Intervention Outcomes Research Articles

Clinical outcomes of percutaneous coronary intervention for severely calcified lesions: comparison between the morphologies of severely calcified coronary lesions.

Existing studies evaluating the comparison of clinical outcome of percutaneous coronary intervention (PCI) for severe calcified coronary lesions are limited, and the clinical outcomes of PCI for different morphologies of calcified lesions are controversial. Overall, consecutive 576 lesions with severe calcification that were treated with PCI from 2010 to 2021 at Nagoya Heart Center were investigated. All lesions were assessed using invasive coronary angiogram (CAG) or computed tomography-CAG at 12months after DES implantation. We divided the patients into three groups based on the results of intravascular ultrasound (IVUS) imaging (concentric calcified lesion [CC] n = 273, eccentric calcified lesion [EC] n = 217, calcified nodule [CN] n = 86). The clinical and angiographic outcomes of each group were investigated retrospectively to compare the prognosis between the three groups and identify predictive factors for the device-oriented composite end points (DoCE). There were no differences in patient characteristics among the three groups, except that there were significantly more patients on dialysis in the CN group. The incidence of DoCE was significantly higher in the CN group than in the other groups (CC; 18.3% vs. EC; 23.5% vs. CN; 36.0%; Log-Rank test; p = 0.001). Cox regression analysis showed that the independent predictors of DoCE were CN, insulin use, hemodialysis, right coronary artery lesions, and calcium cracks. The incidence of DoCE was significantly higher in the CN group. Calcium cracks are crucial for improving outcomes in severely calcified lesions, being key predictors of DoCE.

Integrating Patients Into Programmes to Address the Allergy Knowledge Practice Gap.

There is a wide gap between the first publication of new treatments with efficacy and their successful application in clinical practice. In many respects, the management of allergic diseases is a good exemplar of the knowledge/practice gap. It was assumed that systematic reviews and publication of guidelines would ensure timely delivery of effective care, but this has not proved to be the case. While there are many reasons to explain shortcomings in healthcare delivery, the lack of patient and carer involvement in the planning of research, evidence review, guideline development and guideline implementation is most compelling. To achieve adherence to evidence-based guidelines consistently across all levels of the health service requires the implementation of integrated care with clear pathways through which patients can navigate. Quality improvement methodology could be employed to plan and implement integrated care pathways (ICPs). There is evidence that ICPs achieve improved outcomes for acute hospital-based interventions, but less work has focussed on long-term conditions where more diverse agencies are involved. At all stages, stakeholder representation from the full range of healthcare professionals, patients, their families, social services, education, local government and employers must be involved. In this article we review the step-wise and iterative process by which knowledge is implemented into practice to improve patient experience and outcomes We argue how this process can benefit from the involvement of patients and their carers as equal partners, and we discuss how different initiatives have involved patients with allergic diseases. There currently is a gap in evidence that links patient involvement to improved outcomes. We recommend the use of the Core Outcome Sets (COS) and Patient Reported Experience Measures (PREMS) which have been developed for allergic diseases to monitor the effects of implementation research and the impact of patient and carer involvement on outcomes.

The outcomes of imagery-focused interventions in relation to distress in people with delusions: a systematic literature review

Abstract Background: Imagery-focused therapies within cognitive behavioural therapy are growing in interest and use for people with delusions. Aims: This review aimed to examine the outcomes of imagery-focused interventions in people with delusions. Method: PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE and CINAHL were systematically searched for studies that included a clinical population with psychosis and delusions who experienced mental imagery. The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and quality appraisal of all included papers was completed using the Crowe Critical Appraisal Tool. Information from included texts was extracted and collated in Excel, which informed the narrative synthesis of results. Results: Of 2,736 studies identified, eight were eligible for inclusion and rated for quality with an average score of 70.63%. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Four of the eight studies used case series designs, two were randomised controlled trials, and two reported single case studies. It appears that interventions targeting mental imagery were acceptable and well tolerated within a population of people experiencing psychosis and delusions. Conclusions: Some therapeutic improvement was reported, although the studies consisted of mainly small sample sizes. Clinical implications include that people with a diagnosis of psychosis can engage with imagery-focused therapeutic interventions with limited adverse events. Future research is needed to tackle existing weaknesses of design and explore the outcomes of imagery interventions within this population in larger samples, under more rigorous methodologies.

