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With the increase of urban power grid scale, the requirement of power supply reliability has been improved, and the active intervention type arc extinguishing device (AIT-AED) has been paid more and more attention to. As one of the effective means of grounding fault arc extinguishing, the AIT-AED has a high demand on the operation reliability, but the operation experience of AIT-AED is insufficient. Hence, the pilot application of this device was carried out and its operation situations were investigated in this paper. It is found that the setting value, control logic, accessories quality and artificial operation are the main influencing factors of operation reliability and the corresponding improved measures were proposed, which could provide references for the operation and maintenance of AIT-AED.

Background: Acute changes in glomerular filtration rate (GFR) can occur following initiation of interventions for chronic kidney disease (CKD) progression. These complicate the interpretation of treatment effects on long term progression of (CKD). We sought to assess the magnitude and consistency of acute effects in randomized clinical trials (RCT) and explore factors that might impact them. Methods: We performed a meta-analysis of 53 RCTs for CKD progression enrolling 56,413 participants that had at least one estimated GFR measurement by six months following randomization. We defined acute treatment effects as the mean difference in GFR slope from baseline to 3 months between randomized groups. We performed univariable and multivariable meta-regression to assess the impact of intervention type, disease state, baseline GFR and albuminuria on the magnitude of acute effects. Results: The mean acute effect across all studies was -0.21 mL/min/1.73m2 (95% CI -0.63 to 0.22) over three months, with substantial heterogeneity across interventions (95% coverage interval across studies, -2.50 to +2.08 mL/min/1.73m2). Negative average acute effects were observed in renin angiotensin system blockade, blood pressure lowering and sodium-glucose cotransporter 2 inhibitor trials while positive acute effects were observed in trials of immunosuppressive agents. Larger negative acute effects were observed in trials with higher mean baseline GFR. Conclusion: The magnitude and consistency of acute GFR effects varies across different interventions, and is larger at higher baseline GFR. Understanding the nature and magnitude of the acute effects can help inform the optimal design of RCTs in CKD evaluating kidney disease progression.

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient’s postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.

seguridad del paciente en la Enfermería.Metodología: Revisión integrativa de la literatura, realizada en las bases de datos: LILACS, MEDLINE, BDENF, IBECS, CINAHL, Web of Science y SCOPUS.Resultados: Se seleccionaron 11 artículos publicados a partir de 2007, predominantemente en los Estados Unidos, descriptivos y de intervención, cuya estrategia para enseñanza de seguridad del paciente en la enfermería más utilizada fue la simulación y, en una investigación, el método del aprendizaje basado en el problema.Conclusión: La enseñanza sobre seguridad del paciente en la enfermería ha sido realizada en la mayoría de las veces por medio de simulación, pero es poco difundido en Brasil. Por lo tanto, es fundamental la inclusión de esta temática en las matrices curriculares de Enfermería desde el inicio del curso y el uso de métodos y estrategias robustos de enseñanza. Objective: To identify scientific evidence in the literature on how the teaching of patient safety takes place in Nursing.Methodology: It was an integrative review of the literature conducted in the following databases: LILACS, MEDLINE, BDENF, IBECS, CINAHL, Web of Science, and Scopus.Results: 11 articles published from 2007 were selected, predominantly in the United States, descriptive and of intervention type, in which the most papers used strategy for teaching patient safety in Nursing was simulation and in research, the problem-based learning method.Conclusion: Teaching patient safety in Nursing has been carried out most of the time through simulation, but it remains little-known in Brazil. Therefore, it is essential to include this topic in Nursing curricular programs from the beginning of the course and the use of strong teaching methods and strategies. Objetivo: Identificar na literatura evidências científicas sobre como é realizado o ensino de segurança do paciente na Enfermagem. Metodologia: Revisão integrativa da literatura realizada nas bases de dados: LILACS, MEDLINE, BDENF, IBECS, CINAHL, Web of Science e SCOPUS. Resultados: Foram selecionados 11 artigos publicados a partir de 2007, predominantemente nos Estados Unidos, descritivos e de intervenção, cuja estratégia para o ensino de segurança do paciente na Enfermagem mais utilizada foi a simulação e em uma pesquisa o método da aprendizagem baseada em problema. Conclusão: O ensino sobre segurança do paciente na Enfermagem tem sido realizado na maioria das vezes por meio de simulação, mas é pouco difundido no Brasil. Portanto, é fundamental a inclusão desta temática nas matrizes curriculares de Enfermagem desde o início do curso e uso de métodos e estratégias robustos de ensino.

Objective To compare the effectiveness of an animation against two leaflets with and without images, in educating young people about genome sequencing (GS). Methods An experimental survey with three assessment points (pre- intervention [T1], post – intervention [T2], 6-week follow-up [T3]). Participants (N = 606) were randomly assigned to receive one of three educational interventions; animation (n = 212); leaflet with images (n = 197); or leaflet with text only (n = 197). Measures of objective and subjective knowledge were completed at T1 (N = 606), T2 (N = 606) and T3 (N = 459). Measures of attitudes, intentions and beliefs towards GS and satisfaction with intervention were completed at T2 only. Results The type of educational intervention young people received had no significant impact on their objective or subjective knowledge at both T2 and T3 (all p > .05), nor did the educational intervention type affect their attitudes, intentions and beliefs towards GS at T2 (p > .05). However, participant satisfaction was significantly higher in the animation group than the leaflet groups (p Conclusion Animations and leaflets are both effective ways to deliver genomic education to young people, but the animations lead to higher satisfaction. Practice implications Different individuals may find different modes of educational resources more accessible than others. Therefore a range of resources should ideally be made available to patients.

What are the effects of foreign interventions in ending civil conflicts, especially when multiple different intervention types are deployed in a given dispute? Research to date has studied the role of third parties exclusively focusing on a single intervention type at the expense of others. The current project breaks with that tradition by proposing an integrative framework that incorporates various intervention types—military, economic, and diplomatic studies—employed in one conflict. More specifically, it begins with an interdependence model in which earlier external involvements in a conflict inform subsequent ones, demonstrating that interventions used within a civil war are interrelated with one another. Next, using mathematical models, it generates interventionary patterns in which foreign involvements are sequenced according to their chronological orders, integrating multiple intervention types. Finally, it develops an extended form of bargaining model that accounts for how each interventionary pattern influences civil wars by shifting the power distribution as it also reveals private information in regard to the real capacities of warring parties. Most importantly, the new bargaining framework incorporates the asymmetrical aspects of civil wars, enabling to assess how interventions impact conflict outcomes based on the party they are targeted. Ultimately, the project concludes that external interventions in any form, regardless of its target, end up with increasing opposition’s capacity while undermining incumbent, including, most conspicuously, any state-sided military assistance. The findings overall highlight the asymmetrical implications of foreign interventions in civil wars and the importance of concerted efforts in terminating these conflicts—a result that is undergirded by the incorporation of multiple interventions into the analysis.

