Intervention Studies Research Articles

Subjective Well-Being, Positive Affect, Life Satisfaction, and Happiness With Multiple Sclerosis: A Scoping Review of the Literature.

People with multiple sclerosis (MS) may face challenges maintaining their subjective well-being, life satisfaction, happiness, and positive emotions. This scoping review's purpose was to summarize studies on these positive psychological constructs among people with MS. Observational and interventional studies that included measures of subjective well-being, life satisfaction, happiness, or positive affect were identified. Variables associated with these constructs were classified using the International Classification of Functioning, Disability and Health (ICF). The review included 22 observational and 10 interventional studies. Variables were categorized into each of the ICF domains. Cognitive behavior therapy was the most common intervention, with content and dosing varying widely. Subjective well-being, life satisfaction, happiness, and positive affect are crucial components of community and individual health. The findings of this scoping review highlight the complex interplay between function, personal factors, and environmental conditions in influencing positive psychological constructs. Given the limited evidence, rehabilitation nurses should leverage their skills in delivering holistic care and adopt data-driven approaches to integrate positive psychological strategies into care plans. Further research is needed to measure and compare interventions aimed at improving these constructs and to examine the influence of personal and environmental factors among diverse MS populations.

Perspectives of Nursing Mothers in Ibadan Markets Regarding Management of Childhood Diarrhoea: A Qualitative Study

Introduction: Diarrhoea is a gastrointestinal disorder characterised by the passage of three or more loose or liquid stools per day or more frequently than a normal individual should have. It can be short-term (acute) or long-term (chronic), varying from mild to severe. Aim: The study aimed to explore the perspectives of nursing mothers in Ibadan North East local government markets regarding childhood diarrhoea management. Method: A qualitative study was conducted among mothers of children between 0-59 months at Ibadan, precisely Ibadan Northeast Local Government. The study was conducted in selected Ibadan North East Local Government markets. The selection of these markets for the study was based on their high population of women with children and the moderate commercial activities. A purposive sampling technique was used to select 29 nursing mothers who were interviewed until data saturation was reached. Data was analysed using the QSR NVIVO 12 software program. Verbatim transcription was conducted while listening to the recording. The thematic analysis method was used for data analysis. Results: This study revealed that a significant diarrhoea management pattern is using herbal mixtures and several concoctions. The primary determinant factor for this management is the strong cultural belief of the Yoruba in this herbal mixture, and Yorubas were the most populous in this research setting. Subthemes that emerged include management options and the mother's level of knowledge, traditional management of different types of childhood diarrhoea and actions taken during managing childhood diarrhoea. Conclusion: This study shows that the majority of nursing mothers in Ibadan markets have a wrong perspective of childhood diarrhoea management, and this could be linked to their age, culture, education, and financial capability. Hence there need for further research on Intervention studies to identify bad behavioral practices performed by those Nursing motherand in the market and to render proper health Education on those practices.

Effectiveness of buzz session teaching and perception among medical students: an academic interventional study.

This interventional study was designed to evaluate the effectiveness of buzz session teaching in large groups and assess undergraduate medical students' perceptions of the buzz session teaching method. The study involved 100 first-year medical students divided into two groups, i.e., group I as "buzz first" and group II as "didactic first" comprising 50 students each. The topic "Physiology of the Cerebellum" was taught to group I through a buzz session and to group II through a didactic lecture. After a week, group I received a didactic lecture on the topic "Anterolateral Pathway in the Spinal Cord," whereas group II was taught the same by a buzz session. The students of both groups underwent a multiple choice question exam related to the taught topic immediately and again after 15 days of the teaching session. All students were provided feedback on a five-point Likert scale for the buzz session. According to students' perceptions, buzz sessions boosted communication skills and confidence levels by 94.8% and 96.3%, respectively. Of the students, 93.7% felt that the buzz session helped them retain more information and 94.1% thought they made the classroom environment more lively. More buzz sessions were desired by 94.8% of the participants. There was no difference in the marks gained for the acquired topics using buzz sessions and didactic lectures as teaching methods (P > 0.05). The students scored more marks in the tests taken after the buzz session than after the didactic lecture at 15 days of instruction (P < 0.05). The study concluded that students enjoyed the buzz session teaching method. The buzz session increased short-term retention.NEW & NOTEWORTHY In this current interventional study, we assessed the effectiveness of a buzz session as a novel teaching tool for large-group physiology instruction in first-year undergraduate medical students. Furthermore, we assessed student responses to see how the buzz session was perceived. Experimental evidence indicates that the buzz sessions led to greater retention after 15 days than the didactic lecture approach for physiology teaching in a preclinical context.