Impact of daily music on comfort scores in preterm infants: a randomized controlled trial.

Premature birth heightens neurodevelopmental risks, theorized to partly stem from altered sensory inputs and disrupted sleep patterns. Modifying the acoustic milieu through music intervention (MI) offers promise to improve neonatal comfort, reduce sleep disturbances, and stabilize physiological parameters. This study explores the impact of non-pharmacological MI on these health indicators within the Neonatal Intensive Care Unit (NICU). A single-blinded RCT was conducted. Premature infants (34 > GA > 29 wks) were randomly assigned to either receive 8 min of daily MI or placebo for up to 15 days. Validated behavioral comfort scores were visually obtained by a blinded observer before and after intervention. Additionally, physiological signs (HR, RR, SatO2) were recorded. Differences between the groups were analyzed using χ² tests and t-tests. In total 56 preterm infants were included. After intervention, comfort levels increased significantly in the MI compared to placebo group (p = 0.000). Neonates receiving MI transitioned from wakefulness to a state of sleep significantly more compared to placebo (p = 0.002). Physiological parameters remained stable. This study adds to existing literature demonstrating that a music intervention in a NICU setting can enhance comfort and sleep of premature infants without adversely affecting physiological parameters. The study demonstrates that music interventions (MI) in a Neonatal Intensive Care Unit (NICU) setting can significantly increase comfort levels and positively impact the sleep of premature infants without negatively impacting their physiological parameters. This research increases evidence for non-pharmacological interventions, specifically music, as beneficial for the well-being of premature infants in NICU settings. It replicates and expands upon previous methodological designs, providing more robust evidence of MI's positive effects on this vulnerable population. The positive outcomes of music intervention could influence hospital policies by integrating non-pharmacological practices into standard neonatal care protocols to enhance developmental support for premature infants.

Better together: involving parents to improve the impact of a video game program to promote primary school students’ emotional competencies

AbstractThe objective of the present study was to evaluate whether parents’ participation could enhance the impact of a video game designed to promote children’s emotional competencies. To achieve this, the video game Happy 8–12 was implemented at school. A separate group of children also played the video game Happy for Families at home with their parents. Differences between children who participated together with their parents, children who played only at school and a control group were explored. Additionally, the study examined improvements in children’s anxiety and academic performance, as well as parents’ emotional awareness, emotional regulation, and parental stress. The sample comprised 137 students along with 42 parents. Results indicated improvements in both groups of children compared to the control group, particularly in emotional awareness, life and well-being competencies, and the global emotional competence. Increases in emotional regulation, emotional autonomy, and social competence, were observed solely among children who participated with their parents. However, no differences emerged in terms of anxiety and academic achievement when compared to the control group. In addition to these findings, parents demonstrated improvements in emotional awareness and regulation, though there was no significant reduction in parental stress. These preliminary results support the efficacy of Happy 8–12 and Happy for Families in promoting children’s emotional competencies and emphasize the importance of involving parents to enhance the intervention outcomes.

Surgical Intervention Outcome for Patients With Acute Vision Loss Due to Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-Analysis.

Allergic fungal rhinosinusitis (AFRS) is a severe type of chronic rhinosinusitis (CRS) characterized by a high risk of acute vision loss resulting from the affection of optic nerves. This vision loss results from direct pressure upon the optic nerve by the sinus tissues and bone degradation. This is why early involvement of a professional is significant so as not to result in a permanent disability. This systematic review and meta-analysis will analyze the efficacy of surgical operations in enhancing visual outcomes in patients with acute vision loss due to AFRS. A systematic search was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, Embase, Cochrane Library, and Scopus with the keywords "acute vision loss," "allergic fungal rhinosinusitis," and "surgical intervention." The studies included patients who developed AFRS-related acute vision loss, those assessing the outcomes of the surgical interventions, and those published in English. Two separate researchers extracted data and conducted quality assessments. The data synthesis process employed the R studio software (Posit, Boston, MA). The identified studies for the review constituted 12 and involved 320 patients. The mean pooled event rate regarding acute vision loss of AFRS patients was 33.1%. Ear, nose, and throat surgeries, including functional endoscopic sinus surgery (FESS) and optic nerve decompression, had a mean pooled success in vision recovery of 68%. Early treatment and utilization of other types of corticosteroids were utilized to enhance the results. Hence, early and proper surgery like FESS, optic nerve decompression, and corticosteroid treatment have better visual prognosis in AFRS patients. Standard early diagnosis and management guarantee the prevention of irreversible blindness, which stresses the need for an interdisciplinary approach and further studies.

