receiving treatment compared to the TAU group (OR: 1.97, 95% CI: 1.1–3.4, p = 0.01). Significantly more patients in the Relay group scored 16+ on the AUDIT and had already tried to change their alcohol consumption (both p < 0.01). Adjusted for potential confounders, the effect of the Relay intervention was reduced (OR: 1.37, 95%CI: 0.7–2.5, p = 0.31). Conclusions This study did not find evidence that SBIRT is better than TAU at sustaining significant long-term alcohol treatment utilization after discharge among inpatients from general hospital.

Healthcare workers’ knowledge and preparedness for unprecedented foodborne botulism outbreak in Saudi Arabia

BackgroundThe recent unprecedented foodborne botulism outbreak in Saudi Arabia necessitated an assessment of healthcare workers' (HCWs) knowledge, attitudes, and practices (KAP). This study assessed healthcare workers' knowledge regarding the transmission, contagiousness, presentation, and diagnosis of foodborne botulism, as well as their management practices, including contacting public health authorities, administering antitoxin, preparedness to respond to botulism cases and consulting generative Artificial Intelligent (AI)-chatbots, like ChatGPT. MethodsA cross-sectional online survey targeting Saudi HCWs was conducted from May 6–19, 2024, following the first foodborne botulism outbreak. The survey, developed by infectious disease and public health experts according to the Saudi Public Health Authority (SPHA) botulism guidelines, covered several sections: demographics, knowledge about foodborne botulism, attitudes and perceptions, intended practices, and worry level. Statistical analysis included descriptive statistics, multivariable linear regression to assess factors influencing knowledge, and multivariable logistic binary regression to evaluate factors affecting confidence in handling botulism. ResultsAmong the 1058 participants, the knowledge score was 9.69/20 (48.4 % correct ± 18 %), with higher scores among HCWs working in tertiary centers, older than 34 years, reading SPHA botulism protocol, and using scientific journals as main information sources. HCWs consulting ChatGPT had significantly lower knowledge scores (p-value < 0.001). HCWs displayed highly intended practices in managing botulism, with a mean score of 4.10/5. The self-rated management confidence was moderate (2.84 ± 1.05 out of 5-points). Multivariable logistic binary regression showed that previous experience with botulism and reading SPHA protocol were the most significant factors associated with a higher management confidence. ConclusionsThis study highlights significant HCWs’ knowledge gaps during unprecedented foodborne botulism outbreak. Previous experience with botulism cases and reading recent guidelines were associated with higher knowledge and confidence, while reliance on ChatGPT was linked to lower scores. This study emphasizes the importance of timely publishing local guidelines to favorably affect both knowledge and confidence to deal with infectious outbreaks. Future research should evaluate long-term effectiveness of educational interventions.

Long-term effects of non-pharmacological interventions in adolescents and young adults with type 1 diabetes: A systematic review and meta-analysis.

Consistent diabetes control is crucial for patients with type 1 diabetes (T1D) to prevent diabetic complications. Analyzing the long-term effects of non-pharmacological interventions can improve diabetes management. To examine the long-term effects of non-pharmacological interventions in adolescents and young adults with T1D through a systematic review and meta-analysis of randomized controlled trials (RCTs). The searches, without any year limitations, were conducted in seven databases. Two reviewers independently performed data extraction and risk of bias assessments. The meta-analysis was conducted using the RevMan 5.4 program and R Studio. The study was registered with PROSPERO (CRD42024503185). A total of 40 studies were included in the systematic review, of which 28 were included in the meta-analysis. Notably, non-pharmacological interventions were effective in improving glycated hemoglobin (HbA1c) at 6 months and self-care at >12 months of follow-up. Subgroup analyses revealed that combined interventions encompassing self-care behavior management, education, and psychological interventions could enhance self-care. Additionally, a combination of face-to-face and telephonic communication was effective in improving HbA1c. Non-pharmacological interventions are effective in improving HbA1c levels and self-care in adolescents and young adults undergoing long-term treatment. However, few studies have analyzed their effects on cardiovascular disease risk factors. Future studies should investigate the long-term effects of non-pharmacological interventions.

Effect of exercise referral schemes and self-management strategies on healthcare service utilisation among community-dwelling older adults: secondary analyses of two randomised controlled trials.