Mechanisms of homeostatic plasticity promote compensatory changes of cellular excitability in response to chronic changes in the network activity. This type of plasticity is essential for the maintenance of brain circuits and is involved in the regulation of neural regeneration and the progress of neurodegenerative disorders. One of the most studied homeostatic processes is synaptic scaling, where global synaptic adjustments take place to restore the neuronal firing rate to a physiological range by the modulation of synaptic receptors, neurotransmitters, and morphology. However, despite the comprehensive literature on the electrophysiological properties of homeostatic scaling, less is known about the structural adjustments that occur in the synapses and dendritic tree. In this study, we performed a meta-analysis of articles investigating the effects of chronic network excitation (synaptic downscaling) or inhibition (synaptic upscaling) on the dendritic spine density of neurons. Our results indicate that spine density is consistently reduced after protocols that induce synaptic scaling, independent of the intervention type. Then, we discuss the implication of our findings to the current knowledge on the morphological changes induced by homeostatic plasticity.

Objective To explore the approach to participant coenrolment in publicly funded randomized controlled trials (RCTs) and to consider its impact on study recruitment. Study Design and Setting A cross-sectional study of the UK National Institute for Health Research Journals Library was undertaken. RCTs funded between 2010 and 2019 were eligible. The reporting of coenrolment criteria was assessed through inspection of publicly available study protocols. Where present, the approach to coenrolment was examined, including circumstances in which it was permitted/prohibited and the mechanism for decision-making. For completed RCTs, the impact on recruitment was explored by comparing rates of early recruitment (completion before the expected end date) and extensions (completion after the expected end date) between studies, which did and did not permit coenrolment. Results Of 219 eligible protocols, coenrolment was addressed in 94 (42.9%). Twenty-three (24.5%) of these did not allow recruitment to multiple studies, while 71 (75.5%) permitted it according to a series of caveats, including considerations of study outcomes, intervention type, and patient burden. The final decision for coenrolment rested with the local recruitment team in 57 (60.6%) and with the central organizing team in 37 (39.4%). Early completion of recruitment occurred in 8 of 64 (12.5%) RCTs where coenrolment was permitted and 5 of 20 (25.0%) where it was not (P = 0.285). An extension to recruitment time was required in 31 of 64 (48.4%) RCTs where coenrolment was permitted and 9 of 11 (45.0%) where it was not (P = 0.788). Conclusions The reporting of coenrolment in protocols of publicly funded RCTs is infrequent, and where present, the approach to decision-making is widely variable. In this study, policies of coenrolment were not associated with gains in trial recruitment.

This review evaluated the effects of augmentative and alternative communication (AAC) on speech development in children with autism spectrum disorders (ASD); replicated, updated, and extended the systematic review by Schlosser and Wendt (American Journal of Speech-Language Pathology 17:212-230, 2008). Twenty-five single case design articles and three group design articles published between 1975 and May 2020 met inclusion criteria related to participant characteristics, intervention type, design, and visual analysis of dependent variable outcomes. Overall, AAC resulted in improved speech production; however, speech gains that did occur did not surpass AAC use.

The aim of the study was to report on the association of trial sponsors with intervention type, treatment intent, recruitment success and reasons to terminate cancer trials. The ClinicalTrials database was searched for interventional Phase 3 cancer trials (01/2006-05/2017). Noncancer studies and ongoing studies were excluded, permanently suspended studies were counted as terminated. Trials were stratified according to sponsors (industry/nonindustry), intervention type, setting (curative/palliative) and intent of intervention (curative/symptom-control/life-extending). We identified 345 terminated trials and 1137 completed studies as a control group. The frequency of premature termination did not differ significantly between sponsors. Time to termination was shorter but recruitment per month prior to termination was higher in industry-sponsored studies (7.0 vs 2.2 patients/month; P < .001). Drug interventions were more common in industry-sponsored, all other interventions in nonindustry-sponsored settings (P < .001). Life-extending palliative interventions occurred more frequently, symptom-control interventions in a curative setting less frequently in industry-sponsored trials (both P < .001). Intervention, setting and intent were not associated with termination in industry-sponsored trials. In nonindustry-sponsored trials, the frequency of drug interventions and life-extending (noncurative) interventions were increased in terminated trials (both P < .05); symptom-control interventions in curative settings occurred more frequently in completed studies. Industry-sponsored trials were more often terminated due to toxicity/inefficacy while lack of accrual occurred more frequently in nonindustry-sponsored trials (P < .01). Interventions, treatment setting/intent and reasons for termination differed between sponsor types. In nonindustry-sponsored trials, drug interventions and life-extending (noncurative) interventions were associated with premature termination and symptom-control interventions (curative setting) were associated with trial completion.

Introducción: Las infecciones de transmisión sexual se consideran un problema de salud pública mundial y se consideran como una epidemia que afecta a todo el mundo. Objetivo: Evaluar los resultados de una intervención educativa sobre el conocimiento de la prevención de infecciones de transmisión sexual en adolescentes. Material y métodos: Es un estudio experimental de intervención educativa tipo pre / posterior sin control grupal, los alumnos de la institución educativa Chinchaysuyo del Distrito de Sapallanga - Huancayo, Junín, 2017 a 2018, el grupo de estudio estuvo conformado por el total de alumnos en Escuela de 5º grado que acordó participar en la investigación. El estudio consistió en 3 etapas: un diagnóstico que aplicó una encuesta donde se evaluó el conocimiento previo del tema; una intervención para aplicar el programa educativo y el final de la evaluación donde se confirmó la efectividad de la intervención. Los resultados se expresaron en números y porcentaje sometidos a análisis estadístico. Resultados: El 21.7% de los estudiantes mostró conocimiento insuficiente sobre la identificación de ITS, el 79.7% de transmisión sexual, el 69.6% si los síntomas van al centro de salud, el 53.6% al retrasar el inicio de las relaciones sexuales y el 59.4% las ventajas de El uso del condón, que aumentó después del programa educativo. Conclusiones: el programa de educación aplicada contribuyó significativamente a elevar en los alumnos su conocimiento sobre la prevención de infecciones de transmisión sexual y la infección por virus de inmunodeficiencia humana adolescente.