The Effect of Shared Decision-making on Decision Self-efficacy and Decisional Conflict of Women with Low-grade Squamous Intraepithelial Lesion in Cervical Cytology: An Experimental Study

Background: Women often face decisional challenges and hesitation while choosing the appropriate method to follow up on their abnormal results of cervix cytology. Objective: The present study aimed to determine the effect of shared decision-making (SDM) on decision self-efficacy (DSE) and decisional conflict (DC) about follow-up methods among women with abnormal cervix cytology results. Methods: This interventional study was performed on 54 women referred to the subspecialty clinic of gynecologic oncology. The women were assigned into intervention and control groups using a randomized block design with block sizes of 4 and 6 and an allocation ratio of 1:1. The intervention group received counseling based on the SDM and a decision aid (DA) booklet. The data collection tools included the questionnaires of the demographic and obstetrics characteristics, DC, DSE, and Decision Regret. The collected data were analyzed using SPSS24 software, and independent t-tests and ANCOVA were used. Results: After the intervention, the total mean score of the DC in the intervention group was significantly lower than that in the control group [MD: -22.84 with 95% CI: -23.52 to -21.95, (P &lt;0.001)]. The mean score of DSE in the intervention group was significantly higher than that in the control group [MD: 14.56 with 95% CI: 21.47 to 7.65, (P &lt;0.001)]. Conclusion: The present study results indicated that counseling based on the SDM effectively promotes DSE and reduces DC among women with minor abnormal cervical cytology. Therefore, it is recommended that healthcare providers use SDM for women with abnormal cervical cancer screening results.

GLT-1 downregulation in hippocampal astrocytes induced by type 2 diabetes contributes to postoperative cognitive dysfunction in adult mice.

Type 2 diabetes mellitus (T2DM) is related to an increased risk of postoperative cognitive dysfunction (POCD), which may be caused by neuronal hyperexcitability. Astrocyte glutamate transporter 1 (GLT-1) plays a crucial role in regulating neuron excitability. We investigated if T2DM would magnify the increased neuronal excitability induced by anesthesia/surgery (A/S) and lead to POCD in young adult mice, and if so, determined whether these effects were associated with GLT-1 expression. T2DM model was induced by high fat diet (HFD) and injecting STZ. Then, we evaluated the spatial learning and memory of T2DM mice after A/S with the novel object recognition test (NORT) and object location test (OLT). Western blotting and immunofluorescence were used to analyze the expression levels of GLT-1 and neuronal excitability. Oxidative stress reaction and neuronal apoptosis were detected with SOD2 expression, MMP level, and Tunel staining. Hippocampal functional synaptic plasticity was assessed with long-term potentiation (LTP). In the intervention study, we overexpressed hippocampal astrocyte GLT-1 in GFAP-Cre mice. Besides, AAV-Camkllα-hM4Di-mCherry was injected to inhibit neuronal hyperexcitability in CA1 region. Our study found T2DM but not A/S reduced GLT-1 expression in hippocampal astrocytes. Interestingly, GLT-1 deficiency alone couldn't lead to cognitive decline, but the downregulation of GLT-1 in T2DM mice obviously enhanced increased hippocampal glutamatergic neuron excitability induced by A/S. The hyperexcitability caused neuronal apoptosis and cognitive impairment. Overexpression of GLT-1 rescued postoperative cognitive dysfunction, glutamatergic neuron hyperexcitability, oxidative stress reaction, and apoptosis in hippocampus. Moreover, chemogenetic inhibition of hippocampal glutamatergic neurons reduced oxidative stress and apoptosis and alleviated postoperative cognitive dysfunction. These findings suggest that the adult mice with type 2 diabetes are at an increased risk of developing POCD, perhaps due to the downregulation of GLT-1 in hippocampal astrocytes, which enhances increased glutamatergic neuron excitability induced by A/S and leads to oxidative stress reaction, and neuronal apoptosis.