Unraveling the Complexity of Parkinson's Disease: Insights into Pathogenesis and Precision Interventions.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by dopaminergic neuron loss, leading to motor and non-motor symptoms. Early detection before symptom onset is crucial but challenging. This study presents a framework integrating circuit modeling, non-equilibrium dynamics, and optimization to understand PD pathogenesis and enable precision interventions. Neuronal firing patterns, particularly oscillatory activity, play a critical role in PD pathology. The basal ganglia network, specifically the subthalamic nucleus-external globus pallidus (STN-GPe) circuitry, exhibits abnormal activity associated with motor dysfunction. The framework leverages the non-equilibrium landscape and flux theory to identify key connections generating pathological activity, providing insights into disease progression and potential intervention points. The intricate STN-GPe interplay is highlighted, shedding light on compensatory mechanisms within this circuitry may initially counteract changes but later contribute to pathological alterations as disease progresses. The framework addresses the need for comprehensive evaluation methods to assess intervention outcomes. Cross-correlations between state variables provide superior early warning signals compared to traditional indicators relying on critical slowing down. By elucidating compensatory mechanisms and circuit dynamics, the framework contributes to improved management, early detection, risk assessment, and potential prevention/delay of PD development. This pioneering research paves the way for precision medicine in neurodegenerativedisorders.

The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta‐analysis

SummaryIntroductionBehavioral weight management interventions (BWMIs) are an evidence‐based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta‐analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.MethodsSeven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta‐analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta‐analysis (SWiM) was applied for EBTs where meta‐analysis was not feasible.ResultsThe review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta‐analyses of data from three trials at intervention completion and post‐intervention (average of 28 weeks [±8]) revealed positive short‐term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow‐up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.ConclusionBWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.

Applied Research in Clinical Audiology with Spanish Speakers in the United States: A Scoping Review.

The Hispanic population is growing, and Spanish is the second most spoken language in the United States. When individuals experience a hearing problem, culturally and linguistically responsive services represent an important part of person-centered care, contributing to wellbeing and intervention outcomes. The purpose was to identify research in clinical audiology conducted with Spanish speakers to illuminate gaps and inform future research. A scoping literature review. A database search was completed in January 2022. Included research was conducted in clinical audiology, had Spanish-speaking deaf or hard-of-hearing (DHH) adults/parents of a DHH child in the United States, Spanish language data collection, and published in English in a peer-reviewed journal. Studies were categorized by the area of audiology and a narrative description provided. The search identified 655 articles. Following screening, 11 studies met the inclusion criteria and 1 article was identified from the reference lists of included articles for a total 12 articles. The articles were published between 1997 and 2021. Most studies were conducted with adults and a few were with parents of DHH children. Research was conducted in four areas: hearing loss experiences, hearing aid experiences, hearing screening, and communication. There is limited research with Spanish-speaking DHH individuals and parents of DHH children. There is an urgent need for future research to inform culturally and linguistically responsive clinical practice, and to provide evidence-based interventions for effective hearing health care management.