Background Functional constipation is highly prevalent and places a significant burden on healthcare systems around the world. Manual therapy is a commonly used intervention, however to date there has not been a systematic review that critically appraises a wide range of manual therapy disciplines. Objectives To systematically review the literature and analyse the methodological quality of all included studies, and to provide an overall level of evidence analysis. Methods A database search was completed to identify eligible studies that were published from database creation to July 2018. The relevant characteristics of each study were extracted, and each study was assessed for methodological quality with a modified version of the Downs and Black appraisal tool. Results Seven studies fulfilled the inclusion criteria and were assessed for methodological quality. One study was found to have ‘strong’ methodological quality, five were of ‘moderate’ quality, and one was of ‘low’ quality. All studies reported consistent findings regarding their individual primary outcome measures. Overall level of evidence for the use of manual therapy as an intervention for constipation was found to be ‘moderate’. Conclusions There is moderate quality evidence for the use of manual therapy as an intervention for constipation. The review identified several themes that can guide future research on this topic, including intervention type and frequency, reporting quality, mechanism of effect, and variability of outcome measures.

Clinical trials are essential for assessing the advancements in spine tumor therapeutics. The purpose of the present study was to characterize the trends in clinical trials for primary and metastatic tumor treatment during the past 2 decades.The ClinicalTrials.gov database was queried using the search term "spine" for all interventional studies from 1999 to 2020 with the categories of "cancer," "neoplasm," "tumor," and/or "metastasis." The tumor type, phase data, enrollment numbers, and home institution country were recorded. The sponsor was categorized as an academic institution, industry, government, or other and the intervention type as procedure, drug, device, radiation therapy, or other. The frequency of each category and the cumulative frequency during the 20-year period were calculated.A total of 106 registered trials for spine tumors were listed. All, except for 2, that had begun before 2008 had been completed. An enrollment of 51-100 participants (29.8%) was the most common, and most were phase II studies (54.4%). Most of the studies had examined metastatic tumors (58.5%), and the number of new trials annually had increased 3.4-fold from 2009 to 2020. Most of the studies had been conducted in the United States (56.4%). The most common intervention strategy was radiation therapy (32.1%), although from 2010 to 2020, procedural studies had become the most frequent (2.4/year). Most of the studies had been sponsored by academic institutions (63.2%), which during the 20-year period had sponsored 3.2-fold more studies compared with the industry partners.The number of clinical trials for spine tumor therapies has rapidly increased during the past 15 years, owing to studies at U.S. academic medical institutions investigating radiosurgery for the treatment of metastases. Targeted therapies for tumor subtypes and sequelae have updated international best practices.

Background Identifying ineffective practices that have been used in oncology is important in reducing wasted resources and harm. We sought to examine the prevalence of practices that are being used but have been shown in RCTs to be ineffective (medical reversals) in published oncology studies. Methods We cross-sectionally analyzed studies published in three high-impact oncology medical journals (2009–2018). We abstracted data relating to the frequency and characterization of medical reversals. Results Of the 64 oncology reversals, medications (44%) represented the most common intervention type (39% were targeted). Fourteen (22%) were funded by pharmaceutical/industry only and 56% were funded by an organization other than pharmaceutical/industry. The median number of years that the practice had been in use prior to the reversal study was 9 years (range 1–50 years). Conclusion Here we show that oncology reversals most often involve the administration of medications, have been practiced for years, and are often identified through studies funded by non-industry organizations.

Background The role of sports pharmacists is being emphasized in international athletic events. This study aimed to describe the pharmacy services for the 2019 Fédération Internationale de Natation (FINA) World Masters Championships in Gwangju, South Korea. Method Research focused on athletes and coaching staff who received medications after visiting medical centers and pharmacies located in the athletes’ village from July 5 to July 29, 2019. We collected daily results of pharmacy operation and prescription interventions. The data were analyzed using Microsoft Excel, and were expressed as frequency (%). Results Throughout the tournament, 633 patients received medication at the athletes’ village pharmacy (gender: 338 men [53.4%], 295 women [46.6%]; nationality: 299 Korean [47.2%], 334 overseas players [52.8%]; patient type: 150 athletes [23.7%], 427 non-athletes [67.5%]). Therapy for musculoskeletal disorders was the most common (n = 29, 19.3%), and oral NSAIDs (n = 56, 22.0%) were the most frequently dispensed medication in athletes. Pharmacists intervened for 47 out of 491 prescriptions (9.6%), with dosage change (n = 21, 44.7%) being the most common intervention type. Conclusion Sports pharmacists at FINA World Masters Championships played a pivotal role in ensuring the safe usage of medications by all participants, especially athletes. This study results will be a useful reference for pharmacy services at future international or domestic sports competitions.

We retrospectively evaluated antimicrobial stewardship program (ASP) interventions over a 63-month period. We compared acceptance rates for those interventions communicated telephonically versus those communicated with a temporary note left in the electronic medical record. Telephonic communication produced superior acceptance rates overall and when analyzed by intervention type and provider.

Background Most children eat fewer vegetables than recommended. Storybooks and sensory play may increase vegetable intake. Objective This study tested the effects on intake of learning about an unfamiliar vegetable (celeriac) through storybooks and sensory play. It was predicted that an illustrated, congruent storybook would increase intake of celeriac compared to an incongruent storybook (carrot); and that adding congruent sensory play with celeriac to the storybook would produce a synergistic effect on intake of celeriac. Design Children from 12 UK preschools were randomly assigned by clusters to four intervention conditions using a 2×2 factorial design. The factors were vegetable congruency (sensory play and/or storybook were congruent, or incongruent [carrot] with celeriac) and intervention type (storybook only or storybook combined with sensory play). Participants/setting Three hundred and thirty-seven children aged 2 to 5 years were recruited to take part in November 2017. Intervention Over a 2-week period, children in all four conditions were read a vegetable storybook featuring celeriac or carrot. In addition, two conditions received sensory play with either carrot or celeriac added to the storybook method. Main outcome measures Intake of the unfamiliar vegetable (celeriac) was measured at baseline and after the 2-week intervention. Statistical analysis performed Complex samples logistic regression and general linear modeling were performed to examine group differences at post-intervention. Results Children receiving the congruent (celeriac) storybook had higher odds of eating celeriac compared to children who received the incongruent (carrot) storybook. Receiving congruent sensory play increased the odds of eating celeriac, whereas receiving incongruent sensory play did not. From the 267 children who completed both baseline and post-intervention assessments, 85 ate no celeriac at baseline and were classed as non-eaters. Sensory play (congruent or incongruent) increased the odds of eating some celeriac in non-eaters compared to storybook only conditions. Conclusions Congruency between storybook and vegetable increased intake; sensory play with celeriac increased the likelihood of eating celeriac. Storybooks and sensory play are simple interventions to increase willingness to try an unfamiliar vegetable.