Improving effective coverage of medical-oxygen services for neonates and children in health facilities in Uganda: a before–after intervention study

Medical oxygen services are essential for the care of acutely unwell patients. We aimed to assess the effects of a multilevel, multicomponent health-system intervention on hypoxaemia detection, oxygen therapy, and mortality among neonates and children attending level IV health centres and hospitals in Uganda. For this before-after intervention study, we included children who attended paediatric or neonatal wards of 24 level IV health centres and seven general or regional referral hospitals in the Busoga and North Buganda regions of Uganda between June 1, 2020, and June 30, 2022. All neonates younger than 1 month and children aged 1 month to 14 years were eligible for inclusion. We excluded neonates who were not sick but stayed in the maternity ward for routine postnatal care. The intervention involved clinical training, mentorship, and supportive supervision; provision of pulse oximeters and cylinder-based oxygen sources; biomedical-capacity support; and support to develop and disseminate oxygen supply strategies, oxygen therapy guidelines, and lists of essential oxygen supplies. Trained research assistants extracted individual patient data from case notes using a standardised electronic data collection form. Data were collected on health-facility details, age, sex, clinical signs and symptoms, admission diagnoses, pulse oximetry readings, oxygen therapy details, and final patient outcome. The primary outcome was the proportion of admitted neonates and children with a pulse oximetry oxygen saturation reading documented in their patient case notes on day 1 of health-facility admission (ie, pulse oximetry coverage). We used mixed-effects logistic regression to evaluate the effect of the intervention. We obtained data on 71 997 eligible neonates and children admitted to 31 participating health facilities; the primary analysis included 10 001 patients in the pre-intervention period (ie, June 1 to Oct 30, 2020) and 51 329 patients in the post-intervention period (ie, March 1, 2021, to June 30, 2022). Because 1356 patients had missing data for sex, 4365 (46·7%) of 9347 in the pre-intervention group and 22 831 (46·2%) of 49 410 in the post-intervention group were female; 4982 (53·3%) in the pre-intervention group and 26 579 (53·8%) in the post-intervention group were male. The proportion of neonates and children with pulse oximetry at admission increased from 2365 (23·7%) of 10 001 in the pre-intervention period to 45 029 (87·7%) of 51 328 in the post-intervention period. Adjusted analysis indicated greater likelihood of a patient receiving pulse oximetry during the post-intervention period compared with the pre-intervention period (adjusted odds ratio 40·10, 95% CI 37·38-42·93; p<0·0001). Large-scale improvements in hospital oxygen services are achievable and have the potential to improve clinical outcomes. Governments should be encouraged to develop national oxygen plans and focus investment on interventions that have been shown to be effective, including the introduction of pulse oximetry into routine hospital care and clinical and biomedical mentoring and support. Bill & Melinda Gates Foundation and ELMA Philanthropies. For the Luganda and Lusoga translations of the abstract see Supplementary Materials section.