The objective of this study is to explore whether offering an integrated self-management strategy and exercise referral scheme intervention (ERS+SMS) or a stand-alone ERS intervention is more effective in reducing healthcare service utilisation among community-dwelling older adults over time compared with a stand-alone SMS/control intervention. Secondary analyses of two randomised controlled trials (RCTs) with linkage to Danish national health registries. Three Danish municipalities: Esbjerg, Slagelse and Odense. Danish community-dwelling older adults, aged 65 years or older, were included in the study. Participants originated from two completed RCTs: the Welfare Innovation in Primary Prevention (WIPP, n=115) and the SITLESS project (SITLESS, n=333). Participants in the two trials were randomly assigned to one of three intervention groups: ERS in combination with SMS (ERS+SMS), ERS alone or an SMS/control intervention. Annual number of days with contact to general practice (GP) and days hospitalised for all causes. No statistically significant between-group difference was observed in the annual number of days with contact with GP between participants randomised to ERS+SMS (p=0.759) or ERS only (p=0.156) compared with those randomised to the SMS/control group. In addition, no statistically significant between-group differences in days hospitalised were observed when comparing the ERS+SMS (p=0.222) or ERS only (p=0.060) group to the SMS/control group. Neither the integrated intervention (ERS+SMS) nor the ERS alone intervention was more effective in reducing healthcare service utilisation during a 2-year follow-up period compared with a stand-alone SMS/control intervention. A potential stabilising effect of ERS and/or SMS interventions on the general age-related increase in healthcare service utilisation cannot be ruled out but needs further exploration in future studies along with the exploration of the effects of long-term interventions. NCT04531852 : and : NCT02629666 : .

Effects of early childhood growth and development interventions on children less than two years of ag.

The objective of this study was to determine the effects of early childhood growth and development interventions on children under two years of age. We used PubMed, Science Direct, Scopus, Springer Link, and Wiley to select studies that explored the effects of interventions on the growth and development of children under two years published growth from January 2015 to December 2023. The study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We found 1235 articles, while 26 articles were analyzed thematically. The thematic areas included: impact of intervention, health services implemented, and growth and development of children under two years of age. The results show that providing early and comprehensive education, health and social services has an impact on the growth and development of children under two years of age. Further studies regarding the long-term impact and effectiveness of interventions designed to improve the growth and development of children under two years of age are required.

Long-term effects of a school-based experiential nutrition education intervention

ABSTRACT Nutrition education is essential for the development of healthy eating behaviours among children. Over the past few years, multiple nutrition education programmes have been implemented in primary schools. In the current study, the long-term effects of the experiential nutrition education programme ‘Learning Street’ are assessed. This 3-week programme comprises a classroom-based introduction lesson, a visit to a fruit or vegetable (FV) farmer, a cooking workshop, and a joint eating moment. The programme is designed for children aged 8–12 years. Questionnaire outcomes of 11-to-12-year-old children (n = 87) who participated in a Learning Street programme two years before were compared to those of a control group (n = 102) with similar demographics. The questionnaire included questions on children’s FV knowledge, liking, intake, and attitude, as well as their general health attitude, cooking self-efficacy, and cooking attitude. There was a significant difference in FV attitude (Cohen’s d = 0.55; 95% CI: −0.69 to −0.21) and general health attitude (Cohen’s d = 0.37; 95% CI: −0.56 to −0.07) between the intervention and the control groups. For general health attitude, the difference was only significant for a subgroup of children (n = 25) who had participated in two Learning Street programmes. The findings suggest that regularly exposing children to experiential nutrition education may have long-term benefits.

Rodent Model of Cardiopulmonary Bypass Demonstrates Systemic Inflammation and Neuromarker Changes