In this prospective study we compared Hemoglobin A1c (HbA1c) levels in T2DM (Type 2 diabetes) patients who received psycho-educational intervention vs. usual care. Intervention was provided by pharmaceutics students, and accompanied by an academic course. We further examined the effect of the pedagogical format by which students were taught on HbA1c levels of the patients. The format of the academic course varied: the simultaneous format included theoretical, clinical, and practical themes taught within each lesson; whereas in the non-simultaneous format, theoretical themes were taught during the first several lessons, followed by practical skills taught in the following ones. T2DM patients (n = 171) were recruited through 10 primary care clinics. The inclusion criterion was patients with uncontrolled type 2 diabetes (HbA1c > 7%). Patients were randomly allocated to a training or control group. Pharmaceutics students (n = 85) in their fourth year participated in an academic course and were randomly allocated to a simultaneous vs. non-simultaneous pedagogical format. The interaction effect between intervention type and pedagogical format was significant. Only patients who participated in the training group consisting of students who participated in the simultaneous course format showed improvement on their HbA1c levels. Implications on patients' outcome and suggestions for future studies are discussed.

Background Although it is known that women do not participate in trials as frequently as men, there are limited recent data examining how women recruitment has changed over time. Methods We conducted MEDLINE search using a validated strategy for randomized trials published in New England Journal of Medicine, Lancet, and Journal of the American Medical Association between 1986 and 2015, and included trials evaluating pharmacologic or nonpharmacologic therapies. We abstracted data on demographics, intervention type, clinical indication, and trial design characteristics, and examined their relationships with women enrollment. Results In total, 598 trials met inclusion criteria. Women enrollment increased significantly over time (21% between 1986 and 1990 to 33% between 2011 and 2015; Pfor trend Conclusions Although enrollment of women has increased over time, it remains lower than the relative proportion in the disease population. Future studies should elucidate the reasons for persistent under-representation of women in clinical trials.

Background The Cochrane Collaboration records risk of bias (ROB) judgements on the original studies it analyses. The aim of this review is to perform an audit of all literature produced by the Cochrane Colorectal Cancer Group (CCCG), focusing on whether intervention type has any relationship with ROB and the ability of a review to inform clinical practice. Methods The most recent version of every CCCG review from January 2000 to the end of July 2018 was included. Conclusions were categorized as informing clinical practice (I) or not (N). Both I and N categories were divided into firm (F) or tempered (T) based on the definitiveness of their language. ROB judgements were aggregated. Reviews were classed as Medical (M), Surgical (S), Medical & Surgical (MS) or Other (O) based on their intervention, with O reviews then excluded. Data were analyzed in SPSS. Results Ninety-five reviews were included, covering 1892 studies. Sixty-two percent (n = 59/95) informed clinical practice (I). Thirty-eight percent (n = 36/95) did not inform clinical practice (N). Of the N group, 53% (n = 19/36) were completely equivocal (firm) while 47% (n = 17/36) were moderately so (tempered). In the I group, 46% (n = 27/59) gave a conclusion that was firm and 54% (n = 32/59) were tempered. Seven thousand five hundred sixty-four cases of bias were assessed. Risk of bias was low in 43%, high in 20% and unclear in 37%. A review that regarded a medical intervention alone was significantly more likely to be comprised of studies with a low risk of bias than a review that included a surgical intervention (p

Bringing young people into productive work is a key labor market challenge in both developing and developed economies, and a multitude of labor market interventions have been implemented to assist vulnerable youths. To assess whether these interventions have succeeded in improving young people’s labor market outcomes, this study systematically and quantitatively reviews 113 impact evaluations of youth employment programs worldwide. Of a total of 3105 effect estimates we extract from these studies, one-third are positive significant. The unconditional average effect size across all programs is small, both for employment-related outcomes (Hedges’ g = 0.05, SE = 0.02) and earnings-related outcomes (Hedges’ g = 0.04, SE = 0.02). We analyze correlates of success in a meta-regression framework. We find that (i) programs are more successful in middle- and low-income countries; (ii) the intervention type is less important than design and delivery; (iii) programs integrating multiple services are more successful; (iv) profiling of beneficiaries, individualized follow-up systems and incentives for services providers matter; and (v) impacts are of larger magnitude in the long-term. Some of these findings provide new and important insights about the design and delivery of interventions, whereas others confirm those of previous reviews. Ultimately, our findings provide practitioners with an improved evidence base about how certain design features contribute to successful youth employment programs in different contexts.

BACKGROUND Progression in tumor assessments is often detected at a follow-up appointment rather than when actual change in progression has occurred, which can bias PFS outcomes. AIM We sought to evaluate the frequency of tumor assessment scans in clinical trials of anti-cancer interventions and to compare this to recommended (National Comprehensive Cancer Network) and real-world frequencies of tumor assessments. METHODS In a cross-sectional analysis, we searched for articles published in the three top oncology journals between July 2017 and June 2020. We included articles that were RCTs of patients that had unresectable or metastatic solid tumors and used an intervention that was designed to be anti-tumor. We abstracted median PFS survival for each group, the PFS hazard ratio, frequency of tumor assessment scans, tumor type, intervention type, and information regarding the study. RESULTS We found that, in the 182 comparisons (163 articles), less frequent tumor assessment (occurring more than 9 weeks between assessments) was associated with higher median PFS values for both the intervention group (p

A mixed culture of different isolates of Salmonella serovar I 4,[5], 12:i:- was compared to a mixed culture of reference Salmonella serovars as well as non-pathogenic Escherichia coli surrogates.. The two groups of Salmonella were compared for their resistance to commonly used pork carcass interventions, survival in ground pork and thermal resistance in ground pork. There were no observed differences between the response of the two different groups of Salmonella serovars and the non-pathogenic E. coli surrogates within intervention type. There were no observed differences in the recovery and survival of the two different groups of Salmonella serovars in pork which had been treated with interventions, ground and stored at 5 o C for two weeks. Finally, there were no observed differences in heat resistance between the two different groups of Salmonella serovars in ground pork which had been treated with interventions, ground and stored at 5 o C for two weeks. However, there were observed differences in heat resistance in both groups of Salmonella serovars associated with refrigerated storage. The heat resistance of both groups of Salmonella serovars decreased after refrigerated storage. The results of these experiments demonstrate that there were no observed differences between the responses of Salmonella serovar I 4,[5], 12:i:- when compared to the reference Salmonella serovars to commonly used interventions in the pork industry, and therefore do not present a unique challenge to the pork industry.