Comparative Feasibility Analysis of Retrograde Double J Stenting, Antegrade Double J Stenting, and Percutaneous Nephrostomy Tube Placement for Ureteric Obstruction Secondary to Pelvic Malignancies

Background: The management of ureteric obstruction secondary to pelvic malignancies (UOPM) presents a significant challenge. Objectives: Our study aimed to assess the factors affecting the feasibility of interventions for patients with UOPM - including retrograde and antegrade double J (DJ) stenting, and percutaneous nephrostomy (PCN) insertion. Methods: We conducted a retrospective analysis of patients who underwent intervention for UOPM over two years, from January 2022 to December 2023. Patients were categorized into groups based on intervention type: Group 1: Retrograde DJ stenting, group 2: Antegrade DJ stenting, and group 3: PCN insertion. Demographic, clinical, radiological, cystoscopic, and laboratory data were compared between the three groups. Analysis of Variance (ANOVA), logistic regression, and marginal mean plots were utilized for statistical analysis. Results: Fifty–nine patients were included in the study, consisting of 14 males and 45 females, and the mean age of the study population was 60.1 ± 10.8 years. Retrograde DJ stenting was successfully achieved in 59.3% of patients, with 10.2% undergoing antegrade DJ stenting and 30.5% needing PCN insertion. Serum albumin (P = 0.04), serum creatinine (P = 0.02), albumin creatinine ratio (P < 0.001), and severity of hydroureteronephrosis (HDUN) (P = 0.02) were significantly associated with intervention outcomes. There was an increased likelihood of PCN insertion in higher serum creatinine and lower serum albumin levels. Multinomial logistic regression with univariate and multivariate analysis revealed significance among the above-mentioned variables. Conclusions: Even though DJ stenting remains common, a significant proportion of patients require PCN insertion. Serum albumin, serum creatinine, albumin creatinine ratio, and HDUN severity are significant predictors of intervention success. Further research is warranted to validate these findings and enhance management strategies for UOPM.

Senolytic Prodrugs: A Promising Approach to Enhancing Senescence-targeting Intervention.

Cellular senescence has emerged as a potential therapeutic target for aging and a wide range of age-related disorders. Despite the encouraging therapeutic impact of senolytic agents on improving lifespan and the outcomes of pharmacological intervention, the senolytic induced side effects pose barriers to clinical application. There is a pressing need for selective ablation of senescent cells (SnCs). The design of senolytic prodrugs has been demonstrated as a promising approach to addressing these issues. These prodrugs are generally designed via modification of senolytics with a cleavable galactose moiety to respond to the senescent biomarker - senescence-associated β-galactosidase (SA-β-gal) to restore their therapeutic effects. In this Concept, we summarize the developments by categorizing these prodrugs into two classes: 1) galactose-modified senolytic prodrugs, in which sensing unit galactose is either directly conjugated to the drug or via a self-immolative linker and 2) bioorthogonal activation of senolytic prodrugs. In the bioorthogonal prodrug design, galactose is incorporated into dihydrotetrazine to sense SA-β-gal for click activation. Notably, in addition to repurposed chemotherapeutics and small molecule inhibitors, PROTACs and photodynamic therapy have been introduced as new senolytics in the prodrug design. It is expected that the senolytic prodrugs would facilitate translating small-molecule senolytics into clinical use.

Implementation of Postpartum Nutritional Interventions in Healthcare, Community and eHealth: A Systematic Review.

The efficacy of interventions targeting lifestyle habits, particularly dietary habits, among postpartum women is well established. However, whether these results can be translated into tangible changes in the care and services provided to this population remains unclear. Therefore, the aim is to examine the implementation outcomes of postpartum nutritional interventions delivered in healthcare, community, or eHealth settings. A search was conducted in the MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane Library databases in July 2024, to identify all relevant studies. Included studies had to report at least 1 of the 8 implementation outcomesstudied: acceptability, adoption, appropriateness, implementation cost, feasibility, fidelity, penetration, and sustainability. Study selection and data extraction were performed by two independent reviewers. Descriptive analysis of reported outcomes was performed. CRD42022351411. Of the 8907 unique studies identified, 26 interventions (24 publications) were included.There was a great heterogeneity among interventions studied and implementation outcomes reported. Acceptability, feasibility, and fidelity were the most studied implementation outcomes. Overall, postpartum nutritional interventions were found to be acceptable and useful, but improvements were suggested by participants, such as more frequent contacts and longer programs. Recruitment, retention, participation, and penetration rates widely varied across studies. Challenges hindering the delivery of nutritional interventions were reported by participants, such as lack of time and the presence of medical conditions following delivery. CONCLUSIONSFOR PRACTICE: This review demonstrates the potential forthe delivery and implementation of nutritional interventions in real-world settings during the postpartum period.