Functional outcomes of canalicular laceration repair with self-retaining masterka stent in a tertiary eye care center in France: A retrospective study of 30 patients

To evaluate the long-term functional outcomes of canalicular laceration repair using the Masterka® monocanalicular intubation system. this interventional case series included the data from 30 patients who underwent canalicular laceration repair with a 30-mm pushed monocanalicular stent (Masterka®) and suturing of the lacerated canaliculus with 8/0 Vicryl interrupted sutures. Operative details and complications were meticulously noted. Stent removal took place as early as 3months post-surgery, with functional success defined as the absence of epiphora four years after surgery. The average age of patients was 28.5±26.3 years, with 20 out of 30 patients (66.6%) being male. Lower canaliculus involvement was noted in 23 patients (76.6%), while the upper canaliculus was affected in 7 patients (23.4%). On average, patients presented for medical attention within approximately one day of sustaining with injuries, and all underwent successful repairs. Notably, functional success was observed in all 30 cases, constituting a 100% success rate. Stent-related complications were encountered in two patients (6.6%). One patient reported stent removal after an average follow-up period of onemonth, while the other developed a punctal granuloma one-month post-surgery, which regressed following one month of topical steroid treatment. Repairing canalicular lacerations using the self-retaining Masterka® monocanalicular intubation system demonstrated a notable achievement in long-term functional success while presenting minimal complications. To further substantiate these promising results, an interventional study that includes a comparison analysis with other types of intubation methods is warranted.

A protocol for the ERICA-ARREST feasibility study of Emergency Resuscitative Endovascular Balloon occlusion of the Aorta in Out-of-Hospital Cardiac Arrest

BackgroundFewer than one in ten out-of-hospital cardiac arrest (OHCA) patients survive to hospital discharge in the UK. For prehospital teams to improve outcomes in patients who remain in refractory OHCA despite advanced life support (ALS); novel strategies that increase the likelihood of return of spontaneous circulation, whilst preserving cerebral circulation, should be investigated. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has been shown to improve coronary and cerebral perfusion during cardiopulmonary resuscitation. Early, prehospital initiation of REBOA may improve outcomes in patients who do not respond to standard ALS. However, there are significant clinical, technical, and logistical challenges with rapidly delivering prehospital REBOA in OHCA; and the feasibility of delivering this intervention in the UK urban–rural setting has not been evaluated. MethodsThe Emergency Resuscitative Endovascular Balloon Occlusion of the Aorta in Out-of-Hospital Cardiac Arrest (ERICA-ARREST) study is a prospective, single-arm, interventional feasibility study. The trial will enrol 20 adult patients with non-traumatic OHCA. The primary objective is to assess the feasibility of performing Zone I (supra-coeliac) aortic occlusion in patients who remain in OHCA despite standard ALS in the UK prehospital setting. The trial’s secondary objectives are to describe the hemodynamic and physiological responses to aortic occlusion; to report key time intervals; and to document adverse events when performing REBOA in this context. DiscussionUsing compressed geography, and targeted dispatch, alongside a well-established femoral arterial access programme, the ERICA-ARREST study will assess the feasibility of deploying REBOA in OHCA in a mixed UK urban and rural setting.Trial registration.ClinicalTrials.gov (NCT06071910), registration date October 10, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06071910

A Meta-Analysis of Self-Regulated Learning Interventions Studies on Learning Outcomes in Online and Blended Environments

Self-regulated learning intervention studies influence students’ learning outcomes in online and blended environments. Reviewing the national literature about self-regulated learning strategies, studies have indicated both significant and insignificant effects on learning outcomes in online and blended environments. The aim of this study is to calculate the common effect size of empirical studies conducted out between 2017-2022 that investigated the effect of self-regulated learning strategies on learning outcomes in online and blended environments, and to determine whether the common effect size shows a significant difference in terms of course type, self-regulated learning strategy type, school level, and learning context. A meta-analytical review method was employed to combine the outcome of independent empirical studies. The studies included in this review were collected from Scopus, IEEE Explore, and ERIC databases. A total of 15 studies included in this study. Cohen’s d coefficient was calculated for the effect size in this study. As the heterogeneity among the effect sizes of the studies was high (Q &gt; χ2, p &lt; .05), the common effect size was calculated in accordance with the random effects model. As a result of the meta-analysis, it was determined that self-regulated learning strategies had a “moderate” effect (Q= 0.65) on learning outcomes in online and blended environments. Moreover, the calculated common effect size showed no significant difference according to the type of self-regulated learning strategy, course type, school level, and learning context.