Introduction Russell-Silver syndrome (RSS) is a unique cause of syndromic, and often severe, limb length discrepancy (LLD). RSS causes growth retardation both in utero and postnatally, with asymmetry in limb length more noticeable as growth progresses throughout childhood and adolescent. We aim to present the largest cohort in the literature on limb lengthening in patients with RSS and to validate previous literature supporting faster bony consolidation in these patients with more robust data. We further aim to establish differences in healing within this cohort based on age, sex, segment lengthened, or type of lengthening procedure performed, to help refine patient expectations and guide practitioners in treating this population. Methods This was a retrospective study of patients with a diagnosis of RSS who underwent a limb lengthening procedure for the purpose of limb equalization. They were compared with a historic control group of patients who underwent limb lengthening for LLD of a non-RSS etiology. The primary outcome measure was bone healing index (BHI). Results The RSS group consisted of 24 patients with 29 segments lengthened, and was compared with a historic control group consisting of 20 patients with 22 segments lengthened (Goldman). Patients with RSS had a significantly lower BHI, and therefore faster healing of their lengthening site, than their non-RSS peers (P=0.02). Within the RSS cohort, we did not detect a difference in BHI based on intervention type or sex, but we did find a trend toward faster healing in femurs over tibiae (P=0.08), and established that younger patients tended toward lower BHIs (P Conclusions Our results confirmed with more robust data the prior finding that patients with RSS may undergo limb lengthening procedures at least as safely as their non-RSS counterparts, and with even faster bony consolidation, especially in younger patients. We hypothesize that concurrent treatment with growth hormone supplementation may contribute to this finding, although further study is necessary. This is the largest cohort of RSS patients treated with limb lengthening for LLD reported in the literature, and these findings will help to guide surgeon decision-making when treating this unique population. Level of evidence Level III-retrospective comparative study.

Habitat restoration is a key strategy for recovering imperiled species, and planning habitat restoration activities cost effectively can help advance recovery objectives. Habitat restoration planning involves decisions about where and when to undertake restoration, and what type of restoration to undertake. This article focuses on decisions about the amount of restoration to undertake for a given type, location, and time, termed intervention intensity. A return on investment framework is developed for incorporating intervention intensity into habitat restoration planning. The framework is then applied in the context of planning habitat restoration for Pacific salmon recovery as a case study. Results showed that no single intervention type or location dominated, and several returns to scale relationships emerged across the candidate interventions. Scenarios that considered interventions across multiple intensities outperformed single-intensity scenarios in terms of total benefits and cost effectiveness. These findings highlight the usefulness of exploratory return on investment analysis for prioritizing habitat restoration interventions, and underscore the importance of systematically considering how much restoration to undertake, in addition to what to do and where.

Background: People with dementia are confronted with negative consequences due to hospital stays. When developing new interventions to improve care for people with dementia in acute care hospitals (by intervention we understand organisational strategies, programmes, and/or treatments and actions performed by healthcare professionals), it is crucial to have a comprehensive overview of previous interventions tested in this field and to know the outcomes.Methods: We conducted a systematic review to provide an overview of interventions targeting the care situation of patients with dementia in acute care hospitals. We included trials with interventional study designs and systematic reviews without restrictions regarding the outcomes. We searched five electronic databases, conducted a hand search of journals and performed forward and backward citation tracking of included studies. For risk of bias assessment, we used the Cochrane Collaboration’s tool for assessing risk of bias in randomised trials, ROBANS (for non-randomised controlled trials) and AMSTAR (for systematic reviews). We provide tabular and narrative summaries of the findings. Results: Twenty studies met the inclusion criteria. The findings indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types: educational programmes, special non-pharmacological interventions, delirium management programmes, inpatient rehabilitation interventions, family-/person-centred programmes, use of specially trained nurses, volunteer programmes and special care units. Staff outcomes were investigated in most of the studies, followed by patient outcomes. Outcomes concerning relatives were reported in four studies. Educational programmes were the most commonly reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving patient-related outcomes, e.g. delirium severity and functional performance. Rehabilitation interventions after hip fractures and special care units for people with dementia hardly showed any significant effects. Conclusions: Although the included interventional studies reported improved outcomes concerning patients, relatives and staff, the evidence is insufficient to declare which interventions are effective in improving care for people with dementia in acute care hospitals. Future research should focus on relevant patient and family caregiver outcomes. Thereby, it is necessary to consider the complexity of the interventions. Interventions addressing relatives, interprofessional collaboration and the entire practice culture are needed. Trial registration: PROSPERO: CRD42018111032.

OBJECTIVES/HYPOTHESIS Spin-the practice of adding or omitting information intentionally or unintentionally to make the results of a study more favorable-may influence clinical decision making, especially when present in study abstracts. Here, we quantify and characterize the presence of spin in the abstracts of systematic reviews regarding tonsillectomy. METHODS This study is an analysis of systematic review abstracts. Searches were conducted on September 23, 2019 on PubMed and Embase using the advanced search feature to retrieve systematic reviews regarding tonsillectomies. The nine most severe forms of spin were then evaluated. Spin was classified by two investigators in parallel, with each blinded to the classifications of the other. Study characteristics were also recorded in duplicate. Consensus meetings between investigators were held to resolve disagreements. RESULTS In the 85 included systematic reviews, at least one form of spin was present in 44.7% (38/85) of abstracts. Journals with higher impact factors were less likely to contain spin in the abstracts of systematic reviews (point biserial correlation coefficient of -0.30). No statistically significant associations were found between the presence of spin and intervention type (P = .56) or adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (P = .08); however, there was a significant association between spin and funding source (P = .03). CONCLUSIONS Spin was common in the abstracts of our sample of tonsillectomy systematic reviews. Researchers, clinicians, and peer reviewers could benefit from learning to recognize spin in medical literature. Further research is needed into the effects of spin on clinical decision making. LEVEL OF EVIDENCE NA Laryngoscope, 2020.

The extent to which therapist adherence to guidelines and clinician skill or competence may play a role in the prediction of therapeutic outcomes remains inconclusive. This systematic literature review and meta-analysis considers whether adherence or competence predicts youth outcome in child and adolescent psychotherapy, and whether there are any identifiable factors which moderate the strength or direction of this relationship. A systematic literature search identified 35 studies in 52 papers. The studies contained 29 effect sizes for the relationship between adherence and outcome, while nine effect sizes were extracted for competence, and a further five effects measured a composite of adherence and competence constructs, referred to as fidelity in this report. The meta-analysis indicated a small but significant relationship between therapist adherence and outcome, although the small size of effect suggests that outcomes are likely to be more strongly associated with factors other than adherence. No significant relationship was identified between competence or composite fidelity and outcome. Although variance was observed in effect sizes, no significant moderation by client group, intervention type, or implementation measure informant was identified. Further study is needed to understand the specific circumstances under which adherence and outcome are related. Electronic supplementary material The online version of this article (10.1007/s00787-018-1265-2) contains supplementary material, which is available to authorized users.