Enhancing Urban Sustainability: Developing an Open-Source AI Framework for Smart Cities

To address the growing need for advanced tools that enable urban policymakers to conduct comprehensive cost-benefit analyses of traffic management changes, the Urbanite H2020 project has developed innovative artificial intelligence methods. Among them is a robust decision support system that assists policymakers in evaluating and selecting optimal urban mobility planning modifications by combining objective and subjective criteria. Utilising open-source microscopic traffic simulation tools, accurate digital models (or “digital twins”) of four pilot cities—Bilbao, Amsterdam, Helsinki, and Messina—were created, each addressing unique mobility challenges. These challenges include reducing private vehicle access in Bilbao’s city center, analysing the impact of increased bicycle traffic and population growth in Amsterdam, constructing a mobility-enhancing tunnel in Helsinki, and improving public transport connectivity in Messina. The research introduces five key innovations: the application of a consistent open-source simulation platform across diverse urban environments, addressing integration and consistency challenges; the pioneering use of Dexi for advanced decision support in smart cities; the implementation of advanced visualisations; and the integration of the machine learning tool, Orange, with a user-friendly GUI interface. These innovations collectively make complex data analysis accessible to non-technical users. By applying multi-label machine learning techniques, the decision-making process is accelerated by three orders of magnitude, significantly enhancing urban planning efficiency. The Urbanite project’s findings offer valuable insights into both anticipated and unexpected outcomes of mobility interventions, presenting a scalable, open-source AI-based framework for urban decision-makers worldwide.

A nutrition-focused review of the interventions in US-living Latino communities with type II diabetes.

Type 2 diabetes (T2D) is a chronic, debilitating disease that disproportionally affects the Hispanic/Latino community residing in the United States. Optimal nutrition therapy is fundamental to the proper management of T2D and must be culturally adapted to facilitate permanent behavior change in this population. This review selected and assessed the nutrition components of interventions aimed to improve T2D outcomes in US-based Latinos/Hispanics, published from 2002 to 2023. An overview of the participant characteristics, nutrition intervention, and dietary assessment and outcomes is included. Nutrition interventions in this community benefit from the inclusion of bicultural registered dietitian nutritionist (RDNs) to assure the counseling team promotes culturally tailored nutrition recommendations based on current dietary guidelines. Nutrition assessment and outcomes should be captured with the use of validated dietary assessment tools and dietary quality indices appropriate to their target population. Standardizing these practices will facilitate intervention comparability and replicability and ultimately better target the needs of this community.

Anatomical investigation of the morphometry of the cerebral arteries using digital subtraction angiography in the Thai population.

The main purpose of this study was to investigate the dimensions of cerebral arteries in the Thai population using digital subtraction angiography (DSA), with a focus on the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA). The research aimed to explore anatomical variations in diameters and lengths of these arteries across different sexes and age groups, which are crucial for cerebrovascular interventions. This retrospective study measured the diameters and lengths of the ACA, MCA, and PCA in 177 Thai patients with an average age of 47.6 years (range: 11-82 years) with normal cerebral angiograms. Digital subtraction angiography (DSA) was used for the measurements. The study found significant sex-based differences in the mean diameters of the left ACA (males: 2.12 ± 0.28mm, females: 1.92 ± 0.20mm; p < 0.01), right MCA (males: 2.50 ± 0.25mm, females: 2.31 ± 0.17mm; p < 0.01), and left MCA (males: 2.44 ± 0.19mm, females: 2.30 ± 0.17mm; p < 0.01) with males exhibiting larger diameters. The right ACA length was significantly longer in males (15.46 ± 1.74mm) compared to females (13.98 ± 1.92mm; p < 0.01). While no significant age-related differences were observed in diameters, a significant increase in length with age was noted for the left ACA in the ≥ 60 years group (13.61 ± 1.64mm) compared to the < 60 years group (12.63 ± 1.36mm; p < 0.01). Among others, significant correlations were found between the diameters of the left ACA and right MCA (r = 0.699; p < 0.01), and a strong correlation between left ACA length and left PCA diameter (r = 0.975; p < 0.01). The findings provide invaluable data for tailoring neurosurgical approaches and designing angiographic equipment for the Thai population, emphasizing the importance of considering anatomical variations in clinical practice. These results highlight the necessity for personalized medical care based on anatomical differences to improve cerebrovascular intervention outcomes.