PiccPed® app impact on nurses' knowledge to prevent adverse events for peripherally inserted central catheters (PICC) in pediatric and neonatal healthcare: A quasi-experimental study

BackgroundThe PiccPed® health application was developed to support clinical decision-making in peripherally inserted central catheter (PICC) management. We aimed to evaluate its impact on nurses' knowledge regarding the prevention of PICC-associated adverse events in pediatrics and neonatology. MethodsA quasi-experimental, pre-post intervention study, was conducted with a dependent/paired sample of pediatric and neonatal nurses from two tertiary hospitals in South Brazil. Data were collected from October 2022 to January 2023 across three phases: pre-, intervention (use of the PiccPed®) and post-test. Study outcomes were a knowledge test (15 questions) of evidence-based PICC maintenance procedures, and PiccPed® app time spent and screens used. ResultsA total of 56 nurses completed the study. The post-test mean score was significantly higher (12/15; standard deviation (SD) 1.9) in comparison with the pre-test (mean 9/15; SD 2.2). The change in scores was significantly higher for nurses without postgraduate qualifications, in comparison to those with (Mean Difference 1.26; p = 0.039). Each minute using the app resulted in a significant increase of 0.04 points (95% confidence interval 0.01–0.08; p = 0.014) on the mean post-test score (10.94 points). Conclusion: The research demonstrated that PiccPed® enhances nurses' learning regarding the prevention of adverse events associated with PICC maintenance in pediatrics and neonatology. Application to practiceThe app can be safely and effectively used for training and continuing education of nurses who care for children and neonates with PICCs.

53053 Weighted blankets for the reduction of perioperative anxiety and pain during Mohs surgery: a controlled interventional study

53053 Weighted blankets for the reduction of perioperative anxiety and pain during Mohs surgery: a controlled interventional study

The Impact of CYP 2C9 rs1799853 and rs1057910 Polymorphism on Plasma Losartan Metabolic Ratio in a Sample of Iraqi Hypertensive Patients

Background: The challenge associated with interindividual diversity in CYP2C9 enzyme activity is primarily related to genetic variations among individuals. Polymorphisms in the CYP2C9 gene can lead to different enzyme activity, affecting how individuals metabolize drugs. The understanding of interindividual diversity in CYP2C9 enzyme activity has implications for personalized medicine. Objective: To examine the impact of CYP2C9 gene polymorphisms (rs1799853 and rs1057910) on the losartan metabolism in Iraqi hypertensive patients. Methods: This prospective interventional study was conducted on a sample of hypertension patients from Babylon governorate, Iraq. All patients received 100 mg of losartan once daily. After 4 weeks, blood samples were obtained for genetic analysis and measuring losartan and its carboxylic acid (LCA) metabolite levels. The plasma losartan-to-LCA ratio is used as an indirect determinant of CYP2C9 activity within CYP2C9 SNP genotypes. Results: Two major allelic polymorphisms, CYP2C9 rs1799853 (T allele 15.5%) on exon 3 and rs1057910 (C allele 8.5%) on exon 7, have been identified among the patients. Plasma losartan/E3174 metabolic ratio was significantly higher in patients with a CT genotype of rs1799853 SNP (1.65) than in patients with a CC wild-type genotype (1.03). The losartan/E3174 metabolic ratio in heterozygous mutant AC genotypes of rs1057910 (1.18) was also higher than in those with wild-type AA genotypes (1.15); however, these differences are not statistically significant. Conclusions: The rs1799853 SNP variant, but not the rs1057910 SNP variant, significantly impacts CYP2C9 metabolic activity. The plasma losartan/E3174 metabolic ratio appears to be a practical and reliable measure for CYP2C9 activity.