Background The Community Preventive Services Task Force (CPSTF) has recommended several interventions that have been demonstrated to be effective at increasing vaccination coverage. Objective Conduct a systematic review to examine the costs of interventions designed to increase vaccination coverage among children and adolescents in the United States. Data Sources PubMed, EconLit, Embase, and Cochrane. Study Eligibility, Participants, and Interventions Peer-reviewed articles from January 1, 2009 to August 31, 2019. Appraisal and Synthesis Methods Studies were identified with systematic searches of the literature, reviewed for inclusion criteria, abstracted for data on intervention, target population, costs, and risk of bias. Cost measures were reported as costs per child in the target population, costs per vaccinated child, incremental costs per vaccinated child, and costs per vaccine dose administered. Results were stratified by intervention type, vaccine, and age group. Results Thirty-seven studies were identified for full-text review. Across all interventions and age groups, the cost per child ranged from $0.10 to $537.38, and the incremental cost per vaccinated child ranged from $6.52 to $5,098.57. Provider assessment and feedback interventions had the lowest (median) cost per child ($0.17) and a healthcare system-based combined intervention with multiple components had the lowest (median) incremental cost per vaccinated child ($26.65). A community-based combined intervention with multiple components had the highest median cost per child ($537.38) and the highest median incremental cost per vaccinated child ($5,098.57). Limitations A small number of included intervention types and inconsistent cost definition. Conclusions There is substantial variability in the costs of CPSTF-recommended interventions.

As the need for rigorous evidence of program efficacy increases, integrating evaluation activities into program implementation is becoming crucial. As a result, external evaluators are placing increased focus on evaluation capacity building as a practice. However, empirical evidence of how to foster evaluation capacity in different contexts remains limited. This study presents findings from an evaluation capacity survey conducted within a multisite Empowerment Evaluation initiative, in which an external evaluator worked with 20 project teams at diverse community agencies implementing HIV prevention projects. Survey results revealed representatives from project teams (n = 33) reported significantly higher overall evaluation capacity after engaging with the external evaluator on planning and implementing their evaluation. Improvements differed across organization type, intervention type, staff position, and reported engagement on various activities throughout the course of the evaluation. Results indicated empowerment evaluation and other stakeholder-focused evaluation approaches are broadly applicable when evaluation capacity building is a desired outcome, particularly when able to engage project staff in the planning of the evaluation and in delivering technical assistance services. Accordingly, efforts should be made by program funders, staff, and evaluators to encourage active engagement starting in the early stages of program and evaluation planning.

Background Differences in payer evaluation and coverage of pharmaceuticals and medical procedures suggest that coverage may differ for medications and procedures independent of their clinical benefit. We hypothesized that coverage for medications is more restricted than corresponding coverage for nonmedication interventions. Methods We included top-selling medications and highly utilized procedures. For each intervention–indication pair, we classified value in terms of cost-effectiveness (incremental cost per quality-adjusted life-year), as reported by the Tufts Medical Center Cost-Effectiveness Analysis Registry. For each intervention–indication pair and for each of 10 large payers, we classified coverage, when available, as either "more restrictive" or as "not more restrictive," compared with a benchmark. The benchmark reflected the US Food and Drug Administration label information, when available, or pertinent clinical guidelines. We compared coverage policies and the benchmark in terms of step edits and clinical restrictions. Finally, we regressed coverage restrictiveness against intervention type (medication or nonmedication), controlling for value (cost-effectiveness more or less favorable than a designated threshold). Results We identified 392 medication and 185 procedure coverage decisions. A total of 26.3% of the medication coverage and 38.4% of the procedure coverage decisions were more restrictive than their corresponding benchmarks. After controlling for value, the odds of being more restrictive were 42% lower for medications than for procedures. Including unfavorable tier placement in the definition of "more restrictive" greatly increased the proportion of medication coverage decisions classified as "more restrictive" and reversed our findings. Conclusions Therapy access depends on factors other than cost and clinical benefit, suggesting potential health care system inefficiency.

The goal of this systematic review and meta-analysis was to evaluate the efficacy of mindfulness-based eating disorder prevention programs. Twenty articles met all inclusion and exclusion criteria, including 15 randomized studies (2173 participants) that were included in the meta-analysis. Compared to wait-list controls, mindfulness-based programs were found to significantly reduce participants’ body image concerns and negative affect and improve body appreciation at post-intervention. Compared to cognitive-dissonance programs, mindfulness-based programs were found to significantly improve participants’ self-esteem at post-intervention. There were no significant differences between groups on any other outcome, and no significant differences on any outcome at long-term follow-up. Selective prevention programs and programs that incorporated meditation as the primary intervention type had the largest effect sizes. While the conclusions that can be drawn are limited by both the quantity and quality of available research, results of this review suggest that mindfulness-based eating disorder prevention programs may reduce eating disorder risk factors and increase protective factors.

Emerging literature suggests that virtual reality (VR) may be a viable therapy for neuropathic pain (NP). This pilot study aimed to investigate the immediate effect of VR in reducing NP in people with spinal cord injury (SCI). Eight individuals with chronic NP after SCI were recruited and underwent consecutive exposure to scenery and somatic virtual environments (VE). The numeric rating scale (NRS) was used to assess pain before and after exposure to each VE. The Immersive Tendencies Questionnaire (ITQ) and Presence Questionnaire (UQO-PQ) were used to investigate the interaction between reported pain relief post-intervention with immersion and presence. There was a significant reduction in pain levels (5.1 ± 0.4, mean ± SEM) after short exposure to the scenery (3.1 ± 0.7, p = 0.04) and somatic VE (3.0 ± 0.7, p = 0.04), with no difference between intervention types (p = 0.56). There was a statistically significant negative correlation between the total ITQ score and the change in NRS after the scenery VR intervention (rs = 0.743, p = 0.035). PQ scores showed no significant correlation with changes in pain following either intervention type. We found that short-term exposure to VR environments results in a reduction in chronic NP intensity in people with SCI.