The impact of energy prices in decarbonizing buildings’ energy use in the EU27

The recent surge in end-use energy prices in the EU has intensified the debate on how price signals influence the decarbonization of the building sector, a key contributor to global energy consumption and emissions. This study investigates the role of energy price signals in driving the decarbonization of the EU-27 building sector using the Invert/EE-Lab model to simulate various scenarios up to 2050. The analysis examines the elasticity of energy demand, particularly how different price scenarios impact investment decisions in energy-related technologies. The findings reveal that a 10 % increase in energy prices can lead to a reduction in energy demand by up to 3 %, depending on the scenario. Furthermore, price elasticity varies across different policy and price settings, with stricter regulations resulting in lower elasticity. The results underscore that while stringent regulatory measures can achieve significant energy savings and reduce greenhouse gas emissions, they also limit the responsiveness to price signals, with heat pump shares reaching 47–86 % in high-efficiency scenarios. Conversely, more moderate policy measures increase price elasticity, leading to 15–55 % heat pump shares. This study highlights the importance of better understanding price elasticity in energy modeling to project better the outcomes of policy interventions aimed at achieving a low-carbon energy system.

Creativity outcomes of physical activity interventions for children and adolescents: A systematic review

The objective of this systematic review was to evaluate the evidence on Physical Activity (PA) interventions to foster thinking domain of creativity in children and adolescents, and to investigate the acute and chronic PA interventions variables that moderate creativity outcomes. This review was conducted using the PRISMA framework. A total of 14 studies were identified using WOS and SCOPUS (12 chronic PA and two acute PA intervention), which matched the following criteria: (i) peer-reviewed, longitudinal experimental studies; (ii) studies that included a sample of children or adolescents aged 3–18 years of age; incorporated a PA intervention as the independent variable; (iii) studies with at least one measure of creativity. The total number of participants in the included studies combined was 1539. The results of this review indicate that chronic PA can enhance creativity in school children and adolescents, but the effects varied considerably depending on the qualitative characteristics of the PA and the characteristics of participants. The results of this review suggest that the type of PA, the volume and the intensity of PA may be crucial factors for improving creativity. Regarding the type of PA, games, motor skills, sports and drama activities seem to be the most appropriate, while balancing and walking do not report positive effects. An important finding to emerge from the synthesis was that volume is a key factor, while how they achieve that volume does not have critical implications, as various frequencies of PA were associated with improved creativity. Furthermore, this review identified various moderator variables such as the age of the participants, their creativity level at baseline and whether they were active or inactive.

The Efficacy of Manual Therapy on Musculoskeletal Pain in Menopause: A Systematic Review.

(1) Background: The aim of this review was to evaluate the effects of manual therapy for musculoskeletal pain in menopausal women. (2) Methods: A comprehensive search of manuscripts published from inception until 29 February 2024 was conducted on PubMed, EBSCO Information Services (EBSCOhost), Physiotherapy Evidence Database (Pedro), Web of Science, Scientific Electronic Library Online (SciELO), Cochrane Central Register of Controlled Clinical Trials, and Scopus using Medical Subject Headings (MeSH) and free terms. Randomized controlled trials (RCT) investigating the effects of manual therapy for musculoskeletal pain in postmenopausal women were included. Articles published in non-English or non-Portuguese languages, case reports, expert opinions, dissertations, conference papers, and gray literature were excluded. Studies were screened for population, musculoskeletal pain, intervention, and pain outcome by two independent reviewers using an ad hoc data extraction form. (3) Results: A total of 5 RCTs (4 with high risk of bias and 1 with low risk of bias) were included (total sample = 245), addressing thumb carpometacarpal osteoarthritis, thoracic kyphosis, chronic neck and backache, knee osteoarthritis, and sternocostal joint pain. The combined results of these studies showed improved musculoskeletal pain in menopausal women; duration of the follow-up was between 4 weeks to 6 months. Conclusions: The majority of studies included in this systematic review were effective in reducing musculoskeletal pain in menopausal women. These results come mainly from studies with a high risk of bias with small sample sizes, and the most representative follow-up period was short-term. Therefore, the results of this systematic review should be interpreted with caution.