Impacto de una unidad de farmacia de atención primaria en la optimización del tratamiento farmacológico de pacientes diabéticos tipo 2

ObjectiveTo evaluate the impact of a pharmaceutical intervention on treatment optimization in patients with type 2 diabetes mellitus. DesignBefore-after intervention study. SiteHealth centers of the Primary Care Department of Camp de Tarragona. ParticipantsPatients aged ≥ 18 years, diagnosed with type 2 diabetes mellitus and under treatment with antidiabetic drugs. InterventionsReview of pharmacological treatment for type 2 diabetes mellitus and issuance of proposals for its adequacy. Main measurementsDemographic and clinical variables were collected to assess the adequacy of antidiabetic treatment. A consensus meeting was arranged with the patients’ primary care physician to evaluate the proposals for improvement. The implementation of the proposals and the variation in postintervention glycemic control were assessed. ResultsA total of 907 patients (59% men) were included. A total of 782 proposals for intervention were made in 65.8% of the patients reviewed. Of the proposals, 43.5% corresponded to drug discontinuation, 16% to intensification of dosing and 12.6% to exchange for a therapeutic equivalent. Of the consensual proposals, 54.7% were implemented. HbA1c was reduced by 0.2% after the intervention (7.4 vs 7.2%). ConclusionsReview of the pharmacological treatment of patients with type 2 diabetes mellitus by a pharmacist or pharmacologist facilitates its optimization.

Review of Hydroxypropyl Methylcellulose in Artificial Tears for the Treatment of Dry eye disease.

Dry eye disease (DED) is a highly prevalent condition, resulting in reduced quality of life, lower participation in social life and impaired work efficiency. Hydroxypropyl methylcellulose (HPMC) is a cellulose-based viscosity-enhancing agent and is one of the most popular therapeutic ingredients in artificial tears. This review aims to evaluate the literature on the efficacy and safety of HPMC used in the treatment of DED. Literature searches were conducted in PubMed and Cochrane CENTRAL. A total of 28 clinical trials from 26 publications are included in this review, including 21 clinical intervention studies evaluating the effect of HPMC treatment over time and seven single instillation studies evaluating the short-term physical and symptomatic effects of HPMC after drop-instillation. The duration of clinical intervention studies ranged from 2 weeks to 5.5 months. DED severity ranged from mild to severe. Drop frequency ranged from two to up to 16 drops per day. HPMC concentration in artificial tears ranged from 0.2% to 0.5%. No major complications or adverse events were reported. Artificial tears containing HPMC were effective at improving symptoms and some signs of DED. However, combination drops with HPMC plus other therapeutic ingredients seem more effective than HPMC alone. HPMC appears to be equally effective or inferior to hyaluronic acid (HA). There is no evidence of superiority or inferiority to either carboxymethylcellulose (CMC) or polyethylene glycol 400/propylene glycol (PEG/PG). No single study explained the choice of drop frequency or HPMC concentration. More well-designed studies are needed to determine an evidence-based standard for HPMC treatment, including drop frequency, concentration and molecular weight for different DED severity and subgroups.

The effect of brochure-assisted education given before septorhinoplasty on surgical fear and anxiety: A randomized controlled trial.

This study is a randomized controlled interventional study aimed to determine the effect of preoperative brochure-assisted education on surgical fear and anxiety in patients scheduled for septorhinoplasty surgery. The study was conducted between May 2022 and February 2023 in the Otorhinolaryngology services and clinics of a training and research hospital in the southern region of Turkey. The study included 61 patients, with 29 in the education group and 32 in the control group. All patients received routine nursing care before surgery, with the education group receiving additional education through an informative brochure. The data were collected using the "Personal Information Form", "Surgical Fear Questionnaire", and "Surgical Anxiety Questionnaire". There was no significant difference in the mean scores of surgical fear between the groups on the morning of the surgery (p > 0.05). However, a significant difference was found in the mean scores of surgical anxiety between the groups (p < 0.05). In conclusion, patients in the education group who received preoperative brochure-assisted education had lower anxiety compared with the control group.