The purpose of this study was to characterize the intervention type delivered to individuals with cerebral palsy (CP) in a pediatric outpatient medical setting and to identify factors associated with the total amount of service within each type. Four hundred and twenty-five individuals with CP (1-33 years) Gross Motor Function Classification System (GMFCS): Level I (n = 152); II (n = 63); III (n = 55); IV (n = 80); and V (n = 75). Billing code data was extracted retrospectively from 2008 medical records and categorized to reflect four types: body structures and function (BSF), activity (ACT), environment (ENV), and examination (EXAM). Age at first visit, type of insurance at first visit and GMFCS level was also collected. The majority (47%) of the PT delivered was categorized as activity based units, 25% as body structure and function, 21% as environment, and 7% as examination. Significant differences were found in: total BSF therapy units among GMFCS (p = 0.008) and insurance type (p0.001), ACT units among GMFCS (p0.001), age groups (p0.001), and insurance type (p = 0.008), and ENV units among GMFCS (p = 0.04). The amount of variability (R

Ratings of appetite are commonly used to assess appetite modification following an intervention. Subjectively rated appetite is a widely employed proxy measure for energy intake (EI), measurement of which requires greater time and resources. However, the validity of appetite as a reliable predictor of EI has not yet been reviewed systematically. This literature search identified studies that quantified both appetite ratings and EI. Outcomes were pre-defined as: 1) agreement between self-reported appetite scores and EI; 2) no agreement between self-reported appetite scores and EI. The presence of direct statistical comparison between the endpoints, intervention type and study population were also recorded. 462 papers were included in this review. Appetite scores failed to correspond with EI in 51.3% of the total studies. Only 6% of all studies evaluated here reported a direct statistical comparison between appetite scores and EI. χ(2) analysis demonstrated that any relationship between EI and appetite was independent of study type stratification by age, gender or sample size. The very substantive corpus reviewed allows us to conclude that self-reported appetite ratings of appetite do not reliably predict EI. Caution should be exercised when drawing conclusions based from self-reported appetite scores in relation to prospective EI.

Community correctional sentences are administered to more juvenile offenders in North America than any other judicial sentence. Particularly prominent in juvenile corrections is intensive supervision probation and aftercare/reentry, yet the effects of these supervision-oriented interventions on recidivism are mixed. The purpose of this meta-analysis is to determine the effects of intensive supervision probation and aftercare/reentry on juvenile recidivism. An extensive search of the literature and application of strict inclusion criteria resulted in the selection of 27 studies that contributed 55 individual effect sizes. Studies were pooled based on intervention type (intensive supervision probation or aftercare/reentry) and outcome measure (alleged or convicted offenses). The pooled analyses yielded contradictory results with respect to outcome measure; in both cases, supervision had a beneficial effect on alleged offenses and negatively affected convicted offenses. These patterns across intervention type and outcome measure, as well as recommendations for future research, are discussed.

Despite the benefits of NIV in the treatment of acute respiratory failure (ARF) in hematological malignancies are well established, evidence for noninvasive ventilation (NIV) in solid tumors is insufficient to provide evidence-based clinical recommendations. In addition, analyses of previous studies with samples from mixed populations, as well as small sample size, do not allow us infer or conclude with adequate confidence the findings of NIV intervention specifically for patients with solid tumors. Hence, we examined via systematic review the main studies that addressed NIV intervention in patients with hematologic diseases and solid tumors. PUBMED/MEDLINE, EMBASE, Cochrane Library databases search were extracted based on study characteristics, intervention type, and clinical outcomes. The main outcomes found in these studies were mortality, NIV failure rate, endotracheal intubation (ETI) rate, risk factors for NIV failure, and onset of invasive mechanical ventilation (IMV). Thus, we discuss the results of these studies and their clinical practice implications.

SummaryHeart failure (HF) is common and is associated with high morbidity, mortality and high health expenditure. A multidisciplinary disease management plan (DMP) can reduce morbidity and mortality, save costs and improve the quality of life. In Austria, three HF-specific DMPs are currently in a project phase and four established DMPs are active. Although programs are widely heterogeneous with respect to their intervention type, they pursue the same interventional goal by supporting seamless care between inpatient and community care settings with a multidisciplinary team. This survey presents a systematic survey of the HF-specific DMPs in Austria. Disparities between programs are highlighted and discussed. The nationwide establishment of HF-specific DMPs that integrate primary care and cardiology services including a regulation of the remuneration of stakeholders and program infrastructure is needed to decrease the burden of HF for both the individual and society.

Introduction Pilot and feasibility trials are conducted to determine feasibility or to collect information that would inform the design of a larger definitive trial. Clear progression criteria are required to determine if a definitive or main trial is feasible and how it should be designed. We sought to determine how often progression criteria are reported and the associated factors. Methods We conducted a methodological review of protocols for pilot randomised trials published in three journals that publish research protocols (BMJ Open, Trials, Pilot and Feasibility Studies), using a PubMed search (2013–2017). We extracted bibliometric information including the country in which the study was conducted, source of funding, type of intervention, use of a primary feasibility outcome, sample size reporting, and justification. We used generalised linear models to determine the factors associated with reporting progression criteria. Results Our search retrieved 276 articles, of which 49 were not eligible. We included 227 articles. Overall, 45/227 (19.8%; 95% confidence interval [CI] 14.8–25.6) reported progression criteria. Protocols published in more recent years were significantly associated with higher odds of reporting progression criteria (adjusted odds ratio [aOR] 1.40; 95% CI 1.03–1.92; p = 0.034). Pilot trials from Europe (aOR 0.19; 95% CI 0.08–0.48; p p Conclusion Progression criteria are not often explicitly stated in protocols of pilot trials leaving room for varied interpretation of findings. The development of formal guidance for progression criteria in protocols of pilot trials is warranted.

BackgroundWe have previously reported, in a systematic review of 181 studies, that restriction of antibiotic use in food-producing animals is associated with a reduction in antibiotic-resistant bacterial isolates. While informative, that report did not concretely specify whether different types of restriction are associated with differential effectiveness in reducing resistance. We undertook a sub-analysis of the systematic review to address this question.MethodsWe created a classification scheme of different approaches to antibiotic restriction: (1) complete restriction; (2) single antibiotic-class restriction; (3) single antibiotic restriction; (4) all non-therapeutic use restriction; (5) growth promoter and prophylaxis restriction; (6) growth promoter restriction and (7) other/undetermined. All studies in the original systematic review that were amenable to meta-analysis were included into this substudy and coded by intervention type. Meta-analyses were conducted using random effects models, stratified by intervention type.ResultsA total of 127 studies were included. The most frequently studied intervention type was complete restriction (n=51), followed by restriction of non-therapeutic (n=33) and growth promoter (n=19) indications. None examined growth promoter and prophylaxis restrictions together. Three and seven studies examined single antibiotic-class and single antibiotic restrictions, respectively; these two intervention types were not significantly associated with reductions in antibiotic resistance. Though complete restrictions were associated with a 15% reduction in antibiotic resistance, less prohibitive approaches also demonstrated reduction in antibiotic resistance of 9%–30%.ConclusionBroad interventions that restrict global antibiotic use appear to be more effective in reducing antibiotic resistance compared with restrictions that narrowly target one specific antibiotic or antibiotic class. Importantly, interventions that allow for therapeutic antibiotic use appear similarly effective compared with those that restrict all uses of antibiotics, suggesting that complete bans are not necessary. These findings directly inform the creation of specific policies to restrict antibiotic use in food-producing animals.