IntroductionThe physiologic derangements imposed by cardiopulmonary bypass (CPB) can result in complications such as postoperative delirium. We aim to validate a rodent survival model of CPB demonstrating a systemic inflammatory response and hypothesize that this contributes to post-CPB delirium. MethodsAdult Sprague–Dawley rats were randomized to three groups: 1) Sham peripheral surgical cannulation, 2) CPB followed by acute phase harvest, or 3) CPB followed by 24-h survival. CPB was carried out for 60 min before decannulation and weaning from mechanical ventilation. Physiological and biochemical endpoints were compared between groups. Gene expression analysis of hippocampal tissue was performed using quantitative RT-PCR panels and protein expression levels were confirmed with Western blot. ResultsSixteen animals underwent cannulation and were successfully decannulated without transfusion requirement or inotrope use with one procedure-related mortality. Serum acute phase proinflammatory chemokines cytokine-induced neutrophil chemoattractant 1, cytokine-induced neutrophil chemoattractant 3, fractalkine, and lipopolysaccharide-induced CXC chemokine as well as interleukin (IL)-10 were increased 1 h following CPB compared to sham (P < 0.05). Significant changes in hippocampal expression of biomarkers apolipoprotein 1, vascular epithelial growth factor A, and synapsin 1 were demonstrated following CPB. ConclusionsThis study validated a model of CPB that captures the resultant systemic inflammatory response, and identified differentially expressed proteins that may be associated with brain injury. Modulation of the CPB-induced inflammatory response may be a promising therapeutic target to attenuate post-CPB delirium, and this survival rat model of CPB with low surgical attrition will allow for more comprehensive evaluations of the short- and long-term effects of both CPB and potential therapeutic interventions.

The Impact of Macronutrient and Dietary Patterns on Gestational Diabetes Mellitus

Pregnancy is a physiological condition that increases insulin resistance (IR) due to hormonal changes, including elevated levels of estrogen, progesterone, and human placental lactogen (HPL). Such IR, especially in the later stages of pregnancy, can cause gestational diabetes mellitus (GDM), characterized by glucose intolerance first detected during pregnancy. GDM poses significant health risks for both the mother and the fetus, including the potential for pre-eclampsia, emergency C-sections, and type 2 diabetes (T2D) for the mother, as well as preterm birth, hypoglycemia, and being large for gestational age (LGA) for the baby. Proper dietary modifications can help regulate blood sugar levels, improve insulin sensitivity, and ensure healthy gestational weight gain (GWG), thereby reducing the possibility of undesirable outcomes. This paper discusses the role of energy, carbohydrate, fat, and protein, and compares the effects of the Mediterranean diet (MD) and Western diet (WD) on the risk of GDM. The main objective of this paper is to identify the most effective dietary strategies for preventing and managing GDM. The finding indicates that a MD rich in nutrient-dense foods, complex carbohydrates/lower GI, unsaturated fatty acids (FAs), and balanced protein has beneficial effects on GDM. In contrast, the WD with empty calories, simple carbohydrates/higher glycemic index (GI), saturated FAs (SFA), and animal-based protein increases the risk of GDM. Future studies should continue to explore the long-term effects of dietary interventions, integrate other lifestyle factors, and consider genetic differences to provide comprehensive management strategies for GDM.

Mental health and well-being in prisons and places of detention.

This study aims to address the critical mental health challenges faced by individuals in prisons and places of detention. By introducing and validating a novel conceptual framework that integrates social determinants of health with the stress process model, this study aims to provide actionable insights for improving mental health care in correctional settings. The research seeks to inform policymakers, prison administrators and mental health professionals about effective interventions and systemic reforms that can reduce recidivism, enhance rehabilitation and promote a more humane and just criminal justice system. This study uses a multi-method research design integrating a systematic literature review, qualitative interviews, multi-criteria evaluation (MCE) and a small-scale empirical study within a correctional facility. The systematic review follows PRISMA guidelines, analysing peer-reviewed articles, government reports and policy documents. Semi-structured interviews with 25 mental health professionals provide practical insights, whereas the MCE assesses intervention effectiveness based on expert consensus. The empirical study involves baseline assessments, intervention implementation and follow-up evaluations using validated tools, providing robust data to validate the proposed conceptual framework that integrates social determinants of health with the stress process model. This study finds that mental health disorders are significantly more prevalent in prison populations than in the general population, with interventions like cognitive behavioural therapy (CBT), peer support programs and trauma-informed care showing considerable effectiveness in reducing symptoms. Emerging technologies such as AI and telemedicine present promising avenues for enhancing care but require careful ethical consideration. The research also highlights the critical role of social determinants and the importance of systemic reforms, such as reducing solitary confinement and integrating prison health care with broader public health systems, in improving inmate mental health and reducing recidivism. This study's quasi-experimental design, while robust, may limit the generalizability of the findings to other correctional settings because of specific facility characteristics. Additionally, the sample size for qualitative interviews, although diverse, could have been larger to provide more nuanced insights, particularly for underrepresented groups. This study highlights the need for more longitudinal research to assess the long-term effects of interventions and the scalability of approaches across different cultural and legal contexts. Future studies should address these limitations by using more diverse sampling, larger sample sizes and extended follow-up periods. This study provides actionable insights for policymakers and prison administrators, emphasizing the need to integrate evidence-based mental health interventions, such as CBT and trauma-informed care, into prison reform strategies. It highlights the importance of training correctional staff in mental health first aid and the potential of emerging technologies like AI and telemedicine to enhance care delivery in resource-limited settings. Implementing these recommendations could significantly improve inmate mental health outcomes, reduce recidivism rates and promote a more humane and effective correctional system, with broader benefits for public health and social equity. Improving mental health care in prisons has significant social implications, particularly in promoting social justice and reducing inequalities. Effective mental health interventions can help break the cycle of incarceration and recidivism, particularly in marginalized communities disproportionately affected by the criminal justice system. By addressing the mental health needs of incarcerated individuals, society can foster safer communities, reduce crime rates and alleviate the economic burden on the criminal justice and health-care systems. Furthermore, enhancing mental health care in prisons reflects a commitment to human dignity, fairness and the rehabilitation of offenders, contributing to a more just and compassionate society. This study introduces a novel conceptual framework that integrates social determinants of health with the stress process model, specifically tailored for correctional facilities. It provides original empirical data from a real-world prison setting, offering new insights into the effectiveness of mental health interventions, such as CBT and trauma-informed care. The study's value lies in its comprehensive approach, combining quantitative and qualitative methods, and its focus on underrepresented populations in correctional settings. By addressing significant gaps in the literature, this research offers practical recommendations for policymakers and practitioners, contributing to improved mental health outcomes and reduced recidivism.