Is the Identity Project College-Ready? A Feasibility Pilot Study of an Ethnic-Racial Identity Development Intervention with U.S. College Students

ABSTRACT Ethnic-racial identity (ERI) development promotes psychosocial and academic adjustment during adolescence and early adulthood. However, preventive intervention research into ERI promotion among young adults is limited. The current feasibility pilot study analyzed qualitative data (i.e. interviews, surveys, field notes) to explore the supports and impediments to implementing the Identity Project (IP), an ERI promotive curriculum developed for high-school aged adolescents, with college-going young adults at one U.S. university. Participants (N = 48; M age = 19.52, SD = 1.56; 86.36% female or non-binary) were randomly assigned to participate in the IP curriculum or to only complete surveys; all participants were invited to participate in interviews. Axial coding and thematic analysis revealed that: (a) young adult developmental needs and the ubiquitous salience of ERI in college promoted demand for structured interventions like the IP; (b) college cultural norms and values (e.g., emphasis on instrumental educational aims and ERI not being universal) limited access to the resources necessary for the IP intervention to be practical in college; and (c) implementing the IP as an extracurricular activity is not feasible and should instead be done as a campus requirement. Implications for future IP studies and college-based ERI interventions are discussed.

Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review.

Health care professionals work in challenging environments with extended working hours and excessive workloads to provide high-quality care. However, they hardly get the time to care for themselves. Online mindfulness-based interventions-which are not restricted by time or location-can be a powerful strategy to help health care professionals. This scoping review aims to explore the current evidence about online mindfulness-based interventions for health care professionals. A scoping review was conducted. A literature search was conducted to retrieve articles published between October 2016 and March 2023 in seven databases, including backward and forward citation tracking from the included articles. Among 1,278 articles retrieved, 33 met the criteria for review. Two-thirds of the studies utilized commercialized mindfulness programs (n = 22). Duration of the mindfulness interventions varied from 1 week to 4 months, and half of the studies used audio-guided programs. Online mindfulness-based intervention studies were targeted to reduce burnout (n = 26), and the majority reported reduction in burnout (n = 18). Most studies used individual audio-guided programs that warrant the use of diverse delivery methods such as video media, simulation, and virtual reality for interactions in the future. Although the literature has accumulated evidence for commercialized online mindfulness-based interventions, further studies are needed to develop and test tailored interventions for health care professionals.

Intervention studies with group design targeting expressive phonology for children with developmental speech and language disorder: A systematic review and meta-analysis.