The aim of our review was to ascertain factors associated with the successful completion of a randomized controlled trial in gynecological oncology.This retrospective cohort study utilized data collected from the National Institutes of Health's US National Library of Medicine database on ClinicalTrials.gov. Data was collected over a five year period (2009-2013). Utilizing the search terms under the National Institutes of Health recommended "Studies by Topics" gynecological oncology studies were identified. Randomized controlled trials were selected for based on intervention and randomization criteria. Elements were then compared with statistical analysis performed using SASS.As of September 1st 2018, 149 of the 318 identified randomized controlled trials were successfully completed over a median length of 44 months (IQR 30.0-55.0). Completed randomized controlled trials were more likely to be performed at single centers (p 0.005). Interventional, drug and device trials were not significantly more likely to be completed. There was no difference in funding sources for completed or not completed randomized controlled trials.Prospective randomized trials are essential for establishing the standard of care in clinical medicine. They are, however, time and resource intensive. Herein we have attempted to identify factors associated with successful and timely completion of gynecologic oncology randomized controlled trials including site of origin, number of participating sites, funding source, intervention type, enrollment size, and study length; however, none of these factors were observed to have an association with increased rates of trial publication.

Introduction Premature infants undergo numerous painful procedures during hospitalization. Some trials have examined the effectiveness and safety of combined nonpharmacological interventions in which two or more non-pharmacological interventions are used simultaneously or continuously to relieve repeated procedural pain via multisensory stimulation in preterm neonates. However, a systematic review of this topic has not yet been carried out. Objective To review the evidence on the efficacy and safety of combined nonpharmacological interventions for repeated procedural pain in preterm neonates. Method Eight databases were searched using keywords to identify peer-reviewed journal articles in English or Chinese. Randomized controlled trials (RCTs) focusing on combined nonpharmacological interventions for repeated procedural pain in preterm neonates published from database inception until May 2019 were included. Results Eight RCTs were retrieved that included ten different combined nonpharmacological interventions. Different study designs were used in the included trials, which did not allow us to carry out a meta-analysis. The findings from the included articles were categorized in terms of efficacy and safety. With respect to efficacy, 1. two trials reported that combined nonpharmacological interventions were more effective than usual care during painful procedures; 2. three trials reported that combined nonpharmacological interventions were more effective than single nonpharmacological interventions; 3. three trials reported the effects of different combinations of nonpharmacological interventions and found that their effect depends on intervention type rather than number of interventions. Only four trials reported on safety, and they found that combined nonpharmacological interventions were safe for repeated procedural pain in preterm neonates. Conclusion According to the literature, combined nonpharmacological interventions may be effective and safe for repeated procedural pain in premature infants. However, due to the diversity of interventions included in this systematic review, the evidence is not strong enough to produce a best practice guideline. Further research is needed with larger sample sizes and less heterogeneity to adequately explore the efficacy and safety of combined nonpharmacological interventions for repeated procedural pain in premature infants.

Background: The physical and psychosocial benefits of physical activity for typically developing youth are well established; however, its impact on youth with intellectual disabilities is not as well understood. The aims of this review and meta-analysis were to synthesize the literature and quantify the effects of physical activity on the physical and psychosocial health of youth with intellectual disabilities. Method: Studies meeting the inclusion criteria were grouped by their focus on physical health and/or psychosocial health outcomes. Meta-analyses were performed using 3-level, random effects and mixed effects models. Results: One hundred nine studies met the inclusion criteria. Physical activity had a large effect on physical health (g = 0.773, P g = 0.682, P Conclusions: Physical activity has positive effects on the physical and psychosocial health of youth with intellectual disabilities. Although resistance training shows the most physical benefits, teaching movement and sports skills appear to benefit their physical and psychosocial health.

The transformations in today's society resulting from the development of Digital Information and Communication Technologies (DICT) also require changes in the initial teacher training, in order to consider the development of skills for the pedagogical use of DICT. In this context, a hybrid short course with undergraduate students from the seventh period of a Pedagogy Course was developed and tried with the objective of contributing to the improvement of the pedagogical knowledge of these subjects related to DICT. This article aims to present the referred course, the analysis of the participants' perceptions regarding the relation of the practices and contents worked in the short course with those that are approached in the Pedagogy Course, and about the expressiveness of the course with this type of approach and format in the training of pedagogues. The research is of a qualitative nature, of the pedagogical intervention type. The instruments for data collection were questionnaire, observation and students' responses to the proposed activities. As a result, among other aspects, it was found that: i) the themes and activities worked on in each module of the course were considered important and significant in the training of undergraduate students; ii) there was a satisfactory progression of students regarding the level of digital competence throughout the course; iii) the undergraduate students considered the pedagogical use of DICT to be important in the Pedagogy Course.

This study aims to examine the benefits of wearing a new construction work uniform in real-work settings. A field experiment with a randomized assignment of an intervention group to a newly designed uniform and a control group to a commercially available trade uniform was executed. A total of 568 sets of physical, physiological, perceptual, and microclimatological data were obtained. A linear mixed-effects model (LMM) was built to examine the cause-effect relationship between the Perceptual Strain Index (PeSI) and heat stressors including wet bulb globe temperature (WBGT), estimated workload (relative heart rate), exposure time, trade, workplace, and clothing type. An interaction effect between clothing and trade revealed that perceptual strain of workers across four trades was significantly alleviated by 1.6-6.3 units in the intervention group. Additionally, the results of a questionnaire survey on assessing the subjective sensations on the two uniforms indicated that wearing comfort was improved by 1.6-1.8 units when wearing the intervention type. This study not only provides convincing evidences on the benefits of wearing the newly designed work uniform in reducing perceptual strain but also heightens the value of the field experiment in heat stress intervention studies.