The impact of a rural school-based oral health intervention among primary schoolchildren in Armenia

Abstract Objectives Oral health (OH) interventions are shown to be effective in improving children’s OH status and behavior. This study evaluated the effectiveness of a school-based OH intervention combined with OH educational activities on rural schoolchildren’s OH status and behavior in a rural setting in Armenia. Methods The study population were primary schoolchildren of Mrgashat village, Armavir province, Armenia, and their parents. The intervention included sealant application to eligible permanent molars of children and fluoridization of their teeth twice a year over a two-year period. Educational activities included a training session for children and their parents, and distribution of educational materials among them. Baseline (BL) and follow-up (FU) assessments were conducted before and after the intervention (in 2022 and 2024) to evaluate its impact. Both assessments included clinical examination of children’s OH status by calculating their DMFT/dmft index, and telephone survey among parents on OH knowledge and behavior. The changes in DMFT/dmft index and OH knowledge and behavior scores were measured using paired t-test. Results Overall, 94 children and their parents participated in both BL and FU assessments. There was no significant change in the parental OH knowledge score: 77.4% (SD 14.0) at the BL and 78.7% (SD 13.2) at the FU. Yet, children’s OH behavior score increased significantly: from 44.9% (SD 18.2) at the BL to 60.0% (SD 15.4) at the FU (p &amp;lt; 0.001). Children’s DMFT/dmft index also improved significantly: from 7.31 at the BL to 5.09 at the FU assessment (p &amp;lt; 0.001). Conclusions The study demonstrated the effectiveness of the OH intervention in improving children’s OH status and behavior. Therefore, we recommend expansion of the intervention with inclusion of more rural sites in Armenia, and targeting primary schoolchildren, considering the importance of timely preventive interventions and early development of healthy habits for better OH later in life. Key messages • Oral health interventions among primary schoolchildren covering awareness raising and carries prevention activities result in positive changes in children’s oral health habits and teeth health. • Expansion of this type of interventions with inclusion of new rural sites and conduction of further assessments to explore the long-term effects of such interventions are recommended.

Amending clayey and sandy soils with nano - bio phosphorous for regulating tomato growth, biochemical, and physiological characteristics