Phonological difficulties are prevalent in children with speech and/or language disorders and may hamper their later language outcomes and academic achievements. These children often form a significant proportion of speech and language therapists' caseloads. There is a shortage of information on evidence-based interventions for improving phonological skills in children and adolescents with speech and language disorder. The aim of this systematic literature review and meta-analysis was to systematically examine the effects of different intervention approaches on speech production accuracy and phonological representation skills in children with speech and language disorders. A preregistered systematic review (International Prospective Register of Systematic Reviews ID: CRD42017076075) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was completed. Seven electronic databases (PubMed, Web of Science, ERIC, PsychINFO, Cochrane Library, SCOPUS and Linguistics & Language Behavior Abstracts) were searched for studies related to oral language interventions with children with developmental speech and/or language disorder (mean age ranging from 3-18 years) published between January 2006 and August 2022. The included articles reported intervention studies with a group design in which speech production accuracy was the outcome measure. Studies were appraised using the Cochrane risk of bias tool, and individual effect sizes were calculated using standardised means differences when enough data was available. A meta-analysis was conducted obtaining the average standardised mean difference d. Heterogeneity, influence of possible moderator variables and publication bias were explored. The 23 studies that met the inclusion criteria presented low-medium risk of bias. Nine effect sizes were obtained from seven of these studies that presented a pre-post-test with a control group design. Medium-high average effect sizes were found in phonological accuracy. Heterogeneity was found between individual effect sizes. Significant moderator variables and publication bias were not detected. The results of this meta-analysis indicate positive effects on speech production accuracy. Based on this review, further improvements in the quality of reporting for intervention research are required in developing the evidence base for practice. What is already known on the subject An increasing number of interventions is available for children and adolescents with developmental speech and/or language disorders. Previous reviews suggest relatively low levels of evidence of interventions having phonology as an outcome measure. What this paper adds to the existing knowledge This review and meta-analysis summarise the intervention evidence from a substantial body of group design studies, indicating positive results from a range of interventions with phonological outcomes. It highlights the need to systematically implement and replicate different intervention procedures to understand factors that will maximise positive outcomes and to grow the evidence base for best practice. What are the potential or actual clinical implications of this study? Tentative evidence is emerging for the effectiveness of various approaches in enhancing speech production accuracy skills of children and adolescents with developmental speech and/or language disorder.

Navigating the complexities of global security: the role of the United Nations in Conflict Resolution, Safeguarding, and Humanitarian Aid

This article delves into the multifaceted role of the United Nations (UN) in navigating the complexities of global security, focusing on its contributions to conflict resolution, safeguarding human rights, and providing humanitarian aid. In an era marked by diverse and evolving threats, the UN remains a central actor in promoting international peace and stability. This article explores the mechanisms through which the UN addresses global security challenges, emphasizing its conflict resolution efforts through diplomacy, peacekeeping, and mediation. The role of the UN in safeguarding human rights is examined, highlighting its efforts to protect civilians in conflict zones and uphold international law. Additionally, the article discusses the UN's crucial role in coordinating humanitarian aid during crises, ensuring that vulnerable populations receive necessary assistance in times of need. By analysing case studies of UN interventions, the article provides insights into the successes and limitations of the UN’s strategies in these areas. The significance of this study lies in its comprehensive evaluation of the UN’s impact on global security, offering a nuanced understanding of its strengths, challenges, and areas for future improvement. Through this examination, the article underscores the importance of continued support for and reform of the UN, ensuring it remains effective in addressing the complex security threats of the 21st century. This study is essential for policymakers, scholars, and practitioners interested in international relations and global security, as it offers critical insights into the UN’s evolving role in maintaining world peace and safeguarding human rights.

Perspective: Key considerations when developing and publishing dietary interventions for human clinical trials.

A key guiding principle in the 2020-2025 Dietary Guidelines for Americans emphasizes the need for individuals to choose eating habits that allows for personal, cultural, and traditional preferences while establishing a high-quality diet. This concept becomes a daunting task given the need to reduce the consumption of foods higher in saturated fat, sodium, and/or added sugar - which are typically found in familiar, highly palatable foods most-often liked and consumed in the United States. Similarly, in nutrition intervention studies, adherence to healthier dietary patterns is typically low as a result of many factors, including reduced taste, flavor, and familiarity to the study foods. Increasing evidence illustrates the promising role of herbs and spices to maintain acceptability of healthier food options for nutrition interventions. This perspective paper was informed by a Satellite Session presented at the American Society for Nutrition's annual meeting, Nutrition 2023, entitled, "Developing Culturally Appropriate Recipes for Human Clinical Trials," which explored several proposed 'best practice' guidelines when developing nutrition interventions to improve dietary adherence and acceptability within clinical trials. The session also highlighted a need to include sufficient detail concerning the types and amounts of specific foods included within nutrition interventions in combination with preparation methods and study recipes, including herbs and spices, to improve intervention reproducibility and translatability for future research, dietary guidelines, and clinical practice.