Developing and Evaluating Digital Public Health Interventions Using the Digital Public Health Framework DigiPHrame: A Framework Development Study.

Digital public health (DiPH) interventions may help us tackle substantial public health challenges and reach historically underserved populations, in addition to presenting valuable opportunities to improve and complement existing services. However, DiPH interventions are often triggered through technological advancements and opportunities rather than public health needs. To develop and evaluate interventions designed to serve public health needs, a comprehensive framework is needed that systematically covers all aspects with relevance for public health. This includes considering the complexity of the technology, the context in which the technology is supposed to operate, its implementation, and its effects on public health, including ethical, legal, and social aspects. We aimed to develop such a DiPH framework with a comprehensive list of core principles to be considered throughout the development and evaluation process of any DiPH intervention. The resulting digital public health framework (DigiPHrame) was based on a scoping review of existing digital health and public health frameworks. After extracting all assessment criteria from these frameworks, we clustered the criteria. During a series of multidisciplinary meetings with experts from the Leibniz ScienceCampus Digital Public Health, we restructured each domain to represent the complexity of DiPH. In this paper, we used a COVID-19 contact-tracing app as a use case to illustrate how DigiPHrame may be applied to assess DiPH interventions. The current version of DigiPHrame consists of 182 questions nested under 12 domains. Domain 1 describes the current status of health needs and existing interventions; domains 2 and 3, the DiPH technology under assessment and aspects related to human-computer interaction, respectively; domains 4 and 5, structural and process aspects, respectively; and domains 6-12, contextual conditions and the outcomes of the DiPH intervention from broad perspectives. In the CWA use case, a number of questions relevant during its development but also important for assessors once the CWA was available were highlighted. DigiPHrame is a comprehensive framework for the development and assessment of digital technologies designed for public health purposes. It is a living framework and will, therefore, be updated regularly and as new public health needs and technological advancements emerge.

Implementing palliative care in the intensive care unit: a systematic review and mapping of knowledge to the implementation research logic model.

The importance and effectiveness of palliative care (PC) in intensive care units (ICU)are known. Less is known about the implementation and integration of ICU-based PC interventions. This systematic review aims to use a modified implementation research logic model (IRLM) to identify, map, and synthesise evidence on implementation of ICU-PC (primary and/or specialist) interventions. This systematic review used an adapted Smith's IRLM to understand relationships between implementation factors-determinants (barriers and facilitators), strategies, and mechanisms-and report intervention characteristics and outcomes. Searches up to 2nd December 2023, of MEDLINE, Embase, Cochrane, CINAHL, and PsycINFO, combined PC, intensive care, and implementation terms. 84 studies (8 process evaluations, 76 effectiveness studies) were included. Published evidence on ICU-PC interventions issubstantial, but reporting on implementation factors is variable and often lacking, especially for patient and family-related determinants and for all aspects of mechanisms. Main facilitators forimplementation are adequate resources and collaborationbetween PC and ICU teams. Main barriers to implementation are lack of resources, negative perceptions of PC, and high ICU acuity.Implementation strategies include auditing resources, building stakeholder collaboratives, creating adaptable interventions, utilising champions, and supporting education. Mechanisms most commonly worked by facilitating collaborative working. This review provides recommendations for ICUs when designing (stakeholder involvement, ICU-PC collaboration, assessment of culture and resources); implementing (targeted and adapted strategies, champions, and education); and evaluating/reporting (collect effectiveness and implementation data, including mechanisms) ICU-PC interventions. Use of implementation structures and patient/family involvement are both needed and important to be included.