Phosphorus is a critical nutrient that significantly enhances tomato production, so maintaining an adequate level of phosphorus plays an essential role in enhancing the growth of tomato by being present in the soil. This study assessed the impact of soil texture and phosphorus content on tomato plant properties using a factorial, complete, randomized design with four replications. Treatments included clayey and sandy soils with varying phosphorus sources: non-phosphorus (P0), calcium phosphate (CaP1 and CaP2), and nano-hydroxyapatite (PN1 and PN2), where 1 indicates a concentration of 0.12 g and 2 indicates a concentration of 0.23 g per 5-kilogram pot of fertilizer. Results indicated that treatments significantly influenced yield parameters such as average fruit weight, juice content, antioxidant activity, and fruit volume. In the clayey soil, CaP2 treatment had a superior effect on yield, average fruit weight, and shoot fresh weight. In comparison with sandy conditions, CaP2 produced a 50% increase in fruit number, 29% increase in average fruit weight, and 91% increase in fruit yield. The treatments then impacted the shoot fresh weight and root length, while the phosphorus concentration appeared to be more dependent on soil type than on phosphorus sources. Similar to the CaP1 and CaP2 treatments, the PN1 treatment in clay soil also resulted in the highest fresh and dry weights of tomato shoots when compared with the control group. Generally, the findings from this study suggest that the use of CaP2 can serve as a reliable method to improve the growth, yield, and fruit quality of tomatoes, especially in clayey soil environments. However, nano-based phosphorous sources need to be tested more to see if they can improve tomato performance in a range of soil conditions. Also, further research should look into the long-term effects of phosphorous interventions on soil health and sustainability.

The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal-Fetal Attachment in Primigravida Women.

To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal-fetal attachment in primigravida women. A multi-site cross-sectional research design study. This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal-Fetal Attachment Scale (MFAS-HU-20). The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal-fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal-fetal attachment tends to decrease. The correlations range from -0.263 to -0.426, all significant at p < 0.001. The emotional impact of climate change can adversely affect the bonding process between mother and fetus. Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers. The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women. The research adhered to that is STROBE. Public contributions by women in community health centers.

Improvement in symptoms of anxiety and depression in individuals with type 2 diabetes: retrospective analysis of an intensive lifestyle modification program

BackgroundType 2 diabetes (T2D) is a chronic metabolic disorder that has a notable influence on mental well-being, contributing to elevated morbidity and mortality rates. Depression and anxiety disorders are the most common mental health concerns among patients with T2D worldwide. Therefore, the present study aimed to assess the impact of an online intensive lifestyle intervention (ILI) on mental health outcomes (depression and anxiety) in patients with T2D in India.Materials and methodsThis retrospective pre-post analysis included adult patients (aged > 18 years) diagnosed with T2D who were enrolled in a diabetes management program in India between June 2021 and June 2023. The intervention consisted of lifestyle modifications such as a customized plant-based diet, regular physical activity, psychological support through group and individual therapy, and medical management. Data were extracted from the electronic database of the clinic, including anthropometry, medical history, biochemical parameters, symptoms of depression, and anxiety (assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) scale) at the start and end of the six-month intervention period.ResultsOf the 1061 eligible patients (177 with prediabetes), 40.3% were female. The mean age, duration of diabetes, and HbA1c levels were 52 ± 10.4 years, 9.8 ± 7.8 years, and 8 ± 1.7%, respectively. The prevalence of symptoms of depression and anxiety (ranging from mild to severe) was 46% and 44.3%, respectively, which reduced to 28.7% and 29.2%, respectively, post-intervention.ConclusionIntegrated ILI successfully improved the symptoms of anxiety and depression, highlighting the importance of a multidisciplinary approach that includes diet, physical activity, psychological support, and medical management in enhancing mental health outcomes among patients with T2D. Future prospective studies are needed to explore the long-term effects of such interventions and develop effective strategies for promoting mental health in diverse populations.Trial registrationThe study was approved by the Freedom from Diabetes Research Foundation Institutional Ethics Committee (approval number FFDRF/IEC/2024/7) and registered in the Clinical Trials Registry of India (CTRI/2024/03/064596, registered on March 21, 2024).

Analysis of the Effectiveness of Painting Art Healing in Mental Health Problems in Different Populations

This study aims to systematically analyze the application effect of painting therapy in the treatment of mental health problems in different populations, and to explore its universality and specificity in different age groups, genders, cultural backgrounds, and mental health conditions. Through literature review, comparative research methods, and case study methods, the effectiveness of art therapy in elderly, adult, adolescent, and child populations was comprehensively evaluated. The results of the study show that art therapy can significantly promote emotional regulation, improve cognitive function, enhance social interaction, and develop self-identity, especially in alleviating emotional disorders such as anxiety and depression. However, this study also found that there are certain deficiencies in the methodological quality, sample representativeness, and long-term effects research of art therapy. Future research should further focus on the standardization, long-term effectiveness, and cross-cultural applicability of interventions to promote the widespread application of art therapy in the field of mental health.